Why Does My Child Need a Diagnosis?

-“I don’t want to label my child.”

-“Teachers are biased against diagnosed children.”

-“My son doesn’t act like most kids with _________ (particular diagnosis).”

 

These are statements that I hear on a routine basis, and they are all valid points. Any diagnosis that a child or adolescent may have carries a certain stigma to it. This is human nature. As a neuropsychologist, one of my biggest tasks is to develop the most appropriate and effective diagnosis for any child. My goal with writing this blog is to help identify the importance of an appropriate diagnosis.

How A Diagnosis Can Help Your Child:

First and foremost, an appropriate diagnosis will help explain and answer the “why” questions. Why does my child continue to struggle to read? Why is it impossible for my child to sit still? Why is it that my child cannot make friends? Once we identify the “whys,” we are on our way to solving the problems.  An appropriate diagnosis is intended to help develop the most effective means of intervention. If I diagnosis a child with Dyslexia, I know that traditional teaching of reading and phonics wouldn’t do much good. I would know instead to utilize an empirical approach consistent with the disorder at hand. Read more

4 Quick Tips To Getting Your Child Organized

Helping your child or student get organized can sometime feel like an uphill battle. For many children the problem isn’t that they won’t organize their bedroom, binder, desk, or backpack but truly that they can’t. For example, many children lack the ability to visualize what their desk is “supposed to” look like when it is clean and organized. Difficulty with organization may be hard to understand, especially if you consider yourself to be an organizational expert.

The following tips can help begin the process of teaching organization skills:

• Take a picture of their desk when it is organized and post the picture inside of the desk. Have your child refer to this visual example when it is time to clean the desk. This strategy can also be to help clean up a bedroom (be sure to take pictures of specific parts of the room – i.e. an organized dresser drawer etc.)

• Give your child very specific and concrete directions when asking them to organize. “First pick up all of the dirty clothes from your bedroom floor. Second, put the dirty clothes in the laundry basket.”

• Create a checklist to guide your child through the process of organizing. This can be helpful for children that tend to get distracted, or children that have difficulty initiating tasks.

• Don’t forget to be your child’s cheerleader as they learn how to become an organizational master – give them praise with every small accomplishment!

 Click Here To Download Our Free Executive Functioning Skills Checklist

Developmental Skills While Playing With Dolls

Playing is a child’s primary job, and a beneficial one at that.  Through play, children develop fine and gross motor skills, practice language and develop new vocabulary, and begin to understand new learning concepts. 

Below is a sample of all that is involved and developing when your child plays with dolls.

 Cognition

  •      Develops imaginative play skills as your child cares for her doll.
  •     Teaches different emotions and relationships as child role plays. Read more

W-Sitting And Your Child’s Growth

W-sitting is a position that is too commonly used by children when seated on the ground. In this position, a child sits on their bottom, with knees bent, feet tucked under, and legs splayed out to each side in a “W” configuration. Because this position is so common, most adults do not realize that use of this position can have negative ramifications on a child’s growth and development. 

Negative Effects of W-Sitting:

The reality is that this position can cause orthopedic problems, delay development of postural control and stability, and delay development of refined motor skills. For these reasons, its use is strongly discouraged.

Excessive use of a w-sit during the growing years puts undue stress on the hip abductors, hamstrings, internal rotators and heel cords, leading to the possibility of orthopedic problems in the future. “W-sitting” can lead to hip dislocation, and for children with pre-existing orthopedic conditions, these conditions can worsen when major muscle groups are placed in shortened positions. The muscles begin to tighten, and this can lead to a permanent shortening of the muscle, which can affect coordination, balance, and development of motor skills.

The w-sit widens a child’s base of support, resulting in less need for weight shifting, postural control and stability as they are playing, moving and reaching than in other seated positions. In addition to resulting in decreased trunk control, the w-sit does not require as much trunk rotation, which helps develop midline crossing and separation of the two sides of the body needed for bilateral coordination. Good trunk control and stability, midline crossing and bilateral coordination are needed to develop refined motor skills and hand dominance.

How to Prevent W-sitting:

It is best to prevent children from developing this habit. However, we all know children who have already established this as a preferred seated position. When possible, anticipate and catch it before you see your child move into a w-sit. If and when you do see your child in a “W”, consistently encourage her to adjust to a different position by saying, “Fix your legs.”

Consistency is key. Make sure children know what some of their other options are so they can choose an alternative. Functional seated positions that will allow the child to develop trunk control and mature movement patterns include “tailor sit” (also called “criss-cross”), “long sit” and “side sit”. It is important for parents to teach and encourage alternate seated positions at home, and teachers to teach and encourage their students to use alternate seated positions at school. This encouragement will have positive effects on a child’s growth and development of foundational skills.

When playing with a child on the floor, hold his knees and feet together when kneeling or crawling – it is impossible to get into a w-sit from there. The child will either sit to one side, or sit back on his feet, and from there he can be helped to sit over to one side. Try to encourage sitting over both the right and left sides to promote bilateral development. Using various patterns of movements and positions demand trunk rotation and lateral weight shifting.

If a child is unable to sit alone in any position other than a “W”, talk with an occupational therapist about supportive seating or alternative positions such as prone and side-lying. Sitting against the couch while playing may be one alternative, as well as using a small table and chair. A therapist will have many other ideas based on each individual child.

NSPT offers services in BucktownEvanstonDeerfieldLincolnwoodGlenviewLake BluffDes PlainesHinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

Meet-With-An-Occupational-Therapist

The “Container Baby” Lifestyle

“Container Baby” is a relatively new term used in pediatrics to describe a baby that spends a majority of her time in some sort of enclosed space. These ‘containers’ can include car seats, bouncy swings, vibrating chairs, bumbo seats or other devices that ‘contain’ a baby’s movement. They can be used for any number of reasons, whether it be for safety or to give mom a few free minutes to cook dinner or fold laundry.

How “Containing” Your Baby Can Delay Motor Development:

Some babies spend many of their waking hours in a containing device and don’t get enough floor time to play. Floor time, where a baby is either placed on his tummy or back to play, is extremely important to help with strengthening his neck, back, tummy, arm and leg muscles. Floor time allows a child to explore her environment and provides essential sensory input, including tactile and visual information, that helps with development.

Plagiocephaly or Flatness of the Head:

Another direct cause of the “container baby” lifestyle is the increasing occurrence of plagiocephaly, or flatness of the head. Babies who are contained in the same position are at risk for developing flatness to one part of their head, which can lead to cosmetic deformities, facial asymmetry and torticollis, or the tightening of one side of the neck. Plagiocephaly often begins in-utero, Read more

How To Help Fidgety Students Pay Attention In Class

For many teachers, it can be hard to teach class when students are wiggling around in their seats or on the rug during instruction. Though it may be difficult to determine exactly why children fidget and have difficulty paying attention there are things that teachers can do to help!

Some children might fidget in an effort to pay attention to the teacher. These children are often classified as “low arousal” children who need more movement to keep their bodies upright and to participate in the classroom. Other children might be fidgety because they are constantly seeking out sensory experiences from their environment to get a better understanding of where their body is in space.

Some children might fidget because they do not have the trunk control to maintain a static muscle contraction in order to sit upright. Other children might be overly sensitive to light touch and might be bothered by the way the chair or rug feels on their body, how their clothing feels, or how close their classmate is sitting next to them.

Below are some strategies for teachers to help their students with fidgety behaviors in the classroom:

• Provide students with seating surfaces, such as a Move’N’Sit cushion or therapy ball to give their body sensory input. Read more

Low Muscle Tone | What Does Hypotonia Mean?

In the pediatric therapy world, a diagnosis of “low tone” or “hypotonia” is often given. But what exactly does this diagnosis mean? Muscle tone is the term for the resting length of muscles in the body ( i.e. before a contraction). With low muscle tone, the resting length of the muscles is greater than average and causes hyperextension at the joints, or what some refer to as “double jointedness.” (However, the term double jointed is misleading, as a person doesn’t actually have two joints, just increased muscle length and therefore increased flexibility at the joint).

Signs of Hypotonia in Children:

How can you tell if you or your child has low muscle tone? As stated above, individuals with low tone muscles often have increased flexibility at many joints. The muscles may feel soft and squishy, and because they have increased resting length it literally takes longer for the muscles to contract. Therefore, the individual may seem slow to get going or even lazy, but there truly may be a physiological reason behind it.

Also, because it requires more energy to get the muscles moving, these individuals may be reluctant to move, or conversely, they may move more because sitting still is exhausting and uncomfortable. Read more

Strategies to Decrease Nail Biting and Other Anxious Habits

Many things can cause stress for children, including academics, social problems at school, or even sports. Some children may be less resilient than others, and these stressful events can lead to anxiety problems. Unfortunately, many children may be unable to express their worries and emotions verbally, or they may not be aware of what it is that causes them stress. Therefore, often times children will express their anxiety through behaviors or anxious habits. Stress and anxiety can lead to poor and inconsistent sleeping patterns, depression, fears, difficulties with social interaction and isolation, among other problems. Follow the tips below to help ease the stress in your child’s life.

Tips To Identify Decrease Stress In Your Child’s Life:

• Children don’t often express anxiety with words, as they tend to not understand these feelings, not be fully conscious of them, or do not know how to express them.

• Habits/symptoms that may be signs of anxiety or stress include: nail biting, chewing on fingers, picking on clothing, inconsistent sleep routine, stomach aches, head aches, fear, worry, distress or isolation.

• Anxiety and stress affects concentration, decision-making, ability to make friends, and mood. Depression is closely linked with anxiety.

• How To Help:

Make sure your child has good sleeping habits and can recharge her batteries for the next day. Sleep improves concentration, boosts the immune system and aids in Read more

Help Your Child Develop the “Crossing the Midline” Skill

What is “crossing the midline”?

By the age of 3 or 4 years old, a child should have mastered the bilateral skill (using both sides of the body together) called “crossing the midline”. This is the ability to move one hand, foot, or eye into the space of the other hand, foot or eye. We cross midline when we scratch an elbow, cross our ankles, and read left to right. Crossing the midline of your body helps build pathways in the brain and is an important prerequisite skill required for the appropriate development of various motor and cognitive skills. Children who have difficultly crossing the body’s midline often have trouble with skills such as reading, writing, completing self care skills and participating in sports & physical activities. These skills require a type of coordination that comes from experience with “cross-lateral motion,” which is movement involving the left arm and right leg, or the right arm and left leg at the same time. 

Establishing a “worker hand” and a “helper hand” is a sign that the brain is maturating and lateralization is occurring, and is strongly correlated with the ability to cross the midline. Both sides of the brain need to talk to each other for the “worker hand” and the “helper hand” to work together and compliment each other. Coordinating both sides of the body can be difficult for the child who avoids crossing midline. Often, these children have not yet established a hand preference, sometimes using their left and sometimes using their right to draw, color, write, eat, and throw.

Affects on children who do not develop the bilateral skill:

Furthermore, when a child has difficulty crossing midline, it can affect his/her ability to read. While the child is moving his/her eyes from left to right across the page, the eyes will stop at midline to blink and refocus; however, when this happens, the child will very frequently lose his/her place on the line and become confused as to where they left off. It also affects handwriting, as diagonal lines cross the midline, and the child may need to stop in the middle of the page to switch hands when writing from left to right. Many self care and daily living skills require crossing midline. For example, perfecting the skill of putting socks or shoes on requires one hand to cross over to the other side of the body.

Children who have difficulty crossing midline may appear ambidextrous because they are often observed using both hands, but they actually have a hidden neuroprocessing issue. Both sides of their brains are not communicating, resulting in decreased coordination, decreased motor control of movements and difficulties achieving higher level skills. Often, these children end up with two unskilled hands.

Activities to help develop the ability to cross the midline:

To help develop efficient crossing of the midline, provide children with a variety of two-handed (bilateral) activities. Try some of the below activities to help build more pathways in the brain and to develop the ability to cross the midline, improve coordination, and improve overall functional performance on a daily basis.

Right brain/left brain teasers-

a. Pop bubbles with only one hand (they will have to reach across their body to pop the bubbles floating on the opposite side).

b. Reach for bean bags, balls, stuffed animals, or other objects across midline, then throwing at a target.

c. Draw large figure eights (the infinity sign or an 8 turned on its side) on paper, on the floor with a finger, in the air with a finger, or drive a matchbox car around a figure eight pattern.

d. Let the child play with sand, scooping sand from one side of the body and putting it into a bucket on the opposite side of the body without switching hands.

e. Let the child pretend to drive a car with a ball in his/her hands to use as a steering wheel and encourage the crossing of his/her arms as he/she turns the ‘steering wheel’ OR to make this similar in style to most of the others—pretend to drive a car with a ball in both hands to use as a steering wheel and cross both arms while turning the “steering wheel”.

f. Play flashlight tag. In a dimmed room, lie on your backs and have the child follow your flashlight beam projected on the wall with his own flashlight.

g. Touch the opposite elbow and knee.

h. Cross one foot over the other while walking sideways.

i. Do “grapevine” walks.

j. Knee slap walk- Walk around raising each knee while touching/slapping it with the opposite hand (or elbow). Change it to a skip while touching the opposite knee as it comes up.

k. Windmill-stand with feet spread apart and arms extended out to the sides. Bend over at waist and tap right hand to left foot. Stand back up and then bend and tap left hand to right foot.

l. Point your left finger out and put your right thumb up. Switch them, and switch, and switch, and switch…

m. Hold your nose, then cross the other hand over and grab your opposite ear. Slap your thighs and switch your hands…switch, slap, switch, slap…

n. Write your name in the air while rotating your foot in a circle clockwise.

o. Wash the car and make sure the arms cross midline while scrubbing.

NSPT offers services in BucktownEvanstonDeerfieldLincolnwoodGlenviewLake BluffDes PlainesHinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

Meet-With-An-Occupational-Therapist

Strategies for Oral and Motor/Sensorimotor Input

Children who put toys in their mouths, chew on their clothing or bite their pencils at school may be seeking oral motor/sensorimotor input to help their bodies reach anGirl chewing pencil optimal arousal level. We want to provide them with strategies to get this input in an appropriate manner. Here is a list of alternative strategies to support your child’s oral motor/sensorimotor needs.

Strategies For Children Seeking Oral Input:

1. Engage in activities such as whistling, blowing bubbles and using blow pens

2. Play games with straws (i.e. hockey by blowing cotton balls or splatter painting by blowing on paint using a straw)

3. Have them eat sweet and sour candies

4. Chew gum

5. Blow up balloons

6. Make a chewy necklace out of cheerios and licorice

7. Drink thick liquids (e.g. applesauce, pudding) through a straw

8. Drink water through a water bottle with a straw

9. Make a bubble volcano: Fill a bucket with soap and water, and have your child use a straw to blow bubbles to make the volcano. This is an activity you can use at home to help with self-regulation.

10. Send chewy, crunchy snacks (e.g. pretzels, granola bar, fruit leather, bagels) for lunch

11. Purchase products designed for chewing:

• Chewlery: http://www.therapro.com/Chewlery-and-Chewies-P321445.aspx

• Chew tubes and similar objects: http://www.therapro.com/Designed-to-Chew-C307786.aspx

• Other fun oral motor tools: http://funandfunction.com/oral-motor-chewies-c-65_107_110.html

• ChewEase pencil toppers: http://www.amazon.com/3-Clear-ChewEase-Pencil-Toppers/dp/B001G2DAK8