Feeding Archives - Page 2 of 2 - Carolina Therapy Connection

Transitioning from Bottle to Cup

Posted on February 15, 2022October 4, 2023

When should my child transition from their bottle to a regular cup?

It’s time to transition off the bottle! The American Academy of Pediatrics recommends transitioning from a bottle to a cup when your baby is about 15 months old. You might think it is time for those adorable sippy cups! BUT, current research is clear, and many therapists are recommending skipping the sippy cup altogether and moving straight to an open cup or a straw cup.

Many parents decide to use a sippy cup because they think that’s what they are supposed to do. Sippy cups were not designed as a tool for proper oral motor and feeding development, but instead were created to keep the carpets clean! The occasional use of a sippy cup is nothing to worry about, as it can be great for those long car rides and times where cleanliness matters. It is important to note that if your child has a medical reason to use a sippy cup, follow your pediatricians recommendations (i.e. some children require a valved sippy cup for safety). Despite the convenience of a sippy cup, parents should be aware that it is easy to become dependent on anything that makes life less messy, so when it’s possible to bring out the regular cup or straw, do it!

Why should I skip the sippy cup?

At only 12 months of age, your baby is developing a more mature adult-like swallow pattern! As opposed to the anterior-posterior suckle pattern infants use with a bottle, at only a year old, the tongue begins to stay in place or even move backward and rise while pressing on the alveolar ridge (the hard, ridged spot just behind the front teeth). The tongue will rise, push, and propel the food backwards! When your little one drinks from a bottle or a sippy cup, the spout prevents their tongue tip from elevating, often forcing the tongue down or requiring them to stick their tongue out in order to drink. If the tongue doesn’t rise to the alveolar ridge at rest and when swallowing, the brain creates a habit to keep the tongue on the floor of the mouth. This can contribute to oral motor weakness, and an impaired oral phase of the swallow.

According to the American Speech-Language and Hearing Association, when the tongue sits low in the mouth it often forces the mouth to rest in an open position, which leads to mouth-breathing instead of your little one breathing through their nose. Long-term use of a bottle or sippy cup may also lead to dental concerns. The immature pattern of an anterior tongue thrust during the swallow increases the risk of pushing their teeth forward and creating a dental malocclusion. The tongue, lips, cheeks, and jaw all play important roles in both articulation of speech sounds and eating, and little ones with weaker oral motor skills may be at increased risk for a speech sound delay.

What are the benefits of using a regular cup or straw?

Open cups and straw cups help build normal movements in oral musculature.
Using a straw helps your child develop lip, cheek and tongue strength.
Open cups provide practice using the mature pattern of swallowing that will allow your child to safely drink and eat.
Straw drinking supports a child’s early articulation of speech sounds.
Regular cups and straws encourage proper breathing patterns and prevent mouth breathing.

What’s the best way to make the transition from the bottle to a cup?

When beginning to make the transition from a bottle to a straw cup or regular cup, it’s important to start small! This process can take time and it’s important to know it won’t happen overnight.

Start by introducing an open cup at mealtimes. You can hold the cup for your child to sip from the side of the rim to get them comfortable.
A great straw sipping cup is the Talk tools Honey Bear Straw Cup, which allows your child to squeeze the bottle so they can get comfortable with using a straw to start out with.
Offer both straw cups and open cups to allow for comfort with various drinking cups.
Use a weighted straw cup, which is spill-proof and allows a child to drink from any angle!

How can Carolina Therapy Connection help?

Your child may need speech therapy if they have difficulty with speech/articulation (pronouncing sounds or words) or using words to communicate. Because the muscles and structures used for speech (such as lips, tongue, teeth, palate and throat) are also used in drinking and eating, a speech and language pathologist may also help with feeding, drinking and swallowing difficulties, also known as dysphagia.

While using a sippy cup does not necessarily mean your child will need speech therapy, it’s considered best to encourage oral motor development by using open cups or straw cups at home! Ditch those sippy cups, and check out the spill-proof options for open cups and straw cups they make these days! Spill-proof….now that’s a concept we can ALL get behind!

As always, if you have any questions about your child development, call our clinic at 252-341-9944 to speak with one of our speech-language pathologists!

Written by: Ashley R. Holloway, MS, CCC-SLP

Helping Children Develop Self-Care Skills

Posted on November 2, 2021October 4, 2023

What are types of self-care skills?

As children learn and grow, they have a drive to be independent and do things on their own. One area that an occupational therapist address in childhood development are their activities of daily living (ADLs), also known as self-care skills. Self-care skills are skills that are required to manage a person’s basic needs including:

Brushing teeth
Dressing (upper/lower body dressing, zippers, belts, shoe tying)
Bathing
Grooming (brushing/styling hair, nail cutting)
Self-feeding
Toileting

What are the building blocks necessary for self-care skills?

Executive functioning skills (i.e. attention, sequencing, initiation of task)
Fine motor skills (hand & finger strength, object manipulation)
Receptive & expressive language (comprehension and alternative forms of communication to communicate wants, needs, thoughts and ideas)
Sensory processing (tolerating sensory stimulation in the environment, such as grooming or dressing tasks for tactile processing)
Coordination & motor planning (moving body through space in a functional way)

What age should my child be able to engage in self-care tasks?

It is important to understand that all children develop at their own pace and that is okay! Remember — there is no penalty for being cautious about your growing child, and if there is a problem acting early can make all the difference. Self care skills are the every day practice of the foundations skills for academic performance and not just life skills. According to the CDC and American Academy of Pediatrics, below are a few of the developmental milestones pertaining to self-care skills in early childhood development.

6-12 months

Drinking from a cup
Holding a bottle or cup independently
Using tongue to move food around mouth
Feeding self small crackers or other small pieces of food

1-2 years

Settling themselves to sleep at night or during the day
Attempting to brush teeth
Removing own socks
Cooperating with dressing by extending an arm or leg

2-3 years

Using toilet with assistance and having daytime control
Attempting to manipulate large buttons
Distinguishing between urination and bowel movements, and names them correctly
Using a napkin to wipe face and hands
Feeding self simple meals using a fork or spoon
Taking socks and shoes off

3-4 years

Unbuttoning and buttoning large buttons
Feeding self without difficulty
Tolerating different clothing textures, seams, tags etc
Toileting independently
Brushing teeth independently or with supervision only
Dressing and undressing self (only requiring assistance with laces, buttons, and other fasteners in awkward places)

4-5 years

Choosing weather appropriate clothes
Dressing self independently
Attempting to bathe and groom with supervision only

5-6 years

Dressing independently
Able to manage morning and night time routine with supervision only
Settling independently for sleep
Able to manipulate more difficult fasteners and tie shoes

6-7 years

Showering or taking a bath independently
Independently toileting during the day and at night
Preparing simple meals (i.e. cereal)
Independent grooming (combing hair, brushing teeth, flossing)

7-8 years

Showering independently
Taking on more responsibilities (i.e. chores)
Preparing simple meals and helping with more complex meals (i.e. making a sandwich, using the microwave, spreading condiments, pouring from a larger container into a cup)
Interest in taking on more complex grooming tasks – nail cutting, tolerating hair cuts, styling hair

How can an occupational therapist help address self-care difficulties?

Create a routine: Developing a consistent routine with a child can help them know what is expected of them and when to complete their self-care tasks throughout the day. Creating a routine may require a visual schedule or reward chart, something that an occupational therapist can help your child and family plan, develop, and implement in the home!

Improve fine motor skills: Almost all self-care skills require adequate fine motor skills, such as brushing teeth, using utensils, buttons, zippers, tying shoes, and more! An occupational therapist can help improve your child’s fine motor skills to increase independence of their self-care tasks.

Sensory integration: some children may have difficulty tolerating grooming or dressing tasks which can indicate a challenge with tactile processing. They may also have difficulty with tolerating hair cuts, nail cutting, or teeth brushing. Seeing an OT to address these sensory processing concerns can help your child to improve their ability to register and tolerate tactile input to improve their ability to complete these self-care tasks using a variety of treatment strategies.

Adaptation & modification of tools and the environment: An occupational therapist can recommend different types of adaptive equipment (i.e. button hook, weighted utensils, shoe horn, etc.) to help increase independence in self-care skills. They may also get creative by providing tips for adapting the environment to promote independence in the home.

Executive functioning skills & attention to task: If your child has difficulty with their higher level cognitive skills then self-care may be difficult. Seeing an OT could be helpful by implementing and utilizing a variety of treatment strategies for increasing attention, initiation of tasks, sequencing steps of an activity and more!

Caregiver/parent training: An occupational therapist may be able to provide tips and strategies to parents in the home for carryover of self-care skills into daily routine.

How can Carolina Therapy Connection help?

Through demonstrated excellence in clinical, school, and home-based practice, Carolina Therapy Connection’s occupational therapists provide screening, assessment, consultation, and treatment to children having difficulty with a wide variety of needs, including difficulty with self-care skills. We believe it is critical to make therapy as fun and motivating as possible by celebrating the small victories as well as major achievements. We have a strong focus on helping your child develop the skills appropriate to their age and current stage of development. We also use a holistic approach and evidence-based practices to help your child develop and grow to their greatest potential. If your child is having difficulty with any of the skills discussed above, call our clinic today at 252-341-9944 for a FREE occupational therapy screening! We currently provide occupational therapy services in Greenville, Goldsboro and New Bern, NC!

References

Holland, B. (2017, February 14). Top 10 ways occupational therapy can help children with self-care. Chicago Occupational Therapy. Retrieved November 2, 2021, from https://chicagooccupationaltherapy.com/articles/top-10-ways-occupational-therapy-can-help-children-with-self-care/.

Admin, K. S. W. (2016, November 27). Self care skills. Kid Sense Child Development. Retrieved November 2, 2021, from https://childdevelopment.com.au/areas-of-concern/self-care/self-care-skills/.

Centers for Disease Control and Prevention. (2021, January 22). CDC’s Developmental Milestones. Centers for Disease Control and Prevention. Retrieved November 2, 2021, from https://www.cdc.gov/ncbddd/actearly/milestones/index.html.

Making “Sense” of Our Experiences

Posted on July 16, 2021October 4, 2023

The Pyramid of Learning

The Pyramid of Learning was developed by Occupational Therapist Kathleen Taylor and Special Educator Maryann Trott. The Pyramid of Learning is an easy-to-understand illustration that depicts a general idea of a child’s foundational skills, and what other skills build upon those. Think about it: You can’t place stones on the top until the foundation stones are in place… every block relies on the ones underneath to be strong and stable. This pyramid explains why the sensory systems are so incredibly important to support academic learning. In other words, kids NEED routine sensory input for their bodies and their brain! Our central nervous system processes and organizes the sensory information we put into it each day. Adequate sensorimotor development for things like motor planning, postural security and body awareness are built on adequate modulation and processing of sensory information that we take in every day! Sensory input can be anything such as, smells, tastes, sounds, movements, pressure, and textures.

When a child is referred to occupational therapy, it is usually for things like attention to task, handwriting difficulties, picky eating, self-care tasks, tolerating routine changes, or school readiness skills. These functional difficulties are in the “Cognition and Intellect” categories at the top of the learning pyramid. The role of an occupational therapist is to determine underlying causes of these issues and utilize specific interventions to address them. Often times, it is hard for parents to fully understand why their child is not performing at the level at which they would like them to be. Some parents may see their child become frustrated when they are trying their best to be compliant, listen and learn, but their sensory processing abilities are hindering them. These frustrations root from the child working throughout the day just to do the simple things, the things that should be automatic and unconscious for them. This may include things like listening to the teacher, keeping their balance on the stairs, standing close to their friends in line, trying a new snack, or engaging in messy play. It all begins at the bottom of the pyramid!

Understanding Our Sensory Systems

Proprioception is our ability to sense the location, positioning, and movements of our body and its limbs. It allows us to navigate a crowded area without bumping into people and furniture in our path.
Vestibular sensation is housed in our inner ears and uses gravity to sense spatial orientation and movement. This system is responsible for maintaining balance during movement. If you or child is a victim of motion sickness, you have the vestibular system to blame!
Tactile sensation comes from receptors in our skin found all over the body. Tactile sensation includes sensations of pain, temperature, pressure, and textures.
Gustatory includes specific tastes (spicy, sweet, minty, bitter) and specific textures (crunchy, chewy, mushy). Taste also involves knowing the difference between food items and non-food items.
Olfactory or smells involve the ability to distinguish, detect, tolerate and object certain scents.
Visual includes noticing and tolerating visual patterns, colors, shapes, bright and dimmed lights and moving objects.
Auditory involves the ability to distinguish and tolerate loud sounds (fire alarms, sirens or loud music) and soft sounds (finger snapping, repetitive tapping, hearing others breathing).

How Sensory Processing Difficulties Affect Behavior

As a parent, it can be difficult when our children are having difficulty with negative behaviors. Let’s say that you receive a call from your child’s school reporting that they often seem distracted and don’t pay attention in class, bump into kids in the lunch line, can’t hold a pencil correctly, become upset when asked to switch from one activity to another, or melt down during circle time. Although these seem like behaviors that are caused by the child seeking attention or not getting their way, sometimes it can root from difficulty with sensory input. It is important for parents to work with an occupational therapist in determining the root of the problem. Sensory integration therapy or a sensory diet may be the key to diminishing these behaviors. Sometimes, just some simple routine changes can allow the child to regulate themselves. Regardless, it is important to have an occupational therapist on your team to help make those adjustments.

Sensory Integration

Sensory integration refers to how your body recognizes, processes, and responds to information received by our sensory systems on an individual and combined level. This includes our traditional 5 senses, sight, touch, taste, smell, and hearing; however, we also have proprioceptive and vestibular sensory systems. Occupational therapists use sensory integration therapy by exposing a child to sensory stimulation in a structured and organized way. The goal of sensory integration therapy is to adapt the child’s brain and nervous system to process sensory information more efficiently. The OT may use a sensory gym to engage the child in these repetitive and stimulating activities.

Sensory Integration Strategies

Messy play – mud, dirt, water, food play, finger paints, shaving cream, bath bubbles, etc.
Noise cancelling headphones or ear plugs
Window shades or adjustable lights
Include your child in meal preparation process – encourage them to help whether with their hands or using cooking utensils to interact with the many food textures and smells
Food play – Encourage your child to interact with new foods in the most basic manner; the SOS Feeding Approach, used commonly by Occupational Therapists, encourages the following progression with new foods: See –> Touch –> Kiss –> Lick –> Taste –> Chew & Swallow. It is important to allow your child to move at their own pace and allow them to clean off hands or spit out food at any point along the continuum.
Sensory toys – check out Ark Therapeutic, a leading manufacturer of innovative therapy tools and special needs products! They have great sensory toys, chews and fidgets that can help your child deal with sensory overload.
Finger painting – also try bathtub paint to reduce mess and give child control over cleaning off their hands
Listening to music
Having a clear visual schedule posted with plenty of preparation for transitions.
Providing sensory breaks such as walking in circles, jumping on a mini-trampoline and sucking on sour candy.
For the child who needs to move a bit, you might try an inflated seated cushion or a pillow from home so they can both squirm and stay in their seat.

How can Carolina Therapy Connection help?

At Carolina Therapy Connection, we offer Sensory Integration Therapy and play-based treatment intervention that is specifically designed to stimulate and challenge all of the senses. Sensory Integration involves specific sensory activities (swinging, bouncing, brushing, and more) that are intended to help your child regulate his or her response to incoming sensory input. The outcome of these activities may be better focus and attention, improved behavior, and even lowered anxiety. Our therapists may work on lowering a patient’s negative reactions to touch, help them become better aware of their body in space, and work on their ability to manage their bodies more appropriately (run and jump when it’s time to run and jump, sit and focus when it’s time to sit and focus, etc.). Various techniques include swinging, deep pressure therapy, which may include squeezing, rolling, etc., jumping on a trampoline, or gross motor play such as wall climbing, balance beam, etc.

Carolina Therapy Connection now has the largest and most state-of-the-art sensory gym in all of Eastern North Carolina! Check out our 360° view of our sensory gym HERE. Our sensory gym is fully equipped with a zip-line, monkey bars, slides, scooter board ramps, ball pit, trampolines, rock climbing wall, and an expansive set of swings to offer a wide-variety of sensory experiences for each child.

If you have any questions or would like to schedule a screening for your child, call our clinic at (252) 341-9944 to learn more about what you can do and how we can help!

References:

Pyramid of Learning by Taylor and Trott (1991)

Amy Hathaway, OTR/L DEVELOP, LEARN, GROW

Kids First Children’s Services