Category Archives: Uncategorized

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

Write On!

I commonly get referrals for children with handwriting difficulties between 5-7 years old.

There are so many factors to consider when assessing a child who struggles with handwriting. Here are just a few:
1.  Core strength – Can the child sit upright long enough to do writing in class? Do they tire easily? How do they manage with gross motor and physical activities at recess or P.E.?
A child must have a strong core to sit in their seat and to support their arms for writing.

2.  Shoulder stability and arm strength – Imagine the shoulder to be like a hinge to hold a frame. It must be strong to support what hangs off it (i.e. the hand). Chances are if the shoulders are weak or unstable, it can’t support the hands.  This causes the child to tire easily and have poor grasp on their writing utensil.
http://movingsmartblog.blogspot.co.uk/2011/05/m-is-for-monkeybars-getting-ready-for.html

3.  Visual motor and perceptual skills – Does the child use the muscles of their eyes to visually track objects? Do both eyes work well together? Does the child spatially organise parts to draw a picture such as a house or a person? This is necessary on a finer level to form letters.
http://www.aota.org/Pubs/OTP/2011-OTP/OTP-082211.aspx?FT=.pdf

4.  Fine motor skills – Are the child’s thumb and fingers strong enough to grasp and coordinate the pencil? Do they have isolated control of fingers or use their whole hand to manipulate their writing utensil?

5.  Body and spatial awareness – Is the child aware of front/back, right/left, top/bottom on their own bodies, when given directions, or to draw and write?  These skills are first developed with gross motor skills, on the playground, when building forts from sofa cushions and dining room chairs, playing with blocks and then forming letters.

6.  Balance, midline crossing and bilateral integration – Can the child balance in their chair or when sitting on the floor at circle time? Oftentimes a child may slump over the table or have difficulty sitting still at circle time due to core weakness and poor balance.  Have they developed a hand dominance? To do this the child must comfortably be able to turn their body and cross midline without losing their balance? And lastly, do they use both hands to play, get dressed, open / close bags, cut, or hold the paper while writing.

7.  Motor planning and sequencing – Can the child follow a sequence, problem-solve, do a multi-step task?
http://www.apraxia-kids.org/site/apps/nlnet/content3.aspx?c=chKMI0PIIsE&b=788449&ct=464199

8.  Attention, auditory processing, and more.

Could we help these kids earlier before starting school? ABSOLUTELY!
Here are some difficulties children who struggle with handwriting often have when younger:

-Disliked tummy time
-Short or no crawling period
-Described as ‘lazy’ and lacking desire to move
-Delayed infant milestones
-Cautious with movement and climbing activities

-Avoided manipulative or constructive play (blocks, Legos)

-Difficulty with hand actions to nursery rhymes

Handwriting is very complicated.  There are early red flags and children do benefit most from receiving therapy input early.  It’s never too early or too late, however earlier the better.  If children have the chance for early intervention, they can focus their energies at school on attention, learning, and playing with friends.

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

Sensory Processing – Early Warning Signs for Babies

In my practice I work with many children with sensory processing difficulties that are identified during their school years.  These children may struggle with concentrating in class, coping with transitions or changes, or playing with peers.  They can be clumsy, have difficulty holding a pencil or writing, awkward with their movements, or be either withdrawn or aggressive.  Oftentimes, they are very bright and as a result, their sensory processing difficulties are misunderstood.  Usually, warning signs were present as babies however parents were told to ‘wait and see,’ ‘your child will grow out of it’ or that their child is misbehaving.

Early signs of sensory processing difficulties I have seen amongst babies include:

  • Hates tummy time, prefers to sit or stand
  • Plays while sitting still versus moving around and exploring their environment
  • Tend to get ‘stuck’ with their movements, delayed milestones (e.g. rolling, crawling, clapping hands, waving)
  • Cautious with movement, dislike being laid down or moved
  • Fussy or irritable babies, cry easily sometimes for no known reason
  • Not a ‘cuddly’ baby, resists being held
  • Struggle to settle down or going to sleep
  • Difficulty with nursing, transitioning to other textures
  • Startles easily to loud sounds, distracted, avoids eye contact
  • Very easy going, described as a ‘lazy baby’, don’t know they’re in the room

These difficulties indicate that a child’s central nervous system is struggling to process sensory information.  It is a neurological problem that can impact on their movements and development, learning, and social-emotional skills.

Here’s a nice article that discusses the early warning signs of Sensory Processing Disorder amongst infants.

Due to the plasticity of a young child’s brain, there is hope and good potential for progress and improvement with Early Intervention.  If you are concerned about these early warning signs, seek advice from an Occupational Therapist who specializes in working with infants and younger children, particularly those with sensory processing difficulties.  It is never too early or never too late to get help.

Look here for links and books about sensory processing.

April is Occupational Therapy Month- Hug your OT! :)

I’m so happy there’s a month to celebrate and raise awareness about topics related to Occupational Therapy (OT).  But for me, everyday is OT day. I’m fortunate to have one of the best jobs and love working with the kids and their families.

OT is gaining much recognition and awareness over the past few years, primarily for working with adults.  However, people still do often ask me why a child would need an OT or what’s a child’s job?  My response is:  A child’s job is to move, play, learn, socialize and be happy.  As an OT, we work on the foundational skills they need to do these jobs such as their gross and fine motor skills, sensory processing, eye-hand coordination, or emotional regulation.  Parents, teachers, and siblings are a key part of this process AND it’s NEVER TOO EARLY to start.  The earlier a problem is detected, the earlier we can help.

Many of you know I lived in NYC for a number of years.  Oftentimes, I’d walk along Broadway and look down to see Times Square and its famous big screen.

The American Occupational Therapy Association has an ad playing on the big Times Square screen throughout this month.

Also, check out the AOTA’s Top 10 Reasons to Care about OT Month.

Until next time, Happy OT Month!

Seating for Children at Home and School

Infants and children must have good posture while laying down, sitting or standing so they have a good foundational base from which to move their arms and manipulate objects as well as attend and learn at school.  If a child has to concentrate on holding up their body, this will take away from their ability to grasp and manipulate objects and concentrate and learn at school.

Therefore, it is critical for babies and children to be well supported at their chairs and tables at home, daycares and schools during feeding, reading, writing and learning tasks.

If a child is unable to maintain good posture while sitting in their chairs at home or school, it’s important to consider whether these difficulties are contributed to by poor balance, body awareness, trunk and upper body strength, or sensory processing difficulties.

Here is a great article which describes how a child should be sitting in their chair, alternate sitting positions, and ideas for movement breaks.  Do share with teachers, family and friends.

October is National Sensory Awareness Month in the US

October is National Sensory Awareness Month created by Kathleen Morris from Sensory Integration Focus.

You can download a free poster of 10 signs and symptoms of SPD from SensoryStreet to raise awareness, thanks to Ida Zelaya.

Do share with doctors, teachers, nursery schools, family and health professionals.  The more people are aware about Sensory Processing, the earlier children can get help they need.

Sensory Processing Disorder (SPD) is a real neurological problem affecting 5 to 13% of children entering school.  With help from an Occupational Therapist trained in Sensory Integration, children with SPD show improvements in attention, learning, movement, socialization, coping and self-esteem.

Strokes Happen Amongst Children Too!

People often think of strokes for adults, however they occur amongst children too.

http://www.telegraph.co.uk/health/children_shealth/7907230/The-child-victims-of-stroke.html

Approximately 5 children a week in Britain have a stroke. 2/3’s of those that survive suffer long-term disability that affects their movement. 1/3 of those that survive have no lasting impairment. Oftentimes, there’s already another pre-existing condition such as congenital heart disease.

Due to lack of public and medical awareness of childhood stroke, kids are being diagnosed too late. It is critical to have faster diagnosis and earlier treatment for a better outcome!

Some common signs that indicate strokes can be: headaches, unable to feel or move right side, floppy, and difficulty speaking.  Clumsiness and an alteration in consciousness may also be noted.

Do share with family and friends to raise awareness so others can get support and access to appropriate services faster.

HemiHelp in the UK is a great organization supporting children with hemiplegia.

Down’s Syndrome Awareness Week- 15th to 21st March 2010

This week is Down’s Syndrome Awareness week. Having worked with many infants and young children with Down’s Syndrome, I have been inspired by their hard work, loving personalities, and achievements, particularly with the right support.

One of the events is the ‘Shifting Perspectives Photographic Exhibition‘ which examines the lives of people of all ages with Down’s syndrome, their connection to the photographers and the changes throughout the course of their lives. This is a free exhibition at the Oxo Tower from 17th to 28th March, 11am to 6pm.

2010 also marks the Association’s 40th Anniversary supporting individuals with Down’s Syndrome!

Check out the Down’s Syndrome Associations website for further details of this week.