How to Get a Break From Your Child When You Need To Cool Down

When you’re starting to, or already have, reached your limits with your child, how can you get away without fueling the fire?

Take Some Alone Time

Very Angry Mother And ChildWhen you get angry, it is usually best to wait until you’re calm again to have a productive talk about the issue. Instead of saying things like “go to your room”, tell your child that you need to go into your own room alone to cool down. Talk to your child about “alone time” and why it is a good thing and why everyone needs it sometimes. Explain to your child that “cool down” time helps you to think better and talk better.

Pick a name for your favorite spot to cool down, and call it something like “chill spot”, “cool down corner” or “cool chair” and tell them that this is where you might go sometimes to calm down. Tell them it is very important for you to be alone at this time, and it will be only a minute or two (as long as your child is able to be left without direct supervision). Your child should choose their own spot in the house also, and perhaps they can wait in their spot while you are taking your moment alone.

Start Out Small

If your child has a particularly hard time with this and feels overly rejected, try starting out with short increments of time and gradually increasing it as they handle it successfully. You can use a kitchen timer to set a minute or two, and let them know that when the timer goes off you will be back. I suggest giving them an immediate sign of physical affection along with verbal praise to reinforce their patience!

When you do this with your child, you are modeling extremely positive behavior! You are showing your children how to cope with anger and frustration in an appropriate way.

Teach A Lesson About Anger

When you reunite, be sure to give lots of love and praise! Show them that alone time is not about rejection, it is about making good choices. Always reinforce to a child that feeling angry doesn’t mean they are “bad” (a very common perception of theirs that I hear about often). The only “bad” part about anger is the “bad choice” they can make when feeling angry and do not take time to cool off. “Good choices” need to be taught and modeled, and what better way than to let them see you use this technique yourself!

Don’t forget to use your spouse as a resource when they are around. Have a special signal between you that lets each other know when you need them to step in, so you can take a break. Remember that you will be much more effective with your child once you are calm and that self-care makes you the best parent you can be!

How To: Teach Your Child to Write the Right Way

Young Boy Writing On EaselHandwriting is a very complex process that requires many prerequisite skills and abilities before it can be done successfully and easily. Some of these skills and abilities include the development of the small muscles in the hand, pencil/marker grasp, eye-hand coordination, the ability to draw shapes and lines, and visual perceptual skills.

For beginner writers, emphasis is placed on learning how to hold a pencil or marker, getting accustomed to making strokes on paper and beginning to form meaning out of what is drawn (for example, a loop is defined as a circle). The early writer learns to write first by imitating various strokes (horizontal line, vertical line, circle) , then copying the same strokes from a visual example and eventually drawing and writing independently. Below are preparatory activities your child can do to help them begin to write the right way! Read more

How will health care reform affect pediatric therapy?

Is this health care bill revamp a positive or negative move for families of children with autism and other predominant and growing special needs?  What will this do for children needing occupational therapy, physical therapy, speech therapy, applied behavior analysts, psychology?  Is insurance up for grabs now?  I hear everyone is going to have access to the best health care, the “same ones that the congressmen in Illinois have” is what someone just told me.  Like I said, I have no idea if this new insurance deal is yay or nay but I have some research to start doing very quickly!  Any cheat sheets you have to send me on this new bill and how it impacts therapy is much appreciated!  Please share whatever you know.  I want to hear what you have to say!  Here is where I am starting my research….Let me know what you find!

http://occupational-therapy.advanceweb.com/Article/Health-Care-Reform-and-Disability-Rights.aspx

http://www.amazon.com/Pediatric-Neurologic-Physical-Therapy-Clinics/dp/0443087644

http://illinoisaap.org/

Visual Perception

Visual Perception BlocksWhat is Visual Perception?

Visual perception is a sensory and cognitive process that organizes perceived visual information and interprets and uses what is seen. There are five main subcategories of visual perception: visual discrimination, spatial relationships, visual memory, figure-ground, and visual closure.

What are symptoms of decreased visual perception?

A child who demonstrates decreased visual perception may exhibit difficulty cutting, coloring, constructing with blocks, tying shoes, doing puzzles, getting dressed, using buttons and fasteners, hesitancy going up and down stairs or curbs, and difficulty with classroom activities such as reading, spelling, handwriting, math, and finding items in his desk.

Difficulties may also include an inability to distinguish small visual details, difficulty discriminating contrast and color, difficulty reading or writing, difficulty recognizing familiar faces, difficulty seeing objects such as steps and walls, decreased fine motor coordination, and decreased safety resulting from inability to see obstacles in path of travel. While these difficulties may be indicative of decreased visual perception, there may also be other factors contributing to any of the difficulties listed above. It is important to assess your child’s visual perception in relation to other developmental skills, such as motor planning and fine motor control, in order to truly determine the origin of their difficulty.

If I see symptoms of decreased visual perception, what do I do?

If you observe your child having difficulty with the tasks and activities listed above, it is important to seek out an ophthalmologist or optometrist to determine if any corrective procedures or tools may be warranted (i.e. glasses). An occupational therapy evaluation may also be warranted to evaluate how your child’s decreased visual perception is impacting their performance. Following an evaluation, the occupational therapist will create goals and set up a treatment plan to help to develop the appropriate learning environments in which your child can best participate in all different kinds of activities, thus strengthening their confidence in their own abilities and fostering his sense of independence.

Our approach at North Shore Pediatric Therapy

At North Shore Pediatric Therapy, our therapists work with children who experience decreased visual perception by using a multisensory approach. We provide your child additional sensory experiences when visual skills are decreased. Our therapists engage your child in various activities that incorporate movement, tactile, visual, and auditory sensations to enhance visual perception. In addition, our therapists are trained to alter your child’s environment and/or his activities in order to better utilize his existing visual perception, which in turn helps to improve those skills.

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Visual Motor Skills

Visual Motor Skills HandwritingWhat are Visual Motor Skills?

Visual motor skills, also referred to as visual motor integration, are the skills that emerge from the integration of visual skills, visual perceptual skills and motor skills that allow us to use our eyes and hands in a coordinated and efficient way. Visual motor skills are the foundation for many of a child’s day to day activities, including cutting, coloring, writing, catching or kicking a ball, or tying his shoes. When the visual and motor systems are efficiently communicating with one another, these activities are easy for children to complete.

When these systems are not effectively communicating, children will have difficulty with many of these activities. A child may not have any visual issues with acuity or perception and may not have any challenges with hand strength or dexterity, but the connection between their visual and motor system is not as organized or efficient as it should be, resulting in difficulties with visual motor skills. Functional implications of poor visual motor skills include difficulty with handwriting, drawing, completing mazes, copying from the board at school and poor eye-hand coordination.

Our approach to difficulties with visual motor skills at North Shore Pediatric Therapy

At North Shore Pediatric Therapy, our therapists work with children who have difficulties with visual motor skills by using a multisensory approach to provide the child with additional sensory experiences and successful completion of visual motor integration activities. Deficits in visual motor skills may be caused by difficulties with underlying visual perceptual skills or motor skills. To identify a child’s current level of performance related to his visual motor skills our occupational therapists (OT) will administer a standardized assessment called the Beery-Buktenica Developmental Test of Visual Motor Integration, or the Beery VMI. This assessment provides the OT with important information on the development of the child’s visual and motor abilities, as well as where the child should be performing for his/her age.

Following the evaluation, the therapist will develop goals based on the child’s performance and design a treatment program that concentrates on improving these skills. The therapist will engage the child in various activities that incorporate movement, tactile, visual, and auditory sensations to enhance visual, fine and gross motor skills. Throughout therapy, the therapist will also provide activities and exercises for the child to complete at home, such as mazes, dot-to-dots, puzzles or ball activities. Participation in home exercises will help the child practice these visual motor skills during the week outside of therapy and will ensure improvements in participation of everyday activities.

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Visual Acuity

What is visual acuity?

Visual acuity refers to the clarity or sharpness of vision at both near and far distances. Visual acuity differs from visual perception;Visual Acuity visual perception is a sensory and cognitive process that organizes perceived visual information, which interprets and uses what is seen. Visual acuity also differs from visual motor skills, also known as visual motor integration; visual motor skills are the skills that emerge from the integration of visual skills, visual perceptual skills and motor skills that allow us to use our eyes and hands in a coordinated and efficient way.

What are symptoms of decreased visual acuity?

Symptoms of decreased visual acuity include difficulty with:

  • Distinguishing small visual details
  • Discriminating contrast and color
  • Reading or writing
  • Recognizing familiar faces
  • Seeing objects such as steps and walls

Symptoms also include decreased fine motor coordination, and decreased safety resulting from inability to see obstacles in path of travel.

What should I do if I suspect decreased visual acuity in my child?

If you observe your child having difficulty with the above tasks and activities, it is important to seek out an ophthalmologist or optometrist to determine if any corrective procedures or tools may be warranted (i.e. glasses). An occupational therapy evaluation may also be warranted to evaluate how your child’s decreased visual acuity is impacting his performance. Following the evaluation, the occupational therapist will create goals and set up a treatment plan to help develop the appropriate learning environments in which your child can best participate in all different kinds of activities, thus strengthening his confidence in his own abilities and fostering his sense of independence.

Our approach to decreased visual acuity at North Shore Pediatric Therapy

At North Shore Pediatric Therapy, our occupational therapists will address your child’s visual acuity as related to his performance with his fine and gross motor abilities, visual motor skills and participating in play both individually and with peers. Our occupational therapists may also suggest a visit to your child’s school to observe and collaborate with teachers to set up modifications around his school environment in order to allow him to be most successful and actively engage in the classroom setting.

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Type II Diabetes

Type II DiabetesWhat is Type II Diabetes?

Type II diabetes is the most common form of diabetes. This form of the illness is a chronic condition in which the body is resistant to the effects of insulin or does not produce enough insulin. Insulin–a hormone produced by the pancreas–takes digested glucose from the blood and transforms this sugar into fuel and energy. People with type II diabetes, thus, do not get necessary energy from food during the digestion process and are at risk for glucose build-up in the blood. Type II diabetes is generally diagnosed in adulthood and is associated with family history, obesity, poor diet, decreased physical activity and ethnicity. According to WebMD, 90% to 95% of people with diabetes have type II diabetes.

What are some symptoms of the condition?

Symptoms of the condition include extreme fatigue, unusual weight loss, constant hunger, blurred vision, increased thirst and urination, slow-healing sores and areas of darkened skin.

How does the condition progress?

After diagnosis of type II diabetes, a doctor will discuss treatment options to control blood sugar levels. Type II diabetes is not curable, but it is manageable with proper care and lifestyle changes. Without careful self-management, however, an individual with type II diabetes can endure long-term complications like heart disease, kidney damage, nerve damage in the extremities, eye damage, osteoporosis, Alzheimer’s disease and bacterial or fungal infections. These complications are minimized with efforts to be healthy, maintain daily physical activity, keeping blood pressure and cholesterol under control and routinely checking in with a doctor.

How can I help treat my child’s condition?

Treatment for type II diabetes includes monitoring blood sugar, regular exercise and healthy eating, and possibly diabetes medication or insulin supplements. It is important for people with type II diabetes to monitor their blood sugar level to make sure it is within a target range. In some cases, a doctor may recommend diabetes medication or insulin therapy. Oral diabetes medication lowers glucose production in the liver. A doctor may also prescribe insulin therapy in combination with diabetes medication. There are two options for insulin supplement therapy–insulin injections or an insulin pump. Insulin injections are done manually by means of a small needle or insulin pen which delivers insulin to the body. An insulin pump is a small device worn outside the body that connects to a catheter inserted under the skin, near the abdomen. The insulin pump automatically injects the body with insulin at a steady rate to regulate the sugar in the bloodstream.

Our approach at North Shore Pediatric Therapy

At North Shore Pediatric Therapy, we offer a variety of services that may be beneficial for children with type II diabetes. Specifically, our registered dietitians and licensed professional counselors will work with your child to create healthy meal plans and identify coping strategies, since we know how crucial it is for your child to make their physical and emotional health a priority.

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Somatosensory Impairment

Somatosensory ImpairmentWhat is somatosensory impairment?

Somatosensation refers to the sensations arising from the skin. These sensations include the ability to feel light touch, localize a touch, discriminate temperature, identify an object through the sense of touch (somatosensation), discriminate the sharpness of an object, and the ability to feel pain. Somatosensory impairment refers to any type of impairment that affects one’s ability to effectively and accurately process input received from sensory receptors in the skin. Somatosensory impairments can occur in any part or area of the body.

What are some symptoms of somatosensory impairment?

Symptoms vary widely depending on the severity of condition, injury, or impairment. Some symptoms include tingling, numbness, pain, inability to recognize the position of a limb in space or decreased sensation in one or more areas of the body.

How does the condition progress?

Depending on the cause, somatosensory impairment can be an acute condition lasting a few days or a chronic condition that lasts several years. Some conditions that cause somatosensory impairments include stroke, cerebral palsy, nerve injury or laceration, and nervous system disorders (like brain or spinal cord injury).

How can I help treat my child’s somatosensory impairment?

Treatment techniques may include, but are not limited to, surgery, physical therapy, and occupational therapy to enable the body to interpret, discriminate, and detect sensations to the skin in a more efficient and accurate manner.

Our approach at North Shore Pediatric Therapy

At North Shore Pediatric Therapy, our specialists believe that the most beneficial treatment approach begins with an accurate and thorough assessment of current abilities to perceive somatosensory information. Next, an individualized treatment plan will be created, incorporating somatosensory re-training techniques, including, but not limited to, massage, direct visual and verbal feedback, constraint-induced movement therapy, and the most relevant evidence-based practices.

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Oppositional Defiant Disorder (ODD)

What is Oppositional Defiant Disorder?

Oppositional Defiant Disorder is a neurological disorder thought to be caused by a combination of Oppositional Defiant Disorderbiological, psychological, and social factors. ODD tends to occur in families with a history of Attention Deficit Hyperactivity Disorder (ADHD), substance abuse disorders, or mood disorders such as depression or bipolar disorder. Brain imaging studies also suggest that children with ODD may have subtle differences in the part of the brain responsible for reasoning, judgment and impulse control. Psychological studies have demonstrated that children who display aggressive behavior have trouble accurately identifying and interpreting social cues from peers; specifically, aggressive children tend to see hostile intent in neutral situations. These children also generate fewer solutions to problems and expect to be rewarded for their aggressive responses. Lack of structure or parental supervision, inconsistent discipline practices, and exposure to abuse or community violence have also been identified as factors which may contribute to the development of ODD.

What are some symptoms of ODD?

Some symptoms of ODD include:

  • A pattern of uncooperative defiant and hostile behavior toward authority figures
  • Loss of temper
  • Arguing with adults
  • Actively defying adult rules
  • Refusing adult requests
  • Deliberately annoying others
  • Constantly procrastinating
  • Fussy, colicky, or difficult to soothe as infants

How does ODD progress?

For many children, Oppositional Defiant Disorder does improve over time. Follow up studies have shown that the signs and symptoms of ODD resolve within three years in approximately 67% of children diagnosed with the disorder. However, research has also shown that approximately 30% of children with ODD eventually develop conduct disorder. The risk is three times greater for children who were diagnosed at a very young (i.e. preschool) age. Preschool children with ODD are also likely to exhibit additional disorders several years later, including ADHD, anxiety, or mood disorders. Studies seem to point to the fact that approximately 10% of children diagnosed with ODD will eventually develop some form of personality disorder, like Anti-Social Personality Disorder.

How can I help treat my child’s disorder?

There is no single treatment for children or adolescents with Oppositional Defiant Disorder (ODD). The most effective treatment plan will be individualized to the needs of each child and family. Specific treatment modalities may be helpful for a particular child depending on his or her age, the severity of the presenting problems, and the goals, resources, and circumstances of the family. Treatment must be delivered for an adequate duration (usually several months or longer) and may require multiple episodes either continuously or as periodic “booster” sessions. Treatment will often include both individual therapy and family therapy. Cognitive Behavioral Therapy can help children control their aggression and modulate their behavior. Social skills training has been effective, when coupled with other therapy, in helping children smooth out their difficult social behaviors that result from their angry, defiant approaches to rules. Social skills training incorporates reinforcement strategies and rewards for appropriate behavior to help a child learn to generalize positive behavior. Treatment may also include the use of medication–although medication alone would rarely be considered an adequate or appropriate intervention for children with ODD.

Treatment for children with Oppositional Defiant Disorder includes an individual approach in the form of problem-solving skills training and family interventions in the form of parent management training. An individual approach can be created specifically for the individual child’s needs, geared toward his age, and focused on helping him acquire new problem solving skills.

Our approach at North Shore Pediatric Therapy

At North Shore Pediatric Therapy, our applied behavior analysts will conduct evaluations in the real-world settings in which your child’s inappropriate behaviors are occurring. The behavior analyst will observe what precipitates the aberrant behavior and the consequences that follow. The analyst will then determine the function of the behavior and teach your child an appropriate replacement behavior which serves the same function. A specific behavior plan will be written and a systematic reinforcement schedule will be implemented to consistently reinforce the appropriate replacement behavior(s) and the decrease in the aberrant behavior(s).

(Source: American Academy of Child and Adolescent Psychiatry)

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Gross Motor

Gross Motor Skills


What are Gross Motor skills?

Gross motor skills involve the coordination of large muscle groups in the body to perform movements such as walking, kicking, sitting upright, lifting and throwing a ball. Muscle strength and neurological development are two contributing factors to achieving gross motor milestones.


download-a-free gross motor checklist

Check out this infographic about Gross Motor Skills Milestones


Click on the image below to view the entire infographic. Once opened, you can use the zoom tool in the upper right hand of the viewing window to increase the size!

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What are some symptoms of poor gross motor skill development?

Children with poor gross motor development may demonstrate problems throwing and catching a ball, riding a bicycle, climbing stairs or walking appropriately. If a child’s gross motor skill development is delayed, he may demonstrate clumsy movements which signals low muscle tone.

How do I know if my child is progressing normally?

Parents are often concerned about whether or not their child is growing appropriately for his age. Children grow and develop in stages and, generally, maturation occurs from the ‘top down’–the neck muscles strengthen first, the neck then gains strength, enabling the child to hold up his head, the shoulders then strengthen, then the upper arms, and ultimately the child gains hand control. Following hand control, a child gains trunk control, followed by the hips and pelvis and eventually the legs.

How do I help treat my child’s poor motor skill development?

Dancing to music is a great way to strengthen one’s muscle tone and improve motor skills. Riding a bicycle, balancing on a balance beam and playing tag can be fun ways for your child to exercise his muscles and incorporate physical activity into his daily routine.

Our approach at North Shore Pediatric Therapy

At North Shore Pediatric Therapy, our energetic and experienced physical therapists will evaluate your child’s gross motor skills and set up an individualized treatment plan which enables your child to succeed. If needed, a therapist will visit your child’s school to see how he performs physically on stairs, in physical education class and during academic time. Treatment will include a home exercise program to enable your child to take the skills he learns in our facility and transfer them into his home and school environments.

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