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All About Occupational Therapy

What is Occupational Therapy? 

The main goal of OT is to increase quality of life so that the client can continue to participate in their personal interests as well as take care of their own needs. Through therapeutic use of self, a strong relationship of trust is built between client and therapist that will help the client to grow in skills leading to increased independence. Occupational therapists improve, rehabilitate, or maintain individuals’ performance to complete everyday occupations (IADLs & ADLs).

What is the role of an Occupational Therapist?

As an occupational therapy assistant, working in the pediatric setting, it is my responsibility to implement activities and tasks that will improve my clients ability to perform at an age-appropriate level. In this setting, you will commonly see OTs working on improving age-appropriate grasp and legibility with handwriting, sensory processing, oral motor skills for feeding, core strengthening for postural control, hand strengthening to increase fine motor skills, visual motor/perceptual skills for copying shapes and or letters.

What are IADLs?

IADL’s stands for Instrumental Activities of Daily Living that involve your home and community. Below is a list of different IADLs an individual may complete regularly.

  • Care of others
  • Care of pets
  • Communication management
  • Driving and community mobility
  • Financial management
  • Health management and maintenance
  • Housekeeping
  • Food preparation
  • Religious and spiritual activities
  • Shopping

What are ADLs?

ADL’s stands for Activities of Daily Living and are basic self-are tasks an individual engages in daily.

  • Bathing
  • Grooming
  • Toileting
  • Dressing
  • Feeding
  • Transfers
  • Abulation

How Can OT Benefit Children? 

Occupational therapy can benefit children of all ages with a variety of needs and diagnoses including:

At CTC, our occupational therapist provides screenings, assessments, consultations, and treatment for those concerned about: 

  • Cognitive skills
  • Gross & fine motor skills
  • Self-care tasks
  • Self-feeding tasks
  • Sensory processing
  • Visual processing & perception
  • Social skills

How can Carolina Therapy Connection help?

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.

We use evidence-based treatment approaches including:

If you have questions regarding your child’s development or want to learn more about occupational therapy, call our clinic today at 252-341-9944 or visit our referrals page HERE. We provide services in Greenville, Goldsboro and New Bern, North Carolina. One of our licensed and board certified therapists will be happy to provide you with a FREE developmental screening today! We can’t wait to begin this journey with your family!

Blog Written By: Lacey Smith, COTA/L 

Does My Child Need a Sensory Diet?

What is a Sensory Diet?

As a COTA, during my first visit with a family for Occupational Therapy Services I am looking for and asking about ways to develop a sensory diet for home, school and/or community use.

I often get the question, “What is a Sensory Diet?”

A Sensory Diet is a personalized, organized plan that provides sensory input activities that a person needs to regulate their body throughout the day.

What does it mean to “regulate”?

Sensory regulation is easier to understand once you understand how your senses impact your body. The five senses known to most people are taste, touch, smell, sight and sound. Some people are unaware that you also have two other senses: vestibular and proprioceptive. The Vestibular System is responsible for regulating spacial orientation and providing the brain with information about movement and head position so that our body’s can coordinate movements appropriately. The Proprioceptive System helps regulate body movement by providing our brain with information about force provided primarily through our joints and muscles. Now we have seven systems to look at! To understand more about children’s sensory systems, how they affect learning and sensory integration therapy, read our blog: “Making Sense of Our Experiences.”Vestibular System Carolina Therapy ConnectionProprioceptive System Carolina Therapy Connection

What can be addressed with a sensory diet?

Jumping, crashing and or falling on purpose could look like a kiddo is being too rough or is clumsy. We want to figure out why this is happening. Could this be that the kiddo’s body is not confident about where it is in space, which is regulated by the vestibular system? Could this be because the kiddo’s body is considered “under responsive”? This means simply that this kiddo’s body may not register textures or body movements on the same scale as yours or mine. They would be considered UNDER responsive because their body is always looking for MORE sensory input. If their sensory system is not regulated, it will most likely cause them to try to find ways to do that on their own. This may come out in excessive jumping, movement, crashing into things, falling on purpose, touching everything nearby, etc. This can be frustrating and scary for a parent because the last thing you want is to see your kiddo hurt!

What sensory diet look like on a day-to-day basis?

This is where a sensory diet comes into play. A sensory diet will be comprised of special exercises that are specific to your child’s age, physical and cognitive capabilities. We will also look at your schedule for the day and what items you have at your availability. This does not necessarily mean that you will need 3-4 hours of strength training with your kiddo or a gym with equipment to complete these tasks. It can as simple as using the own body in appropriate ways to provide the input needed! For example, if you are out in the community and see a lot of high energy movements coming from your kiddo, try bunny hopping all the way down the isle at the store or have them help you care bags of groceries, etc. At home, depending on the child’s age and abilities, helping with household chores such and carrying the laundry basket, vacuuming, wiping down the table after dinner, etc. Input can also be provided by drinking thick liquids like milkshakes through a straw, eating crunchy foods/snacks and chewing gum. These simple activities provide the child with the gross motor movement, deep pressure through the joints/muscles, heavy work (as long as it’s appropriate for the age) and the confidence of knowing that they CAN feel regulated!

How can Carolina Therapy Connection help?

Each sensory diet will be very specific to each child, so it is important that you stick with it and consult with your Occupational Therapy Practitioner before making significant changes or if it does not produce the outcomes you are expecting. Please also remember that this change does not happen over night, so please don’t be discouraged if there is not an immediate change. Think of it like a weight loss diet. You cannot expect to eat healthy and exercise for one day and reach the outcomes you want. It takes work and dedication on all parts! The important element here is that the child, with your help as parents, learns helpful and appropriate strategies to regulate their body. This will help in so many more areas such as; school performance, attention, behaviorally, emotionally, etc.

Please talk to your Occupational Therapy Practitioner about a Sensory Diet today or call our clinic at 252-341-9944 to get started!

Written by: Shelby Godwin, COTA/L, AC

Shelby Godwin Occupational Therapy Assistant Carolina Therapy Connection Sensory Diet Goldsboro NC

Image References: Tools to GrowOT

At Home Spring Activities

Spring Fun in Full Bloom!

Spring has officially sprung here at Carolina Therapy Connection! We are taking full advantage of all of the creative opportunities to foster a supportive learning environment. The onset of a new season also brings opportunities for fun, hands-on ways to incorporate goals into daily play routines!

 

The Role of Play

Play is the predominant way that our children learn; it helps them develop and grow into functional roles necessary for daily living. Play helps them access the world around them and is one of the PRIMARY occupations in which they engage.

Through play, we help our children to explore and thrive in a way that is interactive and full of purpose! Here are some of our absolute favorite ways to employ play in a meaningful way. Check them out and share your joy!

Fine Motor Coordination Spring Themed Activities 

  • Lacing rainbow
  • Button Flowers
  • Nature Scavenger Hunt (Handwriting and Grip Development)
  • Seed Sorting
  • Chalk! Make this activity as structured or as creative as you would like. Upgrade the challenge by having them help to “wash it off” using a water gun or spray bottle for greater strengthening of the hand muscles, development of age appropriate grasping patterns, and overall coordination.

Gross Motor Spring Themed Activities 

Spring Themed Sensory Play

We can’t get enough sensory play around the clinic! Sensory play and exploration is vital for developing brains, and has such an important role in overall health and development. Any activity that engages your child’s senses is considered sensory play, but did you know that each new experience builds upon the last? Through sensory play, our children learn to plan movements, develop organizing concepts such as color, shape, texture, foster problem solving, and many more!

So, go ahead.  Squish, scoop, jump, smash, smear, and dig into these ideas for your next play activity!

Feel free to share your creative and fun spring festivities with other families on our social media! 

Additional resources to help keep the Spring fun going!

OT Toolbox: Spring Gross Motor Activities

Pink Oatmeal: Spring Themed Gross Motor Ideas

Kindergarten Connection: Spring Themed Fine Motor Activities 

 

Written by: Katie Joyner, MS, OTR/L

Katie Joyner Carolina Therapy Connection Occupational Therapy Spring Activities

 

Spring Occupational Therapy Activities Carolina Therapy Connection

Does My Child’s Pencil Grasp Matter?

Does the way children hold their pencil really matter?

If you have a pencil handy, pick it up and notice how you hold it. Which fingers does the pencil rest between how are you supporting it? How much pressure do you use when you write? Does it really make a difference in your handwriting? The answer is YES, it does matter! How you hold your pencil really does make a difference—and it will also impact your writing. Your pencil grasp is directly related to handwriting speed and legibility, as having a mature grasp is more efficient and less tiring on your hands (Schwellnus, et al., 2012). Having a mature grasp also directly correlates with fine motor skills and your ability to manipulate other things (i.e. tying your shoes, picking up small objects, flossing, zipping up your jacket, using a fork or spoon).

Handwriting is essential for academic success and a foundation for efficient writing lies in how the child holds their pencil and the order in which letters are formed. It is important to address these concerns as early as possible. After the age of 8, changing grasp and formation patterns is difficult, but not impossible.

What are the stages of pencil grasp development?

There are several stages of pencil grasp development needed to develop a functional grasp that can be used to write efficiently and legibly. Each stage is important and helps to develop different muscles in the hand. Children typically develop control over the larger muscles of the trunk and arms before developing the smaller muscles of the hands. This is why grasp changes over time. Not all children will use all of these grasps during their fine motor development. Some children will use more than one grasp at an age as their skills develop and change. However, they should develop a functional mature grasp similar to the tripod grasp listed below.

 

Palmer grasp/Fisted grasp: typically develops between 12-18 months.

Palmer grasp/Fisted pencil grasp Carolina Therapy Connection Greenville NC

Digital pronate grasp: typically develops at 2-3 years.

Digital Pronated Pencil Grasp Carolina Therapy Connection Greenville, NC

5 finger grasp: typically develops between 3-4 years

5 Finger Pencil Grasp Carolina Therapy Connection, North Carolina

Four finger/quadrapod grasp: typically develops at 3.5-4 years

Four finger/quadrapod pencil grasp: Carolina Therapy Connection Greenville, NC

Tripod grasp: typically develops at 5-6 years

Tripod Pencil Grasp: Occupational Therapy Carolina Therapy Connection Greenville, NC

What is letter formation?

Handwriting is a complex process that involves many skills and body functions to work in a precise manner. Letter formation refers to the order in which each line segment is produced to make a single letter. Children should learn to form letters from top to bottom and from left to right. The order in which letters are formed either aids or interferes with efficient, legible writing.

Proper Letter Formation Carolina Therapy Connection Greenville NC

Why is proper letter formation important?

  • Children who have poor letter formation usually do not enjoy handwriting and/or the process takes longer than they would like.
  • Proper letter formation increases handwriting legibility, speed and accuracy.
  • Without the proper order of formation, letters are being ‘drawn’ more than formed and handwriting suffers.
  • Teaching proper letter formation can help to limit letter reversals such as b and d.
  • Practicing proper letter formation teaches higher cognitive skills ( i.e. working memory, sequencing, self-monitoring).

It’s important to note that every child’s handwriting style and process of learning is different and THAT IS OKAY! Our occupational therapists use a child-centered approach to help your kiddo become confident in their abilities while making handwriting FUN! If you are concerned about how your child forms letters or holds their pencil, an occupational therapist should evaluate your child. The therapist will determine if there are any skill or strength deficits and formulate a plan that is individualized for your child’s unique needs.

 

Written by: Amanda Easter, MS, OTR/L, CAS

Amanda Easter Blog - Does My Child's Pencil Grasp Matter? Occupational Therapy Greenville NC

References

Schwellnus, H., Carnahan, H., Kushki, A., Polatajko, H., Missiuna, C., & Chau, T. (2012). Effect of pencil grasp on the speed and legibility of handwriting in children. American Journal of Occupational Therapy, 66: 718–726.

Pencil Grasp Carolina Therapy Connection Greenville NC

Transitioning from Bottle to Cup

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

Ashley Holloway SLP Greenville NC Carolina Therapy Connection

 

Transitioning from a bottle to a cup Carolina Therapy Connection Greenville, Goldsboro, New Bern North Carolina

Optimizing Therapy Progress

Competence Brings Confidence

When we begin treatment with a new patient, or we begin working on a new skill at home as a parent, we often become so excited about the goal, or the end game, that we forget about all the small steps we should take to get there. Over the past 20 years working with children and families as an SLP and raising my own children I have learned that we need to celebrate the small steps in life and for therapy progress.

At some point I started telling parents of preschoolers and early elementary students, “Competence brings confidence!”

Your child might learn a very small step toward their goal in a therapy session. This small step should bring a lot of excitement, praise, and chances to “show it off” at home. These chances are growing your child’s confidence in their abilities. Those chances are giving neural connections a chance to form. Those chances are reinforcing new motor patterns. Being competent in a new skill, no matter how small, brings confidence! Confidence gives us the drive and the will to keep working hard and keep going. It keeps us excited in our pursuit to learn something new or difficult and optimizes therapy progress.

Focus on the Small Steps for Big Victories

Often parents and practitioners focus too much on the end goal.  Young children do not even know what the end goal is. We need to celebrate each very small step along the way.

With the confidence your child has from practicing a seemingly small skill at home, they come to therapy ready to move on and add more new skills. They will have the skill they have become so good at in their tool belt, and add to it! They might have started making a speech sound with confidence in isolation. When they are confident with that skill because they have shown it off many times, they will be ready to move on to making that sound in words.

In the opposite scenario we might spend time working on the small skills, try to speed along, and forget to give praise and practice at each step. We are focused on the end goal, for example, clear speech. All along your child or patient might practice and never realize all the small gains because we forget to praise them with small steps or have them show off their small steps. In this scenario, opportunities to practice important building blocks are missed. Opportunities to build confidence are missed, and ultimately the pace of progress is slower.

In the end, learning the “end goal” should have felt like many moments of satisfaction and praise to finally reach where we wanted the child to be.  It should not feel like many moments of trying and not {quite} getting there and being corrected over and over until we {finally} get good enough.

Incidentally, this works for grown ups too! If you are trying to learn something new, give yourself some grace. Focus on a small step you have mastered and practice it or show it off many times, and then move on. In the long run, you will be smarter and stronger for building competence in the small steps all along, and you will be more confident with your goal when you get there!

Optimizing Therapy Progress at Carolina Therapy Connection

The key to success is realizing that our large or end goals aren’t going to happen overnight, in the next week or maybe even the next year, but this is okay. We tend to take the present moment for granted – it seems insignificant, and we believe the little things we do in the moment are not changing us. At Carolina Therapy Connection, we believe in a culture that embraces the small victories for your family! Each time your child has milestone achievement, we will find a way to celebrate. We believe it is critical to make therapy as fun and motivating as possible by celebrating the small victories as well as major achievements. After all, when children enjoy what they are doing, who they are with and the environment they are in, anything is possible! If your family has concerns regarding your child’s development or goals you would like to achieve, call us at 252-341-9944. We would love to help you and make you a part of our CTC family and culture. 

 

Written by: Susan Hill, MS, CCC-SLP

Optimizing Therapy Progress Susan Hill SLP Greenville New Bern Goldsboro NC

 

 

 

 

 

 

 

 

 

Optimizing Therapy Progress Greenville NC Pediatric occupational speech and physical therapy written by Susan Hill

Phonological Patterns

What are phonological patterns?

So your child’s speech-language pathologist says your child presents with phonological patterns…What does that mean? Phonological patterns are “patterns of sound errors that typically developing children use to simplify speech as they are learning to talk” (Hanks, 2013). Children often demonstrate difficulty coordinating their lips, tongue, teeth, palate, and jaw for intelligible speech. There are many different patterns that your child may demonstrate.

What is a phonological disorder?

A phonological disorder is when a pattern persists past what is considered “normal” for their age. For example, if your 4 year old still uses the phonological process of “reduplication” (saying, “wawa” for “water”) that would be considered delayed since most children stop using that process by the time they turn 3 (Hanks, 2013).

Typically, if your child is exhibiting several phonological patterns, their speech is difficult to understand or “unintelligible”. You, as a parent, may understand what they are saying because you are familiar with these speech sound patterns; however, other family members and peers demonstrate difficulty understanding your child.

As described above, a speech sound disorder is considered a phonological disorder when:

  1. Phonological processes persist beyond the typical age of development.
  2. Phonological processes are used that are not seen in typical development
  3. A child is highly unintelligible due to the excessive use of phonological processes

 

Phonological Patterns Carolina Therapy Connection Greenville NC Speech Therapy

What are common phonological patterns and what do they mean?

Assimilation: when one sound becomes the same or similar to other sounds in the same word

  • Age of Elimination: 3 years
  • Example: “I want a pip” when they meant to say “I want a sip” (the “s” becomes like the “p” at the end of the word)

Final Consonant Deletion: when a child drops off or doesn’t produce the last sound at the end of a word

  • Age of Elimination: 3 years
  • Example: “Look at the bow!” for “look at the boat!”

Devoicing: when a child produces a voiceless sound instead of the voiced sound

  • Age of Elimination: 3 years
  • Example: “Where is my back?” For “Where is my bag?”

Voicing: when a child produces a voiced sound for a voiceless sound

  • Age of Elimination: 3 years
  • Example: “I want more bees” for “I want more peas”

Stopping: when a child stops the airflow needed to produce a sound and substitutes it with another sound

  • Age of Elimination: 3-5 years
  • Example: “my two” for “my shoe”

Fronting: when a child substitutes sounds that they should be making in the back of the mouth with sounds towards the front of the mouth

  • Age of Elimination: 3.5 years
  • Example: “Daddy’s tea” for “Daddy’s key” (substituting “t” for “k”)

Cluster Reduction: when a child drops off or deletes one of the consonants in a “cluster”

  • Age of Elimination: 4 years
  • Example: “I see a nail” for “I see a snail”

Weak Syllable Deletion: when a child drops off or doesn’t say one of the syllables within a word

  • Age of Elimination: 4 years
  • Example: “I want a nana” for “I want a banana”

Deaffrication: when a child doesn’t produce the pressure sound in a combined sound

  • Age of Elimination: 4 years
  • Example: “I want ships” for “I want chips” (ch -> sh and j -> zh)

Gliding: when a child substitutes the “l” and “r” sounds for the “y” and “w” sounds

  • Age of Elimination: 5 years
  • Example: “The apple is wed” for “The apple is red”

*Examples and explanations are referenced from Adventures in Speech Pathology

How can Carolina Therapy Connection help?

This is a lot of information that can be overwhelming for a parent trying to help their child. We know that you want the best for your kiddo and we want to help! Our team of pediatric speech therapists provide screening, assessment, consultation, and treatment to help children overcome communication obstacles. Call Carolina Therapy Connection at 252-341-9944 to speak with one of our skilled and knowledgable speech-language pathologists. They can evaluate your child’s communication patterns, further explain phonological processes, and discuss the best treatment interventions for your family.

 

Written by: Brandi Ayscue, MS, CCC-SLP, CAS

Brandi Ayscue Phonological Patterns Blog Carolina Therapy Connection Greenville NC Speech Therapy

 

Phonological Patterns Carolina Therapy Connection Greenville New Bern NC Speech Therapy

Should My Child Be Using a Visual Schedule?

What is a visual schedule?

As adults, many of us live by our planners. We gain satisfaction from marking off our to-do lists and being organized with our daily activities. Children are better able to learn, grow and adapt to changes using this same strategy! Although there are many types of visual schedules, they all typically contain images, symbols, photos and/or words to better communicate a task or activity. Depending on your child’s age and specific needs, their visual schedule may contain activities by the minute, hour, day or week. For example, if your child requires more structure, they may use a visual schedule that uses “first, next, then” language to communicate activities for the next few minutes. If your child requires less structure with their daily activities, their visual schedule may list tasks by hour for an entire day. Check out these examples below!

 

Carolina Therapy Connection Visual Schedule Example Autism

Carolina Therapy Connection Visual Schedule Example

What are the benefits of a visual schedule?

Visual schedules are a powerful tool that can help kids perform complex tasks, organize their day, or follow a routine. Here are a list of benefits that result from using visual schedules:

  • Visual schedules provide structure and predictability. Has your child ever become upset because they didn’t want to complete a task or weren’t expecting an upcoming activity? Visual schedules provide a consistent reminder of what activity is next and can show a reward that follows a non-preferred activity. For example, if your child doesn’t like bath time, they can use their visual schedule to understand they will get to watch their favorite TV show following their bath.
  • Visual schedules encourage independence. Once your child becomes comfortable with using their schedule, they can help create it and plan for each day. It will also allow them to select preferred activities or rewards between non-preferred activities. When a child helps create their own schedule, the sense of independence promotes completing activities without being asked to do so.
  • Visual schedules reduce negative behaviors and meltdowns. When kids know in advance what’s happening, it can help them feel more in control and at ease. If there is a change in their routine, they can plan and prepare themselves for that change.
  • Visual schedules work with your child’s visual strengths. Although visual schedules can use words, pictures and symbols often times create ease for reading a visual schedule. You can also use pictures that are specific to your child’s household or routine. For example, you can use a picture of their favorite book using your phone camera instead of a generic or cartoon book.
  • Visual schedules teach a variety of skills during childhood development. Visual supports open the doors of communication, increasing your child’s ability to interact with his or her surroundings. Creating and utilizing visual schedules promote visual motor skills, fine motor skills, organization, positive self-esteem, decision making, and a wide variety of executive functioning skills.
  • Visual schedules can be used for more than just sequencing activities. You can use visual prompts similar to visual schedules to break down one task into steps. For example, if your child has difficulty with sequencing the steps of toileting, they can use a chart similar to the one below provided by A Day In Our Shoes.

Carolina Therapy Connection Visual Schedules Autism Greenville NC

Tips For Implementing a Visual Schedule With Your Child

  • Before using the visual schedule, ensure that your child understands the purpose of it and how to use it.
  • The schedule needs to be manageable. Start with a small schedule that only contains a few tasks and uses language such as “first, then” or “first, next, then.”
  • Mix preferred activities with non-preferred ones. This helps to motivate children to persevere through non-preferred activities.
  • Personalize the schedule with their favorite characters or colors. Use pictures of your child’s specific toys or items in the household. If your child is able, let them help create it!
  • Cue your child to use the schedule or ask them to check it when they begin an activity. Repetition is key!
  • If your child gets satisfaction from marking off completed activities, place a check box beside each task.
  • Use these instructions for tips on creating your own visual schedule at home.
  • This awesome resource from A Day In Our Shoes has plenty of FREE visual schedules you can print from the comfort of your home.

How can Carolina Therapy Connection help?

At Carolina Therapy Connection, we offer pediatric occupational therapy to addresses concerns with things such as self-care skills, including feeding, bathing, and dressing; fine motor skills, including writing, tying shoes, and picking up small objects; neuromotor development; and sensory integration. Our occupational therapists can work with your child and family to ensure they are using the right type of visual schedule for their routine and help them create the perfect one just for them! Our experienced therapists can help your child use a visual schedule in the clinic, as well as carryover of using them in the home or school. As our team of specialists work to help your child reach their goals, you will begin to see remarkable changes in their skills and abilities. More importantly, you will see the happiness, confidence and sense of independence this brings to your child, and the peace of mind this brings to your family.

If you have any questions regarding visual schedules or your child’s development, call Carolina Therapy Connection at 252-341-9944 to speak with one of our occupational therapists! We currently offer occupational therapy, physical therapy and speech therapy in Greenville, Goldsboro and New Bern, NC. 

 

Carolina Therapy Connection Autism Visual Schedule Greenville NC

Importance of Developmental Reflexes

What are developmental reflexes?

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. There are many types of reflexes like this one and almost all of us have them. In fact, we’re born with most of them. The reflexes we are born with are called primitive reflexes and the ones we develop during the first years of life are called integrated reflexes. 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.

What are primitive reflexes?

Primitive reflexes are present at birth and should be integrated by 12 months to two years of age. Reflexes are the basis of our nervous system and our ability to move. Reflexes are automatic movements that happen without conscious thought that help us to survive, search for food, seek protection, avoid danger, and to walk.  Reflexes originate in the brain stem, which is the area of the brain responsible for survival. If these reflexes are not integrated, the body stays in “survival” and “stress” mode which can cause difficulty with concentration, anxiety, poor behavior, deficits in coordination, and poor performance in developmental skills and school tasks. There are many risk factors for retained primitive reflexes including, but not limited to, the following: multiple births, prematurity, c-sections, lack of tummy time, higher instances of alcohol and drug abuse, and poor awareness of developmental stages. 

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

What does treatment look like?

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. 

Importance of Developmental Reflexes Carolina Therapy Connection Greenville NC

Helping Children Develop Self-Care Skills

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 integrationsome 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.

 

Carolina Therapy Connection Occupational Therapy Greenville, Goldsboro, New Bern North Carolina Help with Self-care skills