Category Archives: Intensive Blocks Treatment

Value of providing intensive blocks of treatment using a sensory integration approach for children in home, school, or clinic settings due to neuroplasticity of the brain and time required to integrate skills.

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

Homemade Sensory Equipment

 

**Disclaimer:  All content on this website is my professional opinion and for your information only.  It is by no means a substitute for medical or individualized input from an Occupational Therapist. 

I often encourage parents to use what they have at home for sensory input activities and obstacle courses.   There are many inexpensive items that may be used.  Here are some of my favourites.  Pease obtain input from your  OT of how to use these to help your child. Supervision is necessary for safety.

 

1)  Therapy Ball for trunk exercises, ball massages, throwing and catching games, or cross pattern brain gym activities.

 

2) Sofa Cushions and Pillows can be used as stepping stones, piles to jump and crash onto, or to crawl over for babies to older children.  For example, here are some fun stepping stones made from scrap cardboard. http://wendyjanelle.blogspot.co.uk/2010/05/sensory-steps.html

 

3) Crash Pads for gross motor or sensory input, or as part of a quiet, calming space.  You can make a crash pad by filling a duvet or quilt cover with pillows, blankets or scrap pieces of foam.  Use it to relax in, do homework or read a book, crawl or roll over, walk and climb over to improve balance, or hide objects under.

 

4) Boxes have endless potential. We know babies rather play with a box than toys. 🙂 Use different sizes for climbing in and out of. Open the box flaps to become a tunnel to crawl through.  Lay on a box and use it as a sled. Prop a huge moving box against a sofa and voila, you have a slide. A tight box filled with pillows can be used as a calming spot. For little ones, fill a box with balls or other textures for a sensory bin. Boxes can be used in lots of fun ways as an addition to your sensory tables.
Sand and Water Tables Blog

http://tomsensori.blogspot.co.uk/

Pre school play link

http://pre-schoolplay.blogspot.co.uk/2012/01/sensory-table-cover.html

 

5) Mattress or an air mattress can be used to jump on, crawl over, or prop up against the bed or sofa for a slide or a mountain to climb up.

 

6) Blanket swings for smaller, lighter children.

 

7) Step ladder for climbing practice to develop strength, bilateral coordination and motor planning.

 

8) Suspended Balls – You can either tie a string to a beach ball or place a tennis ball in panty hose and then hang it for lots of fun target practice.

 

9) Tires – Save those old car tires at your next car service. They can be used to sit or stand on, walk around or to step in and out of.

 

10) Plank of Wood as a balance beam. Alternatively fold a bath towel or blanket in the shape of a balance beam or put long strips of masking tape or string on the ground to walk on.

http://movingsmartblog.blogspot.co.uk/2011/08/smart-steps-walk-line.html

 

Have a look at these 2 blog posts for lovely ideas:

http://wecandoallthings.blogspot.co.uk/2012/07/parents-guide-to-diy-therapy-equipment.html

http://www.thegoodneighborhood.com/2012/06/20/a-place-of-joy-pulling-off-a-pop-up-playground-on-buffalos-east-side/

 

For those of you with carpentry and DIY skills, here are some projects I also hope to make…..well, some day. 🙂

 

Woven Wrap Hammock Swing (All you need is a wrap and a coffee table or bunk bed)
Tire Rocker

http://barefootnparadise.blogspot.co.uk/2011/10/tire-rocker-and-see-saw.html

http://www.crumbbums.com/?p=1934

 

Balance Beam

 

Balance Board

Integrated Listening Systems therapy at ot4kids

I use Integrated Listening Systems (iLS) Therapy to improve children’s sensory processing, motor skills development, auditory processing, attention and regulation.

I have found that iLS and Occupational Therapy together make a good pair and help children progress faster.  It is also effective as part of a home program for many children.

iLS is unique in providing bone conduction in the headphones.  This is highly beneficial as it offers additional vestibular (movement) input to the child working on a neurophysiological level.

WHAT IS iLS?

iLS is built upon the techniques and theories developed by Alfred Tomatis, M.D., and has been refined by Dr. Ron Minson over many years.  It is based upon the theory of neuroplasticity, strengthening and creating neuronal maps that support sensory processing, movement, attention and learning.  iLS is a sound-based multi-sensory program that combines movement, visual and auditory input.

HOW DOES iLS WORK?

Classical music has been digitally manipulated to specific frequencies and vibrations that stimulate various parts of the brain to improve the neurological foundation for sensory integration.

Music is delivered via a portable iPod through specially designed headphones with bone conduction (a small transducer).  The bone conduction unit is inside the top of the headphones and provides specific vestibular and auditory stimulation.

In my practice, after I assess a child I determine whether iLS will benefit their program.  We then create an individualized listening program along with sensory, movement, visual and auditory exercises based on the child’s goals.  Generally, the program is administered approximately 3-5 times a week for 30-60 minutes.  For the first 15-20 minutes, the child participates in their home program exercises and for the remainder of the program, they either relax or complete fun projects.  I either use iLS during the child’s treatment sessions or offer units for rental for intensive home programs.

iLS HELPS:

Sensory processing, body and spatial awareness, motor skills coordination

Motor Planning, sequencing

Attention and following directions

Auditory Processing, sound sensitivity

Visual Motor Skills

Self-esteem

Sensory regulation, calming, sleep

iLS can be used for children who have various diagnoses including:

Sensory Processing Disorder

Autism, Asperger’s syndrome

Dyspraxia

Learning difficulties

ADD / ADHD

Neurodevelopmental delays

 

FURTHER iLS RESOURCES-

Research and case studies:

http://www.integratedlistening.com/research-science/

Free parent webinars:

http://www.integratedlistening.com/training/ils-webinars/

Online videos and talks by Dr. Ron Minson about iLS:

http://www.blogtalkradio.com/thecoffeeklatch/2011/10/24/dr-ron-minson–ils

http://www.autismsocialnetwork.org/community/72-ils/videos/video/46-ron-minson-md-a-edward-hallowell-md-qhow-integrated-listening-systems-ils-worksq

http://www.worldtalkradio.com/worldtalkradio/vepisode.aspx?aid=55628

Study by the Spiral Foundation regarding the effectiveness of home-based iLS therapy:

http://on.fb.me/S8eUjJ

How iLS influences sensory processing

http://www.integratedlistening.com/how-ils-influences-sensory-processing/

Parents’ account of using iLS and music therapy with their child:

http://www.autismsupportnetwork.com/news/feeding-hungry-brain-music-autism-2321452

Tips on introducing headphones to a sensitive child:

http://polaristherapy.com/2012/07/07/introducing-headphones-to-the-tactile-and-auditory-sensitive-child/

ot4kids has an office!

I’m so excited to tell you that ot4kids now has its own office space in Southfields, southwest London.

Funnily when I first moved to London a few years ago, somebody mentioned that they worked in Southfields. I think I probably scrunched my nose as I had no idea where or what Southfields was. And now I’m working here. 🙂

At first I wasn’t sure what to call this practice.  When I was in California, we’d use the term ‘Sensory Integration Clinic’  and in New York City, ‘sensory gym’.  Either way, I’ve always wanted a practice that is in a home so that it’s comfortable, a natural environment, and parents can replicate what we do in a treatment session using what they have at home.  I will have specialized therapy equipment however I will also use what’s naturally available in one’s home. I hope this will be a cozy practice where kids can have fun, grow and reach their best potential.

I’m also looking forward to start some BABY groups for parents and babies who are:

  • at-risk due to having prematurity or a traumatic birth
  • have medical diagnoses such as Down’s syndrome
  • have developmental delay or aren’t reaching their developmental milestones
Groups will be hands-on, targeted to a child’s needs, and kept very small so parents and babies can get the most benefit.   Feel free to contact me at munira@ot4kids.co.uk to sign-up or for further details.
I will put up photos as soon as settled in. Stay tuned. 🙂
All the Best! Munira

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:

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!

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.  🙂

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. 🙂

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.



Therapeutic Riding for Children with Prematurity

Many years ago, I won’t say how many, I had the chance to observe children with physical disabilities at a Therapeutic Riding program. I was amazed by all that they could do while riding a horse, so I’m a huge Therapeutic Riding fan.

I just read an interesting story from the NY Post about twin girls who were born prematurely and now, at 4 years of age, go for Therapeutic Riding in NYC.

Oftentimes, reading an article gets me thinking about ‘what else’? Being relatively new to London, this article made me wonder what Therapeutic Riding programs are available in London. I discovered that there is a Riding for the Disabled Association in the UK and they have a list of Therapeutic Riding (Equine Therapy) programs in the UK by location. I’ve seen great results with children I’ve treated in the past who’ve gone for Therapeutic Riding and wanted to share this with you.