Author Archives: munira

Free Writing Mini-Series till 9th August, ’20

Hi Everybody.

I’m offering a free writing mini-series only for PARENTS and TEACHERS to help you learn how to identify the sensory and motor skills your child needs to develop to improve their pencil control for writing through the power of fun and connection.  

I have too often seen children being given pencil grips and writing worksheets to improve their writing, which ultimately causes stress and pain in their hands. 

I want to show a better way where we can work from the child’s foundational sensory and motor skills to improve their pencil control for writing in a way that will have a bigger impact and last longer, and most importantly, whilst preserving their self-esteem and confidence.  All this in a way that is fun for your child. 

I’d love to see as many teachers as possible sign-up for this mini-series so that we can better understand why kids are struggling.  

I hugely believe that children are not lazy or not interested in writing, and we need to dive deeper to learn why they are struggling with these skills.  

This mini-series will help you figure that out. It’s only available till 9th August.  

Sign-up above! 

Munira

How Do Paediatric Occupational Therapists Partner With Parents?

Usually, when people think about paediatric Occupational Therapy, the first thing that comes to mind is dropping your child off to see an OT who will do 1:1 treatment with them.  Sometimes parents aren’t present which means that they may not fully understand what the OT is working on with their child, and more importantly, don’t know how to support their child in their daily lives.  

How do OT’s help parents support their kids? 

At ot4kids, we have always valued working closely with parents in these ways:

  • Parents or caregivers are present throughout our sessions
  • We have regular parent-ONLY coaching sessions (similar to a teacher-parent conference but not rushed and more often) to review how things are going at home, identify areas of continued concern, understand rationale behind certain ‘behaviours’ and why certain sensory tools are effective and how to use them.  
  • Some parents do only parent consultations where they learn about sensory processing and motor skills, learn simple strategies to do with their child, and review in their OT consultations
  • Sometimes even grandparents and nannies have joined coaching and / or treatment sessions which has been so fantastic

What do parents think of 1:1 coaching sessions with their OT? 

Parents often find these consultation meetings to be the most helpful to them in understanding their child’s needs, and parenting their kids in a way that supports them developmentally and emotionally versus using traditional parenting techniques.  

How do parent coaching sessions / consultations help us (OT’s) help you? 

As an OT, I find the parent consultations really effective as:

1) parents know their child best so their input and feedback are great clues into figuring out effective ways to help their child

2) it’s important to know how the child fares in their daily lives as we want them to develop skills beyond the clinic and into their ‘real’ environments for the best impact

The aim of parent consultations / coaching

Our aim is to help reduce the overwhelm that parents can feel, and to help you find simple and effective ways in helping nurture your kids.  

My message to parents is that you know your child best, follow your gut instinct, and know that we can help you to be confident in helping your child to be coordinated, calm, and connected.  

Sign up here to learn more about parent coaching / consultation sessions. http://www.ot4kids.co.uk/occupational-therapy/parent-group-coaching-sessions

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How is Teletherapy and Working Closely with Parents Helping Kids? 

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Can you believe we have been doing Teletherapy and parent consultations for three months now?

Oftentimes, people think that OT has to be done 1:1 with an OT to help their child (and don’t get me wrong, direct treatment is really important and helpful).  Thanks to COVID-19, it has been absolutely amazing to see both parents and kids thriving.  Kids are calmer and building relationships, developing their motor skills, and problem-solving during play.   Parents are understanding their child’s ‘signs’ and needs, and as a result, figuring out what to do coming up with great strategies to support their kids.  

It has been a highlight building relationships, joining forces with parents, and having an impact in the kids’ natural environments. 

How do Occupational Therapists do Teletherapy?

Teletherapy sessions have taken a combination of two forms: 

  1. Directly working with the child via the parent 
  2. Indirectly by meeting only the parent and reviewing videos of child between sessions

What lessons have we learned (i.e. benefits gained) from teletherapy during COVID-19? 

Less is more

Kids have made great progress with what they have at home.  

Parents have been nicely surprised how much we are able to do with what they have at home, and as a result, they are more able to incorporate sensory strategies or motor activities into their days.  In many ways, I have found that children have made even more progress during their intensive blocks as we are so much more focused on certain areas and we use what they have.  

Empowering parents

For me, I have loved building relationships with the parents, and tag teaming with them to support their families and kids.  I feel that this has also been key to the progress we have made in sessions, and the support the parents feel that they are receiving.  Parents are empowered knowing that they can help their kids using their own hands and ideas.  

Learn by doing

I learn by doing things myself. 

These parent consultations and virtual sessions have enabled parents to ‘do’ with their kids themselves, and become confident in their own abilities to support their child.  Being mum to my 8-year old, I know how important this is.  

New future plans? YES!

So far, many families want to continue in this way to some capacity, and I’m fore-seeing positive changes going forwards in how we provide OT via supporting parents, whether it be directly, indirectly, through trainings and coaching, or a combination.  

Get in touch to discuss how tele-therapy can help your child.   

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Sensory Chalk Walk Obstacle Courses

Lockdown has finally given us the impetus to create some Chalk Walk Obstacle Courses for our neighbourhood.  (See video examples below.)  I’ve always wanted to make these, and now that we have started, my son loves making them too.  

People often think these chalk walks are difficult to make, however they’re so fun and you can involve your kids in making them too.  We have now made a bunch of these during the past couple of months, including for younger and older children.  

We have done very simple ones by going down our street drawing designated areas for ‘dancing,’ being ‘goofy,’  doing ‘silly walks,’ and drawing Hop Scotch grids which even the older people on our street have loved doing.  

How chalk obstacle courses develop sensory processing and motor skills: 

  • FUN while social distancing!
  • gross motor skills
  • body and spatial awareness
  • balance and coordination
  • motor planning skills to create, plan and execute 
  • fine and visual motor control 
  • organisational skills
  • emotional regulation 

TOP TIP:  Check the weather before you draw out your chalk course.  We learned the hard way as it sadly rained the day after we made ours a couple of times. 

How to create and arrange a chalk walk obstacle course, keeping your child in mind: 

  1. Start with a more intense, heavy work component such as jumping or doing press-ups
  2. Next, do a balance and / or challenge task such as walking along a wavy line or jumping and turning
  3. Have a high energy component (running on the spot for a minute, running for the home stretch)
  4. a mindful calming section (e.g. blow out the candles, sniff the flowers, sing a song, or unscramble letters to words, or say affirmations).   

Although do just have fun, follow your child’s lead and get them involved in creating these.    

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Chalk Walk Obstacle Course Examples: 

Here are several examples that my son and I have done for our neighbourhood.  Do share your ideas.  We’d love to see them. 

 

Shop Local – Occupational Therapists in Southfields

 

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The Southfields Grid Association has put out this list of local businesses to particularly support during these times.  I’m so grateful to them for including ot4kids on there, and for living where we do. 

My husband and I moved to Southfields 9 years ago when I was pregnant with my son.  I needed a work balance shift as I developed Hyperemesis and couldn’t travel anymore so my husband had this great idea of building a ‘house practice’ with a clinic where families could come to me in a cozy environment.  At the same time I wanted more time with the baby as he’d grow up.

 This was the beginning stages of two babies, my clinic and my child. 

We passed by Southfields when Riverford, our local veg box scheme, had offered a free dinner nearby.  It was soooo delicious.  We were immediately drawn to the ‘village’ because of its quaint family feel, small independent shops, and ease of reaching the city centre.  I never heard of Southfields before this.  For those who know me, you know my heart is in my stomach so this sequence of events is not at all surprising.  🙂

As we have our own independent practices, we have always tried to support local businesses which in return means supporting local families, our community, and more jobs.

I always recommend local cafes and shops to families who come to see me.  We have so many great places nearby including:  Chanteroy, the french deli for amazing sandwiches on freshly baked baguettes, Salt and Pepper for super friendly company and local grown homey food (we love their tapas), our local fruit and veg shop, Chalk for cards and stationary, Drop Shot for coffee, De Rosier for hot chocolate and deserts, Thai restaurants, optometrists, a physiotherapist, an osteopath, and so much more.  

To support locally, check out their listing here

Click here to follow ot4kids’ blog. 

 

Movement Breaks and Programs while Staying At Home

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We have been Staying At Home for 5 weeks.  We know because we have stuck it through to our 6th week doing PE with Joe now.   We usually have a very active week with swimming, yoga, skateboarding, and parks.  Currently, our top two activities have been moving and crafting.  

My son is lucky to have access to OT swings since I run a clinic from home.  For others, this is a great time to explore getting either a Gorilla Gym doorway set (stays in place via strong suction) or the Rainy Day Indoor Playground (has 4 small screws to stay in place in the doorway) with swings and trapezes. 

Below are also some movement programs and videos that suit individual children. 

PE with Joe, Mon to Fri, 9-9:30, is very popular and we do this daily.  It is challenging and great for certain children …and parents. 🙂  Joe also has shorter videos for children.  

Group HIIT’s for children are great for those who need more intense sensory and movement breaks, particularly during this time where we are limited to home.  

The Kids Coach -These are really good short fitness videos developed with an Occupational Therapist

Cosmic Kids Yoga is a wonderful program where yoga is completed to familiar stories children love, such as Frozen, Minecraft or Star Wars.  She also has a wonderful Zen Den videos to support mindfulness in children, and Peace Out relaxation for kids programs.  

GoNoodle is a fantastic program I’ve recommended for years, filled with movement and brain breaks that can be searched through by school grade.  

The Little Gym UK has put out some nice children’s gymnastics videos by age ranges from infants and toddlers, to  younger and older children.  

Andy’s Wild Workouts are also lovely, slower paced, interactive, and shorter, run by Cbeebies.  These are great for younger children. 

For children who like to dance, there are many dance options right now with Zumba Kids, samba with Oti Mabuse live on Facebook everyday at 11:30, and ballet with Royal Opera House.  I have been doing Movement Warriors with my 8 year old son for the past few weeks and it has not only been great fun but really nice to be connected and doing something joyful and tricky together.  

I’d love to hear if you have found any movement games, activities, or programs you enjoy. 

 

Helping Kids Understand COVID-19

It seems that some children are concerned when they’re going to see their friends and grandparents as time has been settling in.  It’s so hard to know what to tell our kids.  Many great stories, videos, and resources about COVD-19 have been popping up to support children.   

Here are some: 

Time to Come in Bear:  A Children’s Story About Social Distancing

Sesame Street Coronavirus Town Hall – The awesome Sesame Street had an amazing program with doctors explaining COVD, hand washing, and making masks; how to deal with big feelings; and tips to stay healthy.  

BrainPOP

ROBert using Playmobil 

Authors of The Gruffalo have written this free book about COVD-19, mores for older children.  They also have these lovely re-imagined cartoon images from their most loved stories, to help children understand the current situation.  

Great social stories by Autism Little Learners on wearing masks, social distancing, why schools are closed, and more. 

And for children who need a social story to help know how tele therapy will work, this story can easily be adapted.  

Teletherapy Paediatric Occupational Therapy

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We have now been in lockdown for about three weeks.  Like many families, mine is also finding a new routine.  My 8-year old son and I have been doing ‘PE with Joe’ every weekday, trampolining in the garden, drawing sensory chalk walks outside, and crafting.  It has been lovely spending time together and having time to do things we ordinarily wouldn’t.  This slower pace of life is growing on us.

I’ve now been doing teletherapy, virtual Occupational Therapy sessions, with local families for a few weeks.  The OT community worldwide has been brilliant.  Thanks to technology, we have had many Zoom Catch-ups to share ideas, learn from and support each other. 

I work with amazing families and it has been great to see how well Teletherapy has been working for all of us. 

Families have said that the sessions are different to 1:1 clinic sessions, yet they are valuable and they like using what they already have at home in new and creative ways. 

Parents also feel good that they are the ones doing the handling, modifications, and putting the session into action, and the online sessions have ensured we keep progressing. 

Some families were hesitant to give teletherapy a go as they weren’t sure if it would be effective, however they’ve also been surprized how well their children have adapted to the new way of OT and are enjoying a new routine.  It’s been helpful to see family’s home space, come up with sensory strategies and obstacle courses using what’s at home, and more easily address skills that happen at home. 

For children who need preparation, this social story has been helpful and can be adapted.  

Overall, during these unpredictable and unsettling times, it has been so heart-warming to be connected with the children and their families.  I’ve finally been able to ‘meet’ their siblings and pets which is definitely a fun bonus.  It’s also been exciting to have another way of delivering therapy and partnering closely with parents, whilst providing an effective and valuable service. 

I bet that teletherapyteletherapy will be opening many doors down the road for working with families and team members. 

Teletherapy / Telehealth OT Sessions

 
 
I have been providing Telehealth Occupational Therapy sessions for families from abroad for a while.  However, due to the implications of Coronavirus, ot4kids is moving over to provide increased Telehealth (virtual) sessions.  I hope that this post will answer some questions regarding TeleTherapy and OT for your child. 
 

What is Telehealth or Teletherapy?  

 
The Occupational Therapist will guide the parent and child through their session ‘live’ in cyber space.  E.g. Skype, FaceTime, Zoom, Google Hangouts. As such, the parent or caregiver must be available throughout the session time. 

What to expect from a tele therapy virtual OT session

Telehealth sessions will differ from actual sessions with your OT, however, it will be valuable. 
 
The parent or adult must be present to support the child throughout the session. 
 

Before your teletherapy Occupational Therapy session:

Your OT will confirm details regarding which platform to use to connect, a plan of activities and goals for the session, share any necessary handouts, and advise on where to conduct the session as well as what toys and supplies to keep ready.  

During the teletherapy Occupational Therapy session: 

  • your OT will catch up with you and your child, review progress and goals
  • parents may request support regarding specific skills that take place at home (e.g. dressing, eating, organisation of the room, toys or games, setup and size of furniture).  
  • The OT will demonstrate and explain the activity, guide the parent or caregiver on how to set up and implement the activities for the session, listen and observe how the activity is completed by the child, and basically, work through the parent to support the child.  
  • The OT will likely ask the parent questions, problem-solve, demonstrate or explain how to change or modify an activity, and provide guidance and feedback as needed. 

At the end of the teletherapy OT session:

The parent and OT will provide feedback of the session, discuss strategies and hom
ework to incorporate into daily routines at home, and make a plan for the following session.  

Pros of telehealth OT sessions

-Convenience of having OT at home, anywhere in the world
-Helpful to get ‘real-time’ support to tackle what matters the most to families in their home
-Good to use the child’s own toys and resources
-Parents get to learn how to implement activities and support child’s needs by actually implementing the session.  As such, it allows more opportunities for carryover on a daily basis. 
 
For families whom tele therapy is not an option, we are offering video consultations with parent coaching /consultations, home programming, and follow-up support and check-ins accordingly.
 
For new children, although we aren’t able to complete a full assessment with testing, we are providing screenings where we can observe how the child does on specific tasks, parent consultation, and basing tele therapy sessions from there.  
 
Despite this difficult situation, we are so fortunate to have technology on our side.  Please speak with myself or your therapist so we can figure out how best to keep supporting your child.   
 

Benefits of Yoga for Children in Occupational Therapy

Last year at this time, my husband, then 2-year old and I visited Copenhagen, Denmark for 9-days. Not a holiday. I attended Sonia Sumar’s course, Yoga for the Special Child. It was my first course after becoming a mum and first time away from my son for the entire day. He had fun with his dad, and I had fun doing yoga, meditation (well, trying) and relaxation everyday. It felt like a retreat. 🙂

Sonia Sumar is an amazing teacher with lots of personal wisdom to share. I have never taken a course that wasn’t offered by an Occupational, Physical or Speech Therapist. I had no idea I was going to learn about chanting, meditation, and lots of life lessons from Sonia versus just yoga (body) exercises. It has been as good for me as it has for my son and kids I work with.

A year later, I regularly do my own yoga routine learned in the course and have felt stronger, healthier and more energetic overall. The kids and my 3-year old love it too.

There are so many benefits to yoga but some of them are:

-calming and grounding

-chanting helps with calming, joint attention and engagement, auditory processing

-breathing alongside movements encourages children to breathe while moving (many children who are weak tend to hold their breath while doing motor tasks as they are using their diaphragm, a breathing muscle, to hold their body versus to breathe)

– builds an emotional connection between yogi and student

-yoga poses build core strength, body and spatial awareness, balance and motor planning skills

-yoga flow – a sequence of yoga poses that connect from one to another – build rhythm and timing, fluidity of movements and sequencing skills

-incorporates of breath and movement of eyes whilst doing the yoga poses

-kids learn how to calm and find a ‘quiet space’

-deep relaxation – it’s amazing how many of us can’t still our bodies or minds to relax. I’m still working on this myself and it’s a tough one.

For more information, check out:

Yoga for the special child

For those who are in or near London, check out the work of MahaDevi Yoga Centre

You can also learn more from the Yoga for the Special Child Book

Om Shanti Shanti. (Peace peace peace)

 

OT for Babies – Never Too Young

Parents are often surprized I work with babies. I usually hear ‘aren’t they too young’ or ‘what do you do with a baby?’

Babies are always learning new skills and reaching new developmental milestones. As everybody says, they do mostly feed, poop and sleep, but they also, move, play and interact. These skills all develop from birth onwards.  An OT experienced in working with babies can evaluate which foundational areas the baby is struggling with and how to improve them

Here are three scenarios:

1) When a baby struggles with feeding, we would assess their tolerance for touch with their body and in their mouth, oral motor skills in their mouth for nursing or eating foods, muscle control in their core / neck / shoulders, and their body alignment and positioning for feeding.  See more here.

2) If a baby has a flat spot on their head or turns their head to one side (plagiocephaly or torticollis), we assess their core strength, body awareness on the weaker side, motor planning, eye movements, jaw alignment and oral motor skills, which muscle groups are weak or tight, tolerance for movement and motor skills using both sides of their body.

3) Another common scenario is when the child is described as a ‘lazy baby.’  Usually there’s a reason for this.  They may be sensitive or fearful of movement, have difficulty figuring out how to move their body, or have weak body strength and stamina.  Sometimes the baby could have a lower state of arousal and need more sensory input (touch, muscle / joint and / or movement input) to rev up their engines the so they feel the urge to move and play.

When we explore deeper, there are underlying areas we can develop. And as babies are changing and growing so fast thanks to brain plasticity, they have amazing potential to progress at a faster rate. Early intervention helps.

Babies whom I treat usually may have:
-Plagiocephaly (flatness on head)
-Torticollis (turn or bend their head to one side)
-Avoid moving to one side of their body
-Don’t use one arm or leg
-Dislike being on their tummy
-Have difficulties with breastfeeding or transitioning to foods
-Appear colicky or are described as a fussy baby
-Sensitive to sounds or being moved
-Not meeting motor milestones
-Feet tend to turn outwards
-Born prematurely so need extra help to catch up
-Have diagnoses such as Down’s syndrome, Cerebral palsy, Hemiplegia or other genetic syndromes

If you have any concerns about your babies’ development, feel free to contact me to have a chat and discuss further.

For more information:
Sensory and motor developmental milestones month by month by Pathways Awareness:

http://pathways.org/milestones/

What does a baby OT assessment with me look like?

http://ot4kids.co.uk/baby-evaluations-never-too-early

Infant red flags for sensory processing difficulties

http://ot4kids.co.uk/babies-early-signs-how-do-you-know

Baby Owned Movements

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Baby Owned Movements

My son crawled at 9 months, sat at nearly 10 months, and walked at 16 months. According to developmental charts, his sitting and walking are considered to be within the later range of ‘normal.’  Charts indicate that babies sit at six months when placed in sitting by an adult.  The baby does not own that movement of sitting by being able to move in and out of positions. Most are actually stuck in sitting and struggle to get ‘unstuck.’

When treating babies, my main goal is for them to figure out and plan how to move their own bodies in and out of rolling, sitting, crawling, standing and walking. For example, to stand, the baby must be able to get onto hands and knees and push off the floor into standing. To cruise along the sofa, they need to crawl up to the sofa to pull themselves up and then cruise.  I do not put babies in positions that they cannot get into themselves. There are so many benefits to this including:

1) Baby uses their own muscle strength to get into a position versus being forced to hold a position that their body can’t handle which can lead to muscle strain or locking joints for stability.

2) Develops body and spatial awareness. As the child uses their own body (muscle and joint) sense to get in and out of positions, they develop an innate body awareness and sense of space around them. This is much safer as the child can get their own body not only in the position but ‘unstuck’ to get out of it. When placed in a physical position by an adult, they aren’t required to use their own body sense to move.

3) Develops motor planning skills – the baby has to come up with the idea to move, plan how to move their bodies, and then make the move. These skills are so important for motor planning and the beginning to problem-solving, sequencing, and figuring out how to do new things – all skills children need for pretend play, being independent and school projects.

4) Increases balance – by completing movements actively themselves, balance and confidence improves. Active movement develops ones movement sense and stability more than passive sensory input.  The movement system has strong links to one’s ability to calm and self-soothe, be alert and focused and much more so it’s a good one to strengthen.

In my professional and personal experience, I find that children who can move in and out of positions on their own versus being placed in positions are more safe and stable, have better posture and are less slumped over, more flexibility and variation in their motor skills, less sensitive or fearful of being moved, and are comfortable getting in and out of different positions.

As a paediatric OT, I will use sensory processing, Neurodevelopmental, myofascial, socio-emotional or play-based strategies to help the child develop the skills they need to be flexible and functional in their motor skills so they own their own movements, and can be more safe and independent in their play.

Here are some other interesting reads on this subject:

http://mamaot.com/2013/07/14/to-sit-or-not-to-sit-developing-functional-sitting-skills-in-babies/

http://www.janetlansbury.com/2012/04/sitting-babies-up-the-downside/

http://www.janetlansbury.com/2009/12/dont-stand-me-up/

http://www.janetlansbury.com/2011/03/9-reasons-not-to-walk-babies/

Sensory Swings Pre-Made Part 3/3

 
 
 
**Disclaimer:  The following are just ideas and must be used at your own discretion for safety.  Please be sure to use appropriate soft padding, measure for size in your space, and most importantly, provide supervision for your child’s safety.
 
I’d love to have more DIY skills or even a little workshop to build toys and equipment. But alas, I often resort to Amazon!
 
I’ll share some swings, trapezes and other equipment I’ve purchased from Amazon or local shops that kids really like.
 
Firstly, I’ve bought carabiner hooks and rope from a local outdoors climbing shop.  Make sure the carabiners will hold the amount of weight for your child to safely swing.  When looking for rope, consider whether your child will do better with static rope which has no give and will be less unpredictable, or dynamic rope which has some stretch and bounce to it.
 
 
If your child responds to spinning input, a rotary spinner can be found on Amazon.  This is what I use at ot4kids’ clinic:
 
I have also used aerial yoga ‘daisy chains‘ to help adjust the swings either higher or lower if kids need their feet to be close to the ground.
 
Here are some ideas of swings and trapezes from Amazon:
Please note I have included affiliate links below so do receive a little £, however all proceeds go to charity.
 
For hanging and climbing:
Twizzler – this is a fun one that also spins
 
Trapeze with gymnastic rings for hanging by arms and also hanging upside down.
 
Crow nest swing seat – add pillows and blankets here for nice calming deep pressure input.  It appears very similar to the IKEA Ekorre Swing.
 
Hammock swing – There are many different varieties and although I often suggest to parents to go to the fabric shop and feel the material and how stretchy it is (if your child likes bounce, a stretchy one may be great, if they need a calming space, a less stretchy lycra one may be more suitable). I have both a lycra hammock and a Yogapeutics hammock which has no-give for different situations.
 
Flexible Swing Seat – Try this one from different positions such as laying on tummy or sitting forwards or even sideways
 
 
Tire swing – for sitting or standing
 
Nest Platform Swing – This swing looks like it could be used from different positions similar to a platform swing, albeit, not the same. Perhaps a more economical option if you struggle with DIY like myself.
 
 
 

Homemade Sensory Integration Swings – Part 2 / 3

 
 
**Disclaimer:  The following are just ideas and must be used at your own discretion for safety.  Please be sure to use appropriate soft padding, measure for size in your space, and most importantly, provide supervision for your child’s safety.
 
 
This time I thought I’d share more on how to make some swings.
 
In my clinic, I mostly use my homemade platform and hammock swings.  Personally, I love the hammock swing after a long day and my toddler would love to nap in it.  I wish I were a bit more handy and could actually sew, I’d create a lot more.
 
Here are some ideas to guide you to make homemade swings:
 
1) Platform Swing –
 
If you’re into DIY, you could make this. Here are a few alternative ways others have made their platform swings.
 
 
 
 
2) A Hammock Swing
 
This one is so easy to make and requires no sewing or tools.
For mine I bought 4 yards of Lycra material from Fabrics Galore on Lavendar Hill in London.  I tied a knot on both ends through a ring and then attached it to my swing ropes. Here are some other more detailed guides.
 
 
 
I’d love this one!
 
3) Inner Tube Swing
I don’t have one but kids I previously treated loved playing bumper cars with these at my first job in California.
 
 
 
4)  Taco Swing
This is on my wish list along with a homemade bolster swing. It looks relatively easy to make if only I could sew.
 
 
Next blog post, I’ll share some of the swings easily available locally.
 

Installing Sensory Integration Swings – Part 1/ 3

 

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**Please note all ideas shared in this blog post are to be done at your own risk or discretion. It’s recommended to have an engineer or contractor assess your ceiling structure to determine whether it is safe and sturdy.

During OT sessions, parents often want ideas they can replicate at home, especially activities their kids really enjoy.  Swinging often falls in this category.
 
Part of classical sensory integration therapy includes using suspended equipment and therapeutic swings. Although there are lots of other effective and fun ways for children to get movement input without swings, swings are an option for the home.
 
The following are some ideas of how to install a swing for your child at home:
 
1) CEILING
 
Here is a great resource explaining different ceiling hooks. This is where an engineer or contractor will help.
 
 
Nice step by step directions from the DIY Network:
 
 
This blog post is written by a parent describing the process:
 
 
 
 
2) DOORWAY
 
This is a good alternative if you can’t access a ceiling for swings, especially if you happen to have a double doorway. 🙂  Prior to my current clinic space, I used the Rainy Indoor Playground Support Bar, however now am fortunate to have a larger area.
 
See how these two parents have used their doorway for swings:
 
 
 
I can personally recommend the Rainy Indoor Playground Support Bar. It’s so easy to install and if you move or rent homes, the holes from the screws can very easily be patched up.  For those in the UK, it can be purchased from Sensory Direct here:
 
 
Many parents have also installed a pull-up bar in their doorway from which they’ve attached a swing or trapeze.
 
 
 
For those in the US, there’s an Indoor Gym which I haven’t tried but looks interesting.
 
 
 
3) LOFT BED 
 
I’d love to do this when my son is ready to sleep in a loft bed.
 
 
 
 
4) A STRONG TREE!
 
My neighbors are so lucky to have a great tree from which they’ve hung a cool IKEA swing for their kids. If you do too, consider attaching swings there.
 
Here’s a tree swing kit on Amazon.
 
 
For all of the above ideas, be sure to put down an old mattress, crash pad or gym mat under and around the swing for safety.
 
Happy Swinging! 🙂
 
Munira

Happy 2015!

We usually visit family in Canada for the holidays. It’s a nice way to come back to London feeling refreshed and relaxed. It’s also always exciting to hear about everybody’s holidays, and see the new things the kids I work with are up to after a break.

As most families know, I usually return to London with new goodies for my OT sessions. Last year, it was the PeaPod and Ziggle which have been great except that my PeaPod received a lot of love and ripped already.

This year I’m really excited about these items:

1) An aerial yoga hammock swing from Yogapeutics – it looks and feels lovely.  Can’t wait to relax in it myself and try some new moves in it.  I know my little guy will love it too.

2) Air-lite bolster swing from Fun and Function – I was planning to make a bolster swing but these kind of projects take a long time especially when you have a little one and aren’t as handy in the DIY department. This one looks to be easily portable and just the right challenge I’m looking for.

3)  Dreampad by Integrated Listening Systems – I’ve been wanting to try this for myself, my son and kids I work with.  Hoping it will help with sensory regulation, calming, and sleep.  You can read more about it here.

4)  New CDs for my Therapeutic Listening Library

Sometimes I’m not sure who is more excited about the new games, me or the kids! 🙂

Wishing all of you a Happy New Year filled with peace, joy, light, prosperity and fun.

Munira

Breastfeeding & Sensory Processing Difficulties

BREASTFEEDING AS A THERAPY

This is my first blog post in perhaps two years!  I’ve been pretty busy with my now-toddler-then-baby but this is a topic very close to my heart. I lived it and breathed it for a whole year which is how long it took for my little guy, M, to become ‘functional’ at breast feeding. It is also something that many of the families I work with have or do struggle with so I wanted to share our story.

Here’s our abridged story.

Following birth, M immediately struggled to latch on and nurse. He was only 2.2 kilos so we were kept in the hospital for a few days. We received a lot of advice from the midwives of which all were conflicting and really, although my Occupational Therapy head knew better, my new-mum head was a bit overwhelmed and second-guessed myself. I always tell parents to trust their own gutt instinct.

Some feeding difficulties my son had were:

-Gagging (I hated it when the midwives or GPs would say ‘big mouthful’ and to put a lot of breast in the baby’s mouth. This did not work for my baby who was sensory defensive and couldn’t organise his body, let alone his mouth)

– difficulty latching on

-struggled to mould or ‘snuggle’ during feed and other times

– hiccups, gasped for air, guzzled liquid down while bottle drinking

– difficulty getting in a rhythm of suck swallow breathe

– took over an hour to feed

– struggled to move one side of his face, tongue, cheek, lip

– lopsided wonky smile (one side didn’t turn up or move), drooled only on one side, preferred feeding on one side

– jaws seemed to wobble

– held up his head from birth (yes, this is a red flag as he had tightness in his neck and back muscles which led him to always lift his head and arch his back. He could not relax at all when on his back. This position also brought his tongue back so he couldn’t bring it forward to latch on and suck /swallow.)

Our Team:

I contacted a speech feeding therapist of mine whom I hugely respect at day 3! We were so fortunate to have her support as the NHS speech therapist said there’s nothing to do until M eats foods. Not only couldn’t we wait but I knew better. Please know this is so not true. It was important to strengthen and develop M’s jaws, cheeks, lips, and tongue so he could nurse and later, eat foods and talk.

At 4 months, we saw an osteopath I’ve known and worked with. She worked with M using a classical approach, loosening and mobilising tight areas, so he could be more comfortable in flexion and move his body forwards, ESP his tongue. She also worked on his gutt mobility so that his body could best absorb nutrients, digest, pee and poop.

A craniosacral therapist who treated me saw M and worked wonders on his cranial system so he could be less sensitive, relax his body, and again, bring his neck and tongue forwards for nursing

A Jin shin Jyutsu therapist worked with M on relaxing his body via different Asian flows.

I, OT mummy, worked with M to become more comfortable with touch, movement, and sounds, develop his body awareness to move with more flexion and be able to bring his head forwards, move smoothly in and out of positions, and coordinate both sides of his body versus only move via one side. We also worked on positioning M’s body so he could be more comfortable with feeds. Once his body was more comfortable, his mouth followed suit.

The oral motor therapist worked with us on different feeding positions for myself and M to support his breastfeeding needs, supporting and strengthening his jaw, how to strengthen the oral muscles using specific, targeted exercises on the tongue, cheeks, lips, and jaws.

Private DAN doctor inspired by Asian medicine – He confirmed he wasn’t concerned about weight and size, continue with breastfeeding versus formula, but was more concerned about gutt absorption of nutrients. So he prescribed us some chinese herbal supplements, vitamins, probiotics and MCT oil which apparently is a natural ingredient already found in breast milk.

By 10 months of age, breastfeeding had finally become very comfortable.

Later speech and feeding therapy sessions worked on spoon feeding, emerging munching, eating different textures and building interest in foods, working on chewing tougher foods, and developing sounds of consonants and particularly lip sounds such as ‘m’ and ‘n.’

Using breastfeeding as a therapy gave us the chance to work on M’s sensory processing and oral motor skills soooooo many times during and before every feed.

We were fortunate to receive a lot of amazing, private support from very early on. During times, we felt desperate so also tried many ‘wrong’ things before figuring out what they worked. But as they say, it took a village and I really believe we need to support families with breast feeding challenges using a whole body and a collaborative team approach.

What did I, OT mummy 🙂 do that helped?

-Worked on sensory defensiveness, flooding M with calm, sensory input. Deep pressure input, linear movement input, building tolerance for movement in different planes using music, rhythm and predictability, heavy muscle and joint work for added proprioception to his body and mouth, and building tolerance for multi-sensory input. ‘Baby wearing’ was a huge part of our life for all sorts of positive sensory input.

-Before every feed, we did some gentle body work to build motor skills and body symmetry and encourage flexion.

-Targeted oral motor exercises for cheeks, tongue, lips, and jaws before feeds and later, when starting solids, we had therapeutic feeding strategies.

-Used straw and open cups as no concerns with aspiration, or safety of swallow.

-Positioning – Swaddling for feeds was a huge help and he relied on this till 7 months. I laid semi- reclined so M kind of ‘fell’ into me and gravity could help.

-Music –I remember using classical 90-beat Baroque music for children feeding in the hospital so we tried this too.

-Mental stuff  – meditation, imagery, positive self-talk, trying to keep the feeds happy despite it being so stressful

-Surrounded myself by like minded and positive people

 

Resources:

Kellymom.com

-An invaluable source on breastfeeding and busts so many myths.

Dr Jen 4 kids

http://www.drjen4kids.com/

www.talktools.com

Book-

Supporting Sucking Skills in Breast Feeding Infants by Catherine Genna Watson

It’s very in depth, but I love it’s team approach and whole body outlook

 

ot4kids Job Opportunities

When I moved to London 5 years ago, few people knew about occupational therapy especially for children.  There was even less awareness about early intervention (EI) and sensory integration therapies.  I had gone from having a caseload full of babies and toddlers whilst in New York City to only one baby here in London.  It was so sad to hear others say ‘wait and see’ and ‘your child will grow out of it’ especially when I had firsthand seen the difference early intervention makes for the entire family.

During my first several years in London, I spent a lot of time raising awareness and advocating for children who have special needs and developmental delays by developing my website as a resource, and writing articles for National Childbirth Trust (NCT), Families and special needs magazines.  I also held baby ‘Move and Groove’ groups with many local NCT mums groups to advocate for early intervention, encourage and show parents how to help their baby move in and out of different positions. Many parents were nervous to put their babies on their tummies.  It was great fun and a fantastic opportunity to advocate for EI.

Five years on……I now treat lots of babies and toddlers.  Although parents come to me by word of mouth, many want to start early as a means of prevention and so their child will be more ready for school and require less support.  I still treat children up to 7 years as its important to see how kids grow and what they face in their future.

I would now love to have a team join me so we can provide the best and most effective services for kids to progress and thrive in London.  I am looking for experienced and passionate therapists.  Below are some requirements:

QUALIFICATIONS:

Bachelors and / or Masters in OT
8-10 years pediatric experience
SI education and experience a MUST
Bobath / NDT knowledge (preferred)
Ongoing CPD and courses
HPC qualified
Liability insurance

SKILLS:

Evaluate and treat children with disabilities
(Cases offered based on your experience and expertise)

Must be self-motivated to keep up with continuing education, professional development, peer networks, and staying up-to-date with new information

Creative and resourceful with therapy supplies – must be able to use what’s available in homes, schools and your own therapy bag

Good communication skills with parents, schools, diverse health professionals, and the kids

Team player required to work with diverse team

Eclectic treatment approach, modern and up-to-date, SI, NDT / Bobath knowledge critical

Holiday – 5th to 25th August, ’13

Hello.

Please note that I will be away from 5th to 25th of August, ’13.  I will not have access to voicemail or text messages.  If you would like to reach me, please email me at munira@ot4kids.co.uk and I will respond within 1-3 days.

Thank you and hope all of you enjoy the rest of summer.

Munira

Babies – Early Signs: How do you know?

Does my baby need Occupational Therapy?

People often wonder how soon can you tell a baby requires early intervention therapies. I thought I’d share a little bit based on my experience with my own son and babies I treat as well as common red flags from other parents.  I hope it will help others.

First of all, parents just know!  They have a gutt instinct and are always right. Sometimes as a mum, I know it’s hard to follow your own gutt especially when others around you say it’s too early or your child will grow out of it. Please know that as a parent, you know your child best.

Secondly, babies’ main daily living activities are to move, sleep, feed, and poop. Usually, if these areas are a challenge, you will have an idea that they need some support.

For my son, I knew as soon as he was born and we were moved into the maternity ward. He was the only baby constantly crying, he had a hard time with breast feeding – struggling to nurse more on one side, startled at every sound that went by, only wanted to be on his tummy being very uncomfortable on his back, had too great head control for a newborn, and was unable to fall asleep.  Everybody, including strangers on the street, always commented on his head control (which was too good for his age because of tightness) and how alert he was (due to being in an over-stimulated state of arousal).

Babies benefit from Occupational Therapy when the following red flags are present: 

Sensory processing

– doesn’t mould their body to you when held, hates baby massage

– arches back, lifts head as a newborn (newborns should be able to turn their head and clear their airway but not hold up their head yet)

– only sleeps or soothes with intense movement input

– needs to be held all of the time

– startles to sounds easily, appears on edge or in distress, doesn’t like busy places

– very alert (as in sensitive to all sounds, sights, movements)

– difficulty sleeping, takes hours to fall asleep

– unable to tolerate sitting in car seat or stroller

– difficulty with car rides

– becomes upset when laid down on their back for diaper and clothing changes

– described as ‘colicky,’ upset or unable to settle

– doesn’t move and prefers sedentary play

– does not interact or make eye contact with parents

Motor

– only wants to lay on stomach and cannot tolerate laying on back (due to strong back muscles, weak flexors, and overall imbalance of muscles on front and back of body)

-arches body backwards

– flat spot on head, turns head more toward one side

– uses one side of body more than other side – babies do not have a hand preference or sidedness

– delayed motor milestones

– moves to one side only such as rolls or comes up to sit via one side

– tightness in limbs during dressing, diaper changes, or bathing – parents may feel arms are stiff to get into sleeves, or legs do not open for diaper changes

– motor milestones are a bit delayed

– doesn’t move, described as ‘lazy’

Feeding

– nurses better on one side or unable to nurse on both sides

– pulls away from breast

– difficulty figuring out how to latch on during breast feeding

– takes excessive time to nurse

– difficulty drinking from the bottle, liquid pooling out at sides

– drools on one side of mouth, smiles a bit wonky

– difficulty transitioning to foods, refuses to eat

– does not put toys in mouth for exploration

These are just some examples. If you have any concerns about your child’s development, please see an occupational therapist right away. Do not wait and see. Start early, there’s so much to do from the beginning versus when the child starts school and skills become ingrained. Babies are like sponges due to brain plasticity. Its really so encouraging to see how quickly they respond with the right support and early intervention.