7 Ways to End Bedtime Battles

Bedtime battles are a common issue among many parents with young children. However, putting your child to bed atend bedtime battles night can become an enjoyable time where you can wind down and spend some quality time with your child. By following a few simple guidelines, the bedtime routine can turn into a more enjoyable experience for the whole family.

7 Tips for a Smooth Bedtime:

  1. Keep the Time for Bed Consistent, and Create a Nightly Routine to Follow – Children respond really well to routines, and it will help them learn what is expected each night.  It will also make the whole bedtime process easier for everyone.
  2. Avoid the Use of Electronics the Last Hour Leading Up to Bedtime – Instead of your child playing video games or watching a movie, have her engage in more calming activities such as reading, coloring or taking a bath before bed.
  3. Gradually Transition Into Bedtime – Do not suddenly tell your child that it is time for bed. Instead, give warnings that bedtime is approaching starting about 45 minutes before she needs to be asleep, and then remind your child again 15 minutes before she needs to be asleep.  Continue to give warnings right until it’s time for bed.  If your child does not yet fully understand the concept of time, you can use a timer to help.
  4. Always Remain Firm but Calm – Never negotiate when you child does not want to go to bed, or if your child gets out of bed repeatedly. Calmly tell your child that it is time for sleep, and lead her back to her bed. In this situation, the less talking, the better.
  5. Adjust Nap Schedules if Necessary – If you notice that your child does not appear tired during her regular bedtime, consider adjusting her nap schedule or eliminating naps altogether.
  6. Give Your Child Choices During the Bedtime Routine – When children have choices, it gives them some degree of control.  This sense of control is likely to make them more compliant. Examples of choices that can be given at bedtime include what books to read, which pajamas to wear, or how many stuffed animals to keep in bed.
  7. Teach Your Child to Fall Asleep Alone in Her Own Bed -These are good skills to teach at an early age.  If your child begins to fall asleep only when a parent is in the room, or only when she is in her parent’s bed, this can become a habit that is difficult to break. Teaching independent sleep early will help alleviate many future bedtime struggles.

Click here for advice on how to deal with night terrors.  For more information on healthy sleep habits, contact our behavior therapy team.

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Summer Training for Fall Gaining

As summer begins, summer plans take shape.  Hopefully these plans involve lots of fun and sunshine.  Summer should be an enjoyable and exciting time for all children and their families, but it is important to remember to also focus on children’s growth and development.  Sometimes during the break from school, skills gained in an educational or summer therapytherapeutic setting can be lost.  It is important to remember that summer is a great time to keep working on skill development, therapeutic goals, and preparing each child for the challenges of the upcoming school year.

Research continues to show that consistent and high intensity therapy (two or three times per week) results in faster and better functional outcomes for daily skills.  With a more relaxed schedule, summer is a perfect time to increase therapy intensity and have fun building the skills children will need for the new school year.

Specific areas of focus in the summer to prepare for school:

North Shore Pediatric Therapy wants to help your child gain the confidence and independence to conquer all age appropriate tasks! Summer spots are limited. Call us at 877-486-4140 and let us know how we can best support you and your child!

Bed Time Strategies for Children with Sensory Processing Disorder

Bed time can be a difficult time for any child.  It can be even more of a struggle for a child with Sensory Processing Disorder (SPD).   

Bed time strategies for child with SPD

Throughout the day, all children engage in various activities that excite them, including interacting with peers, playing on the playground and fighting with siblings.  It can be a challenge to calm kids down from a daytime of activity. This can be even more of a challenge for a child with SPD.

 As adults, we are able to engage in various tasks to relax our bodies after a busy day.  Children with SPD need the same input, but they are not cognitively aware of their body’s needs.  For example, if an adult has a stressful day, he or she may drink a hot cup of tea, read, or place a hot towel on their face as self-calming techniques.  A child that had a rough day may act out or refuse to go to bed because he or she doesn’t understand what his or her body needs. 

The following strategies can help your child with SPD calm down and improve the process of getting to sleep:

  • Have a Strict Nightly Routine– Completing a predictable bedtime routine decreases anxiety, gives your child control and establishes healthy habits.   A visual schedule of the routine can assist the little ones with understanding the steps.
  • Incorporate Rocking- Typically, slow linear (back and forth), vestibular movement creates a calming effect.  Rocking in a rocking chair or swing is a great activity to help your child wind down.
  • Enjoy Bath Time– Warm water is calming.Incorporating a nice, warm bath at night not only provides your child with calming sensory input, it also provides an opportunity for you and your child to bond over bath play time.  This special, nightly, one-on-one time will also ease the minds of children who may worry about separating from their parents.
  • Read a Favorite Book-Reading your child’s book of choice provides your child with some control.  It is also another great way to relax mind and body.
  • Avoid Excitatory ActivitiesAvoid engaging in alerting activities before bedtime, as this might make it difficult for your child to calm his or her system down and go to bed. Spinning and jumping movements are excitatory and alerting.  In regards to proprioceptive input or heavy work, light touch, such as tickling, is excitatory and alerting.  
  • Avoid Screen Time-Create a rule:  1-2 hours before bedtime no electronics or TV.  This will promote a smoother transition into quiet time.

If your child with SPD needs help with bed time, or if you need more information on Sensory Processing Disorder, contact one of our pediatric occupational therapists today, or download our free SPD infographic.

Sleep Deprivation in Children and 5 Tips on How to Get Your Child to Sleep

Sleep is one of the most important activities in your child’s day but it is often overlooked as such. It is as essential as food, water, and child sleepingsafety and vital for adequate physical and cognitive development.

How much sleep does your child need? Often more than we typically expect, school-age children need 10-12 hours, with younger children needing the most, and adolescents needing 9-10 hours of sleep per night to function optimally. If your child is not getting this on a regular basis, they can become sleep-deprived. When this is prolonged, a number of problematic issues can arise, including problems focusing, mood dysregulation, and risk for falling behind in school.

How do you know if your child is sleep-deprived? Some of the signs include:

  • Excessive daytime sleepiness (e.g., falling asleep in the car, wanting to take naps)
  • Needing to drag your child out of bed in the morning
  • Waking up irritable and unrested
  • Problems falling asleep at night (more than 30 minutes)
  • Sudden change in emotions or behavior

Here are some tips to help your child sleep and for your entire family to get the rest they need:

  • Dim the lights: Our sleep cycle is regulated by light so try turning off or dimming lights around the house 30 minutes before bedtime.
  • Avoid the “second wind:” Tune into your child in order to find the time when they begin to slow down and become tired. If this opportunity passes, children may become more hyperactive and difficult to settle.
  • Routine is key. Keep it simple and short (less than 30 minutes)
  • Oftentimes children will need help settling down. When other strategies have not worked, you may want to talk to your pediatrician about Melatonin, an over-the-counter supplement.
  • And finally, make bedtime a time in which to look forward. Use it as an opportunity to unwind from the day and bond with your child.

If you suspect that your child may not be getting enough sleep, and your attempts to alter the problem have not helped, talk with your doctor or schedule an appointment with one of our behaviorally-trained social workers and experts.

3 Signs of Childhood Depression | Pediatric Therapy Tv

In today’s Webisode, a licensed social worker gives us 3 signs to look out for when it comes to childhood depression.

Click here to read our popular blog outlining all symptoms and treatment of Childhood Depression

In this video you will learn:

  • What can cause a child to become depressed
  • Indications of depression in children

Video Transcription:

Announcer: From Chicago’s leading experts in pediatrics, to a worldwide audience, this is Pediatric Therapy TV, where we provide experience and innovation to maximize your child’s potential. Now, your host, here’s Robyn.

Robyn: Hello, and welcome to Pediatric Therapy TV. I’m your host, Robyn Ackerman, and I’m sitting here today with Ali Wein, a licensed professional social worker. Ali, can you give us three things to look out for inchildhood depression?

Ali: Absolutely. The main thing we really want to look for is any sort of deviation from typical behavior. So the first thing we want to note, are there any changes in eating or sleeping patterns? If your child usually wakes up really early in the morning and they fall asleep really early at night, and all of a sudden they’re having a harder time falling asleep at night and they’re requiring more hours of sleep per evening, this might be indicative of something greater going on underlyingly.

Additionally, any changes in the eating habits. Are they eating more? Are they eating less? Are they rapidly gaining and/or losing weight? Things that aren’t just sporadic, but you’re noticing changes in patterns of behavior. Another thing we want to look for is disinterest in previously enjoyed activities. So if your child really loves soccer and can’t wait for Tuesdays when they get to wake up in the morning and practice with their soccer team, all of a sudden they’re crying. They don’t want to go. They’re coming up with excuses because they just don’t want to go to soccer. That might be indicative of something else going on as well.

Finally, we also want to pay attention to any sort of change in personality, mood, and affect, affect being the way that we present ourselves. So if your child is typically really easygoing, calm, relaxed, and now all of a sudden they’re having trouble communicating, maybe, they’re a little bit more spaced out and more inattentive, they’re more easily to get angry and have outbursts, this might also be indicative of childhood depression.

Robyn: All right. Thank you so much for letting us know those three signs. Thank you to our viewers, and remember, keep on blossoming.

Announcer: This has been Pediatric Therapy TV, where we bring peace of mind to your family with the best in educational programming. To subscribe to our broadcast, read our blogs, or learn more, visit our website at learnmore.me. That’s learnmore.me.


There are many significant milestones you go through as your once “totally dependent” child grows up. Sleepovers are one of these milestones. As a girls sleepoverparent, the first time your child gets invited to a sleepover can leave you shaking in your boots. The persistent question, “is my child ready?” can be a pervasive one!

There are no hard and fast rules as to when your child is ready, as each sleepover experience is different just as each child is different. While it would be easy to be able to pull out a handbook that would indicate at what age your child would be ready for this independent step, this is simply not the case. Some 6 year-olds may be ready for a sleepover and some 11 year-olds may not. Nevertheless, here are 5 signs that your child is likely ready for a successful sleepover.

5 Signs Your Child Is Ready For A Sleepover:

  1. Your child typically does not have trouble sleeping through the night and is not prone to nightmares.
  2. Your child is capable of basic self-care. He is able to brush his teeth, put on his pajamas and engage in his typical nightly preparations for bedtime without much adult intervention.
  3. Your child is able to ask for what she needs and will feel comfortable doing so!
  4. Your child WANTS to attend the sleepover. This is the most important sign. You want your child to look forward to this new experience.
  5. You, the parent are ready for this separation. If you are not, you will likely send mixed messages to your child as to her ability to succeed during this exciting milestone.

Prior to your child’s first sleepover at a friend’s, try out a sleepover at a family member’s home first. This will help build your child’s confidence that he can, in fact, successfully sleep away for home and enjoy the experience. Just remember part of allowing your kids to grow up is allowing them to try new endeavors. Your job is to make sure they have the necessary tools and support to tackle each new experience as it comes.


What Does my Child’s ‘Engine Level’ Refer to?

Many therapists use the term ‘Engine Level’ throughout your child’s therapy sessions, and possibly within her goals as well.  ‘Engine Level’ refers to your child’s energy level and the way her body is feeling in various environments and in various times throughout the day.  A child’s body is typically functioning at one of three ‘Engine Levels’.   Ideally, the goal is to be at the ‘just right’ level, in which your child can accomplish the most and focus on the task at hand.

Below are some explanations and examples of how your child’s engine level can be moving too fast, too slow, or just rightHappy child jumping

  • An engine level which is too fast means that you might notice rushing; distractibility; decreased body awareness; and decreased organization.  This might look like your child is running around aimlessly, touching her friends and neglecting personal space, or ignoring instructions and what her body should be doing.
  • An engine level which is too slow means that you might notice low energy and decreased endurance, inattention, and that your child is lethargic, sleepy, or unmotivated.  This might look like your child is slouching or falling out of her chair, propping herself up or leaning on a peer, not listening, or not attempting the task at hand.
  • An engine level which is just right means that you might notice that your child is refreshed and energized, that she is alert and ready to focus on the task at hand, and that she is aware of how her body is moving around her environment.  This might look like your child is maintaining an erect posture at the table to complete her homework or engage in mealtime, and she is correctly following directions and using her listening ears.

Try to use this ‘Engine Level’ lingo in a consistent manner so that your child can ideally develop increased body awareness and self-regulation.  Make sure you provide your child with examples of how your own body is feeling, or how you perceive her body to be feeling, so she can best understand what you are referring to (e.g. “It looks like your engine is moving too fast.  Your body keeps falling out of your chair.  Why don’t you stand-up and do 10 jumping jacks, and then try sitting in your chair again.”)  Stay tuned for my next blog on strategies to obtain a just right ‘Engine Level’.

Reference: Williams, Mary Sue and Shellenberger, Sherry. (1996,) “How Does Your Engine Run?”:  A Leader’s Guide to The Alert Program for Self-Regulation.  Therapy Works, Inc.

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How to Cope with Night Terrors

Night terrors are a sleep problem that is most common in children ages 2-6 (but can occur at almost any age). They occur occasionally in about 15% of young children and can last 5-30 minutes. You may see your child bolted upright in bed, crying or screaming, sometimes appearing to be awake but with no recognition of who you are. Night terrors differ from nightmares in that your child is not likely to remember anything in the morning.child with a night terror

Because night terrors are considered normal, you do not need to seek treatment (as long as you have ruled out any underlying medical or mental health conditions). However, they are often very scary and distressing for both the children and their parents. What you can do, is identify ways to help your child cope with the stress and promote a calming sleep environment. Children who are overtired, experiencing stressful life events, or have a fever may be more likely to have night terrors.

If you catch your child in the middle of a night terror, it is suggested that you do not try to wake them out of it. This could scare them—especially because of your own stressed reaction. It is usually best to make sure they are safe (gently restrain if needed) and wait until it is over. You can provide comfort, speak softly and calmly, and help them return to sleep (in their own bed).

Steps You Can Take to Ease the Stress of Night Terrors:

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Is it hard to help your child “turn-off” her brain before bedtime?  Does your child constantly get out of bed or struggle to fall asleep at night?  Oftentimes, it is hard for a child to understand what her body is feeling and vocalize what she might need in order to feel more balanced and organized.  Overall, children truly benefit from a daily bedtime routine that helps their bodies find a consistent sleep cycle.

The following activities will make for a smoother bedtime transition and help your child’s mind and body become more relaxed:

1)      Use a visual schedule: Pictures and cues can help your child see what is included in each step of the routine and help you both talk about the plan and keep a consistent bedtime routine (e.g. first is bath time, second is brushing teeth, third is story time, fourth is turning the nightlight on, fifth is hugs and kisses, etc).

2)      Prepare for the next morning:  Help your child get ready for the next day (e.g. lay out her outfit, pack her lunch, and organize her backpack).  This will not only help your child be more independent, but also will eliminate the morning rush.BEDTIME

3)      Keep a bedtime notebook/journal: Keep a notebook near your child’s bed, and help your child write down the day’s events, anything she might be worried about, and any thoughts that are running through her head.  If she is a younger child, have her describe her feelings by drawing pictures or using one or two phrases.  If she is an older child, have her use complete sentences or bullet points, and possibly write out her thoughts independently.  Jotting down what is fresh on her mind will ideally help to eliminate any anxiety that might keep her from falling asleep.  It can also serve as a “to-do” list or reminder of what needs to be done in the next day or two.

4)      Heavy work:  Have your child engage in heavy exercise activities to help fatigue her mind and body, and  get out all the excess energy.  Heavy work can include: animal walks (e.g. crab walk, wheelbarrow walks, bunny hops, seal walks, army crawls), exercises (e.g. jump-roping, push-ups, sit-ups, Superman position (on stomach, with arms and legs extended and lifted off of the floor), Silly bug position (on back, with arms crossed over chest and head and legs flexed into body), and everyday activities (e.g. pushing/pulling wagon or stroller, carrying/pushing full laundry basket).

5)      Take a warm bath: Oftentimes, warm water serves as a great muscle relaxer, and can help melt away some of the stress and worries of the day.  Try using a soothing lavender scent, which can help your child further unwind.

6)      Lotion massage: Help your child apply lotion after bath time and/or before putting her pajamas on.  Provide your child with either a gentle or firm massage, depending on her preference, as the lotion rubs into her skin, as some children show aversion to light or deep touches.  Massages help relax the muscles and decrease stress and tension.  http://www.target.com/p/JOHNSON-JOHNSON-Bedtime-Lotion-15-fl-oz-15-oz/-/A-13682492#?lnk=sc_qi_detailimage

7)      Make a “kiddo sandwich/hotdog”: Provide your child with proprioceptive and tactile input by creating a “sandwich/hotdog” using large pillows and blankets (e.g. have the child lay on top of a large pillow or pile of pillows and cover her body with another pillow, providing “squishes” to add the sandwich ingredients; or roll your child snugly in a blanket like a hotdog, providing “squishes” to add the ketchup and mustard, etc).  This will help increase her body awareness and calm her body down.

8)      Set a timer: Set the timer on the microwave or use a regular timer to show your child how much time she has before bed, or more specifically, how much time she has left to complete a certain bedtime activity such as reading a book.  This will ideally help to eliminate the battle of “just one more book” or “just 5 more minutes”, because there is already a pre-determined amount of time set aside.   http://www.american-classroom-supply.com/nsearch.html?query=time+timer

9)      Listen to calm music: Help your child set a sleep timer on her alarm clock or simply play a CD , either while she lies in bed or as she begins her bedtime routine (e.g. reading a book).  Quiet lullaby music can help a child let go of the thoughts running through her mind and help her get in a more relaxed state.

10)   Weighted blanket/sleeping bag: Cover your child with a weighted blanket in order to provide her with extra tactile and proprioceptive (body awareness) input.  A weighted blanket helps provide an evenly distributed weight and a calming effect.  http://funandfunction.com/sensory-integration-everything-weighted-c-65_235_237.html

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Note:  If you have more specific questions regarding your child’s sleep patterns, please contact one of our neuropsychologists for further evaluation.  Similarly, if you have questions as to how to apply the above strategies to your own child, feel free to contact one of our occupational therapists.

What To Expect When You Are Expecting… Special Needs

With the new movie “What To Expect When You’re Expecting” coming out based on the pregnancy bible, it is important for expectant mother’s and father’s to also familiarize themselves with the possibility that they may have a child with a special need.  Of course, the last thing we want to think about when we are What To Expect When You're Expectingpregnant is a special needs child. However, a pregnant couple can just keep in mind what to look for or ask when they are expecting:

5 Steps to take when you are expecting a baby:

  1. If the ultrasound is anything but normal, or if they see anything that raises concern, find out what can be done immediately upon birth.  You may also want to set up meetings with a therapy clinic to talk with experts and specialists.
  2. Read up on parenting, behavior management, and normal child development so that you know what to look for when the infant arrives. You do have a pediatrician, but you are the expert on your own child and even pediatricians will depend on you, the parent for providing any concern or red flags. The American Pediatric Association is a great resource as is the state association, such as the Illinois Pediatric Association.
  3. Tell your best friends and your family to let you know if they ever think something is off or up with your baby once it comes. Ask them beforehand, you may be too emotional afterwards.
  4. Eat well, exercise per doctors orders, keep yourself happy and calm, and avoid alcohol and non-advised medicine, see your OBGYN for regular pre-natal visits and stay out of trouble!
  5. If you are an expectant mom, expecting an adoptive baby, use expert websites such as the Children’s Research Triangle  in Chicago, or Northwestern Family Institute, to know what to be looking for in your child. You may not have been there for the first months and need to be a super-detective when it comes to you child.  Read the blogs here, to learn everything you can about child development!

While you need to enjoy your pregnancy, reality and knowledge is always a good thing to have just in case.  No parent is ever fully prepared for a special needs child.  However, have any knowledge prior to a diagnosis, will only help you make the right decisions for your child and family.

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