Category Archives: Assessments

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

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.

Sorting Out Developmental Delay for Infants

Today I found a newsletter called A Pediatric Perspective put out by Gillette Children’s Specialty Healthcare in Minnesota, US. I really appreciate their articles focusing on Early Detection and Early Intervention.

This particular article written by a Neurodevelopmental Paediatrician, Dr. Raymond Tervo, M.S., reviews Red Flags for infants, toddlers, and preschool aged children that can indicate Developmental Delays in the areas of language, gross motor, fine motor, and cognitive skills.

The article can be slightly heavy but a great read for parents and definitely for health professionals. It was so nice to read what I say and believe on paper! 🙂

Here are the main points:

1)    PARENTS KNOW BEST!! If a parent is worried, chances are that something needs attention. Concerns may be in areas of speech and language, fine motor / hand skills, cognition, or difficulty reaching motor milestones.

2)    Early detection of problems is vital because brain development is very impressionable at an earlier age. Therefore, if you observe a delay, REFER on early for necessary medical treatments and therapy services. Early Intervention is crucial.

3)    Monitor infants with risk factors such as low birth weight, prematurity, brain bleeds, or known diagnoses including Down Syndrome or Fetal Alcohol Syndrome.

4)    Delays in one developmental domain (e.g. language) can impair development in another area (e.g. motor skills and/or cognition).

5)    Red Flags for parents to look out for at specific ages for babies and young children.