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Fidget Tools: The Bottom Line

A fidget tool is one sensory strategy used to help children achieve self-regulation. Self-regulation is the ability to maintain an optimum level of arousal in order to participate in daily activities.Blog-Fidget Spinners-Main-Landscape (1) Self-regulation is a critical component of learning, as it can impact a student’s attention, emotional regulation and impulse control; a child’s performance in the classroom is directly related to his regulatory state.

A child’s nervous system, specifically the sensory system, needs input to help achieve a regulated state to successfully complete tasks. The theory behind fidget tools is that it provides a sensory experience to increase self-regulation, attention, participation and performance.

During the school day, a child’s body works tirelessly to perform the functions necessary to participate in the classroom. Children need:

  • Muscle control and endurance to sustain a seated, upright position to sit at a desk or on the rug during circle time.
  • Auditory attention to attend to instructions and lessons, while also blocking out surrounding sounds of peers chattering, shuffling papers or chairs scooting across the floor.
  • Visual attention to read work instructions, look at the teacher during lessons and complete written work, while also blocking out other visual distractions around the classroom.
  • Impulse and body control to keep hands, legs and other body parts from touching objects or peers nearby.
  • Emotional control to regulate emotions when happy, sad, confident, frustrated or embarrassed throughout the day.

For some kids, the demands of the classroom environment exceed what their bodies can handle. This isn’t due to a lack of intelligence or willingness to learn; it stems from difficulty coping with a neurologic system that isn’t organizing and responding appropriately to a variety of sensory stimulation from the external world.

The result of a child’s inability to organize his nervous system during the school day is an increase in behaviors that are often deemed inappropriate or distracting in the classroom. Such behaviors may include inability to sit still, wandering around the room, constant touching of objects or peers, laying on the floor, emotional outbursts, not following directions or not understanding how to complete a task.

These behaviors are actually how the child attempts to regulate his body to participate in the classroom. To minimize these behaviors and increase positive participation, it is important that the child is set up for success by providing individualized strategies for him to sustain a regulated state throughout the day.

One of these strategies is the fidget tool. I frequently recommend that my clients use a fidget tool in the classroom to help sustain attention and increase performance. Fidgets come in a variety of forms including Koosh balls, stress balls, small weighted balls, small figurines or fidget spinners.

Fidget tool recommendations are always given with the stipulation that the student must understand that the fidget needs to be used appropriately. I suggest that the parent and teacher review appropriate uses for the fidget with the child (i.e keeping the fidget in the hands, under the desk in the child’s lap), inappropriate uses for the fidget (i.e. throwing the fidget, rolling the fidget, giving the fidget to a friend) and the consequences for inappropriate use of the fidget (i.e. having the fidget taken away). Laying out clear guidelines for the use of the fidget helps students know the expectations and follow the rules.

While several schools have banned the use of fidget spinners in the classroom due to the craze they have caused, as an occupational therapist I support fidget tools as a sensory, regulatory strategy, as long as clear expectations are set and rules are followed. I have seen great success in my clients’ performance and attention when they use fidgets appropriately and not as a toy.

Does that mean my child needs a fidget spinner?

Fidget spinners or tools may not be suitable for everyone. Each person’s sensory system will respond differently to various strategies and may be needed at different times during the day. Some children benefit from fidget tools during writing activities, some may benefit from the tool during lecture periods and others may require use of the fidget more frequently. There may also be children who have difficulty with self-regulation where fidget spinners or fidget tools cause increased distraction or dysregulation. Check out our other blogs for ideas on other strategies that may be incorporated in the classroom to promote optimal performance.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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Dana Pais

Dana Pais

Dana Pais, OTD, OTR/L is an occupational therapist who obtained her Masters of Occupational Therapy (MS) and Doctorate of Occupational Therapy (OTD) at the University of Illinois at Chicago. During her doctoral studies, she spent time working in Lima, Peru at the Centro Ann Sullivan del Peru (CASP), a center for families and their children with cognitive and physical disabilities, where she provided intervention for many children and their families in the areas of low vision accessibility, independent living, school inclusion and supportive employment. Her interests include sensory processing and its impact on daily life and managing visual deficits. She is passionate about helping children reach their full potential in every aspect of their lives.

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Gravitational Insecurity and Recess

Gravitational insecurity is a term that means an excessive fear of ordinary movement. Blog-Gravitational Insecurity-Main-LandscapeIt can also be characterized by a child being uncomfortable in any position other than upright, or fear of having one’s feet off the ground. Gravitational insecurity is a form of over-responsiveness to vestibular input. This input is detected by the Otolith organs, located in the inner ear. These organs detect movement through space as well as the pull of gravity.

Recess is a common time you may notice children having difficulties with gravitational insecurities.

Here are some common red flags that may indicate your kiddo is having difficulty with gravitational insecurity:

  • Avoidance of playground equipment that kids of similar age enjoy
  • Avoidance of swings
  • Fear of heights or uneven surfaces
  • Overwhelmed by changes in head position
  • Fear of having their feet off the ground
  • Overly hesitant on slides
  • Has difficulty tilting their head back to look up at monkey bars

If you notice your child exhibiting some of the red flags listed above, they would likely benefit from an occupational therapy evaluation and treatment focusing on sensory integration. Throughout therapy your child will receive graded vestibular information through a multisensory approach. Slowly, they will learn to integrate and process sensory information more effectively.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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Lindsey Moyer

Lindsey Moyer

Lindsey Moyer, is a licensed pediatric occupational therapist. She graduated from Western Michigan University in Kalamazoo, Michigan with a Bachelors Degree in Health and Human Services. A year later, she graduated with her Masters of Science in Occupational Therapy. While a student, Lindsey gained expansive knowledge of the field by working in a variety of settings with people of varying ages and disabilities. Lindsey’s interest and compassion for working with children and their families became apparent as she completed internships and independent studies focusing on educational, social, and physical development. One such internship was completed at North Shore Pediatric Therapy (NSPT). Lindsey loves supporting kids in the acquisition of skills needed to lead fun and enriching childhoods.

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Explaining Your Child’s Behaviors in Response to Sensory Input

The way children take in and respond to sensory input from the environment may vary from child-to-child and day-to-day. It’s important to take into consideration that how children’s senses pick up information from the environment may influence their reactions and behaviors. Children might have a harder time taking in and processing sensory input to respond appropriately within the environment. Blog-Sensory Input-Main-Landscape

Below are several ways you can explain these sensory input reactions and behaviors to family, friends, and community members:

Auditory Input: Some children are sensitive to sounds (e.g. hand dryers; toilet flush; alarms). You might see these children cover their ears to certain sounds. Other children may not be as aware to sounds. You might see these children not respond to their name being called.

Visual Input: There are children who may demonstrate sensitivity to light by covering their eyes from bright sunlight or they may express discomfort by florescent lights. Other children might seek visual input by being visually attracted to TV/computer screens with fast-paced and/or flashy visual effects.

Tactile Input: Children may demonstrate sensitivity to certain textured clothing and resist/avoid wearing them (e.g. jeans; cotton materials; tags on clothing; tight socks). There are children who have a difficult time being in close proximity to other people. These children may feel overwhelmed and demonstrate over reactive behaviors when touched/bumped into (e.g. in crowded places; in line).

Oral Input: Some children might present sensitivity to specific textures or taste of food and avoid eating them (e.g. mushy/crunchy/chewy foods; sweet/sour foods; foods mixed together). Others might seek oral input to the mouth and put everything in their mouth (e.g. toys; finger; clothing).

Vestibular/Proprioceptive Input: Children might be hesitant and present distress when their feet are not on the ground or when they are spun in a circle. These children might avoid swings, climbing on the playground, riding a bike, or car rides. There are children who seek out a lot of movement and take climbing/jumping risks. You might also see children spin in circles to obtain additional vestibular input.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Sima Rashidianfar

Sima Rashidianfar is a licensed and registered occupational therapist (MS, OTR/L) with a love and passion for working with the pediatric population. She received her Bachelor of Science degree from the University of Illinois at Urbana-Champaign in Human Development & Family Studies with a concentration in Child & Adolescent Development. She then received her Master of Science degree from the University of Illinois at Chicago in Occupational Therapy. Sima is also a certified Early Intervention Specialist. She recently spent a year at Aspire Kids in Hillside, servicing children with developmental disabilities within homes/daycares through Early Intervention and at the outpatient clinic. Sima has experience working with children who have autism, sensory processing disorders, developmental delay, ADHD, brachial plexus, prematurity, learning disabilities, Down Syndrome, and muscular dystrophy. Prior to attending graduate school, Sima worked at Giant Steps Illinois in Lisle, a therapeutic day school for children with Autism. Sima is dedicated to assisting children with their engagement and participation in daily activities both directly and in collaboration with parents, caretakers, and other professionals, to help meet each child’s greatest potential.

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Occupational Therapy’s Role in Improving Self-Care Performance in Children

The role of the occupational therapist, when working with clients of any age, is to support participation and daily functioning. For a child, one of the primary occupations is self-care. Self-care Blog-Self-Care-Skills-Main-Landscapeskills, which include feeding, toileting, dressing, bathing and grooming, are classified as Activities of Daily Living (ADL’s), because they are a critical part of a child’s overall health and participation each and every day. In order to participate in self-care, a child must have component skills within a variety of performance areas, and delays in any of these areas can make seemingly simple tasks feel nearly impossible.

During an initial evaluation, an occupational therapist will help you determine which performance deficits or barriers within the child’s environment are causing your child to struggle with self-care. The OT will first obtain information by asking you questions about your home setup, your family’s routines, what kind of assistance your child currently needs to perform age-appropriate self-care skills, and what your goals are in terms of self-care independence.

These questions will help the therapist obtain a snapshot of your child’s current self-care performance and provide more information about the home environment in which your child is performing. The therapist will also complete a comprehensive evaluation of your child’s underlying skills through clinical observation and standardized testing to determine potential causes of delayed self-care skills.

Below are a variety of performance areas an occupational therapist will assess that could contribute to self-care performance:

  • Motor performance: A child’s physical ability to perform the motor tasks required for a self-care skill is dependent on his or her strength and endurance, range of motion, body awareness, grasp, manual dexterity, and bilateral coordination. In addition, a child may have decreased motor planning, or difficulty generating an idea for and executing a specific movement pattern.
    • Example: A child may be unable to tie his shoes because he cannot maintain a pincer grasp on the shoelaces.
  • Executive Functioning and Attention: A child may have difficulty sustaining attention to a self-care task, sequencing the steps of a task in an efficient order, or remembering when and how to do the task at all.
    • Example: A child may not be able to remember or mix up the order of steps to tying shoes.
  • Sensory Modulation: A child may have decreased sensory modulation, or ability to filter out irrelevant sensory stimuli. Children with poor sensory modulation may be hypersensitive to input, which can often make children very uncomfortable in their own skin, easily distractible, or easily upset and overwhelmed. Other children may be hyposensitive and not notice certain important sensory input. You can read more about how sensory processing impacts self-care and hygiene in one of our other blogs, “Horrible Haircuts and Terrible Toothpaste” http://nspt4kids.com/occupational-therapy/horrible-haircuts-and-terrible-toothpaste-helping-your-child-with-sensory-processing-disorder-tolerate-hygiene/
    • Example: A hypersensitive child may be bothered by the feeling of their socks and refuse to wear tie shoes; a hyposensitive child may not notice that his shoes feel or look funny when on the wrong feet.

Once the evaluation is complete, the occupational therapist will be able to determine if the child would benefit from ongoing occupational therapy. Future treatment would focus not only practicing specific self-care skills, but also engaging in activities that facilitate the overall development of underlying motor, sensory integration, and executive functioning abilities. In addition, the therapist will work with you to adapt your child’s environment through the use of home modifications, visual supports, and adaptive equipment to support performance. Through all of these modalities, the occupational therapist will be able to increase your child’s participation in self-care activities, thereby increasing his or her independence and overall development.

Check out one of our previous blogs on self-care written by a Board Certified Behavior Analyst: Self-Care Skills for Children with Autism

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Amanda Langer

Amanda Langer

Amanda Averack Langer, MS, OTR/L, is also a licensed occupational therapist. Originally from Connecticut, Amanda attended college at the University of Rochester, where she pursued a double major in Brain and Cognitive Science and Music. Prior to obtaining her license in occupational therapy, Amanda gained experience in special education as a 4th grade resource teacher. She also has experience in inclusive and adaptive arts programming for children and adolescents with special needs. Amanda attended the University of Illinois-Chicago, where she received her master's degree in Occupational Therapy. Amanda has clinical experience at OTA-The Koomar Center, a world-renowned pediatric clinic engaged in research and treatment of Sensory Processing Disorders, as well as the Rehabilitation Institute of Chicago working adults undergoing physical and neurological rehabilitation. When she is not working with NSPT, Amanda loves to cook, attend concerts and plays, enjoy the outdoors, and sing with her a cappella group, the Southport Singers.

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10 Common Household Items to Develop Fine Motor Skills

The building blocks for fine motor success begins on day one. Skill development is commonly observed when the child becomes explorative in their environment and increasingly independent. Independence in age appropriate tasks is often a great measure of where they are developmentally. Specifically, the common influencing skills for fine motor development are strength, coordination, visual perception and motor planning. To assist in maturation of these skill areas you can engage your child in simple activities with things you may already have around the house! Blog-Home Fine Motor Skills-Main-Landscape

10 great tools you may find around the house to develop fine motor skills:

  • Broken crayons– Don’t get rid of those broke crayons! Coloring with these can assist with precision, hand strength and grasp maturity.
  • Q-tips– They can be utilized for painting, dotting and erasing from a chalk or white board. Fine motor precision and grasp maturity are challenged in activities with Q-tips.
  • Clothes pins– Transferring small items while playing different games such as matching, minute to win it, and relay races. Clothes pins also assist with motor planning, strength, and coordination.
  • Tweezers– This is another great tool for transferring small items while playing different games that addresses motor planning, strength, and coordination skills.
  • Child safe scissors– Begin with snipping construction paper and progress into more complex activities such as cutting shapes. To start, make a fun fringed edge for a picture they drew or advanced beginners can make a snowflake with parental assistance. Cutting activities can be difficult, but it significantly addresses coordination, strength, visual motor, and motor planning skills.
  • Legos– These small pieces may hurt when stepped on, but they are great for coordination, precision, visual attention, and strength.
  • Small blocks– Blocks can be used in many ways. A few suggestions would be to stack, string, and build various structures. Blocks are wonderful tools for coordination, visual perception, and grasp maturity.
  • Play Doh– Great way to mature manipulation, coordination, strength, and creativity skills.
  • Shaving cream– A fun way to practice their drawing skills in a non-traditional pencil and paper way. This can assist with precision and motor maturity as well.
  • Spray bottle– Clean up from the shaving cream and painting activities with a spray bottle filled with water. This can really test as well as develop the child’s grasp strength and endurance.

**All activities should be closely supervised and supported by an adult.

NSPT offers services in Bucktown, Evanston, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Shelly Sears

Shelly Sears

Graduated from Western Michigan University with both her undergraduate and graduate degrees. Shelly has a master’s of science in occupational therapy with a concentration in pediatrics. While in school Shelly had an opportunity to work closely with children who have a variety of functional challenges particularly those with autism, trauma backgrounds, and diverse physical limitations. She also had the opportunity to work as a pediatric home therapist and clinical instructor at a sensory motor facility for several years while in school. Shelly begun working at North Shore Pediatric Therapy at the Glenview location in 2014. More recently she has been certified in Therapeutic Listening through Vital Links to further assist children’s sensory development. As a clinician, Shelly is dedicated to individualize treatment with a concentration on parent education for a holistic experience and optimal care.

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9 Ways to Make Gym Class Successful for a Child with Sensory Processing Disorder

A class full of students in an open gymnasium can make for a very overwhelming experience for a child with sensory processing disorder. Echoing voices, shoes squeaking on the floor, whistles blowing, the smell of sweat and cleaning agents, bright colors and moving objects are enough to increase anyone’s stress level. Blog Sensory Processing Disorder Gym-Class-Main-Landscape

Throw in the demand to attend to instructions, learn new motor skills, and keep up with your more advanced peers. For a child with sensory processing disorder, this could potentially become a recipe for disaster.

Or, with the right structure and supports put in place, this time can be a regular opportunity for fun, growth, and learning!

Below are 9 suggestions to help children with sensory processing disorder feel successful in gym class and participate to the fullest extent possible:

  1. Provide the child with an out. Let him know that if the experience becomes too overwhelming he can let the teacher know he needs a break. The student could sit outside the room for a moment, take a trip to the restroom, or get a drink of water. Sometimes a brief break is all that’s needed.
  2. Be aware of the student’s particular needs and allow accommodations. If a student is over responsive to noise, allow the student to wear noise-reducing headphones. If a student has tactile defensiveness, avoid putting them on teams with jerseys.
  3. Break down new activities as much as possible. Teach one skill at a time and provide multiple modes of instruction.
  4. When providing instruction, ask students to repeat the rules or act out a scenario. It may be helpful to repeat important points and explain why the rule exists in order to be sure they are understood.
  5. Modify games or exercises as necessary. Students will be at different levels and physical activity can present unique challenges for those with sensory processing disorder. Provide simpler options when possible.
  6. Establish space boundaries. Using visual cues for personal space and working in small groups can relieve anxiety for those with tactile defensiveness. Visual cues may also be helpful in showing students where they should position themselves for games and exercises.
  7. Take extra care to maintain a positive environment. Emphasize the importance of sportsmanship and supportive language.
  8. Avoid bringing attention to a skill the child is having difficulty with in front of his peers. When playing games in large groups, it may be best to avoid placing the responsibility of a key position on students who are already experiencing increased stress.
  9. Provide feedback to parents. Let the student’s parents know what skills you are or will be working on so that the child can get in extra practice at home. This can be a big confidence booster for children and allow them to fully master skills with their peers.

Remember to keep it fun! Gym class is not only important for educating students on specific skill sets, it also lays the foundation for their attitudes towards physical activity in the future.

Recognize that not all students with sensory processing disorder will have the same strengths and difficulties. Meeting a student where they’re at and finding their particular strengths to build on is the best way to set them up for success!

NSPT offers services in Bucktown, Evanston, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Shannon Phelan

Shannon Phelan

Shannon Phelan graduated with a Master of Science in Occupational Therapy from Colorado State University in Fort Collins, Colorado. As a student, Shannon completed an independent thesis project on attentional abilities in adults and children using measures of behavior and brain activity. She has research experience as a lab assistant in the Brain Waves Research Lab administering and reading results of electroencephalograms (EEG). Her practical experience includes spent time in a variety of settings including schools and inpatient, acute, and psychiatric hospital units prior to establishing her niche in the outpatient pediatric setting. Shannon has received training in Sensory Integration and Kinesio taping. Her favorite part about working at North Shore Pediatric Therapy is working closely with talented professionals of other disciplines who understand that quality care requires a holistic approach and open communication between families and team members. She believes in implementing evidence-based practice to address the unique needs of each child. Shannon is excited to help provide children and their families with the tools they need to lead full and satisfying lives.

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How Do Weighted Blankets Work?

Does your child have trouble sitting still for long periods? Is it hard for your child to pay attention in class or at home? Does he or she engage in frequent crashing, falling, or jumping? What aboutBlog Weighted Blankets Main-Landscape playing too rough with peers or siblings? Does he or she have a hard time settling down for bedtime and falling asleep? Does he or she exhibit anxiety in non-preferred or unfamiliar situations? If you answered yes to any of these questions, your child may benefit from the use of a weighted blanket.

Weighted blankets are designed to provide deep pressure input to a child’s muscles and joints. This deep pressure input targets our proprioceptive system. The proprioceptive system is our body’s sense of our position in space (in other words, where we are in relation to other people and objects).

A child who has difficulty regulating their arousal level and their movements is likely looking for a way to stabilize their nervous system. By providing the body with this deep, proprioceptive input, we calm and organize the nervous system. This allows for improved attention, a regulated arousal level, a decrease in excessive movement, and improved body awareness.

When beginning to use  weighted blankets, use a wearing schedule for the most effectiveness. If a child has the blanket on all day, his or her body will adjust to this weight and the proprioceptive system will become less activated. Instead, wear the blanket during times that the child typically has difficulty focusing, sitting still, or calming. Wear the blanket for no more than one hour at a time, with at least an hour off before wearing the blanket again. The weighted blanket could be worn in the morning before school, after recess, during specials, during reading or written work, before bedtime, or even during an activity that the child perceives as stressful (dentist appointment, shopping, etc.).

Weighted blankets should not exceed more than 5-10% of a child’s body weight. Consult with an occupational therapist for assistance with wear schedule and the amount of weight to use.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Amanda Burkert

Amanda Burkert

Amanda Burkert is a licensed occupational therapist who is certified through the National Board for Certification in Occupational Therapy. She earned both her Bachelor of Science degree in Kinesiology and her Master of Science degree in Occupational Therapy from Indiana University. Amanda has experience providing both pediatric outpatient and early intervention services through Unlimited Mobility Therapy, Inc. There she treated children from 0-18 years old who presented with fine and visual motor delays, developmental delays, Autism Spectrum Disorder, Down Syndrome, Cerebral Palsy, arthrogryposis, and Sensory Processing Disorders. Amanda has always had a passion for the pediatric population, and became interested in occupational therapy upon her involvement in Indiana University Dance Marathon, a philanthropic organization benefiting Riley Hospital for Children in Indianapolis, IN. Since that time, her love for both children and the profession of occupational therapy has continued to grow.

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Why Crossing Midline is Important for Development

As babies grow and develop certain milestones are often celebrated, such as rolling, sitting, crawling, and walking. As a pediatric occupational therapist, one of the milestones I always celebrate might not be visible to the untrained eye. Crossing midline, defined as the ability to reach across the body’s invisible midline with your arms or legs to perform tasks on the opposite side of the body, is a required skill for many higher level coordination activities. Blog Crossing Midline Main-Landscape

This skill typically develops around 18 months of age. Oftentimes when children are referred for occupational therapy due to poor fine motor skills, handwriting, or coordination, they are not crossing midline efficiently.

Some ways to observe whether or not your child is crossing midline efficiently include:

  • Watching to see if your child switches hands during drawing tasks. Do they switch from left hand to right hand to avoid their arm crossing over when drawing lines across paper?
  • Evaluating hand dominance: by age 6, children should have developed a hand dominance. Children with poor midline integration may not yet have developed a hand dominance.
  • Tracking an object across midline: this can be observed during reading, as decreased midline integration can lead to poor ocular motor skill development required for scanning.
  • Observing ball skills: children who are not yet crossing midline may have a difficult time crossing their dominant leg over their non-dominant leg to kick a ball forward.
  • Assessing self-care skills: putting on socks, shoes, and belts may be extremely difficult as these are activities that require one hand to cross over to assist the other in the process.

Children who have difficulty crossing midline may not be able to keep up with their peers, which may cause increased frustration during participation at school and in social situations. In addition, crossing midline is a required skill needed in order to complete more challenging bilateral coordination activities, such as cutting with scissors, using a fork and knife to cut food, tying shoe laces, writing out the alphabet, and engaging in sports.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140.

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Mary Kate Mulry

Mary Kate Mulry

Mary Kate Mulry is a graduate of Rush University’s occupational therapy program in Chicago, Illinois. Before becoming an OT, she received her undergraduate degree in Spanish and psychology at Loras College in Dubuque, Iowa. Her clinical interests include working alongside children who have sensory processing disorder, feeding delays, Autism Spectrum Disorder, and overall delay in fine and gross motor development. Mary Kate has past experience working with children in an outpatient pediatric setting, and also completed fieldwork placements in adult inpatient and outpatient rehabilitation. She is a recently published author in The American Journal of Occupational Therapy (AJOT) and believes in the importance of integrating evidence-based practice into daily treatment activities. As a clinician, Mary Kate is dedicated to providing the best care and individualized treatment for each child on a daily basis.

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10 Red Flags for Poor Sensory Registration

When most people hear Sensory Processing Disorder (SPD), they tend to think of the child who cannot tolerate tags on clothes, covers their ears and screams at parades, and who pulls away from hugs at family parties. While these are all behaviors associated with SPD, they only align with one type. Blog-Sensory Registration-Main-Landscape

Hypersensitivity, or sensory defensiveness, occurs when a child has difficulty filtering unnecessary sensory input and therefore gets bombarded with a waterfall of input, overflowing his or her regulatory system. However, there is another side to the story that often surprises parents that I work with. Just like a child may be over-sensitive, they may also be under. Poor sensory registration, or hypo-sensitivity, is another common classification of sensory processing disorder and applies to children who do not absorb, or register, all of the input entering their body. They are therefore “missing out” on crucial information from their own body and the environment, which is used to make adaptive responses and learn.

Imagine a giant waterfall, filling a pool at the bottom to the “just right” level. Now imagine that waterfall has a giant strainer at the bottom, causing a tiny fraction of the water to pass through and barely filling the pool. While typically processing children naturally and efficiently take in information from the environment through their many sensory receptors and use this information to make adaptive responses, this is much more difficult for children who miss some of the information coming in. Using the waterfall metaphor again, think how much more water you would need to send through the strainer to fill up the pool. This explains why poor sensory registration is often (but not always!) associated with “sensory seeking” behaviors, as children attempt to obtain additional input so that they may better absorb it. These seeking behaviors can often be misperceived as having difficulty following directions or misbehaving, while children may actually be trying to “fill their pool.” Another possible presentation is that children might appear to “be in la la land” and are likely not noticing or absorbing the cues they need to respond appropriately.

While it is very important to identify poor sensory registration, it can be difficult to identify at times.

Below you will find 10 red flags for poor sensory registration, organized by sensory system, to help you identify potential sensory processing deficits in your child:

Touch (Tactile) Processing:

  1. Your child does not notice when his or her face has food, toothpaste, or other materials on it. He or she may not be registering that input and will not notice unless pointed out by someone else or by looking in a mirror.

Auditory Processing:

  1. Your child does not respond quickly when you call his or her name or needs to hear directions several times to respond. If a child does not have actual hearing impairment, being less responsive to auditory input can be a sign of poor registration of sound input.

Visual Processing:

  1. Your child has a particular difficulty finding objects in a drawer, toy box, or other storage space, even when the object is very visible. They may have visual perceptual deficits related to poor registration of visual information.
  2. Your child may perform writing, coloring, or other visual motor tasks in a way that appears careless and not notice their errors unless specifically pointed out. They may be having difficulty noticing the difference between good work and poor work.

Body Awareness (Proprioceptive Processing):

  1. Your child may have difficulty navigating through hallways without leaning against or rubbing their hands against the walls. This may be their way of compensating for decreased body awareness to help them understand where their body is in space.
  2. Your child may have difficulty maintaining upright posture, whether slouching in a chair, w-sitting on the floor, or leaning against a wall when standing.
  3. Your child may use excessive force when giving hugs or using objects (e.g. breaks crayons, throws balls too hard).
  4. Your child may prefer sleeping with very heavy blankets or prefer to keep their coat on indoors. This input gives them the weight he or she needs to better perceive where his or her body is.

Movement/Gravitational (Vestibular) Processing:

  1. Your child loves intense movement (i.e. spinning, rolling, or going upside down) and can do so for a significant period of time without getting dizzy or nauseous.
  2. Your child may appear clumsy when moving about and lose his or her balance unexpectedly.

Of course, as with any set of red flags, one or two red flags does not qualify for a sensory processing disorder. However, if quite a few of the sensory registration items above resonate with you, and if any of these items significantly interfere with your child’s daily functioning, it would be helpful to set up an evaluation with an occupational therapist.

Occupational therapists are specially trained to identify sensory processing disorder through parent interviewing and clinical observation of your child. If a disorder is identified, an occupational therapist can work with you to create a sensory diet, or prescribed set of sensory activities, to help your child get the input he or she needs to feel organized and calm to better learn and grow. They may also teach you strategies to help your child better attend to the input that is entering their body.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

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Amanda Langer

Amanda Langer

Amanda Averack Langer, MS, OTR/L, is also a licensed occupational therapist. Originally from Connecticut, Amanda attended college at the University of Rochester, where she pursued a double major in Brain and Cognitive Science and Music. Prior to obtaining her license in occupational therapy, Amanda gained experience in special education as a 4th grade resource teacher. She also has experience in inclusive and adaptive arts programming for children and adolescents with special needs. Amanda attended the University of Illinois-Chicago, where she received her master's degree in Occupational Therapy. Amanda has clinical experience at OTA-The Koomar Center, a world-renowned pediatric clinic engaged in research and treatment of Sensory Processing Disorders, as well as the Rehabilitation Institute of Chicago working adults undergoing physical and neurological rehabilitation. When she is not working with NSPT, Amanda loves to cook, attend concerts and plays, enjoy the outdoors, and sing with her a cappella group, the Southport Singers.

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Why Are Occupational Therapy Screens Necessary for Schools?

Occupational therapists are skilled in assessing how a child’s sensory processing abilities, fine motor skills, visual motor skills and gross motor skills impact performance and function in daily life including self-care, play and academics. Proficient skills in these areas are imperative for children to be successful in the classroom environment.blog-occupational-therapy-screenings-main-landscape

  • Sensory processing skills support a child’s ability to learn. A child who is unable to process environmental stimuli effectively and efficiently will be unavailable to learn. Children with sensory processing dysfunction may have difficulty sitting still for an extended period of time in their desks or during circle time, they may be unable to pay attention when others around them are talking or they may have difficulty standing in line without touching, or hanging on a friend in front of them. These behaviors are a result of poor processing of the vestibular, auditory and proprioceptive systems, respectively.
  • Efficient fine motor skills are necessary to complete academic work. From writing to cutting with scissors and keyboarding to making crafts, fluid fine motor skills help children complete classroom activities and homework.
  • Efficient visual motor skills provide a foundation for writing and copying from the board as well as completing math work.
  • Efficient gross motor skills are important within the school environment for moving safely throughout the school and classroom, engaging with peers on the playground or during gym, and sustaining appropriate posture while sitting at a desk to complete work.

When a child struggles in any of these areas, it may not always be obvious. Oftentimes, sensory processing difficulties go unnoticed for many years and the child is left with academic or behavioral challenges. Therefore, occupational therapy screens are essential for schools.  An occupational therapist’s knowledge of child development, and its impact on daily functioning, can help identify children who would benefit from therapy services.

The screens can also be used as a preventative measure to ensure that a child’s development is on track and the child will have the foundational skills necessary to be available to learn. Occupational therapy screens also allow the opportunity for OTs to educate and collaborate with teachers and educators to provide suggestions that they can share with families and use in the classroom.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

Meet-With-An-Occupational-Therapist

Dana Pais

Dana Pais

Dana Pais, OTD, OTR/L is an occupational therapist who obtained her Masters of Occupational Therapy (MS) and Doctorate of Occupational Therapy (OTD) at the University of Illinois at Chicago. During her doctoral studies, she spent time working in Lima, Peru at the Centro Ann Sullivan del Peru (CASP), a center for families and their children with cognitive and physical disabilities, where she provided intervention for many children and their families in the areas of low vision accessibility, independent living, school inclusion and supportive employment. Her interests include sensory processing and its impact on daily life and managing visual deficits. She is passionate about helping children reach their full potential in every aspect of their lives.

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