Not Your Average Toy!

Posted on December 1, 2023December 1, 2023

Not Your Average Toy offers a transformative approach to pediatric therapy, catering to the different needs of our pediatric patients in occupational, speech, and physical therapy within our clinic. These specialized toys aren’t just playthings; they motivate children to develop essential skills like fine motor control, visual perceptual abilities, grasping techniques, following multistep directions, stimulating ‘what’ questions, fostering color and shape recognition, encouraging problem-solving, and refining hand-eye coordination. What makes these toys exceptional is their unique ability to grasp the children’s attention while integrating therapeutic goals into engaging activities tailored to each child’s journey toward progress and achievement. Check out some of our favorite “Not average toys!”

Examples of Not Your Average Toy:

Water Beads:

What sets water beads apart? Water beads stand out for their fun way of developmental skills. They offer an enjoyable sensory and messy play while enhancing color recognition and sorting abilities. These beads serve as a tool for reaching milestones. Children can play by using a spoon for scooping into a cup, counting exercises, and even hiding items like toy fish or other objects within the beads to engage both hands in a tactile search. These toys facilitate various developmental goals, from color recognition and sorting to refining fine motor skills, in-hand manipulation, bilateral coordination, and sensory play. They also stimulate counting skills and engage in figure-ground activities.

Building Blocks:

Building blocks are known for making a tower and watching it fall, but did you know that they offer various developmental opportunities? These square toys build structures with two hands, allowing a child to work towards bilateral coordination, midline crossing, and fine motor skills. Playing with blocks can also help with color recognition, shape learning, spatial orientation, and teaching concepts through block positions.

Building blocks can also help with emotional regulation. If a task is challenging or the tower does not stay quite the way intended, this is an excellent opportunity to discuss the feelings raised and allow your child to have a voice.

Puzzles:

Puzzles are a fun, versatile learning tool for children. They can help children learn about shapes and colors, expand their vocabulary, and identify different types of animals. Puzzles also help children learn to act like put in and take out. You can add a multi-step direction to make a puzzle more challenging, like putting the cow and horse puzzle pieces together in their correct spot. For more engaging questions, ask your child, “What does a cow say?” or “Where is the cow?” Puzzle helps achieve milestones that involve enhancing visual perceptual skills, grasping technique, mastering multi-step directions, and developing problem-solving abilities.

How can Carolina Therapy Connection Help?

At CTC, we are committed to supporting our families and the child’s developmental journey and helping them achieve these goals at home. Please explore our website (https://www.carolinatherapyconnection.com/) or our Amazon Storefront (https://www.amazon.com/shop/carolinatherapyconnection). These are not your average toys; they are carefully innovative toys that can help foster growth and development. To further understand these toys’ impact, ask your therapist if you can sit in during a session. By watching the interaction between the child playing and the therapist, parents can gain insights into how effective these tools can be and bring these Not Your Average Toys into their home.

By: Lauren Hodges, COTA/L, and Allison Hicks

What are primitive reflexes?

Posted on November 15, 2023November 7, 2023

A reflex is an automatic and instantaneous response to a sensory stimulus. Remember when you were a child at the doctor’s office and they tapped your knee with a small mallet to check if your leg kicked upwards? You didn’t decide to kick your leg, it just kicked. From infancy, reflexes are vitally important for proper development of the brain, nervous system, body and sensory systems. Some reflexes are meant to stay with us our whole lives. Others are designed to be dormant after their function is fulfilled – also called integration. Check out this awesome resource from Tools to Grow to learn more about specific reflexes and how they impact a child’s function during their daily life. Primitive reflexes are adaptive responses that develop before birth and typically integrate as the brain matures. Primitive reflexes are important for survival and development early in life; however, it is also important that they become integrated as the child grows. Retained reflexes can cause sensory issues, postural disorders, decreased motor skills, and attention/behavioral issues.

What causes retention of primitive reflexes?

Some potential causes of retention of primitive reflexes include c-sections, trauma during birth, exposure to toxins, decreased tummy time during infancy, decreased time crawling, chronic ear infections, or head injuries during infancy among many other unknown causes.

Five Commonly Retained Primitive Reflexes and their Impact on Occupations

1. Moro Reflex

The Moro Reflex is known as the “startle” reflex. This reflects is a fight or flight reaction. It is present at birth and should be integrated by four months. Common effects of retention include emotional outburst, motion sickness, and difficulties with vision, reading, and writing.

2. Asymmetric Tonic Neck Reflex (ATNR)

The Asymmetric Tonic Neck Reflex (ATNR) is known as the “Fencer’s pose”. It assists in the birthing process. It appears at birth and should be integrated by nine months. Common effects of retention include decreased eye-hand coordination, poor handwriting, poor balance, difficulty with reading and math, and difficulty focusing.

3. Symmetric Tonic Neck Reflex (STNR)

The Symmetric Tonic Neck Reflex (STNR) is an essential foundation for crawling. It appears at six to eight months and should be integrated by nine to eleven months. Common effects of retention include poor posture, W sitting position, poor eye-hand coordination, messy eater, and low muscle tone.

4. Tonic Labyrinthine Reflex (TLR)

The Tonic Labyrinthine Reflex (TLR) is commonly seen in children with ADHD diagnoses. It appears before birth and should be integrated by three and a half years of age. Common effects of retention include decreased balance, poor spatial awareness, toe walking, weak muscles, poor posture, and difficulty with climbing.

5. Spinal Galant

The Spinal Galant Reflex also assists in the birthing process. It appears at birth and should be integrated by three to nine months. Common effects of retention include bed wetting after potty training, hyperactivity, postural issues including scoliosis, attention issues, and decreased endurance.

What are integrated reflexes?

Integrated reflexes are important for developing motor control. A child needs motor control to maintain proper posture at a desk in school, ride a bike, read a book, cross midline, write, and get dressed. A child with integrated reflexes has normal movement patterns to complete these functional tasks at home and at school. A child with unintegrated reflexes could benefit from skilled reflex integration therapy which will essentially train a child’s brain by establishing an efficient movement pattern that supports higher level motor skills or cognitive tasks.

How do you know whether or not your child has integrated these reflexes?

There are many common areas of difficulty that may suggest a retained reflex including the following:

“Bouncing” Child: Constantly moving, can’t sit still on a chair, hyperactive
“Noodle” Child: Leans on everything, rests head on table
“Shirt Chewers”: Constantly chewing on shirts or pencils, and touches everything
“Emotional Child”: Challenges with regulating emotions, easily frustrated or upset, difficulty with utilizing age appropriate coping strategies to calm body
School Performance Challenges: difficulty with reading, handwriting, language/speech, poor sitting balance and immature grasp on writing utensils
Coordination Challenges: Chronic body aches, poor endurance, fatigue, muscle weakness, poor concentration, fidgeting, disorganization

How do I know If My Child Has Retained Primitive Reflexes and What Can I Do?

Once your Occupational Therapist suspects a retained reflex, he/she will educate the caregiver on the importance of carryover for treatment recommendations. Caregivers play an important role in seeing progression in their child’s everyday activities. It is typically recommended that the child completes a set of tailored exercises to meet your child’s needs, 5-10 minutes per day, for 30 consecutive days in order to see any progress. Your therapist may recommended a reward or sticker chart in order to keep your child motivated towards an end goal. Progress can be noted short term and over 9-12 months. In addition to exercises, your Occupational Therapist will make recommendations for modifications in the school and home environments which may include changing positioning during school work, movement breaks, sensory techniques, relaxation techniques, decreasing auditory and visual stimulation, and organizational skills, just to name a few!

In order to determine whether your child would benefit from direct treatment for Reflex Integration, it is recommended that your child be evaluated or screened by an Occupational Therapist at Carolina Therapy Connection. Give us a call at 252-341-9944 today to schedule your FREE occupational therapy screening with one of our experienced and knowledgable OT’s.

Down Syndrome Awareness Month!

Posted on October 17, 2023November 7, 2023

October is filled with so many exciting things, the start of fall weather and holidays approaching; but did you know that October is also Down Syndrome Awareness Month? Established for over 40 years, it is a time to recognize and celebrate our friends with Down Syndrome and the amazing abilities they have!

What is Down Syndrome?

Down Syndrome is often called Trisomy 21, though there are actually three types: trisomy 21 (nondisjunction) which makes up 95% of cases, translocation (4%), and mosaicism (1%). It occurs in approximately 1 out of every 691 births, and more than 400,000 people are living with Down syndrome in the United States. These individuals are born with an extra copy of the 21st chromosome. They are able to work, go to school, develop meaningful relationships, make their own decisions, and participate in society however they wish! According to the National Down Syndrome Society, “Quality educational programs, a stimulating home environment, good health care, and positive support from family, friends, and the community enable people with Down Syndrome to lead fulfilling and productive lives.”

You are welcomed here!

Here at Carolina Therapy Connection, we are honored to serve our families who have children with Down Syndrome! One of our special friends, Hannah Hill, has made tremendous progress in her therapy. Her mother stated, “Because Hannah is very verbal, people often ask me if she has a ‘mild’ case of Down Syndrome. It’s not commonly known that there is no ‘spectrum’ of Down Syndrome! You either have it or you don’t! While the extra chromosome does impact their lives, people with Down Syndrome are unique, and have their own strengths and weaknesses. They have physical features, personality traits, abilities, challenges, interests, successes, and failures just like everyone else!”

Hannah: Age 8

How can therapy help?

Speech therapy services provided by a speech-language pathologist reap great benefits. Many children with Down syndrome develop language later than same-age peers. Low muscle tone could also impact the ability to produce speech sounds accurately, and therapy is paramount to helping a child develop the ability to confidently and effectively communicate their thoughts, feelings, wants, and needs. SLPs can provide assistance with prelinguistic and oral-motor skills, as well!
Physical therapy can help a child with Down Syndrome starting at a young age to increase strength and gross motor development. From rolling and sitting, to developing an efficient walking pattern, and even participating in sports, physical therapy can make a huge difference in a child’s life. In a physical therapy session, our PT’s will focus on things such as: gross and fine motor development, balance, coordination, and age-appropriate daily living skills.
Occupational therapy can assist people with Down Syndrome in learning to complete many everyday tasks. Occupational therapy will provide support specifically in three areas, motor, cognitive, and sensory integration. Specifically, an occupational therapy session may include activities that promote self-care, fine motor, play, and social skills!

A Total Communication Approach

Many parents are excited to begin therapy and learn ways to promote and enhance communication for their children. According to our colleagues at the Boston Children’s Hospital Down Syndrome Program, a Total Communication Approach can be beneficial! The Total Communication Approach means using any functional means of communication; this could include: verbal speech, ASL, gestures, pictures, and/or simple or high-tech communication devices. Many children with Down syndrome are visual processors, and the goal of Total Communication is multi-sensory (i.e., visual, auditory, tactile, etc.) in order to encourage any form of expression. What are some ways to facilitate this approach at home?

Visual input: Pointing to objects and pictures that you are naming or describing.
Use sign language for basic words (eat, want, bath, play, etc.). Research shows using signs increases understanding and offers an additional method for communication.
Incorporate music into pretend play.
Joint book reading. Follow your child’s lead!

How can Carolina Therapy Connection help?

Children with Down Syndrome often benefit from therapy from skilled professionals, including speech-language pathologists, occupational therapists, and physical therapists. At Carolina Therapy Connection, our treatment is highly individualized to your child’s needs. A standardized assessment will be administered to detect any delays, and our therapists will work with you and your child to develop a plan for enhancing skills to build confidence across all social environments (home, school, social groups, etc). If you have any concerns or questions regarding your child’s development, call our clinic at (252) 341-9944.

By Ashley Holloway, MS, CCC-SLP, CAS

Is My Child Ready For Potty Training?

Posted on October 3, 2023October 4, 2023

Is My Child Ready For Potty Training?

Many parents ask the question, “Is my child ready for potty training?” Making the transition out of diapers is an important developmental milestone but it can also be a topic that causes frustration and anxiety for both children and their caregivers. Questions about when to start and how to promote a child’s success with potty training can feel overwhelming. If you are a caregiver that can relate to any of those feelings, this blog post is for you!

When Should I Start Potty Training?

This is a question that many caregivers ask themselves. A variety of factors must be considered before initiating the toilet training process. A child must be physically, emotionally, cognitively, and physiologically ready prior to starting the process. Here are some tips to identify whether your child may be ready:

Emotional readiness – Can your child tolerate sitting on the toilet or potty training seat? Are they excited about wearing “big kid” underwear?

Cognitive readiness: Can your child follow 1-2 step directions? Can they communicate their need to use the restroom?

Physiological readiness: Are they able to stay dry up to two hours at a time or wake up from a nap with a clean pull-up?

Physical readiness: Is your child able to sit on a toilet or potty training seat without assistance? Can they get on and off the toilet with little to no assistance? Can they assist with managing their clothing during toileting tasks?

If you have said yes to the majority of the above questions, then your child may be ready to begin potty training!

At what age can I expect my child to start potty training?

The following list includes general guidelines to help establish a baseline of where a child might be on their journey towards potty training. However, each child has a different timeline in which they are emotionally, physically, cognitively, and physiologically ready for potty training. It is vital that you never push a child towards progressing through the developmental sequence. If you see meltdowns or signs of regression, it may be best to take a break and try again at a later time.

Developmental Sequence for Toileting:

1 year – Children indicate that they are wet/soiled through non-verbal signs of distress

2 years – Child begins to tolerate sitting on the toilet

30 months – Child communicates that they need to use the bathroom and will likely require assistance with managing their clothing and wiping

3 years – Children will initiate using the toilet independently. They may attempt to wipe but continue to require assistance for thoroughness.

4-4.5 years – Children may have a few accidents. They are able to manage their clothing independently.

5 years – Child is able to complete a full toilet routine independently, including washing and drying their hands.

5-7 years – Children are consistently able to stay dry throughout the night.

Tips to Help Progress Through the Potty Training Process

Make potty training FUN!

Whether it is the sound of the toilet flushing or the new environment, some children may have a fear of sitting on the toilet. If a child is anxious, they may be hesitant to sit on the toilet or may not even tolerate sitting on it. One method to help ease this transition is to allow the child to play with their favorite toys while sitting fully clothed on the toilet. Another method to make potty training fun is to invite the child into the process. You can do this by allowing the child to pick out their underwear and ask them to choose their potty seat. This helps address their newfound need for autonomy and allows them to take pride in the potty training process.

Consistency is key.

Establishing a consistent routine will help minimize a child’s accidents and increase their likelihood of using the toilet successfully. A general guideline is to prompt the child to sit on the toilet as soon as they wake up, after naps, and in two hour intervals throughout the day. Encourage your child to sit on the toilet for a few minutes at a time. It can be helpful to read a story to them while on the toilet or provide them with a preferred toy to make this time fun and engaging.

Know the signs.

If a child is squatting, holding their genital area, or fidgeting, they may need to use the bathroom. Prompt the child to sit on the toilet when these signs occur. This can help the child become familiar with these signals to increase their ability to identify these signs as well.

Celebrate the small victories.

It is important that parents and caregivers build up a child’s confidence and self-efficacy during the potty training process. Caregivers can do this by providing their child with positive praise and celebrating the small victories! Some examples of this include praising their child for sitting on the toilet, communicating that they need to use the bathroom, successfully using the toilet, and completing all other steps in the toileting sequence (ex. Pulling up their pants, flushing the toilet, washing their hands). Sticker charts can also help motivate children to use the bathroom by providing them with a tangible reward to work towards!

Know there will be accidents.

In combination with Point 4 above, it is important to know that accidents will happen and how to respond when they do. Never punish a child for soiling their clothing. Instead, always be prepared with an extra set of underwear or clothing, especially when going out in the community.

You can find more tips on the potty training process here!

How can Carolina Therapy Connection Help?

If your kiddo struggles with self-regulation, completing their daily activities, or meeting developmental milestones, call our clinic at (252) 341-9944! Your child may benefit from an occupational therapy screening or formal evaluation!

Blog By: Emily Britt, OT

Does My Child Have Dyslexia?

Posted on September 12, 2023October 4, 2023

What is Dyslexia?

Dyslexia targets about 15-20% of our population! Most of us may not even know we are dyslexic. We could continue our lives undiagnosed and seek little to no help with this problem. Many people with Dyslexia that have been evaluated struggle with academics, self-esteem, and most importantly, they struggle with reading/writing within their own home and in the school environment. Many adults with this diagnosis have difficulties with finding or obtaining employment and causes them to lose self-confidence. Dyslexia is a type of learning disability, specifically reading, but not to be compared with low intelligence. There are many types of disabilities that involve learning, but dyslexia meaning is more in-depth of someone having issues with learning to read, although they are most likely educated enough to learn when want to learn.

What are the symptoms of dyslexia before and at school age?

When it comes to signs of Dyslexia, it can be difficult to visually see a child’s symptoms before they reach a certain age or start going to school. There’s a high chance that the child’s educator will notice an issue before the caregiver.

Here are some signs of Dyslexia:

The child will have difficulties with letter reversals; (b and d) and/or word reversals (was and saw).
Your child could be a late talker.
Problems processing and understanding what is heard
The child may have difficulties with reading aloud and learning new words and an age-appropriate pace; the child may avoid activities that involve reading
The child may mispronounce words; or form words incorrectly, such as reversing sounds in words or confusing words that sound alike.
The child may have trouble with rhyming words and remembering nursery rhymes
Difficulties with math word problems.
Difficulties with understanding jokes, punchlines, sarcasm, and inferences.
Your child may have difficulties with following a written outline of directions or telling directions.
Difficulties with spelling, learning to read, and recalling names or words.

What Causes Dyslexia?

Dyslexia is not a disease. It is a neurological condition caused by the way the brain is wired up enabling reading and writing causing the individual to result in utilizing coping strategies to adapt to normal environments. Studies show that an individual born with this condition are neither more nor less intelligent than the general population. Research has shown that dyslexia is one of the most common inherited neurological disorders an individual is born with. Even though it affects how the brain processes reading and language, most children have average or above-average intelligence; therefore, work extremely hard to achieve and overcome their reading problems.

What should you do if you suspect or if your child has Dyslexia?

Have a conversation with your healthcare provider and discuss your child’s reading level if you or his/her teacher notice a below-level reading status for your child’s age or if you notice other signs of dyslexia. Fortunately, with the proper assistance, most kids who are dyslexic can learn to read and develop strategies that allow them to stay in the regular classroom. If you suspect you or your child may be dyslexic, early detection and evaluation to determine specific needs and appropriate treatment can improve success. In many cases, treatment can help children become competent readers. It’s important to set an example and support your child with goals that are attainable. Show your child that reading can be enjoyable.

Set Goals for yourself and the child:

As a parent, you should play a key role in helping your child succeed.
You can assist your child by reading aloud to them while they are young, then transition to reading together when they’re old enough.
You can also listen to recorded books with your child.
Collaborate with your child’s educator.
Engaged in creating a schedule for reading time.

How can Occupational Therapy help?

Pediatric occupational therapists and certified occupational therapy assistants can encourage children to participate in meaningful tasks within the school and home environments. Therapists can assist in managing dyslexia and assist in increasing children’s confidence and participation in reading and writing tasks. Occupational therapy for kiddos really focuses on building confidence and implementing client-centered care for the child and their families. OT’s can provide strategies for home and school such as:

Implementing multi-sensory approaches – using other senses to approach learning such as seeing, listening, doing, and speaking).
Visual prompts: Providing visual prompts for both instructions and organization.
Visually sequencing tasks (or components within a task) using visual cues.
Use of colored lines and templates to assist with line placement and letter sizing.
Visual strategies to assist with reading and spelling such as colored coding paper size according to letter size.
Using modeling techniques rather than only giving a simple verbal instruction
Letter formation practice

Written By: Carlos Guilford

Why Is Food Play Important For Picky Eaters?

Posted on August 17, 2023October 4, 2023

What Is Food Play?

As a child, most of our parents would tell us not to play with our food…well, sometimes playing with food is a great benefit for children.

Food play is an important sensory play activity for children with sensory defensiveness and those that are picky eaters. This type of play can be fun and a non stressful way for children to explore different foods using all of their senses. Children gain skills through play-based learning. Food play is a great opportunity for children to explore and learn about foods and over time become comfortable with interacting with the foods. Not only does food play increase exposure to different foods, it improves fine motor skills for self-feeding, imaginative play, family interaction, and increases vocabulary to help describe foods.

Food Play Activities:

Pretending to make a meal for you, their dolls or friends.
Having a tea party with dolls or parents.
Playing restaurant
Using a paint brush and paint with puree food
Using tongs to play with cooked noodles
Cutting foods with knife or a cookie cutter
Simon Says with food (placing food on different parts of the body, make it dance, make a noise, take a bite, etc.)
Making a sensory box out of cereal or dried noodles
Drawing with shaving cream, apple sauce, or pudding with their finger
Driving cars and digging through rice, beans, or dried noodles
Cutting foods into small pieces to feed to toy animals

Great Tips for Setting Up Food Play Activities:

During food play, go with the pace of the child. Do not force your child to do food play. It should be a positive and low-pressure activity. Present foods with different colors, shapes, sizes, and textures. You can present foods during food play that you would like your child to eventually eat. It is important that food play should not be engaged in the child’s regular mealtime environment. Conduct it outside, on the floor with a blanket, activity table, etc. During food play, it is okay if the child denies eating the food that is being presented. Remember the goal is to expose the child to these foods not consumption. You can model eating the foods but try not to pressure your child into eating.

How Can Carolina Therapy Connection Help?

In addition to utilizing the tips above at home, we know that sometimes children need an extra push to expand their food repertoire. At Carolina Therapy Connection, our occupational and speech therapists provide feeding therapy that uses a collaborative approach to work closely with you and your child to determine the source of a child’s feeding difficulties, and develop specific intervention plans to make the entire eating process easier and more enjoyable. Often times, feeding therapy happens on a weekly basis and may consist of working on difficulty with trying new foods, chewing, swallowing, sensory issues, irritability at meal time and so much more. Our goals are to broaden your child’s scope of foods, teach them the benefits of healthy eating, and develop oral motor skills needed for optimal growth and nutrition.

Our Occupational Therapists take a sensory-based feeding approach to therapy. They focus on: oral motor skills, sensory sensitivities, progressing through food textures, and using adaptive equipment and tools to develop self-feeding skills. They also use a process called food chaining, which is a child-friendly treatment approach that helps introduce new foods while building on the child’s past successful eating experiences. In this process, the child is presented with new foods that may be similar in taste, temperature, or texture to foods the child already likes and accepts. Our occupational therapists are certified in the SOS Feeding Approach, a nationally and internationally recognized approach for assessing and treating children with feeding difficulties.

Our feeding therapists have 15-20 years of experience with children of all ages and a variety of feeding disorders. They have certifications in SOS and AEIOU approaches and significant training from around the country on feeding approaches, treatment strategies, and focused plans. We also having consistent collaboration with other professionals in the community to guarantee the best care. Call our clinic at 252-341-9944 for a free phone screening with one of our feeding therapists and schedule an evaluation today!

Teaching Kids Independence With Life Skills

Posted on July 6, 2023October 4, 2023

Chores or Life Skills?

Kiddos may ask themselves this question: Why do I have to do these chores? Here at CTC, we call chores “Life Skills” because that is simply what they are. Although not always the most preferred thing for your child to do, washing dishes, washing clothes, making the bed, vacuuming, sweeping, mopping, grocery shopping, cooking, and many more are essential life skills that are necessary when becoming an independent adult. Not only are they necessary, they are also very helpful for the development of time management skills, executive functioning, sensory regulation, and even emotional regulation.

You may be wondering how you can gauge what skills are appropriate for your child. Below is a short list of age appropriate chores to get you started based on your child’s age:

Life Skills for 2-3 years old

Picking up toys
Wiping up a mess (wiping off the counter after eating or messy play)
Putting laundry in the hamper after taking off dirty clothes

Life Skills for 4-5 years old

Making the bed (even if it is assisting you with the task!)
Starting simple meal preparation (putting thing into bowls, stirring, etc.)
Helping wash/rinse dishes

Life Skills for 6-8 years old

Feeding pets
Vacuuming, sweeping, mopping
Folding laundry/putting away own clothes

Life Skills for 9-12 years old

Prepare simple meals (heating up a hot pocket, TV dinner or oven pizza)
Taking out garbage
Cleaning areas of the home other than own bedroom (bathroom, living room, outdoor areas)
Helping make a shopping list and helping to find items in the grocery store

13-18 years – Include all listed above with increased to total independence!

So your child may be age appropriate for the tasks at hand, but what if you wonder whether they are developmentally, emotionally, physically or cognitively appropriate for the task at this age? Recently CTC held a Life Skills camp with 4 days of fun while completing tasks that increase independence within the home environment. The kiddos in this group worked on grocery shopping, meal preparation, cleaning up after themselves, household life skills, taking care of pets and plants, team work and communication. During the camp, each child was asked to review their skills and determine the toughest part of doing “chores”. The #1 answer was time management and feelings of overwhelm when presented with multiple tasks to complete. We all worked to develop either written or visual (picture) schedules for each kiddo to take home to aid in these concerns, making getting these life skills done easier and less frustrating!

Talk to your child’s occupational therapist to see if these could be options to help your child regulate their emotions, plan their time with greater efficiency and learn new skills after mastering current ones! If your kiddo struggles to complete their daily activities, call our clinic at (252) 341-9944! Your child may benefit from an occupational therapy screening or formal evaluation!

Here is 2 recipes of foods that were made during the camp:

Rice Kripsy Treats – The Original Rice Krispies Treats™ Recipe | Rice Krispies®
Soup (written by a kiddo in the camp)

Ingredients

3-4 boneless chicken thighs
1 medium onion
3 carrots, sliced
2 chicken stock boxes
1 small rice pack (boil in a bag)
1 can black beans

Add a pinch of…

Pink Himalayan Salt
Chili powder
Seasoned Salt
Black pepper
Red pepper flakes

MIX TOGETHER IN A SMALL BOWL

Steps:

Make the rice according to directions on the rice bag
As the rice is cooking, cut chicken into 1 inch cubes
Sprinkle seasoning onto chicken
Cut carrots and onion into preferred size and cook until preferred texture
Cook the chicken until done in saucepan
Once all ingredients are finished, combine with stock in a pot and boil for 2-5 minutes
Simmer for 10-15 minutes

Written By: Shelby Godwin, COTA/L, AC

Why Does My Child Put Everything In Their Mouth?

Posted on May 24, 2023October 4, 2023

What is Oral Sensory Seeking?

Oral Sensory Seeking is the constant desire or need for a child to place objects in or touch their mouth. Children who have an oral fixation usually feel the need to constantly chew or suck on something. Depending on the age of the child, this may or may not be appropriate. As a parent, this can be difficult to navigate, especially due to the risk of choking on small objects. We know it is impossible to have eyes on your child every minute and scary to feel like you need to keep everything picked up off the floor and out of reach at all times. The oral stage of development that happens from birth to 21 months involves an infant’s pleasure center being focused on the mouth and lips, which are used for sucking and feeding. This is the age when the infant puts everything in the mouth—from hands, fingers, wrists, toys, pacifiers, clothing, blankets … just about anything within hands reach. One of the first prominent objects the baby’s mouth becomes accustomed to is a mother’s breast, for milk. In this blog, we will explore some of the reasons why your child may continue seeking additional oral sensory needs when it is no longer age-appropriate and activities to help them with this behavior.

What are Oral Sensory Seeking Behaviors?

When a child chews, mouths, sucks, or bites non-edible objects and/or edible objects frequently, we will call this an oral sensory seeking behavior. It can also involve harmful behaviors like biting. Some children who are seeking out oral and tactile (touch) sensory input will bite parts of their body, such as the arms, legs, feet and hands. Although oral seeking behavior can help children regulate their bodies and emotions at times, it can also prevent children’s learning if the child is constantly looking for objects to put in their mouth, or cause harm when they bite or suck on themselves. If children are distracted by finding objects or fixated on this behavior, it can affect their ability to focus at school or on an activity at hand.

Here is a list of common oral sensory seeking behaviors:

Excessive or frequent licking and/or chewing of random objects or toys
Excessive or frequent chewing of soft items or clothing (shirt sleeves, bed sheets, blankets, stuffed animals)
Biting toys or people, especially when unprovoked or when overly excited
Chewing the inside of the cheeks or biting/sucking on lip
Biting nails
Grinding teeth
Stuffing mouth with food or holding food in mouth for a long period of time
Drooling or spitting purposefully

How Can I Help My Child With Oral Sensory Behaviors?

Although there are a variety of ways to provide oral sensory input to children in a safe way and to replace oral sensory behaviors.. no child is the same when it comes to the solution. Our occupational therapists at Carolina Therapy Connection recommend that you experiment with these activities as part of your child’s sensory diet and notice what tends to calm, alert, and/or regulate them.

Create a FREE sensory diet with this template from “Your Kids Table” HERE!

Oral Sensory Seeking – Chewing Activities

Chewing crunchy foods, chewy foods, gum etc.

Use a chewy jewelry or other sensory chew toys

Vibrating chew toys (for kiddos who need that extra sensory input!)

Various Activities for Sensory Input

Blowing bubbles or blowing up balloons
Suck on sour candies, lollipops, ice cubes, etc.
Clicking tongue
Drink various textures through a straw (apple cause, milkshakes, yogurt, pudding, etc.)
Whistles, party blowers, kazoos, harmonicas, pinwheels etc.
Make a bubble mountains with dish soap and water

How can Carolina Therapy Connection help?

Occupational therapy addresses any barriers that affect someone’s physical, mental and emotional wellbeing, which includes sensory integration difficulties. 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. Often times, oral sensory processing or seeking difficulties are paired with other sensory system difficulties. 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.

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, providing oral sensory input 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.).

Our occupational therapists will complete an initial evaluation to become familiar with your child’s strengths, weaknesses and daily routine. Following the evaluation, they will create an individualized treatment plan and goals to address any concerns with development. We take pride in making therapy enjoyable and fun for your child, so that they can be motivated to live their life to their greatest potential. If you are interested in a FREE occupational therapy screening in the Greenville, Goldsboro, or New Bern, NC areas, call us at (252) 341-9944.

Mealtime Tips For Your Picky Eater

Posted on January 20, 2023October 4, 2023

Why Is Mealtime So Important For Children?

The 3 most important things for humans to survive is: food, water and oxygen. For some parents, the concern for their kiddos health and well-being becomes heightened when they notice their kiddo isn’t eating as much food or as many types of foods as they may have at one time. Some kiddos who are referred to Occupational Therapy are considered “Picky Eaters” and others may be referred to as a “Problem Feeder”. We all know a picky eater. This is a person/kiddo who has at least 30 foods in their repertoire. Whereas a “Problem Feeder” is a person/kiddo who has less than 20 foods in their repertoire. There are many reasons this could happen such as trauma, sensory related challenges, anxiety, behavioral challenges, and more. As Occupational Therapists, we are trained to assist these kiddos by addressing these challenges which can increase their tolerance for trying new foods! Keep reading to learn more picky eater tips we have below!

So why is MEALTIME so important to assist with this?

One of the first things we will ask as OTRs or COTAs is “What does mealtime look like at home?” Some parents may say,

“We all sit down as a family every night for dinner but we are busy or gone for breakfast and lunch”, “We are so busy that we are lucky to eat all at the same time”, or “(The child) eats all day but won’t eat the food I cook at dinner”. Of course these are just examples, but can you relate to any of them? It’s a possibility!

Asking about mealtimes is very important to your therapist because this gives us an idea of how your child eats during the day. Kiddos need fuel to keep their bodies going. However, WHAT they are taking in and HOW/WHEN they are taking it in will make a huge difference in behavior, attention, ability to process/retain information and regulate emotions/emotional responses. To give you an idea of why the “what”, “how” and “when” are so important, I’ll follow up on the questions above.

1. “We all sit down as a family every night for dinner but we are busy or gone for breakfast and lunch”

This could be a beneficial time to incorporate feeding techniques and build interest in the foods around the table. Interest always comes before action. A child must first be interested in the food before they will interact with it. This is one reason that mealtime is so important for kiddos. It can be an opportunity to build interest in various smells, sights, and textures of foods provided by parents in a supportive and positive manner.

2. “We are so busy that we are lucky to eat all at the same time”

How can you work your schedule to have a least one meal together every other day? We understand that this busy world requires busy people to keep it going. However, when you are overwhelmed and exhausted your child may pick up on that. Children are very intuitive. Incorporating as many mealtimes as possible may assist with parent/child interaction and decreasing anxiety and overwhelming emotions in adults which can in turn make eating less stressful for a “picky eater”.

3. “(The child) eats all day but won’t eat the food I cook at dinner”

Grazing is when a kiddo eating little snacks all throughout the day. Have you ever seen a child leave a snack on the table, go play for 30 minutes, then return to finish the snack? If your child is doing this all day, it may explain why they are not eating at mealtimes. Typically, the brain lets us know when we need to refuel because the digestive system sends signals saying, “I’m empty in here!”. When grazing, a child’s brain will begin to have a hard time distinguishing when the child is hungry due to constantly having food in the digestive system. This can effect metabolism and the ability to regulate hunger. When given mealtimes, the body has time to regulate, digest and filter out what it needs for fuel. Additionally, if given processed snacks that are high in sugar or carbohydrates throughout the day, the body will begin to crave them. This can create a difficult loop to break when introducing thing like vegetables, meats and some fruits. Positive interactions at mealtimes can assist with parent/child interactions, lowering anxiety and stress levels, giving the child’s body time to process what it needs for fuel and providing learning opportunities for the sensory system. This can be a major changing factor in how your child engages with food!

Additional Mealtime Picky Eater Tips

Picky Eater Tips #1: Don’t force foods on children

As parents, we want our children to eat a variety of foods, including vegetables, fruits and other healthy snacks to help them grow to be strong and healthy. Studies show that forcing a child to sit and eat until they have cleared their entire plate is not the best method for achieving this goal. Instead, parents should promote foods that may have not been a hit the first time around. You can model this yourself by trying a food you haven’t liked in the past, and explain that you’re giving it another chance because your tastes may have changed. We want to show kids that we are adaptable. Remember: It can take as many as 10 or more times tasting a food before a toddler’s taste buds accept it.

Picky Eater Tips #2: Get Creative With Food Bingo

You can also put together a list of new foods for the family to try and make a game out of it—what will we try tonight? You can make it interactive and fun by doing something creative like Food Bingo. There are many free printable online similar to the image shown below. You can even make your own! Hang it on the fridge and have your child place a sticker or check off the new foods they have tried. You can even add in a reward for them getting “bingo” – a trip to their favorite place, a new toy, a play date, or something else they really enjoy!

Picky Eater Tips #3: Don’t Make a Second Meal

When you serve a meal to your family and your kiddo refuses to eat it, we recommend having simple and consistent back up options, such as yogurt, a cheese, nut & fruit snack pack, apple sauce, cereal etc. It’s important for children to know that if they can not eat the meal you have prepared, they will receive the standard option – rather than the usual chicken nuggets baked quickly in the oven. We should also teach kids that a meal isn’t ruined if it comes in contact with something they don’t like. Finding an unwanted pickle on your cheeseburger will not contaminate it. Children should be encouraged to push food they don’t like off to the side, or onto another plate, or offer to share it with someone else.

Picky Eater Tips #4: Involve Your Kiddo in the Meal Prep Process

Some cooking tasks are perfect for toddlers and small children (with supervision, of course): sifting, stirring, counting ingredients, picking fresh herbs from a garden or windowsill, and “painting” on cooking oil with a pastry brush. Allowing our children to interact with the foods they are going to eat will help to promote and encourage them to try it!

Picky Eater Tips #5: Food Chaining

Once your kiddo tries a new food and that food is accepted, use what one our Occupational Therapist’s favorite pickle eater tips call “food chaining” to introduce others with similar color, flavor and texture to help expand variety in what your child will eat. Children with sensory concerns have difficulty with leaping from the types of food they are willing/able to eat. Food chaining builds a bridge to get to those foods you really want your child to eat one step at a time through links to food they’re already eating. Examples include:

If your child likes pumpkin pie, for example, try mashed sweet potatoes and then mashed carrots.
If your child loves pretzels, try veggie straws next, and then move on to baby carrots or carrot sticks. Carrots are hard, crunchy, and stick shaped, but are cold and have a different taste.
If your child loves French Fries, then give a try to Zucchini fries.
Move from cookies to Fig Newtons, to jam toast, to jam sandwich, to bread with sliced strawberries, and lastly to fresh strawberries
If chicken nuggets are the fan favorite, try to first change the brand of nuggets, then move to homemade chicken nuggets, then to homemade tenders, and lastly to a baked chicken breast.
Maybe your kiddo love goldfish crackers. Next give Cheeze Itz a try, and then move on to saltine crackers, and lastly to saltines with cheese slices.

How Can Carolina Therapy Connection Help?

Blog Written By: Shelby Godwin, COTA/L, AC & Morgan Foster, MS, OTR/L

The Vestibular System in Pediatrics

Posted on October 3, 2022October 4, 2023

What is the Vestibular System?

Vesti-what?!? The vestibular system is made up of the inner ear, vestibulocochlear nerve that communicates between the inner ear and brain, parts of the brainstem, and cortical areas in the brain. The vestibular system responds to head movements like when you nod your head “yes”, shake your head “no”, or tip your head to shake the water out of your ears. It also responds to movements like when you move forward or backwards when you’re sledding, move up and down like when you’re jumping, or when you spin around in circles. Overall the vestibular system helps you figure out where you are in space as you move around your environment so that you can…

Maintain your gaze on a target while moving your head (vestibulo-ocular reflex)
Maintain postural control or balance
Orient yourself to your environment
React appropriately to your surroundings
Avoid falls

Check out this helpful resource from Integrated Learning Strategies, who breaks down the vestibular system as an internal GPS system for the body!

What is vestibular dysfunction?

Vestibular dysfunction may be attributed to deficits or impairments of the inner ear, vestibulocochlear nerve, brain, or brainstem. As adults we may notice difficulties with our vestibular system due to symptoms like dizziness, vertigo, trouble keeping objects in focus while moving our head, or changes in our balance. Children who have vestibular concerns may not realize that they are dizzy or that movement of letters when reading is atypical if they have always experienced these symptoms. This can make diagnosing vestibular concerns hard and can often times be mistaken for other issues (learning disabilities, behavior problems etc.) due to a child’s inability to explain the symptoms they are experiencing.

Migraines, Benign Paroxysmal Vertigo of Childhood (BPVC), and Traumatic Brain Injuries are the most common causes of childhood vertigo. Ocular disorders, inner ear malformations, labyrinthitis (inflammation of the inner ear), and neuritis (inflammation of the vestibulocochlear nerve) are also common causes.

As a parent, here are a few signs and symptoms to watch for regarding vestibular dysfunction:

Head tilted to the side
Easily stressed, anxious, or upset with quick changes in movement or being on unstable, uneven, or taller surfaces
Nausea and vomiting
Imbalance or frequent falls
Vertigo or dizziness
Reduced cognitive performance
Decreased consciousness or arousal
Poor spatial awareness, navigation, or orientation
Ringing in ears
Spontaneous and involuntary eye movements
Motion/car sickness
Constant need for movement or taking unsafe risks for various positional changes or movement patterns

What should you do if your child is experiencing vestibular dysfuntion?

First and foremost, consult your child’s pediatrician to discuss your concerns. You may be referred to a neurologist for further evaluation and recommendations. If your child’s pediatrician or neurologist determines that your child would benefit from Physical or Occupational Therapy treatment, your child may be referred for an initial OT and/or PT evaluation.

How can a pediatric occupational therapist or physical therapist help with vestibular concerns?

During the initial evaluation your therapist may…
- Assess how your child’s eye move in a variety of situations
- Screen for abnormal eye movements
- Assess your child’s visual acuity
- Test your child’s balance while static or standing still, as well as their dynamic balance while on a variety of surfaces, while they are moving, or while they are performing a task
- Assess how your child responds to various positional changes and movement patterns
- Assess for seeking or avoidance behaviors of various positional changes or movements
During treatment your therapist may…
- Use balance beams, obstacle courses, balance boards, single leg stance activities, etc. to challenge and improve your child’s balance.
- Use stair training, climbing a rockwall or ladder, standing on a platform swing, etc. to address gravitational sensitivities and challenge balance at various heights.
- Use swinging, spinning, rolling in a foam cylinder, sliding down slide, riding on a scooter board, etc. to help strengthen your child’s vestibular system. These activities will also potentially help delay the onset or reduce the severity of your child’s dizziness.
- Use specific activities involving movement of their eyes and head to strengthen their vestibular system.

If you have concerns about your child’s vestibular function, motor development, sensory difficulties or anything else, call Carolina Therapy Connection at 252-341-9944 or email us at info@carolinatherapyconnection.com to get started today! We accept all major insurances and would love to help your family and kiddo maximize their independence and potential to grow healthy and strong!

Blog Written By: Joann Flaherty, PT, DPT and Jessica Reynalds OTD, OTR/L

References:

Casselbrant ML, Villardo RJ, Mandel EM. Balance and otitis media with effusion. Int J Audiol. 2008;47(9):584-589.
Christy, J., Beam, M., Mueller, G., & Rine, R. (2019). Just Screen It!! (Part 2): Developmental Disability, Vestibular Deficit, or Both?. Presentation, APTA Combined Sections Meeting.
Christy, J., & Rine, R. (2019). Just Screen It!! (Part 1): Developmental Disability, Vestibular Deficit, or Both?. Presentation, APTA Combined Sections Meeting.
Lin, C. (2019). Vestibular Rehabilitation Intervention. Presentation, East Carolina University.
Salami, A., Dellepiane, M., Mora, R., Taborelli, G., & Jankowska, B. (2006). Electronystagmography finding in children with peripheral and central vestibular disorders.International Journal of Pediatric Otorhinolaryngology, 70(1), 13-18. doi:10.1016/j.ijporl.2005.05.001
Wiener-Vacher, S. R. (2008). Vestibular disorders in children. International Journal of Audiology, 47(9), 578-583. doi:10.1080/14992020802334358