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Why Is My Child Picky About Clothing?

Is your child picky about clothing? It is common for children to have a favorite shirt, blanket, or pants, but what if they refuse to wear anything besides their one outfit of choice? In the pediatric world of occupational therapy, we often work with children who cannot tolerate wearing various clothing items. We have seen the stress of dressing tasks for children and their caregivers. The intended purpose of this blog is to educate parents on why a child may be sensitive to clothing and point caregivers in the right direction to address these concerns.

Why is My Child Picky About Their Clothing?

Every child processes sensory information differently. Children who demonstrate intolerance to various clothing textures may often have sensory sensitivities to tactile (touch) information, also known as tactile defensiveness. This indicates that the neurons responsible for processing tactile information have lower neurological thresholds, meaning more sensory information reaches their brain quicker, which can cause children to become overwhelmed by the stimulus. This results in heightened responses (ex., Crying, screaming, itching) when a child is prompted to wear clothing that feels uncomfortable to them. Another underlying reason for tactile sensitivities can be connected to retained primitive reflexes. Retained primitive reflexes often contribute to a child’s hypersensitivity to general sensory information and can make clothing items with tags or tight waistbands challenging to wear. 

When Should I Be Concerned About My Child’s Intolerance for Clothing?

It can be hard to discern when a child’s intolerance to clothing is a behavioral or sensory concern. A child who doesn’t “like” to wear a particular clothing item or texture is very different from a child who physically cannot tolerate certain textures. True sensory concerns will present with consistent behaviors across settings. For example, a child with true tactile defensiveness will have difficulty wearing a non-preferred clothing item at home or daycare. Additionally, consulting a professional is not customarily warranted if their limited clothing items do not impact a child’s performance and participation in meaningful activities. However, if a child’s clothing sensitivities are impacting their meaningful activities, then it may be beneficial to talk with a pediatric occupational therapist to determine what options or strategies are appropriate. An example could be a child who wants to play soccer but cannot tolerate wearing soccer cleats or sneakers and, therefore, refuses to play. Another example would be a child or adolescent who refuses to wear clothing to match the temperature outside, such as refusing to wear gloves or mittens in the middle of winter.

Strategies to Expand A Child’s Wardrobe

  • Keep a diary/log:
    • Children will normally demonstrate a pattern of behaviors to show caregivers what types of clothing are uncomfortable. It will be essential to keep a log of what items/fabrics are preferred to limit the child’s discomfort when presented with new clothing items to try on. 
  • Present sensory-friendly clothing:
    • There are common characteristics of clothing that can be aversive to children with tactile defensiveness. For these reasons, we have provided a list of clothing items that are often more tolerable for sensory-sensitive children:
      • Clothing without seams
      • Clothing without tags
      • Loose fitting clothing
      • Soft/smooth fabric
      • Breathable clothing: avoid clothing that holds moisture
  • Invite them into the process:
    • Providing the child with autonomy in choosing their clothing will help remove feelings of stress that surround dressing activities. One way to do this is to take them shopping and ask them what clothing they want. Depending on the child’s comfort level, it can also be beneficial to have them choose a variety of clothing to try on and have a “fashion show” in the dressing room.

 

What Other Concerns Can arise with Children Being Picky About Clothing, and How Can Carolina Therapy Connection Help?

Tactile defensiveness does not only impact a child’s ability to tolerate various clothing items. Typical areas of difficulty for tactilely defensive children include, but are not limited to, difficulty with hair brushing/washing, hair cuts, tooth brushing, nail clipping, and bathing. If your child has difficulty tolerating any of the above activities, then it may be beneficial to meet with a pediatric occupational therapist to discuss the best care plan for the child. Call our clinic at (252) 341-9944! Your child may benefit from an occupational therapy screening or formal evaluation!

 

By: Emily Britt

 

Spring Activities For All Ages!

Join us as we welcome spring!

As the world outside bursts into color and warmth, it’s the perfect time to dive into some fun activities that celebrate the season. We’ve put together a bunch of excellent OT spring activities for all ages that you can do that are fun and help you learn and grow.

From making yummy flower-shaped snacks to crafting bird feeders and sensory bottles, there’s something for everyone to enjoy. Whether you’re a parent looking for fun OT activities with your kids at home or a teacher searching for exciting activities, you’ve come to the right place!

Join us as we explore the wonders of spring through activities that work on our fine motor skills and try new foods! Let’s make this season even more remarkable by having a blast with these therapeutic activities.

Spring Activities: Flower Snacks: 

This fun and creative activity works on fine motor skills, food play, and meal preparation skills. It is also a great way to introduce healthy snacks into your child’s diet. 

  • Beet slices flower snack– Use a flower-shaped cookie cutter to cut beet slices (or other soft fruit/veggies: pineapple, apples, thin potatoes…)
  • Mandarin orange flower– Peel an orange and open one end.  Add celery for a stem.
  • Orange with flair–  Add a grape tomato to the center of your orange to add a little color.  Other fruits could also be arranged into a flower shape: apple, pear, and banana slices would work.
  • Dried cranberry mini flowers– Arrange cranberries (or raisins) into petal shapes.  Add chickpeas for a center to each flower.
  • Tulip cucumbers– Cut a jagged line into cucumber slices.  Add a piece of the peel for stems for each flower.
  • Flower art–  Get the kids involved in this one!  Provide carrots, broccoli, red peppers, and grape tomatoes, and create a flower design as a family.  Enjoy!

Paint With Flowers: 

This is an easy and cheap activity to complete at home that only requires paint, paper or plate, and flowers. Use the flower as a brush and press it into the paint, then paint away!

Oral Motor Exercise With Plastic Easter Eggs: 

This is a fun activity to incorporate into your routine before feeding. Adding oral motor exercises provides sensory input and “wakes up” the muscles of the mouth. Give your child a straw and ask them to blow into the straw to push easter eggs toward a target. 

Spring Animal Walks: 

This is a fun gross motor activity that can be done in the home or outside. Have your child bunny hop, bear walk, frog jump, and snake slither from one side to the other. You can even have an animal race to see who gets to the finish line first!

Homemade Bird Feeders: 

This is a great activity to improve executive functioning skills and bilateral coordination skills. You will need toilet paper rolls, peanut butter, birdseed, and spreading tools. Spread the peanut butter on the toilet paper, roll it in the birdseed, and hang it up outside!

Spring Themed Sensory Bottle: 

Sensory bottles can provide a calming sensory experience to children by focusing on the different moving objects inside. All you need is 4 ounces of clear glue, warm water, hot glue (to seal the lid), a bottle, and any desired spring-themed objects to put inside (glitter, small toy animals, flowers, etc.). 

 

Winter Activities for All Ages! 

What are Some Winter Activities When the Weather is too Cold Outside?

Ever wonder what you can do to keep your Kiddo occupied and safe while providing the necessary sensory input when it’s too cold to play outside? It is recommended to take indoor breaks every 20-30 minutes when the temperature outside is between 13-30 degrees; however, some kiddos tolerate cold weather better than others. Here are some tips for activities that can be done indoors when it’s just too cold to go outside this winter!

A Fun Winter Activity: Play Board Games

This is dependent on your child’s age and skill set. If you have some board games tucked in the closet, break them out and have family fun! This will work on building your child’s reciprocal play skills, following multistep direction skills, coping skills, and emotional regulation. Check out our Amazon storefront for some of our recommended board games! 

Build a Pillow/Blanket Fort

Who didn’t love making a fort under the kitchen table as a kid? Build a fort in the kitchen and living room, then place some of their favorite books, toys, and stuffed animals inside. This can be a fun way to get your kids into critical thinking mode and build their visual perceptual and motor skills! 

Scavenger Hunt

Another fun winter activity is to hide some items in your house and have your kiddos find them! This can be graded according to skill level and age. For example, for a younger kiddo, have them locate items they would typically use. For older kiddos, give hints to the item they are looking for. “Find two things mom uses to stir within the kitchen (utensils)” or “Find something round and blue in your bedroom (ball).” This will work on their figure ground skills and get their body moving!

Bake/Cook

Have your kiddos help you bake/cook your favorite snack or dessert in the kitchen. Have your kiddos follow the directions given or help with the messy tasks. This can be great for our sensory-seeking kiddos and those resistant to messy play!

Dance Off!

GET MOVING with a fun dance-off! Put off some of your favorite music and have a contest to see who dances best to the song! This is a great way to work on gross motor skills, coordination, and auditory processing, and it’s just plain fun!

Watch your Favorite Movie and Act Out the Scenes.

Many kids like to watch movies; however, do you ever notice that they get bored halfway through and are on to the next thing? Get them involved with the movie. Have that pause button ready and have them act out a scene to see if they can recall what happened! 

Indoor “Snowball” Fight

Do you have some extra tissue paper lying around after wrapping those Christmas presents? Make snowballs and toss them at each other! This is a great way to get kiddos moving without fear of knocking things off tables/counters and breaking things! 

Keepie-uppie with Balloons

Everyone knows this one! Can we keep the balloon off of the ground? Try it! It is so much fun, works on your kiddo’s hand-eye coordination, and has less risk of damaging something in your home!

How can Carolina Therapy Help?

With winter in full swing, ask your therapist about tips/tricks to have fun indoors with adaptations specifically for your child’s sensory-related needs. A therapist at Carolina Therapy Connection can help adapt the activities listed above and give more ideas for your specific child! Also, check out our link for Amazon storefront to find fun toys/activities to make the indoors fun! Many great toy ideas and sensory-related tools can be used when your child needs to get some energy out!

I hope these tips have helped build some fun ideas for you and your family for this winter season! Stay happy, healthy, and warm!

By: Shelby Godwin, COTA/L, AC

Not Your Average Toy!

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

The Vestibular System in Pediatrics

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!

Vestibular Therapy Carolina Therapy Connection

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
Pediatric Vestibular Therapy Greenville, NC Carolina Therapy Connection

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

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

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

Making “Sense” of Our Experiences

The Pyramid of Learning

Pyramid Of Learning

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

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

Understanding Our Sensory Systems

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

How Sensory Processing Difficulties Affect Behavior

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

Sensory Integration

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

Sensory Integration Strategies 

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

How can Carolina Therapy Connection help?

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

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

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

 

References:

Pyramid of Learning by Taylor and Trott (1991)

Amy Hathaway, OTR/L DEVELOP, LEARN, GROW

Kids First Children’s Services 

Sensory Blog

Neuro-diverse Hangout Night

Carolina Therapy Connection’s First Neuro-diverse Hangout Night!

Carolina Therapy Connection is so excited to announce that our first neuro-diverse hangout night will be on July 15th at 6:30 PM. This all inclusive hangout group is designed for pre-teens/young adults interested in engaging in shared experiences, positive peer relations and having fun! Leading this awesome group will be our friend Fiona Holler. Fiona is a 17 year old girl who is willing to share her experiences growing up with Autism Spectrum Disorder. She loves to help others and her goal is to spread awareness. For our first hangout night, we have 10 spots available for those between the ages of 11 and 18 years old. If you miss out on the first one, don’t worry! We plan to continue having these hangout sessions in the future. Click HERE to sign up!

What can I expect for the neuro-diverse hangout night?

Fiona has planned to begin the session with introducing the surroundings. This will include snacks and making sure everyone has an understanding that it is a judgement free zone. You are free to stim, tic, and sit anywhere that you are comfortable! Fiona would also like to engage all participants in introducing themselves, sharing their likes and dislikes, sharing challenges they have faced, discussing strengths and similar interests and much more!

Here are a few ground rules for this hangout:

    • This is a judgement free zone – please do not make fun of others or make inappropriate or rude comments. This is the opposite of the purpose of this group!
    • Everyone who wishes to speak is allowed to have their own turn to speak as long as it is appropriate and polite.
    • Please be mindful of others – some people may have different needs than you. Be kind and accepting!
    • If you don’t wish to share something you don’t have to – this is a safe place for everyone!
    • Please be encouraging and kind to the people around you – we will have a better experience when we are accepting of everyone!
    • Anything that anyone shares in this group that they wish to keep private stays in this group. 

What are the benefits of a neuro-diverse hangout?

People on the spectrum and their families benefit greatly from autism support groups and hangouts. Support groups and hangouts like this one can provide people with a space in which they can swap stories, share information, ideas and tips to help manage different parts of their lives, or simply enjoy being with people who have had similar experiences. Another benefit of support groups is that through these groups, parents who are present can learn about new resources, therapies, services, and most importantly create lasting friendships with other parents who are going through the same things as them. The greatest benefit of all is that everyone gets to have fun and feel good! Our greatest goal for this hangout night to make everyone feel comfortable and leave feeling better than they came. If you have any suggestions or questions about our neruro-diverse hangout night, call our clinic at 252-341-9944! We can’t wait to see you soon!