Tag Archive for: pediatrics

Cabin Fever? Beat the Winter Doldrums

“I’m bored.”  In the middle of winter, this phrase can make any mom or dad break out in a sweat.  And a snowy winter day with children who cannot find anything to do may seem to last centuries.  A long day at home or a lengthy winter vacation is the perfect time for children to participate in fun activities that will build their skills, as well as put a stop to the classic complaints of boredom.  Coming up with creative ideas in a variety of skill areas, along with ideas for adaptations for children with special needs, can be a daunting task for parents as well.  Consider the child’s age and/or developmental level, safety, needs, and preferences to help you select appropriate activities to bust those cries of boredom!

 

Plan Ahead

To avoid being put on the spot in coming up with a fun activity when the famous “I’m bored…” complaint erupts, put together a “boredom box” with ideas from which the children can select.  Assist your child with coming up with his or her own ideas of what to include.  This can be a good strategy to use whenever your child has more ideas of things to do than time.  Include skill building activities that are developmentally appropriate and are “just the right challenge” with a fun twist so that the activity is not viewed as work.  To avoid having to scramble for materials for activities at the last minute, organize an additional “supply box” with basic craft supplies (e.g., construction paper, crayons or markers, cardboard tubes, paper plates and bags, glue, glitter or other decorations).   Consider including small craft sets with instructions, puzzles, and small travel games that are new or seldom-used.  Examine the skill categories below and adapt the following activities to your child’s skill level and safety needs.

 

Make Dressing and Self-Care Fun!

Winter break, snow days, and weekends afford plenty of opportunities for children to master the art of getting dressed, due to the extra time to get ready, and the extra seasonal clothing, such as snowsuits and boots.  If your child needs additional practice mastering fasteners, or resists getting dressed without assistance, incorporate fasteners and dressing into a game.  When multiple children are present, have a suitcase race where children don clothes (over their own clothing) as quickly as they can to win a prize—this can be done as a relay race for more than two children.  Institute a fashion show where the children can practice putting together their own outfits from old clothes (including parents’ clothing), or a doll or stuffed animal fashion show.

 

Visual and Fine Motor Skills

As visual and fine motor skills are an integral part of the school day from an early age, incorporating some of the fun activities below at home will help to boost skills

  • Make some homemade Valentines or birthday cards.
  • Write letters to family or friends on personalized letterhead.
  • Design scrapbook pages from a recent vacation or holiday to incorporate cutting, coloring, and handwriting.
  • Dust off the jigsaw puzzles, legos, lincoln logs, or travel editions of games (these have smaller parts).
  • Encourage building from a model made by a parent or older sibling, or if appropriate, building from instructions on the box. In addition to visual motor skills, word finds or crossword puzzles build vocabulary, and your child can design his or her own puzzle for someone else to solve.
  • For imaginary play, set up a pretend office with supplies such as paper clips, binder clips, old folders, or junk mail to practice manipulating common items. Get messy with squirt bottles (to spray a window or shower), hole punches, or clay tools and presses to strengthen fingers.
  • You can make handwriting fun by designing a secret code to write with fun squiggly pens, bathtub or window markers, or invisible ink markers.
  • Institute a “no-talking, only writing” time to communicate for fifteen minutes or so to encourage writing (this also might help to calm a noisy household).

 

Gross Motor Skills

After spending too much time indoors due to inclement weather, children will need to find a safe way to move around and expend some energy.

  • In a large, open area (basement, family room), provide your children with common household items, such as chairs, plastic juice bottles, a broom handle, hula hoops, or jump rope to design an obstacle course (with adult supervision for safety).
  • Hang up an over-the-door basketball hoop, or design one from a box with the top and bottom cut out to play rag basketball (from knotted up towels or t-shirts), or use a lightweight sponge ball.  Using these homemade toys or games can be more fun than purchased ones, and this will encourage their creative development.
  • If your child enjoys dance or aerobic exercise, consider renting or purchasing an inexpensive exercise or dance video for kids, use a dance pad video game, or have your own dance choreography contest.
  • Consider games from birthday parties or gym class, such as “Twister,” hopscotch (many toy stores offer foam mats), hula hoops, jump rope, “Simon Says,” or “charades” to encourage development of certain movement skills and physical activity.  By playing these games in a fun, friendly atmosphere, rather than being graded in gym class, or being concerned with winning a prize in sports, children who have difficulties with coordination may become more comfortable with motor planning.

 

Cognitive and Social Skills

We all continue to build our cognitive and social skills throughout life, establishing systems to do things and how we appear to other people; therefore, these are very important skills to practice.

  • If your child has difficulties interpreting emotions from facial expressions and body language, try body language charades (what is this person telling you?) or making an emotions collage of people from magazines with a designated facial expression or body language.
  • Practice teamwork by building something together or use an obstacle course as a relay race.
  • Work on sequencing via the oldie but goodie “follow directions game” by having children write down the directions to make a peanut butter and jelly sandwich, then have someone else make the sandwich following the directions exactly (use your *clean* hands if the directions don’t specify a knife)!

 

Sensory Skills

For children who have difficulties interpreting and processing sensory information, winter may be a difficult time to get used to seasonal changes in sensory input, and less access to outdoors (where many calming strategies might be located).

  • You can put clean snow in a dishpan or large plastic container for some table play inside to adjust to the sensation and temperature of snow prior to immersing the child in snow outside.
  • For a slightly easier to clean up sensory experience, place rice, beans, flax, or popcorn kernels into a bowl/bin/container with some of those summer sand toys!
  • Also, pull out the summer mini child’s pool, and fill with lightweight plastic balls (available at many toy stores) to create your own ball pit.
  • To create an indoor quiet area, your children may enjoy draping old sheets or blankets over two chairs to create a tent or use a large (appliance) box for a calming space with cushions or pillows for resting.
  • Children may enjoy spending a day inside making pretzels, kneading bread dough, rolling out cookie dough, or making “slime” as a tactile sensory experience.
  • Some household heavy work can be calming to children with “cabin fever,” such as pushing or pulling a vacuum, pushing a shopping cart, shoveling snow, pushing a wagon or wheelbarrow—all of these should be of appropriate size/weight (toy or regular), depending on the child’s size/abilities.

 

Seeking Expert Assistance

If your child has significant difficulties with dressing/fasteners, fine motor or handwriting skills, visual motor skills, motor planning, or sensitivity to tactile experiences, he or she may benefit from a physician’s referral for a pediatric therapy evaluation.  A pediatric therapist working in an outpatient center can determine if your child could benefit from skilled services and home exercise programs that build on these skills.

Playing with Purpose: A Pediatric Speech Therapist’s Perspective

With holidays and birthdays, come many toys that cycle in and out of your home. They come in many different brands and styles but all have the same underlying potential for developing your child’s communication skills. Here are just a few commonly found toys that I use as a Pediatric Speech Therapist with the children I work with in order to develop and expand their speech and language abilities.

 

toy farmToy Farm: This toy is loaded with opportunities for you to model early developing speech sounds to your child. Some of the first sounds acquired by infants and toddlers are made with their lips such as “b” “p” and “m”. When playing with this toy with your child, exaggerate these target sounds while modeling animal names and noises.  Some of the target words I use include: “baaa”, “moo”, “pig” with exaggerating the initial sound of each word. Try to have your child watch your mouth while you are saying these words. Allow wait time after saying a target word to give your child an opportunity for imitation.

Cause and Effect Toys: These toys come in many varieties but all have the same underlying theme.popup They are toys that allow a child to “cause” an event to occur. In the case of the pictured toy, when your child pushes a button, the window opens and an animal appears. Communication is founded in cause-effect. Even before a child learns to speak, they understand that when they cry, it results in an event. This event can be a diaper change, a feeding, or attention from their caregiver. When a child understands this relationship, the door for purposeful communication is opened.

Kitchen Set: Pretend play is a huge component of a child’s language development. It is their way of taking scenes from their environment and re-enacting them using language they hear daily. When you listen to your child play, you may hear some familiar phrases!

Kitchen play

This is a great toy for children of all ages. When playing with this toy, help your child to pretend. Model actions such as: stirring with a spoon, putting food in the oven, or turning the sink on and off. While performing these tasks, keep your language SIMPLE.  Phrases such as “too hot”, “all done”, “more please”, and “all gone” are simple beginning phrases that can be used in many situations throughout the day.

While these are just a few suggestions for your holiday and birthday gift list, there are many other options of toys and play that stimulate communication. Any toy that encourages an opportunity for interaction between you and your child is a learning opportunity!

When you go shopping, look for toys that encompass interaction. Although there are several toys on the market that light up or make noise, many of these toys only have a visual component, but do not allow your child to manipulate or physically engage in active play. Much of our early language consists of “active” words that rely on motion or position. Some of the best toys set the scene for using words such as “go”, “stop”, “up”, “down”, “in”, “out”, “on” and “off”.

Why is this type of play important? Young children understand much more than they can verbally express. Even before your child says their first word, they are acquiring and understanding of multiple vocabulary terms daily. By the age of 2, a typical child understands 200-300 vocabulary terms! This makes your task of modeling these early vocabulary terms during play that much more meaningful.

If you are concerned about your child’s speech and language development, below are a few warning signs that may warrant assessment by a Speech Language Pathologist:

  • reduced eye contact
  • disinterest for communication
  • does not respond to their name or sounds in their environment
  • frequent ear infections
  • limited babbling or verbal output
  • difficulty understanding simple commands
  • For toddlers who have speech that is very difficult to understand, resulting in frequent anger outbursts and temper tantrums

There is no “right” age for seeking help for your child’s speech and language. Speech and language development varies for every child. A child who is behind may catch up on their own without intervention, especially when developing their speech sounds. With that being said, do not ignore your parental instincts. It never hurts to seek assistance or an expert opinion.

Michelle Keenan, SLP-CCC is a Tx:Team Speech Language Pathologist treating the Pediatric population at FMH Rose Hill Outpatient Clinic. You may contact Michelle at 240-566-3132 or find out more about Speech Language Therapy go to www.fmh.org/Rehabilitation

 

Is Love an Open or Closed Door for Children with Autism?

Leslie Crawford is an Occupational Therapist with Tx:Team treating Pediatric patients in Frederick, Maryland.

 

If you are a parent of a school aged child, or have recently viewed YouTube’s top viral videos of 2014, you may have already heard Disney’s hit song “Love Is An Open Door,” from the PG rated flick Frozen.  However, with the warm sun and a plethora of outdoor activities in mid summer, the only thing with icicles in July may be your own AC unit, on the brink!

With the enticing outdoor activities summer offers and the rise of children away from their normal routines of school, it is important to raise awareness regarding wandering and elopement of children with Autism and take a minute to second guess that “open door.”  Children with Autism, or an autism spectrum disorder (ASD), are often known to wander away from safe places and familiar environments resulting in increased danger and sometimes tragedy.  Particularly in the summertime, wandering behaviors contribute to increased risks of drowning and emergency medical service calls.  Therefore, preparedness by both parents, the community and first responders is essential.

Try “walking a mile”in the shoes of a child with ASD.  If an adult were to actually wear a child’s size 4 shoe all day, they would most likely have throbbing feet by their workday’s end!  I know I would!  Think of this throbbing as the continued discomfort and hypersensitivity that a child with Autism experiences on a daily basis.  Not only may children with Autism be hypersensitive to tight shoes, but to clothing in general with itchy tags around their collars, environmental temperatures, lights, sounds and vestibular motion.

While sensory processing in the brain is quite complex and can vary from person to person, we can all agree that when we are overwhelmed by a specific sensation, it is hard to filter out the extraneous input and attend to the task at hand. If you can’t relate to this experience, I challenge you to go to your local convenience store and buy a bag of “Pop-Rocks”or sour “Warheads” candy.  Next, open the candy and place some in your month.  Now, simultaneously begin a crossword puzzle.  How long will it take you to complete this task?  Are you having difficulty?  As I place candy in my own mouth while typing this blog, my mind is concentrated on the explosion of candy in my mouth: at my left cheek, now gums, now right cheek!

To promote Autism awareness in your community, help others to identify characteristics and potential behaviors a child with ASD may demonstrate.  Aforementioned, try the simulation above with random community members to help them understand sensory integration difficulties.  Further educate the community on communication difficulties children with Autism may experience, such as their ability to accurately interpret help, or those able to help them, their ability to identify danger, and their need for extra sensory, gestural and communication processing time.  With more knowledge regarding pervasive developmental disorders, the easier and safer it will be for all involved to respond to a situation regarding wondering or elopement.  Additionally, while some behaviors may prove to be challenging during a crisis situation, remind members of the community and first responders that certain behaviors may be self-soothing to the individual, and halting this behavior may exacerbate stress and increase the present danger to a child with Autism.

If your child has ASD, I encourage you to establish a plan and be proactive in anticipation of wandering and elopement.  Alert neighbors and your local EMS squad of you child’s diagnosis, as well as provide EMS with contact information of family members to be reached in case of emergency.  Know your neighborhood and preferred places your child may like to visit.  Occupational therapists can assist children and a family establish sensory diets and strategies to manage challenging behaviors, as well as their overall health, wellness and functional independence.  Many resources are available to practitioners and parents to help plan for wandering and elopement, such as The Big Red Toolkits for caregivers, clinicians and first responders.  This resource, developed by the Autism Wandering Awareness Alerts Response Education team, helps establish safe occupational engagement in the community.  The Big Red Toolkits are available online and contain educational materials, caregiver resources, tip-sheets, social stories to help child habituate to common events.

With the appeal of water in community pools, lakes and rivers, the risk of drowning associated with elopement and wandering is highly prevalent.  Ask your community pool about sensory supported swimming classes lead by an Occupational Therapist, who can provide aquatic training techniques to instructors to interact and teach children with ASD.

In order to make our community like Disneys, “Magic Kingdom”, we must increase awareness and educate those around us of the Autism population’s needs.

 

 

 

Tag Archive for: pediatrics