If you are seeing some signs that your child may fall into the Autism Spectrum category, I encourage you to do your research as there are many websites, support groups and networks available through the internet and most likely in your area. The sure way to determine if your child’s symptoms and behaviors fit within this category is to have your child seen by a pediatric developmental specialist. This is often times a developmental pediatrician, behavioral pediatrician, pediatric neurologist, psychologist or a neuropsychologist. You will have to see what practitioners or physicians are available in your area.

Early diagnosis for your child is key, whether you feel comfortable with this or not, because you need to know what you are dealing with, in order to find every opportunity to make the most progress with your child. There are stories of children no longer having Autism, because parents have worked so hard to find the right resources to help their children at a young age, so let’s get you on this band wagon!  This is the opportunity you will want to have, if your son or daughter needs it.

The diagnosis of an Autism Spectrum Disorder is very hard to swallow, and it may be very difficult for some of you to believe this or want to share this information with others.  Just know that it is completely your choice of who you want to share this information with.  It’s usually best to tell your child’s child care providers and your family, or it may be in your child’s best interest to keep this on the quiet side for the time being.  This is sometimes the case when your child is unfortunately stuck in an unsupportive environment.  This is a personal decision that you will have to consider, and decide if sharing this information will help your child, or hurt your child.  Most times sharing this news is going to be helpful, so you can get services and accommodations for your child, and understanding from others when your child may do things that appear out of the ordinary.

Once you get past this initial stage, you need to get moving!  Your child is going to need a lot of interventions to try to beat this diagnosis!  The most common treatments children seem to receive now are sensory-based occupational therapy which I will talk about mostly, speech and language therapy, behavioral therapy, and nutritional modifications from an alternative health care specialist or a DAN! Doctor.  DAN! is the acronym for Defeat Autism Now.

Now when it comes to the world of therapy and interventions, it doesn’t matter whether your child has a diagnosis of any specific condition or not, it’s just important that your child gets help!  Therapists do not work with your child’s diagnosis per say; they work with their specific symptoms and areas of difficulty, as every child is unique.  I encourage you to do your internet research on the types of interventions I mentioned, to help you decide where you may want to start.  Once you receive an evaluation from a physician or any specialty therapists, they should be able to direct you to the other services that would be helpful and complimentary.

I am going to share some of the benefits of Occupational Therapy services for these children with you, while emphasizing the need to work with a therapist or clinic that specializes in treating sensory processing disorders.  The most common symptoms I expect to see with young children who may be on the border of being diagnosed are:

• Speech delays
• Echolalia (parroting what others say, or repeating themselves)
• Less eye contact
• Decreased sensation awareness

(i.e.- unaware of touch; unaware of safety hazards; wandering off; stepping into a pool or off a ledge without realizing; needing constant pressure from hugs or tight clothes; not being aware of drooling or food in the mouth- causing them to stuff their cheeks or gag; not realizing when their diaper is wet or dirty due to not feeling it or smelling it; constantly seeking movement with swinging, spinning or jumping on furniture; not being able to sit still and tune in to group activities or show the same level of sustained interest; being a risk seeker like wanting to climb on top of play sets or furniture; not being as emotionally connected with family members as one would expect; or constantly seeking visual stimulation through fast moving TV shows, or rolling or flapping objects close to their eyes).  These are only a handful of sensory symptoms that are often reported.

Then you have a group of symptoms related to when children are hypersensitive or hyper-reactive to sensations, such as- screaming, tantrumming, running off or possibly showing aggression toward others with self-care or play times; refusing hair washing, tooth brushing, being tilted back in the bathtub, the feel of a diaper, or certain clothes, or refusing certain foods; having digestive issues with strong gas, constipation or frequent diarrhea; not being able to tolerate loud or busy environments, being taken out in public without tantrumming, running off or melting down; not being tolerant of touch from others, being held, and having excessive difficulty tolerating any changes in their home routine, or anyone messing up their agenda.  Again, this is not an all-inclusive list, I am just trying to give you a general idea of what is commonly seen.

Your child’s symptoms should be looked at from a non-biased eye to help you determine if the frequency and severity of symptoms (like the ones I have mentioned) are a big enough problem to affect the success of your day or your child’s day.  If the intensity of your challenges are affecting normal routines and expectations and someone’s overall stress level (which means you, your child, or your child’s caretakers), then it’s time to get an evaluation from a sensory trained occupational therapist.

The testing completed by an occupational therapist will look at developmental skills and abilities that are expected for your child’s age, as well as your child’s ability to function and perform in his or her everyday environment.  The therapist will focus on family stressors and sensory symptoms that may warrant intervention.  The great part about starting this type of therapy is that sensory symptoms can be highly reduced if not eliminated in most children, and the intervention is done in a play-based way.  Most children enjoy their therapy sessions, as they get the stimulation or calming strategies that their body so badly craves, and then you as the parent will be taught how to continue these activities at home, and how to incorporate them into your daycare or school environments.

Auditory integration training programs are also an integral part of helping your child’s sensory processing difficulties.  These programs can help decrease their hypersensitivity to sound; improve their attention, eye contact, initiation of language, and overall coordination skills, as well as improve their mood stability for those high stress kids and frequent tantrummers!  You can refer back to previous episodes to learn more about these types of programs. They can be just short of working miracles, when you have the right combination of therapies for your child!

I encourage you to find a local occupational therapist that you feel comfortable with, in terms of being able to communicate with them openly, getting your questions answered to your satisfaction, and most importantly seeing progress in your child!  You will also want the therapist you choose to be willing to collaborate with other professionals as needed, so your time and money is not being spent receiving conflicting information from different professionals and then trying to figure out which way to go!

Here are some websites to get you started with some other research, if you haven’t scoured them already! Best of luck to you and your family!

http://www.defeatautismnow.org/

www.centerforautism.com

www.NationalAutismAssociation.org

http://www.autismspeaks.org/

www.autismnetwork.org

http://www.ianproject.org/

http://www.autreat.com/

www.autism-pdd.net

www.Icare4autism.org

http://www.theautspot.com/

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They have a great self-explanatory website that I encourage you to check out. They are currently offering “clothing basics”, which include casual/dressy clothing that mix and match well with many outfits, ranging in sizes from 4-12. They use a super silky cotton that never pills, that even the pickiest of children have raved about, along with flat seams, waistbands with elastic encased in cotton, water-based printed labels versus tags (with printing from vegetable dyes to not be irritating or distracting), wide/flat collars to not disturb the sensitive neck line, and designer prints on the clothes that are not rough, crackly or annoying. Upcoming in April 2010 are their seamless socks, soft jeans, shorts and collared shirts, and they are working on some super cool underwear that will be available in 2011! Oh boy, I can’t wait!

Jessica shared with us that she always has some type of offer or sale going on that you can find out about, or you can sign up to receive information on new product releases on her website. They may have anything from free shipping, to 20% off, or free shirt offers!

In addition to offering this great starter line of clothes, Jessica has put together an extensive website to offer support services to teachers and parents on the overall topic of tactile hypersensitivity. You can find these additional resources at www.softclothing.net. There is a section on this website she calls “therapy corner” where she posts the best resources she has found over her years of research. Some of these resources are checklists for teachers and parents to determine if a child may have sensory processing difficulties.

For more information on Jessica’s “Soft” products, I recommend you listen to this podcast as she is fun and informative. If time doesn’t permit, then you should be able to get your all your questions answered between her two websites above, and you should be able to order some clothing basics quickly online from her e-store.

Thank you Jessica for your time and great innovations! I can’t wait to share your information with some of my current clients as well as a good handful of past clients!

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Suzette is a nurse practitioner who is a co-founder of the Parents Everywhere Network with a show in the network: The Madness of Motherhood Show.  She is also a mother of three great children!

She gave some great suggestions in this episode, delivering them with such fun and sincerity.  I encourage you to listen to this episode as you will surely enjoy her description of these tips! If you can’t, then here are the highlights:

1. Take a nap!

This is her favorite recommendation and she encourages you to do this daily, for 20-60 minutes at a time. Try making this fun by letting your kids get into your bed, setting up a tent or fort in the house, or setting out a blanket in the middle of the floor and snuggling up!

2. Get good sleep!

This is so important for restoring your body’s health, repairing your body and rejuvenating it, so you can be your best for your children and for yourself.

3. Give your kids a choice of what they can do to help.

They may not want to do what you have planned for them (like writing out Christmas cards), but they may be more willing to unload the dishwasher or complete another household chore.

4. Use your time in the shower to relax and set the tone for the day.

Suzette turns off her bathroom lights, lights one candle and plays some relaxation/meditation music, or her favorite Pop CDs, and uses deep breathing techniques to help rejuvenate her self. She allots 15 minutes to do this with the door locked so she cannot be interrupted by one of her three children. Doesn’t this sound great? I can’t wait to try it myself!

5. Use deep breathing techniques

You can really do this anywhere: in your home, office, or even in your car. If you have a busy morning getting your kids off to school then you can sit in your car and just take a few minutes of quiet time, with slow breathing.  Try not to think of anything, just be at peace and relax. Five minutes of this type of breathing and total relaxation could feel like an hour when you are really busy or stressed, and really, it’s only five minutes!  You could also spend time listening to your favorite music or some relaxation music while driving, versus listening to the kid music that you may be so programmed to play.  If you are a working parent, you can also bring your lunch to work and find a quiet place outside to eat and relax, or just spend a few minutes of quiet breathing outside, at your desk, or in your car before going back to work.

6. Let it go!!!

The chaos will wait for you, and the chores won’t go anywhere, so why be in such a rush?!  You can only do so much, so pace yourself and be content with your choices of what needs to be done, and what will have to wait.

For more great information from Suzette, you can find her online at www.parentseverywhere.com.  She can also be reached by emailing her if you have a specific question, at  sboyette@parentseverywhere.com.

Thank you so much Suzette, you are so inspiring and amazing!

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So I came up with a list of key points to remember around the holidays, as if I was talking to a parent in my office:

Tips to Make the Holidays Smoother:

• Plan ahead for changes in the schedule
• Try to keep your child’s sleeping and eating schedule the same
• Plan for sensory breaks built in throughout the day (to prevent over-stimulation or over-tiredness)
• Plan to incorporate sensory and self-regulation activities into your daily routines (have opportunities for movement, quiet time, a change of clothes, chewing objects, etc…to prevent meltdowns based on what makes your child’s nervous system stressed)
• Set aside quiet time opportunities (away from other siblings, away from large family gatherings, etc…)
• Setup a schedule for your child to refer to throughout the trip or for each day, if your vacation is packed with a lot of activities in one day. This schedule can be a group of pictures on a dry erase board or poster board, or a written outline for those who are good readers
• Sleeping arrangements (try not to change too much if your child is sensitive to his/her bedtime routine).
• Make your own list of survival tips if you are concerned about your child acting out or being overly stressed.
• Shop early for food/presents so you are not rushed and more stressed.
• Think about the foods your child will be around and what type of foods may affect your child’s behavior in a negative way, and plan to have your own food accommodations in advance

Foods Recommended:

• A high protein diet
• Low sugar foods
• Organic when possible, especially for meat, milk (if any at all), grains and porous fruits that can easily absorb pesticides when they are growing

There are some great pies and desserts that can be found in health food stores more commonly now, to address food sensitivities, such as gluten, wheat, dairy, soy & other ingredients that can affect our children as well as the rest of the family, such as sugar or dyes & preservatives.

It’s also easy to find recipes online now to accommodate your child’s food sensitivities. Try to do your best to incorporate foods and routines into your daily schedule that can be helpful to others as well as your child. You don’t want to make your child look any more different that necessary, so you may find fun things to do with family in town or some great recipes that are yummy for everyone.

Here’s a sample plan to help you come up with your own plan, specific to your child:

• Have chewy foods available (snacks in the car) or chewy objects (chew tubes, teethers, soft pencil grips on a shoelace, etc…)
• Plan where the local parks are if the weather is nice, or know where the indoor kid places are, to provide your child with a good physical outlet
• Plan physical activities into your vacation, based around your child’s sensory needs and dislikes (skiing could be a great choice or it could be disastrous for a child who is hypersensitive to touch).
• Balance out your plan for sedentary or adult-based activities with some sensory calmers.
• Know what you are going to tell your relatives or friends that you don’t see often, when you may need to make some accommodations for your child. This includes thinking about how comfortable you are with discussing your child’s sensory difficulties with the rest of the family, and what you want to share with them, if you choose to be selective.)

Another very important tip to keep in mind is that you need to be calm and organized in order to be an effective parent for your sensory sensitive child, so you have to take some time to plan for yourself.

Next week we will have Suzette Boyette from the Parents Everywhere network on the show to talk about ways to distress the body and stay sane for the holidays!

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Cris reported that in a 10-year period of working in the public school system, she noticed a huge explosion of child diagnoses such as AD/HD and Autism. She was curious about the effect that technology had on the changes that were seen in these children. She started researching this area by asking parents how much their children were using technology when she met with them during school IEP meetings. Then she left her school system position and began to develop class interventions and workshops for teachers and therapists while in her private practice.

Cris shared with us the following steps to successfully unplug children from technology, based on her research and expertise in the fields of child development and technology usage:

• Become informed.
• Parents need to disconnect from technology to reconnect with kids and establish “sacred time” in their daily routines, during times such as car rides, meal times, holidays and evenings, such as one hour before bed.
• Enhance child performance skills in alternate activities to build self-satisfaction (i.e.- climb a tree).
• Ensure critical milestones of movement, touch and human connection are met at a frequency of 3-4 hours per day.
• Address parent misperceptions of outdoor safety.
• Restrict all technology use for toddlers under two years of age, and limit technology use to no more than two hours per day for elementary-aged children. (Cris would love to see TVs outlawed in pre-k and daycare programs.) She also has a rule of one hour in- one hour out to balance play time for children.
• Restrict all media violence (including cartoons!) for children under the age of eight years.
• Remove all TVs from bedrooms.

Cris has also developed numerous products and initiatives to make changes in how children to use technology, and she continues to develop new games, programs and resources for families all the time. Here are some of her products which can be found on her website:

Zone’in is a self regulation program that teaches children to harness their energy to focus and attend, and is complete with simple strategies and tools that achieve immediate results. Zone’in is accessible learning for all students, while making a teacher’s job easier.

Move’in is a two part program. A fun board game assesses fine motor skill components and provides individualized interventions to improve printing and reading. Move’in comes with easy-to-use software to create a database, as well as make custom work and journal sheets.
Unplug’in addresses TV, videogame and internet addictions in children, helping them develop the necessary skills to unplug. Traveling through the Me, We, Earth and Spirit dimensions builds performance skills, empowering children to unplug. Unplug’in brings imagination and creativity back into children’s lives!

Live’in improves child health and promotes a life long love of learning.  Designed for school and home use, the Live’in Resource Guide contains information regarding the negative effects of technology overuse, the Zone’in Research Fact Sheet, Technology Topics for Discussion, Technology Addiction Questionnaire, the Survivor Unplugged Challenge, Ten Steps to ‘Unplug’ Your Kids, Alternate Activities to Technology and the Technology Schedule.

Unplug’in brochures provide parents, teachers and health professionals with useful information and techniques to address TV, videogame and internet addictions in pre-school and elementary aged children.

She has also set up the following child health initiatives which can be found on her website:

• Balanced Technology Management Champion Status: for Canadian Governments, Health Units, Elementary Schools, and Technology Production Corporations.
• Linking Corporations and Communities Initiative- where she is working with large corporations such as Microsoft to redesign some of their programs and get them to put money back into community parks and nature, etc…
• Creating Sustainable Futures Program
• Unplug – Don’t Drug Policy Initiative

If you would like to contact Cris, sign up for her newsletters, participate on her new forum called “The Source”, or view her website, you can find her at:

www.zonein.ca
info@zonein.ca

1-888-8zonein (888-896-6346)
604-885-2666

Remember you have any questions or comments; please post them on The Sensory Show blog.

Thank you again Cris for everything you do. It’s obvious that you are passionate about taking such an active role in making a difference in this world for our challenging, but amazing children!

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She shared some astounding facts with us, including:

• The American Academy of Pediatrics states that children 0-2 years of age should have zero TV time, but they get 2.5 hours on average per day.
• France banned baby TV due to negative effects.
• Baby Einstein videos are linked to children having delayed speech.
• Children should have 1-2 hours per day of total technology use (TV, video games, computer time, etc.). She doesn’t advocate for completely unplugging a child from technology because our future is so dependent on it.

The Impact on a Child Physically:

• 15% of Canadian children are obese. This rate doubles if a TV is in a child’s bedroom.
• 15% of Canadian children are diagnosed with Developmental Delay, which hugely impacts their ability to print and read.
• Stress – a chronic & high adrenalin state is detrimental to our immune, endocrine and cardiovascular systems. 20 hours of technology use per day has resulted in blood pooling, blood clots, strokes and heart attacks. Our bodies respond to technology (i.e.- video games) as being real, causing the body to feel the stress of this type of stimulation.
• Sleep disorders are on the rise and children are having difficulty getting to sleep and staying asleep.

The Mental Effects of Technology Use:

• 14.3% of Canadian children have a diagnosed mental illness, such as anxiety or depression.
• Anxiety is the fasting growing disorder in Canada and the US.
• 9% of Canadian children are diagnosed with ADHD. Every one hour per day of technology use prior to the age of seven, increases that child’s risk of attention problems by 10% upon school entry.
• Behavioral problems are being diagnosed at high rates and medication is becoming more of a common treatment. Cris started an initiative called “Unplug-Don’t Drug” in Canada to work on reversing this trend.

The Social Effects of Technology Use:

• Social isolation, suicide, rage and violence are becoming more pronounced with the increase in overall technology use. Brandon Crisp from Ontario and Daniel Petric from Ohio were talked about as examples.
• Media violence is classified as a public health risk in the US now due to resulting child aggression.

The Effects of Technology on Academic Success:

• 15% of Canadian children are classified as having learning disabilities (LD).
• Illiteracy is on the rise as well as children with developmental delays who often have printing and reading deficits.
• The increase in technology use correlates with lower grades, higher drop out rates in high school, and lower university pursuits.

Cris really emphasized the need for parents to have “sacred time” in the home where they are completely unplugged from technology and fully engaged in spending time with their children. She recommends these sacred times to be at least: during dinner time, during car rides and 1-hour before bedtime. Next week she has agreed to come back for a third and final time (for now at least) to help us find ways to balance our children’s use of technology with activities they need in order to grow and succeed in today’s world.

Thank you so much Cris for sharing this information with us today. For the listeners, if you haven’t listened to the previous episode or looked at the blog, I encourage you to do so. If you would like to contact Cris or sign up for her monthly newsletter, you can find her at:
www.zonein.ca

info@zonein.ca

1-888-8zonein (888-896-6346)
604-885-2666

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Today we have Cris Rowan with us- an amazing pediatric occupational therapist and child development expert from British Columbia. She has been in practice for 20 years now and has spent the past 15 years working in schools; she is SIPT certified, and she is the owner of “Zone’in Programs, Inc.”- which offers products, workshops, and trainings to improve children’s health and enhance their academic performance. She provides training throughout North America on topics such as Sensory Integration, attention and learning, fine motor development, and the impact of technology on child development. She is also an expert reviewer for the Canadian Family Physician Journal, and she authors a very informative monthly Zone’in Developmental Series Newsletter which is how I found her!

As kids today are changing, and more-and-more kids are having problems with attention, learning and behaviors, Cris talked to us about the most important factors we need to consider when looking at balancing our kids’ daily activities for healthy child development. She stated “studies have found that children who use more that 1-2 hours per day of combined technology (TV, video games, internet, texting), are likely to encounter a variety of difficulties, both at home and at school” and that “wise parents might consider helping their children “unplug” their way back to school, but “pulling the plug” is too extreme”.

Balanced Technology Management (BTM) is a concept Cris Rowan developed, that states children need to learn how to manage balance between activities they need to grow and succeed, with technology use. There are 3 critical factors outlined below that need to be addressed in order to balance good child development based on this concept.

1. Movement – the vestibular system is the sensory system found inside the inner ear which is responsible for helping children to learn their center of gravity, set their core muscle tone, successfully coordination their right and left sides of their body as well as the upper half with the lower half of their body. It also helps the eyes learn to talk to each other for coordinated activities such as reading, copying, etc…

• Young children require 3-4 hours per day of active rough and tumble play to achieve adequate sensory stimulation to their vestibular and proprioceptive sensory systems for normal development.
• Vestibular and proprioceptive input ensures normal development of posture, bilateral coordination, optimal arousal states and self regulation necessary for achieving foundation skills for eventual school entry.
• Infants with low tone, toddlers failing to reach motor milestones, and children who are unable to pay attention or achieve basic foundation skills for literacy, are examples of inadequate vestibular and proprioceptive input.
• The use of safety restraint devices such as infant bucket seats, toddler carrying packs and strollers have further limited movement in children, as have TV and videogame overuse.
• Many of today’s parents perceive outdoor play as ‘unsafe’, which additionally limits essential developmental components that are usually attained in outdoor rough and tumble play.

Cris’s favorite activity recommendations for movement inside the home include: using a platform swing suspended from your ceiling; wrestling; and building forts and knocking them down.

2. Touch – the tactile system is the sensory system throughout our entire body that sends information to our brain about what we touch and feel.

• The skin is the largest organ of the body, with 70,000 receptors per square inch.
• Tactile sensory input is a biological need, and without touch humans would die.
• Tactile stimulation is integral to child health and well being.
• When infants are deprived of human touch, they develop into children who exhibit excessive agitation and anxiety, and may become depressed by early childhood (Dr. Ashley Montagu).
• Technology is grossly limiting access to necessary tactile stimulation, and many children are touch deprived.

Cris’s favorite activity recommendations include: hugs; reading books together; playing “hands-on”; rolling the child tight in a blanket to play “burrito” games; or tucking the child in tight to bed, or into the corners of the couch with a blanket (which is great for anxious or agitated kids).

3. Human Connection – this is defined as the primary attachment bond between infant and parent.

• The critical period for attachment development is the first year of life
• Connection to technology is causing a disconnection from self, others, nature and spirit. This is more and more often seen in a parent who spends time using technology outside of working hours and therefore less time connecting with the family. Cris asks the parents about their technology use first, before looking at their child’s technology use.
• Disconnection is most apparent in children with Autism, ADHD, anxiety, depression and bipolar disorders, all of which are increasing in number and severity.
• Attachment disorders are causally related to child and adult addictions.
• It’s highly valuable to have one parent at home with a child through his or her first year of development (when possible), in order to strengthen this human connection and parent bond.

Thank you so much Cris for your time and expertise on this new and very important topic of balancing our technology use for the benefit of our children!

Next week, Cris Rowan has agreed to come back to talk more specifically about how too much technology use can affect a child’s physical, mental, social and academic health. I highly encourage those who are reading this blog to listen to this episode to get more great information, national statistics and details from Cris on this topic.  I also encourage you to check out Cris’s website, games and products, and to sign up for her free monthly newsletter, which has been amazingly informative to me! You can connect with her in the following ways:

www.zonein.ca
info@zonein.ca

1-888-8zonein (888-896-6346)
604-885-2666

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The following categories are often, but not always assessed in order to get a good overall picture of a child’s developmental and sensory processing status. Remember, every child is different!:

1.  Sensory Processing -
Tests for sensory processing are highly variable as there is no set and definitive way to assess sensory processing and monitor progress over time.  The most comprehensive evaluation tool available for testing sensory processing skills is the SIPT test, which is the “Sensory Integration and Praxis Test”.  Therapists can take courses in order to become certified in the administration and interpretation of this test, but there are many ways to get the necessary information in order to help a child get better, so this is only one way to test a child.  Commonly therapists use comprehensive checklists, the Winnie Dunn Sensory Profile, parent feedback and the evaluator’s observation of the child during all testing to make judgments on a child’s sensory processing skills and difficulties.  A comprehensive assessment will give information on each of the child’s seven senses, to determine if the child “over” or “under” processes information coming into the brain from each sense.

2.  Sensory Modulation/Self-Regulation Skills -
These are terms that are similar in their definitions, although “sensory modulation” is the term used to assess the brain stem’s “automatic” ability to maintain homeostasis or calmness throughout the day in order for children to learn, pay attention, have good behaviors and appear to be well-adjusted and well-coordinated.  Children who fluctuate between being overly and under-sensitive to certain types of sensory stimulation (i.e.- touch, or any other sensation, like sound, or movement) within a matter of seconds, minutes or hours, often times have a “modulation” disorder, as the sensory systems cannot balance out on their own.  The term “self-regulation” is used when a child can remain calm and appear to be well-adjusted in an ideal environment, but can’t maintain a good level of calmness when a high level of stimulation or stress is present around him or her.  Kids with self-regulation difficulties can be perceived as being “fine” until they go to a party, eat too much sugar, or get provoked by their peers in some way.  They are often easily excitable, frustrated or quick to anger in “specific” situations, whereas a child with a modulation disorder is experiencing these feelings and emotions more often throughout the day.

3.  Motor Planning/Praxis Skills -
From a sensory perspective, motor planning, also known as praxis, is the ability to quickly and efficiently take in sensory information, process it and respond with a motor action.  Motor planning difficulties impact a child’s ability to transition between tasks, accept changes in plans and routines and be more flexible in nature when plans or activities do not go as expected.  Motor planning difficulties in the broader sense of the word are related to a lack of motor coordination.  This is what you will most likely find if you do a search on the internet for this term, so try not to get confused, as this information may not apply to your child properly, if he or she mainly has sensory-related motor planning difficulties.

4.  Attention -
Attention is the end result of having good sensory processing, self-regulation, postural endurance, eye muscle coordination/endurance and big muscle coordination skills.  It’s also based on a child’s frustration and learning potential as he or she can become avoidant and therefore appear inattentive when tasks are overwhelming or hard.  It’s very important to determine the cause of attention problems, because there are more than a handful of ways to make attention skills better, and the therapist needs to determine how your child is going to make life-long gains in this area.  Food and chemical sensitivities, lack of sleep and high intelligence are other reasons why children may be inattentive!

5.  Muscle Endurance/Tone -
Muscle endurance is based on how long the muscles can hold in a particular body position before they get tired, and muscle tone is based on the amount of messages the brain sends to the muscles in order to keep them activated over a period of time.  Difficulty with the prone extension (superman) and supine flexion (cannonball) positions is strongly associated with difficulty achieving higher level postural control, balance and movement.  These are positions where the child has to hold his back, neck, stomach and hip muscles up against gravity for the assessment.  A lack of endurance or tone is often the reason why children have a hard time sitting still, paying attention over a period of time, or standing in one place without fidgeting or tiring.  Respiratory weakness also effects a child’s ability to sustain good upright posture, attend quietly to tasks when seated at a table, and maintain self-regulation when excited or physically active.  Children are also commonly known to “W” sit to assume a more stable position when they have deficits in their postural stability.  This is not good for the ligments on the inner sides of their knees over time.

6.  Reflexes -
Some therapists believe it’s important to test reflexes which are primitive motor movements that infants and young children have innately built into their bodies for survival and for very basic skills (i.e.- survival skills).  It’s known that these reflexes need to disappear over time in order for children to acquire higher level coordination skills between the right and left sides of the body, as well as between the upper and lower halves of the body.  Sensory therapists often look at the lack of reflex integration to mean “nervous system immaturity”.  This is good general feedback for a therapist to consider when looking at the overall strengths and weaknesses of a child.  The post rotary nystagmus (PRN) test assesses the vestibular-ocular reflex. that gives us information on how well the brain interprets movement at a reflexive level.  The vestibular system is the sensory system that detects movement, which is responsible for activating greater balance, posture, attention, ocular skills, coordination and motor planning skills in the developing child.  This test is used often by therapists who are more experienced in identifying and treating sensory processing disorders, who have a keen eye for knowing how to interpret the results of this assessment.

7.  Bilateral Coordination -
This is an important area to assess as children with sensory processing difficulties quite often have a hard time integrating or coordinating the right and left sides of their body together.  When a child is born, he or she has two brains (the right hemisphere or brain, and the left hemisphere or brain).  Children learn to reach across their body for objects, and cross their legs and even eyes over to the other side of their body as they learn through play exploration.  Each time this is done, a pathway is made in the corpus collosum which is the connector piece between the two sides of the brain.  As these connections are made, skill is being established.  This is why children don’t know how to crawl when they are first born, hold their own bottle with two hands right away, hold their own pacifier, or ride a bike.  Children have to learn to integrate the right and left sides of their body in order to complete all coordination activities that require both sides of the body to do something at the same time.  The body’s extremities can even be doing different tasks at the same time, such as: one hand holds the paper while the other hand cuts, draws or writes.

8.  Gross Motor Coordination/Balance -
Gross motor skills are coordination skills that involve large muscle groups of the body for many activities such as balancing, skipping, hopping, being coordinated for P.E. classes, bike riding, engaging in after-school sports and completing many outdoor recreational activities.  At a more basic level, gross motor coordination skills are required for a child to maintain his or her balance, crawl, and walk.

9.  Eye-hand Coordination Skills -
This term is pretty self-explanatory as it relates to overall coordination skills that involve the eyes having to be lined up with the body to complete a task such as: throwing or catching a ball, batting a ball, and playing many sports or games that involve larger body movements (compared to an activity such as handwriting which is more often considered a visual motor activity).

10.  Ocular Motor Skills -
Eye tracking difficulties can cause frustration or resistance toward any activities involving the eyes, including reading, writing, copying skills and/or sustained attention with the eyes over a period of time.  Convergence difficulties (moving into a cross-eyed position) can affect depth perception skills for activities such as walking up and down stairs or escalators, riding a bike or focusing on table top tasks.

11.  Fine Motor Coordination -
This is the child’s ability to use his or her fingers in a coordination manner for activities such as writing, drawing, coloring, stacking blocks, cutting, tying shoes, buttoning, snapping and zipping clothes (just to name a few!).

12.  Visual Perceptual Skills -
Visual perceptual skills are based on the brain’s ability to make sense of what is seen with the eyes in order to complete puzzles, identify the difference between similar objects, pictures or designs, and to understand how to form letters using diagonal lines, curves and straight lines.  This does not include how well a child coordinates his or her fingers to complete such tasks.  It only considers what the eyes see and therefore what the child understands.

13.  Pencil Grasp/Hand Strength & Dexterity -
A pencil grasp is often affected by a child’s hand strength and ability to maneuver the pencil in his or her hand efficiently (which is dexterity). A child should have a 3-finger tripod grasp for an efficient grasp and his or her hand and arm should not be moving, as the fingers should be doing the work on their own.  This is expected of children when they are in their preschool/kindergarten years now.  There are many fun activities on the internet that can help make hand-strengthening fun for children such as play-dough activities when done with all the play-dough tools, the use of hole punchers, cutting thick paper, using mini-staplers, tearing construction paper or multiple pieces of paper at the same time, coloring or scribbling on paper with tiny broken pieces of crayon (so only 3 fingers can fit, versus 4 or 5), etc….

I hope this is a helpful guide for you and I encourage you to ask your therapist questions anytime you don’t understand why he or she did a certain test, what it means, and how that information will help your child to perform better.  The more you ask questions and become involved, the faster progress your child will make!

Best wishes for fast progress and much success!

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Screenings are informal assessments that typically take approximately 15 minutes to complete by a licensed occupational therapist. The purpose of the screening is to get a quick overview of the child in order to see if any “red flags” present themselves, which would indicate the need for a full OT evaluation. An evaluation is a comprehensive assessment that includes standardized tests, which often takes an hour, and sometimes longer. This is a compilation of specific assessments that define the child’s skills to be “average”, “above average”, “superior”, “below average” or “poor” in all areas that were tested. The evaluation then ends with recommendations for treatment. Occupational therapy on average may be two times per week, 30-60 minutes per session over a period of 6 months, before another formal assessment is completed to measure gains made. This may be different based on your insurance policy or the severity of your child’s difficulties, so this information is just a guide.

It is extremely valuable to have an occupational therapy professional complete a screening on a child when the parents or teachers are not sure of what is going on for that child. A quick and inexpensive screening is an opportunity for the professional to review any concerns reported, to see whether OT services or even another type of service would be appropriate to pursue. Early detection of difficulties is “key”, as children can make great progress in a short amount of time with assistance. So why wait until your child is really unsuccessful in school, lacking behavioral control, unsuccessful with social interactions, behind in his or her developmental or coordination skills, and/or lacking self esteem?

Examples of categories that may be assessed in a screening include, but are not limited to:

1. muscle tone/strength- muscle tone relates to the amount of messages the brain sends to the muscles to activate over a period of time; low muscle tone is most common in children who have difficulty sitting still, holding a pencil, focusing with their eyes, and/or who are lethargic or get tired easily.
2. balance – i.e.- to stand on one foot, walk on a balance beam or curb, or walk on their tippy toes.
3. sensory processing – often relating to sitting still, paying attention, keeping their hands to themselves, not invading others’ space, demonstrating self-control verbally & physically, and responding appropriately to touch, sounds, movement, smells and the ability to remember and follow directions.
4. fine motor and visual motor skills – related to forming letters, writing words/sentences, staying within the boundaries of lines and having good sizing of letters, as well as age-appropriate drawing, or coloring, and ability to manipulate buttons, snaps, shoe laces, or food containers, etc…
5. ocular motor skills – related to moving their eyes smoothly to watch a moving target in all directions, which is needed for good writing, reading, attention skills and copying from a book or the board in a classroom.
6. visual perceptual skills – this is related to how the brain interprets what it sees versus how the child can control his or her hand/finger movements for eye-hand coordination activities (which would be considered visual motor skills, not visual perceptual skills) some visual perceptual activities involve drawing pictures or people, completing puzzles, and stacking blocks to match a model or an example.

Examples of common concerns that arise with children in the following age ranges include:

1. infants – colicky baby symptoms, always fussy, hard to calm down
2. toddlers – constantly on the go, very irritable, may not like being touched, more rough or withdrawn than other toddlers, fearful with a “deer in headlights” look when prompted to try something new, hyper, or very high-maintenance and may be generally very difficult to manage
3. pre-k – difficulty following directions, sitting still, touching peers without excessive force, may show resistance to following class routines or distress when changes occur in plans or routines (more so than his or her peers), may have a harder time than others with physical activities and/or fine motor activities
4. kindergarten – difficulty sitting at a desk without constant fidgeting or standing, holding a pencil correctly and keeping up with classmates with reading and writing lessons, over-reactive to touch, movement, sounds, easily upset with changes in plans or routines, may dislike school or feel self-conscious about doing certain activities if they are not as good at something than his or her peers
5. grade school – difficulty with sitting posture, sustained attention, academic skills are slow, unmotivated or resistant to going to school, having physical/verbal outbursts, uncoordinated, or being socially awkward
6. middle/high-school – lack of organizational skills, attention problems, uncoordinated for sports or physical activity, craves movement or sports, may like extreme sport activities, withdrawn, or socially awkward, can’t handle “change”, may not have any friends or may not have many friends, needs to be protected more than his or her peers

This is certainly not all-inclusive, it’s just a quick “cheat sheet” to give you an idea of what symptoms or challenges may present themselves for children in a school environment. These symptoms can happen and stand out in children of all ages, so don’t let the above categories fool you; they are just there to give you an idea.

I hope this information helps you to figure out what is needed for your child. You should be able to contact the therapist who screened your child if you have any further questions or concerns.

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1. Intelligence (IQ testing) which can cautiously be assessed as early as 2 years of age.
2. Achievement/Academic Testing- i.e. reading skills.
3. Process Testing- which looks at functions such as memory, and can assess auditory, visual, and perceptual-based difficulties.
4. Behavioral/Emotional Testing- which includes screenings for anxiety, depression, mood disorders, ADD/ADHD, etc…

She also talked about how “memory” problems are so easily misidentified and misconstrued these days. She stated that back in the 70’s they didn’t have treatment options for memory problems, but now there are many ways you can practice and strengthen memory skills, like you would strengthen a weak muscle. She encourages parents to check out library books that give 100’s of activities or find memory games on-line, such as subtraction games for your child to do in his or her head, or having them find 3-4 random objects in the house and bring them back to you using only their memory.

She also teaches us that when we challenge children, we need to make sure we are allowing them to have 2 successes for every 1 failure. This is a good balance to achieve so your child is not overly frustrated with tasks that are too easy or hard. Dr. Messenger used the great example of: Shaquille O’Neal practices what is “hard”, not what is “easy”. This is how we acquire difficult skills.

Dr. Messenger feels we can all make a huge difference in the world of a child when we use multiple approaches, and this can be the best way to address children who have sensory processing difficulties. She shared an example of when a parent brought her child into her office feeling like there was a mental disturbance and that medication would be beneficial. It turned out this child needed dietary changes, behavior modification techniques (a simple behavior chart), training in self-control with some play therapy used, exercises for home, and a supportive teacher.

As far as helpful tips for stressed parents…Dr. Messenger encourages parents to take care of themselves, and be patient (as hard as this may be) as nagging and scolding children are not highly effective parenting tools. She also encourages us to be aware of each child’s developmental stages and mental ages, so we are setting our expectations at an appropriate level for them to understand and feel successful. Dr. Messenger also has some great resources on her website including some self-help materials she has developed herself, including her long time book: Secrets of the Third Little Pig which you can find in an Orlando Public Library or on-line, and a game she’s creating for kids that comes with a higher level manual for parents- teaching self-help skills.

Thank you again Dr. Messenger, you are such a pleasure and we are so grateful for your time and expertise over the past 3 episodes.

If you would like to schedule an appointment with Dr. Messenger, find out more about her services, or benefit from the extensive knowledge and resources posted on her website, you can visit her web page at:www.brighterpathways.com or contact her office at 407-895-0540

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