Category Archives: Assessments

Occupational Therapy Assessments for Babies and Children in London at home, school, or clinic

Baby Occupational Therapy Assessments – Never Too Early!

People are often surprised that I work with babies. They wonder whether it’s too early, do all babies just develop at their own pace, or how does one work with a baby.

Fortunately we now know a lot about early intervention and milestones tell us about a child’s development. Early detection and early intervention can minimize or in some cases, eliminate issues that arise. I know this both professionally and personally as a mum to a 15-month old who has thrived due to having early intervention support from his very early days.

As they say, babies mostly sleep, eat, poop and I add, move. 🙂 If any of these baby ‘occupations’ are a challenge, occupational therapy may help.

What’s involved in an Occupational Therapy Assessment with Babies? 

Generally for infants, this is what I look at in an assessment:

  • Sensory processing skills – alertness, activity level, response to touch and movement, internal body and spatial awareness for motor skills, visual and auditory processing, motor planning and problem-solving skills
  • Gross motor skills – head control, shoulder and pelvic stability, core strength, respiratory muscles activation, arm and leg movements, and transitional movements (how the baby moves in and out of positions)
  • Fine motor skills – reach, grasp, release, object manipulation, two-handed play, eye-hand coordination, how the child moves and plays with their hands at the same time
  • Social-emotional skills – how the baby calms, self-soothes, copes with multi-sensory input and either everyday or novel experiences, relates to and interacts with familiar or new people
  • Neuromuscular development – muscle tone, strength and coordination, body alignment and movement patterns, are there any asymmetries, positioning and posture in seats and equipment at home and whether modifications are required
  • Oral sensory and motor skills particularly related to feeding and daily hygiene skills

Based on the assessment findings, we do different exercises to address areas of need. I show parents various carrying techniques, positioning and therapeutic handling strategies to develop sensory and motor skills, as well as ideas of how to address sensory, emotional, motor and play skills for the baby’s age. Parents are given a home program of exercises to complete with their baby and we address skills during therapy sessions.

Prior to the assessment, I ask parents to send me information regarding the child’s birth and medical history, services to date, general concerns, any medical reports, and a completed questionnaire. I also love to see photos of the baby in various positions to help me get to know the baby and plan for the session accordingly.

If parents are concerned about their babies’ development, I suggest do not wait and see, early intervention is critical, and better to address areas of need now versus waiting till the child is older and struggling in school.

 

 

Intensive Treatment Blocks

Why we provide an intensive model of treatment at ot4kids, London? 

Traditionally, Occupational therapists treat children 1-2 times per week, oftentimes for years.  We prefer to provide intensive blocks of treatment for children receiving OT.

Research from the SPD Foundation indicates that children actually benefit more from intensive blocks of treatment.  This is the chosen model of treatment at Lucy Miller’s STAR centre in Denver, Colorado.  I am a huge FAN of this model.

Since 2011, I have also been providing intensive blocks of OT treatment sessions followed by a break, and then another intensive block.  The frequency of the intensives vary based on the individual child and family’s situation, however they can for example run from 2-4 times per week over a 3-5 week period.  Children then have a break for 4-8 weeks followed by another intensive block of treatment.  In time, the breaks tend to be longer and longer.  The break is a fantastic time for children’s to solidify their new skills and integrate them into daily life.  During this break, kids often participate in their favourite activities whether it is going to the park, swimming, horseback riding, learning to ride a bike, cooking or having play dates.

Benefits of intensive blocks of OT treatment:

Personally, this model of treatment has been beneficial in my clinic for many reasons:

  • Due to the plasticity of the child’s brain, kids are making faster progress and skills are integrating better
  • For school aged children, intensive blocks can take place during holidays and half-term breaks
  • Families from out-of-town or overseas can access services
  • Parents find it encouraging that they can do other fun activities with their kids during the breaks and continue to see progress
  • Less burn-out from therapy and kids are excited to come to OT

OCCUPATIONAL THERAPY ASSESSMENT – What’s it all about?

Parents often wonder what’s involved in an occupational therapy assessment?  This really varies amongst Occupational Therapists based on our experience and interests, what the parents want  the child’s individual needs.  In my practice, this is how it generally goes.

 

PHONE CALL:

Initially, parents call and we have a phone conversation where they tell me about their child, their concerns and reason for an occupational therapy assessment. I prefer to talk about any sensitive topics during this time versus discuss in front of children, particularly older kids.  We then determine whether or not an assessment is necessary.

 

INFORMATION AND DATA COLLECTION:

Next, I send parents information regarding scheduling, what the assessment entails, and any questionnaires to complete. For children who are in school or have other therapists and support team members, I attempt to get as much baseline information I can prior to the assessment such as:

Birth history and medical history

Report cards

Drawings or handwriting samples

Photos of younger children in various positions to give me an idea of their motor skills

Reports from other therapists including educational psychologists, consultants, and speech therapists.

Completed questionnaires or sensory profiles by parents and school.

 

ASSESSMENT:

The actual assessment varies based on each child and their needs. No two children are alike.

For the first part of the assessment, I usually chat with the child and parent to get to know each other. During this time, the child often explores the clinic and engages in free play while I make initial observations of how they move, interact, and play. For older children, I ask about their hobbies and interests, how they find school, and what they’d like to do. Both parents and children are involved in this discussion as appropriate.

We then complete formal and informal tasks (standardized testing and clinical observations) to assess the following as it applies to the child:

-*****Child’s STRENGTHS.  This is so important as we will want to continue and encourage these in the child and also, use this to build on areas that need help. We are not trying to change the child but want to embrace them for who they are.

-Sensory processing: tactile processing, body and spatial awareness, balance, motor planning, organizational skills, does the child avoid or seek sensory inputs, how do they play with and figure out new toys

-Gross motor skills (head control, trunk control, body alignment, core strength, movement patterns)

-Shoulder and pelvic girdle stability, joint stability, upper and lower extremity strength and coordination, endurance

-Postural control, bilateral integration, rhythm / timing / coordination of movements

-Fine motor skills (reach, grasp, release, object manipulation, in-hand manipulation, 2-handed use, hand preference / dominance), eye-hand coordination

-Self-help and self-care skills

-Visual motor and perceptual skills, visual processing (eye tracking, motility, convergence / divergence, how both eyes are working together)

-Auditory processing, following directions, attention and focus

-Sensory regulation, how the child transitions, manages multi sensory input, copes with daily challenges and demands, attends and focuses during self- and adult directed tasks.

-Social skills – how the child initiates interactions, joint play / reciprocal interactions, recognizes their own feelings and how to manage them

-Organizational skills and executive functions for child’s age

-Consider adaptations, strategies, sensory supports for home or school

-Provide ideas of useful and meaningful sports, extra curricular activities and games are provided according to the child’s individual needs

 

Throughout the assessment, parents are involved and present. I provide suggestions of exercises and activities to try at home. We will try some exercises and activities together.

 

Summary and recommendations: Towards the end, we review findings of the assessment, prioritize concerns of parent and child, discuss home exercises, and come up with a plan of what to do and how to work together with the child’s home and school team.

Based upon the child and parents, the initial assessment can take from 1-2 hours.

Finding an Occupational Therapist or Health Professional

As a mum of a little guy who has needed some extra help, I know it’s hard finding the right support for your child.  Parents often ask me how to find a good occupational therapist and make sense of their qualifications.  Here are my suggestions from both personal and professional experience:

1)   ****FOLLOW YOUR GUT*****:   You will have a feeling by talking to a therapist whether they are right for you.  Personally, I prefer to talk via phone to potential therapists for my child versus emailing or texting as it has given me a good feel for them.  Also, by watching my child interact with the therapist and see how comfortable they are, I just know! 🙂

2)  BASIC REGISTRATION:

In the UK, occupational therapists must be registered with the Health Professions Council.

In the US, occupational therapists are registered with the National Board for Certification in Occupational Therapy.

3)    ADVANCED CERTIFICATIONS:

Pediatric occupational therapists can go for many higher level intense accreditations based on their special interests.  Personally, my treatments and assessments became much more thorough and effective after undergoing these certifications, resulting in faster progress.  Two main certifications to look for are:

-Sensory Integration – In the UK, there are a series of four courses offered through the Sensory Integration Network.  In the US, these courses may be offered by either Western Psychological Services or Sensory Integration International.  Have a look here to learn more.   It can take years to complete the coursework and all the requirements to pass and become certified in Sensory Integration.

-NDT (Neuro-Developmental Treatment) Certification also known as Bobath Approach.  This is an 8-week course for children with Cerebral Palsy or any motor impairment.  For me, the course was a labour of love & rather intensive.  Therapists often make some sort of life compromise to complete the certification such as temporarily moving to the town where the course is being held, or leaving their families for long periods of time.  For therapists who are NDT certified in the US, this requires a continuous process of updating information via ongoing continuing education and professional development.  You can learn more here

Personally, I moved to Chicago to complete my coursework and had a brilliant time exploring the city and enjoying stuffed pizza whilst studying during every other spare moment. 🙂

– NDTA Advanced Baby Course – 2 to 3 weeks – This certificate course can only be taken after the 8-week course above and is an add-on to specialize further into baby treatment.  I took mine in what felt like the boonies, Allentown PA, however it was completely worthwhile to have spent this time with baby guru, Lois Bly.

4)    CONTINUING PROFESSIONAL DEVELOPMENT – I would look to see that the therapist takes ongoing continuing education courses in a variety of areas.  I list most of my CPD on my ‘About Me’ section under CV for others to see how I stay current.

5)    EXPERIENCE:  What’s their experience?  How long?  Where?  What population do they work with?

6)    SPECIAL INTERESTS:   Do their special interests relate to your child’s needs?  E.G. Baby treatment, pediatrics, splinting, kinesio taping, seating and wheelchairs, assistive technology, home modifications, oral motor / feeding therapy, listening therapies, yoga, brain gym and so much more.

7)  LISTENS TO YOU:  I find it encouraging when our team members listen to and involve us.  After all, parents know their child best.

8)  CREATIVITY:  Fancy clinic equipment is great however I have seen great therapists do so much while working in a shoebox or with very little.  Creativity goes a long way.

9)  COST – Personally, I have found it so worthwhile to have fewer sessions with a more skilled therapist versus more sessions with less skilled ones.  It’s important to look at the therapist’s credentials, approach and personality to find a good fit.

 

Babies and Strokes

It’s Hemiplegia Awareness Week!

Oftentimes people associate strokes with the elderly.  Kids have strokes too, most often from a brain bleed / hemorrhage either while in the womb, at birth, or afterwards which causes tightness and difficulty using one side of their body, also known as Hemiplegia.
Red flags common for children with a stroke are:
-Inability or difficulty  using one side of body – the baby may hold their arm tightly at their side, fist their hands, or predominantly use one side.
-Early hand preference – Please know that babies are never right- or left- handed, they should not yet have any hand or foot preference.  If they do, it’s important to see a neurologist and be assessed by an OT and / or PT.
-Difficulty feeding, slurry speech,asymmetric facial features such as droopiness on one side of face or a crooked smil
-Stiffness in arms or legs while dressing or bathing
-Reaches with only one arm, head tilts to one side, body bends or cures to one side like a banana
-Delayed milestones
-Seizures
-Abnormal eye movements
-Extreme sleepiness, lethargy

 

I often hear health professionals say a baby with hemiplegia doesn’t need Occupational Therapy till they’re older and using utensils. This is a myth! Babies use their arms from the very beginning to self-soothe, find the breast for feeds, randomly move their body and then to reach for their parent’s face, bring their hands together, put toys in their mouth, push up on their arms or grab their feet. All these developmental experiences require core stability, strength, coordination, sensory awareness and more.  It is NEVER TOO EARLY.  An occupational therapist experienced with babies can help achieve these skills. This is so important because each skill creates a foundational building block for more advanced skills.

 

Infancy is the best time to intensely work with babes with neurologic impairments for several reasons:
1) Brain neural plasticity allows the best chance for change by developing new  neuronal maps and pathways for increased function
2) Develop good alignment and movement patterns from the very start so the baby can learn to roll to both sides, sit straight, crawl, walk with good balance, point, and clap their hands. Then the baby doesn’t need to compensate and only use their unaffected side.
3) Reduce chances of muscles becoming increasingly stiff over time
4) Collaborate closely with parents on handling techniques to encourage bilateral movements and incorporate exercises in a fun way into daily routines

 

The following treatments can help:
1) Baby massage – it’s calming, builds body awareness, and decreases tightness.
2) Neurodevelopmental Treatment / Bobath trained therapist.  Note that some have advanced training for babies which is a bonus.
4) Developmental play approach using therapeutic exercises to achieve milestones, ESP reaping the benefits of rolling and crawling
5) Kinesio taping, splints, orthotics, suits or compression garments to promote good alignment, posture and movement
6) Adapting daily activities and games
7) Sports and hobbies such as swimming, horse riding, gymnastics, yog
8) Baby wearing for many reasons including it’s comforting after a traumatic birth, provides deep pressure and boundaries for body awareness, movement input helps balance and is calming, and better able to promote body alignment.
9) Parent support groups – HemiHelp and HemiChat in the UK.

 

HemiHelp has a fact sheet and video to raise awareness about Hemiplegia here:

Follow Your Gut, part 2.

Mums and dads know their child best! They are their child’s biggest advocate.  In a recent post I had written to ‘Follow Your Mummy Gut’ or Daddy Gut.

Sadly, in my practice I’m often told by parents that they just knew ‘something wasn’t right’ from early on however their concerns were dismissed by their doctors, health visitors or even family members. They were often told to wait and see, let him / her (child) be a kid, or they’ll grow out of it. So, what can you do as a parent if you’re in this situation?

This article offers some great suggestions to parents including:

1) Get a second opinion
2) Keep a record of behaviours via either a log, journal, photos, or even videos
3) Research – nowadays the internet is full of resources and it can at times be overwhelming, however there are some fantastic parent groups out there with other parents who are in your same shoes
4) Don’t stop, keep asking questions and get a referral for a specialist
5) I’d like to add that if you have concerns with development, behaviour, learning, social-emotional skills, sensory processing or motor milestones, have your child assessed by an Occupational Therapist experienced in these areas right away. They can assess your child’s development, let you know how it is impacting on their functional skills and start working on these areas now versus later. It’s never to early to get help.

Follow your Mommy Gut!

I recently watched Holly Robinson Peete share her family’s story about their son who has Autism. Her story sounds so much like the stories of families I work with. I loved what she had to say as it applies to families and children with all types of special needs, not just Autism.

Follow your “mommy gut!” Nobody knows your child like you do.

As health professionals and therapists, we should be listening carefully to what parents are saying as they know their child best and in effect, are telling us their child’s diagnosis. Early Intervention is key.

Check out the video:

Early Detection of Learning Difficulties – Act Now!

Guiding Questions for Doctors to help identify signs of learning difficulties – By Kathryn Burke from LDExperience.

Paediatricians have a huge role in identifying children who are at-risk of learning difficulties or developmental delays, and to set families in the right direction to have necessary supports in place. Early detection leads to early intervention which is crucial.

Doctors, teachers and professionals must be on alert when parents approach them with concerns, particularly about their child’s struggles at school. “Wait and see” or “every child develops differently” are NOT options. It’s important to know the signs and symptoms of learning difficulties amongst young children.

Read Kathryn Burke’s article for guiding questions for parents and children as well as early signs and symptoms of learning disabilities.

Common signs of learning difficulties that may warrant an Occupational Therapy evaluation include:
• Difficulty learning to read or write
• Poor pencil grasp or tires with handwriting
• Completes school work only with great effort
• Dislikes school
• Clumsy, accident-prone, gets lost easily
• Decreased gross or fine motor coordination
• Difficulty with new skills, sports, games
• Poor posture, slumps forward
• Easily distracted

Early school years are critical for creating a foundation for future learning. If a child struggles at school, let’s identify the problems NOW and refer these children on for the right support.

Treating the Cause, Not the Diagnosis

Lilly, a baby gorilla, gets Occupational Therapy! Trainers noticed she had a weak grasp for climbing and self-feeding, her left side lagged behind, and she struggled to latch on while nursing. Medical experts found nothing. Disney switched their emphasis from diagnosis to quality of life.

I found this to be such a great story with good reminders for health professionals and parents:
1) Paying attention to normal developmental milestones is very important. If concerned that a child is struggling to meet milestones, it’s important to get an evaluation.
2) The earlier we detect a problem, the sooner we can help and the easier to correct or minimize. Early Intervention is critical.
3) Treating the cause not the diagnosis – I treat many children who have no diagnosis. We identify the child’s strengths and areas of difficulty, and then determine why are those areas a challenge. For example, a child may have a weak grip for many reasons. Perhaps they have weak core strength and can’t hold themselves up. Are their shoulders loose or stiff causing them to have difficulty lifting their arms to reach? Or does the child lack sensation of their body parts related to each other? Do they have limited eye-hand coordination so that tasks requiring a precise grasp and dexterity are challenging? Labels don’t matter— As Occupational Therapists, we assess the cause of actual areas of difficulty versus the diagnosis.

It’s fantastic that Lilly’s caretakers follow through with her home programs twice a day and are encouraged by her good progress. Hooray!

Sensory Processing and Babies

1 in 20 children have sensory processing difficulties!   Clearly, this is very common and impacts on childrens’ behaviour, motor skills development, learning and confidence.

As an Occupational Therapist, I specialize in treating infants and younger children.  I’m often asked ‘what can you do with a baby’ or how do you know a baby has sensory processing difficulties?

Meet Ryder from Pathways Awareness’ newest video!  🙂

Ryder’s sensory processing difficulties were noted at FIVE months of age.  He had difficulty lifting his head, hardly moved, tired easily, and was anxious during new situations.  He was overwhelmed by sensory input leading to sensory overload.  Later on, this also impacted on his ability to communicate with peers, play with other children, and keep up with his motor milestones.

With Early Intervention therapies (OT, PT, and SALT) and a home program from very early on, Ryder showed improvements in his coordination, behaviour, confidence and ability to organize and respond to sensory information.  He was able to be in group settings, keep up with peers, multi-task, and have fun with age appropriate activities.  Hooray for Ryder.

Another great video by Pathways Awareness.  I admire their efforts in advocating for early detection and Early Intervention as well as raise awareness about sensory processing.

First Signs-Early detection and intervention for Autism

I often work with parents who are concerned that their baby or child is not making eye contact, struggling to meet their motor and learning milestones, or doesn’t respond to their name.  Oftentimes, the wonder whether the child has Autism.

First Signs is a wonderful organization dedicated to educating parents and professionals about early signs of autism and the importance of Early Intervention.

They have great pages on:

  • Red Flags
  • Hallmark milestones from birth to three years
  • How to share your concerns with your doctor?
  • Screening, Diagnosis, and Treatment

I love how they emphasize that paediatricians should better screen children during routine visits and the importance of partnership between parents and healthcare providers.  Parents know their child best and have a gut instinct when there is a problem.  It’s our job as healthcare providers to listen carefully to what parents are saying and make a proactive action plan. Rather than wait-and-see, let’s act early and make the most of a child’s early years when they are constantly learning and growing.  Let’s use prevention versus trying to remediate a problem later.  It’s never to early and Early Intervention is key.

Plagiocephaly-more than just a flat head?

Sadly, plagiocephaly (flat-head syndrome) is often dismissed as being just a cosmetic issue or one that babies will outgrow.  Finally, studies done at the Children’s Institute in Seattle, Washington, US, show that there may be an association between plagiocephaly and developmental delay.

In this study led by Matthew Speltz, PhD, 472 babies between 4-12 months were screened for cognitive and motor development. Half of these babies had been diagnosed with plagiocephaly from Seattle Childrens Hospital’s Craniofacial Centre and the other half were a “normal” control group.

It was discovered that babies with some degree of plagiocephaly were more likely to perform worse on the Bayley Scales of Infant Development III than the control group.

These findings indicate that there may be an association between plagiocephaly and developmental delay or that children with existing motor problems are at risk of developing flatter heads due to lack of movement.

I find that babies with plagiocephaly often have other underlying problems such as:

  • low muscle tone
  • poor strength and coordination
  • sensory processing, movement sensitivities
  • motor planning
  • organizational skills
  • poor regulation
  • …….and more

Research shows the following babies can be at-risk of developing plagiocephaly:

  • those born prematurely
  • multiple births
  • torticollis (tight neck muscles on one side)
  • developmental delay
  • certain syndromes
  • eye muscle problems.

****Babies with Plagiocephaly should be screened early on to determine whether there are possible motor, cognitive, neurological, orthopaedic, or cognitive delays. Definitely worthwhile catching a problem early!

Understanding Premature Infants and their Signals

I have been wanting to write a follow-up to my last blog post about premature babies being at higher risk of disability and how important it is to know the early signs which can indicate a delay.

Just in time, March of Dimes has posted about an excellent interactive program called “Understand Your Premature Infant” which is designed to help educate parents and professionals and explain how premature babies respond to their world.

Premature babies communicate to their parents and caregivers how they feel and what their needs are using SIGNALS.  Due to having immature nervous and motor systems, their signals may be different than a term baby.  They may communicate using their bodies, through movement, crying and fussing, and by how they respond to various sensations.  These cues help you know when the baby is ready to feed or interact, when they are stressed, when they need a break, or what is soothing to them.  It’s critical to be able to recognize these behaviours and signals and understand what they mean to best support the baby.

The program reviews a premature baby’s sleep and awake cycles, their development of senses, feeding, and how to interact with the baby.

I highly recommend this program to any parent, family member, or professional who works with premature babies.

P.S. ot4kids is now on Facebook where I post more regularly. Feel free to share with others who may benefit.  🙂

Learn the Signs-Act Early!

Learn the Signs-Act Early is the message of the CDC (Centers for Disease Control and Prevention) in the US. It’s also the message I share with families and colleagues.

CDC has a great developmental chart where you can track a child’s social-emotional, movement, fine motor, cognitive, hearing and vision, and language milestones from 3 months to 5 years of age. (The vision and hearing sections are quite limited though.) The age at which a child reaches their milestones can offer important clues regarding their development.

This video highlights the importance of keeping track of how a child moves, plays, learns, speaks, and acts.

The earlier parents and health providers recognize that a child has a delay in reaching their milestones, the more intervention can help the child reach their fullest potential. It is never too early. Parents should follow their gut, they are the expert on their child.

If one suspects a problem, or is concerned that their child is not reaching their milestones, ACT EARLY! It is critical to seek specialist advice and support immediately. According to the CDC, most often, children will not grow out of a developmental problem on their own. However, with help, they can reach their fullest potential.

What is Sensory Processing Disorder?

I just saw a brilliant animated video on ‘What is Sensory Processing Disorder?’ I think this would be great to share with kids, parents, and teachers. It’s developed by www.sensoryteamhandbook.com

Please do also listen to Lucy Jane Miller, PhD, OTR, the foremost sensory processing researching in the USA for the past 30 years, explain sensory processing disorder, it’s various manifestations, and three subtypes. This is really worth a listen for 8 minutes. 🙂

TEACHING BABIES 101

Recently, I did a talk for parents on ‘Movement and Brain Building’ where we discussed how movement has a profound effect on not only motor skills but also vision, hearing, emotional regulation, attention, learning and academic skills.

This article is about the benefits of early education and teaching babies. Do think about ‘learning’ as being both physical and cognitive skills development.

Two major points were:

  1. From five months of gestation (i.e. when the fetus is five months old in the womb!) to five years of age, the brain is highly plastic and adaptable. As a result, teaching a child during this time presents a ‘unique window of opportunity for learning.’ This is a critical time for the baby’s brain to develop and set the neurological foundation for future physical and cognitive development. I find it particularly amazing that babies are already learning before they are born!

Consider this:

The brain at birth weights 25% of an adult’s brains weight.

The brain at 1 year weights 50% of an adult’s brains weight

The brain at 2 years weights 75% of an adult’s brains weight

The brain at 3 years weighs 90% of an adult’s brains weight

As a Paediatric Occupational Therapist, this is a crucial time in which to treat infants who are at risk of or have a developmental delay, or with delayed milestones or a medical diagnosis. The earlier we start therapy intervention, the more significant and longer-lasting benefits noted. It’s NEVER TOO EARLY!

If we wait till school years, it is not too late, however we miss out on the unique opportunity to enhance baby brain development, and create strong neuronal maps and foundations.

2)    Four essential ingredients in teaching babies are:

AFFECTION – Happier the child, more likely they are to learn

NUTRITION – A baby’s brain is sensitive to the quality and quantity of nutrients it consumes

REPETITION – Children master skills by repeating them over and over again. This helps develop and strengthen correct neural maps and pathways in the brain

STIMULATION – Teach children through all their senses (touch, vision, hearing, movement, body sense, smell, and taste), however consider that ‘too much’ can be overwhelming

These are also critical ingredients for treatment sessions with babies. We aim for sessions to be fun and motivating for both parent and baby. 🙂 Repetition and stimulation are also used to help develop good neural pathways and foundations for movement and learning.

Pay Attention! ADHD or Auditory Processing Difficulties?

I just found an interesting article about Rosie O’Donnell and her son who has an Auditory Processing Disorder (APD). APD is when an individual’s brain has difficulty identifying, filtering, and interpreting sounds.  Children with APD typically have difficulty attending, following directions, having conversations, and can also be sensitive to loud sounds and large busier group settings.  I have often treated children who are mislabeled as having ADHD or ‘attention problems’ due to these difficulties whereas they really have Auditory Processing problems amongst other Sensory Processing difficulties.
At schools, children are often told to ‘pay attention,’ ‘listen,’ or ‘be a good listener’ however in reality these children are listening…..they just struggle to hear and make sense of auditory information ‘right.’ Here is an interesting post by a young woman of ‘What it’s like to have an Auditory Processing Disorder?’
Raising awareness about APD with teachers, parents, and medical professionals is key so that these children can get the right support versus being treated incorrectly or labeled as having a behavioural problem. Therapy using a Sensory Integration approach combined with an Auditory Training program (e.g. Therapeutic Listening, Listening Program, etc) have been helpful for many children with APD.

Tummy Time and Early Intervention

This is a great resource and should be shared with all parents with babies. I love their documents, pictures, video clips, research, and advice.

Pathways Awareness is an organization in Chicago dedicated to increasing knowledge about the gift of early detection and the benefit of early therapy for infants and children with early motor delays. As an Occupational Therapist, I share this belief and value early detection and Early Intervention for children to prevent problems from escalating and affecting a chlid’s future learning and development.

According to Pathways Awareness, research shows that one in 40 babies is diagnosed with early motor delays and 400,000 babies a year are at risk of developmental delays.  ‘Early motor delay’ can refer to conditions ranging from low muscle tone to Cerebral palsy. Some ‘early motor delays’ are present at birth and others develop or become worse over time. On a positive note, most of these children respond well and catch up quickly when provided early therapy and strategies involving Tummy Time while the baby is awake.

Pathways Awareness has a section on their website called ‘Tummy Time Central.’ It includes details to questions such as: How much Tummy Time does a child need? When to do Tummy Time? And when to be concerned a child is struggling with Tummy Time?

The main points were:

1) Tummy Time helps:

-strengthen neck, shoulders, back, stomach, buttocks, and hand muscles.

-develop eye-hand coordination

-shape arches of the hand for reaching, grasping, and object manipulation

-develop motivation, problem-solving, body and spatial awareness

2) Incorporate Tummy Time into your daily routine such as while carrying the baby, during feeding, or following diaper (nappy) and clothing changes. See their handout called ‘Five Essential Tummy Time Moves’ which contains great images. The site also has video clips of what tummy time should look like and when to be concerned regarding early motor delays.

3) Change the direction your baby lies on their back while sleeping in their crib to build strength and prevent early motor delays.

4) If concerned regarding a child’s development, seek advice from a healthcare provider, Occupational Therapist or Physiotherapist who specializes in infants. If they give you a wait-and-see approach, don’t hesitate to get a second opinion or to self-refer to a trained therapist.

**Please share this valuable information with parents, grandparents, friends, nursery and daycare providers, and others.

World Autism Awareness Day

“I can remember the frustration of not being able to talk. I knew what I wanted to say, but I could not get the words out, so I would just scream.” -Temple Grandin

Today the Empire State Building in my old hometown, NYC, will be lit in Blue! …..Wear your blue today for Autism Awareness Day.

In London, check out:

Flap, an art exhibition by UK artist, Robyn Steward, a woman with Autism.
Location: ACE Fusion (Caribbean Restaurant), 110 St Johns Hill, Wandsworth, SW11 1SJ
View this site for worldwide events.



Too Few Words?

Recently, there was an article in the New York Times regarding ‘When to Worry if a Child has Too Few Words?”

The following points were emphasized:

1) Paediatricians should have a better understanding of speech language development. Early detection results in an earlier start to therapy services, which ultimately, leads to improved prospects.

2) There is more to speech than simply talking. It is important to look at speech development in the broader context of cognition to communication.

3) Speech and language delay is often an indication to global developmental delay or neurodevelopmental disorders. Therefore, it’s critical to also be assessed by an Occupational Therapist as well as a Physiotherapist to determine if there are other delays such as Sensory Processing, Gross Motor, Fine Motor, Visual Motor, or Self-Help Skills.

4) Finally, paediatricians are reminded not to look at speech delays casually and to refer on for therapy early.