4 Fun Ways to Practice Handwriting

As we all know, practicing handwriting is not a kid’s top pick for a summer activity. Luckily, there are ways to make handwriting fun! Blog-Handwriting-Main-Landscape

Try some of these ideas and see if you can’t trick your kid into becoming a handwriting master:

Use Different Mediums

  • Try practicing writing numbers and letters in shaving cream on a tabletop or tray. Kids love the feel and it adds a whole other element to learning the formation!
  • Other ideas include drawing in sand or dry rice in a cookie tray.
  • You can also make a mess-free activity with colored gel in a plastic zipped bag; you can use your finger to write and draw on the outside of the bag!

Play a Game

  • There are plenty of games out there that you can use to practice handwriting. Try playing Boggle and have your child find a word and then write a sentence with that word in it.
  • Playing Guess Who can become a sneaky secret game, where questions can only be written and transferred across the table to the other player who then writes the answer (Yes/No) and returns it.
  • Hangman is a classic game that already incorporates writing! That is a fun one that can also be played in shaving cream. Other games you can incorporate writing into include Scrabble and HeadBandz.

Try Different Writing Utensils

  • Sometimes kids are just sick of using paper and pencil all day. Adding in the novelty of using a dry erase marker or chalk on a small board can totally change their attitude!
  • Practicing writing on an iPad can also be fun, ideally using a stylus.

Be Creative

  • Try writing a creative story together; take turns writing sentences, trying to create a story. It will likely turn out to be silly! They can even illustrate a picture to go with it.
  • Another idea is to write a letter to their favorite author/singer/actor. There are also lots of websites with creative writing topics that might motivate your child to write.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale 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!

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Here’s What You Can Expect from a Neuropsychological Evaluation

A child may be referred for a neuropsychological evaluation when there are concerns about one or more areas of development. This can include cognition, academics, attention, memory, language, socialization, emotional, behavioral, motor, visual-spatial, and adaptive functioning. Blog-Neuropsychological-Evaluation-Main-Landscape

A neuropsychological evaluation aids the psychologist in determining an appropriate diagnosis, such as Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Specific Learning Disorder, Language Disorder, and emotional and behavioral disorders. An evaluation can also be recommended if your child has been diagnosed with a medical condition such as Down syndrome, epilepsy, or a traumatic brain injury (TBI). The purpose of the evaluation would be to identify your child’s strengths and weaknesses in order to provide appropriate treatment recommendations, determine progress and response to intervention, and monitor functioning.

After your pediatrician has made a referral for a neuropsychological evaluation, you will need to schedule an intake appointment, which is typically an hour long.

What to Expect During the Neuropsychological Intake:

  • Inform the psychologist about your areas of concern
  • Provide information about your child’s history
    • Including medical, developmental, academic, attention, behavior, motor, and social history
  • Inform the psychologist of any current, or past, services your child receives (e.g., speech language therapy, occupational therapy, physical therapy, individual therapy, academic tutoring)

What to Bring to the Neuropsychological Intake:

  • Completed intake paperwork
  • Any prior psychological/neuropsychological evaluation (if applicable)
  • Your child’s most recent 504 Plan or IEP (if applicable)
  • Any recent private intervention evaluation (e.g., speech language therapy, occupational therapy)
  • Your child’s most recent report card or standardized exam scores
  • Any relevant medical information (e.g., EEG report, CT/MRI scan report)

After the intake, you will schedule the testing session for your child.  Most of the time, testing is completed in one day (5 hours of testing), but occasionally the testing will need to be completed over two days.  The psychologist will create a neuropsychological battery based on the areas of concern; however, the battery could be adjusted on the day of testing.  Typically, this occurs if another area of concern arises during the testing session.

What to Bring on the Day of the Neuropsychological Test:

  • Plenty of snacks and lunch
  • Completed paperwork and rating forms
  • Any prior evaluations that were not brought to the intake

After testing is complete, you will return for a one hour feedback session approximately two weeks later, with the clinician to review the testing data, any diagnoses determined based on your child’s profile, recommendations for home and school, and any intervention services to foster your child’s development.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale 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!

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What Parents Need to Know About Feeding Therapy

Should I Have my Child Evaluated for a Feeding Disorder?

Does your child…

  • Experience extreme anxiety or exhibit behaviors during mealtime?
  • Find mealtime to be an exhausting process that requires too much time and energy to complete?
  • Have difficulty tolerating a variety of food groups?
  • Require you to prepare a separate meal from the family dinner or snack time at school?

If so, a feeding evaluation by a qualified speech-language pathologist or occupational therapist may be warranted.

What Does an Evaluation Look Like?

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The parent interview often provides the most valuable information and it is important to fill out all case-history information completely. The therapist may inquire specifically about your child’s medical history of any respiratory, gastrointestinal, renal, and craniofacial issues. Report any food allergies or restrictions (soy, gluten, dairy, egg, nuts) to ensure your child’s safety. If time allows, a 3-4 day feeding diary that includes a detailed report of all the food/drink ingested would allow the clinician to analyze any patterns of behavior and preferences related to feeding. The therapist should know the child’s regular feeding times, a list of all foods and drinks preferred/tolerated, any foods the child used to enjoy but no longer accepts, the length of a typical mealtime, and any positive or negative behavioral or physiological reactions to foods.

The clinician will examine the oral cavity (jaw, tongue, hard/soft palate, dentition, etc.) for appropriate symmetry, strength, and range of motion for feeding. Based on your child’s level of comfort, food and/or drink brought by the parent may be presented. The clinician will observe the child’s postural stability, acceptance of food/drink, munching or rotary chewing patterns, chewing side preferences, and the timeliness/success of the swallow response, and overall rate of feeding. The clinician will take note of signs/symptoms of airway penetration such as coughing, wet vocal quality, watery eyes, or excessive throat clearing. All of this information will assist the therapist in making appropriate referrals and/or developing a feeding treatment plan tailored to fit your child’s needs.

What’s the Difference Between a Picky Eater and a Problem Eater?

A picky eater is a child who accepts 30 or more foods, requires repeated exposures prior to eating the food consistently throughout varying food environments, and has specific routines with food presentation (e.g., needs crust cut off, no foods can be touching, will only eat one specific brand of chicken nuggets). Children who are picky eaters are still able to maintain adequate nutrition and hydration without nutrient-based supplements. Parents complain that new food experiences such as going to restaurants and birthday parties are often difficult due to their child’s feeding preferences.

A problem eater is a child who accepts roughly 5-10 foods and has no more than 20 foods in their food repertoire. The child presents with extreme phobic reactions to new foods such as crying, screaming, throwing foods, and most often times, absolute refusal if their foods are not preferred. Physiological symptoms become evident with facial grimacing, gagging, or vomiting when presented with or during mastication of foods. Parents often feel obligated to allow their child any food so they will eat something. A problem eater likely has underlying medical or functional impairment such as autism spectrum disorder, gastroesophageal reflux disease (GERD), reduced strength and coordination of the oral musculature, and/or sensory processing disorder. Extreme self-restriction can occur if problem eating is left untreated and most often leads to pediatric undernutrition (PUN). Most parents express that the “wait it out” approach does not work with a problem eater and they will continue to self-restrict for days until preferred foods are presented. Children who are problem eaters often require nutrient-based supplements to maintain their health.

A speech-language pathologist can treat both a picky and problem eater to expand the food repertoire and increase tolerance of various tastes, foods, and textures.

What Does Feeding Therapy Look Like?

There are many different approaches to feeding therapy. Your speech or occupational therapist will choose a technique and plan of care that suits your child’s needs most appropriately. Since feeding is a daily activity that requires parent assistance and preparation, you will likely be included in the sessions for education and training purposes.

A feeding therapy session will focus on creating a positive mealtime experience for the child. Intervention targets will likely include increasing awareness, stability, or strengthening the oral cavity, improving the motor plan sequence for feeding, and/or imposing behavioral modifications during feeding, and educating the parent. Behavioral modifications may include a daily mealtime schedule, with no “grazing” in the kitchen allowed, restricting the amount of preferred foods presented to the child, or implementing positive reinforcement for when a child is trialing a new food (access to a favorite toy for 1 minute.) Parents also benefit from behavioral modifications, such as allowing the child to choose foods from two choices, reestablishing trust after hiding something nutritious in the food, and maintaining the promise of “just 5 more bites.”

A technique called “food chaining” uses the child’s core diet (what they will reliably eat across all settings) to “chain” or transition to another similar flavor and texture of foods.

Here is an example of the steps taken while food chaining:

  1. Core diet – what the child will eat reliably across all settings.
  2. Flavor mapping – analysis of your child’s flavor preferences
  3. Flavor masking – use of a condiment or sauce to mask a new taste
  4. Transitional foods – favorites used to transition a child to a new food.  These foods cleanse the palate in-between bites of new foods
  5. Surprise foods – new foods that are significantly different – something you make together, for example: chocolate to peanut butter, apples to pears, and chips to veggie sticks.

Food chaining often incorporates all senses to transition to a new food using a feeding hierarchy. A feeding hierarchy is a tool to teach the child how to taste/trial food in slow increments in attempt to reduce the amount of anxiety associated with trialing new foods. The feeding hierarchy may include providing the child with a goal to interact with the food, or an item of similar consistency a number of times.

Some examples of what may be included in a feeding hierarchy are:

  • Tolerating the food and its scent in the room
  • Allowing the food on the table or on the child’s plate
  • Touching the food with a utensil or hands
  • Touching the food to the lips (kissing) teeth, and tongue
  • Licking or sucking the food
  • Sinking the teeth into the food
  • Taking a small “nibble”
  • Taking an average bite of food

If your child is experiencing these symptoms consult with your physician regarding your concerns. Should you have any questions regarding a feeding evaluation/therapy, consult with a qualified speech-language pathologist or occupational therapist as soon as possible.

References:

  • Fraker, C., Fishbein, M., Cox, S., Walbert, L. (June 2004). Food Chaining: A systematic approach for the treatment of children with eating aversion. Retrieved from Journal of Pediatric Gastroenterology and Nutrition: Volume 39, pg. 51.
  • Fraker C., Fishbein M., Walbert L., Cox S. Food Chaining: The proven 6-step plan to stop picky eating, solve feeding problems and expand your child’s diet. Cambridge, MA: Da Capo Press; 2007.
  • Roth, M., Williams, K., Paul, C. (August 2010) “Empirically Supported Treatments in Pediatric Psychology: Severe Feeding Problems”. Journal of Pediatric Psychology, vol. 24, no. 3, 193-214.
  • Toomey, K. Ross, E. “SOS Approach to Feeding”. Perspectives on Swallowing and Swallowing Disorders (Dysphagia). 2011. 20: 82-87. Retrieved from http://spdfoundation.net/library.html#effectiveness.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale 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!

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10 Signs of Auditory Processing Disorder

What is Auditory Processing Disorder?

Auditory processing refers to what we do with the messages we hear. An auditory processing disorder occurs due to an auditory deficit that is not the result of other cognitive, language, or related disorders. However, children with an auditory processing disorder may also experience other difficulties in the central nervous system, including learning disabilities, speech-language disorders, and other developmental disorders. Auditory processing disorder may also co-exist with other diagnoses, such as ADHD or Autism. Blog-Auditory-Processing-Disorder-Main-Landscape

10 Signs of Auditory Processing Disorder

  1. Difficulty understanding speech in noisy environments
  2. Inability to consistently and accurately follow verbal directions
  3. Difficulty discriminating between similar-sounding speech sounds (i.e., /d/ versus /t/)
  4. Frequently asking for repetition or clarification of verbally presented information
  5. Poor performance with spelling or understanding verbally presented information
  6. Child typically performs better on tasks that don’t require or rely on listening
  7. Child may not speak clearly and may drop ends of words or syllables that aren’t emphasized
  8. Difficulty telling stories and jokes; the child may avoid conversations with peers because it’s hard for them to process what’s being said and think of an appropriate response
  9. Easily distracted or unusually bothered by loud or sudden noises
  10. Child’s behavior and performance improve in quieter settings

How is Auditory Processing Disorder Diagnosed?

An initial diagnosis of auditory processing disorder is made following a comprehensive audiological evaluation, which is completed by a licensed and ASHA accredited audiologist. Following the diagnosis, the speech-language pathologists at NSPT work closely with the audiologist and collaborate on an ongoing basis. Children with an auditory processing disorder benefit from working closely with both speech-language pathologists, as well as occupational therapists. Professionals at NSPT can collaborate with teachers and other professionals to provide recommendations to help set up a successful learning environment for your child. Therapy will include activities to increase auditory closure skills, vocabulary building, discrimination skills, grammatical rules, and auditory perceptual training.

Resources:

 Bellis, Teri James. Understanding Auditory Processing Disorders in Children. American Speech-Language-Hearing Association. Retrieved from http://www.asha.org.

www.understood.org

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale 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!

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What You Need to Know About Sensory Diets

  1. While it is called a “diet,” it’s not a FOOD diet, but it should be considered nutritional intake that your child’s body/brain need daily. Blog-Sensory-Diets-Main-Landscape
  2. Consistency is key and it is important to find a schedule that works for you. Work with your occupational therapist and teacher to develop a timeframe that works best. Do not overdo it if it does not seem sustainable.
  3. As much as possible, sensory diet activities should be completed around the same time each day.
  4. Many sensory diet activities can be adapted to be used across many environments in order to promote consistency i.e. at home, in school, while traveling.
  5. When appropriate, get other siblings and family members involved!
  6. Watch your child’s responses before, during, and after sensory diet activities and be sure to address any abnormal changes you see with your occupational therapist.
  7. The best sensory diet combines tactile, proprioceptive, and vestibular based activities.
  8. Just as no two children with sensory processing difficulties will present the same, no two sensory diets will be identical.
  9. As your child’s brain continues to develop, the sensory diet will likely eventually need to be updated in either types of activities or frequency.

Examples of sensory diet activities for each sensory system:

  • Proprioceptive: jumping and crashing on pillows, heavy work activities such as pushing a heavy laundry basket or helping carry grocery bags to put away, wheelbarrow walk or animal walks (bear crawl, crab walk), joint compressions.
  • Vestibular: log rolls, cartwheels, swinging, head inversions over the edge of a couch, yoga poses, rocking chair.
  • Tactile: messy play (shaving cream, water, finger painting), sensory bins (uncooked rice or pasta noodles, kinetic sand), exposure to novel materials (i.e. corduroy, velvet, sandpaper, sand, silk).
  • Auditory: participation in Therapeutic Listening program under the guidance of your occupational therapist, listening to calming music, listening to white noise, play exploration with various instruments or toys/books that make sounds.
  • Oral: blowing bubbles, use of straws, use of chewy tubes or “jewelry”, food texture exploration (i.e. creamy, dry, wet, lumpy), having a chewy or crunchy snack to provide “heavy work” to the mouth”.
  • Visual: activities such as “i-spy”, spot the difference picture games, and word searches, de-clutter the home environment, oculomotor exercises, dim lights and avoid fluorescent bulbs.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale 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!

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Sensory Activities for Rainy Days

Every child needs sensory input to stay focused, regulated, and organized throughout the day, especially children who have sensory processing challenges. Every child has different sensory needs that need to be met each day and acquiring that input can be difficult when the weather turns rainy. Blog-Rainy Sensory Activities-Main-Landscape-01

Below are some fun and easy to do sensory activities that can be done with the whole family to ensure that your child is getting the sensory input they need:

  • Tactile/messy play is a great indoor activity for the child with tactile processing challenges:
    • Play doh/theraputty
    • Finger painting
    • Shaving cream
    • Create sensory bins of rice, beans, sand, noodles, etc.
    • Cooking/baking (allow the child to mix with their hands to explore new textures)
  • Heavy work activities and activities that provide vestibular input can be great to help regulate a sensory seeking child:
    • Obstacle courses
    • Blowing bubbles
    • Somersaults
    • Animal walk races
    • Using a rolling pin and cookie cutters while baking
  • For the anxious child or a child that has self-regulation difficulties:
    • Building forts
    • Listening to calming music
  • To increase attention, alertness, and address impulsivity challenges:
    • Freeze dance
    • Red light/green light
    • Simon Says

Be creative and have fun using these activities to brighten up a gloomy, cold day!

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale 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!

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Is My Child Depressed? What You Should Know About Childhood Depression

What the Numbers Show

Research has shown that children, even babies, have experienced depression. In the United States alone, research studies suggest that up to one percent of babies, four percent of preschool-aged children, five percent of school-aged children, and eleven percent of adolescents meet the diagnostic criteria for Major Depressive Disorder. Blog-Childhood Depression-Main-Landscape-01

It is important to understand the risk factors and symptoms of childhood depression to help your child receive the necessary therapeutic interventions. Suicide is the second leading cause of death for children, adolescents, and young adults aged 10 through 24 (http://jasonfoundation.com/prp/facts/youth-suicide-statistics/). Suicide is significantly linked to depression, so early detection and diagnosis is critical and sometimes even life-saving.

Symptoms of Childhood Depression

Just like adults, children are capable of changes in mood, expressing negative thoughts, but are more likely to show depressive symptoms in behavioral ways. For example, a child experiencing depression may complain of fatigue, stomach aches, headaches, or experience irritability, changes in appetite, and changes in sleep patterns. These physical symptoms, often known as somatic symptoms, are expressed physical aches and pains that are real experiences for your child, although they have no known medical causes. These somatic complaints are often common in children who experience depression. It is important to rule out physical illness or other medical problems with your pediatrician if your child is experiencing these symptoms.

What Parents Can Do to Help

Parents are a child’s greatest advocate and support, so it is important to know what to do to help your child if you suspect that he or she is struggling with depressive symptoms.

  • Talk about depression with your child. Support and encouragement through open communication help your child feel comfortable to express his or her feelings. This lets your child know that he or she is not alone, is loved, and understood.
  • Talk with your child’s pediatrician. Mental health is just as important as your child’s physical health. If you notice your child is experiencing symptoms of childhood depression, call your pediatrician to alert him or her of your child’s emotional concerns. Your pediatrician may recommend a diagnostic screening or refer to an outpatient licensed therapist.
  • Don’t ignore it! Depression is a serious mental illness that cannot be brushed aside or ignored. Ignoring your child’s emotional concerns will not help your child obtain the treatment that he or she needs to overcome depression.

Treatments Offered

Depression is a treatable illness with success rates of up to 80% for children and adolescents who receive therapeutic intervention. The other 20% may respond well to medicinal interventions along with traditional therapy (https://blogs.scientificamerican.com/mind-guest-blog/what-adults-need-to-know-about-pediatric-depression/). Recommended treatments include play therapy, family therapy, and individual talk therapy, including cognitive behavioral therapy (CBT) that helps children re-frame their negative thinking patterns to help them change their self-perception and consequently, improve their mood. Cognitive behavioral therapy is goal-oriented, problem-solving focused, and is one of the most commonly used interventions to treat depression.

Medicinal options are another commonly used treatment for children who experience depression, with the goal of reducing depressive symptoms. The majority of children who take antidepressant medications will be able to stop their medication with support from their pediatrician or psychiatrist when their symptoms improve. It is important to note that the use of antidepressant medication for children and adolescents may carry a higher risk for suicidal thoughts for this population. It is imperative to receive ongoing medication monitoring to assess risk of side effects and other interactions.

I Think My Child is Depressed. What Should I Do?

If you suspect that your child may be experiencing depression, it is recommended that you contact your pediatrician. Share your concerns and plan for a medical evaluation to begin the diagnostic process. If medical testing shows no other reason for the fatigue, stomach aches, headaches, sleep, appetite changes, or sadness that often come with depression, a licensed mental health professional will evaluate further to determine the most appropriate treatment plan.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale 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!

Social Work

A Counselor’s Take on 13 Reasons Why

If you have a preteen or teen child, you probably have heard of the hugely popular Netflix show 13 Reasons Why. The show, based on a best-selling novel, centers around Hannah, a teenage girl who dies by suicide and leaves behind tapes to the people she feels pushed her towards ending her life. This popular and controversial show has brought in discussions about mental health, bullying, sexual assault, substance use and suicide. As a counselor, I agree that raising awareness on these topics is crucial and necessary, especially considering the frightening increasing rates of these issues. However, I am concerned about the potential impact that this show might have on young teens. Blog-13 reasons why-Main-Landscape-01

Teenagers are very vulnerable to graphic content. The show can be hard to watch, and some scenes can be potentially very triggering. Many teens are binge-watching the show, which increases concern about the possible emotional distress that can be caused by doing so. I do not recommend that anyone struggling with suicidal thoughts watches the show as it might develop potential ideas or even romanticize the idea of suicide. The problem with the ultimate fantasy is that the character does not get to change her life with suicide nor does she get to find out what happens next. Suicide is final.

13 Reasons Why also misses the mark in its failure to address mental illness or depression ( the most common risk factor in completed suicides). Depression can look differently in teens than adults.

Some risk factors include:

  • Significant sense of sadness
  • Significant irritability
  • Isolation
  • Negative comments about life
  • Loss of interest in sports, hobbies, etc.

My recommendation is that if your child wants to watch the show, you watch with them.

Although it might be hard or uncomfortable, it might bring an opportunity to discuss important topics such as:

  • Talk to your children about bullying and what it might look like. Bullying can be physical or verbal abuse, excluding others, or using the internet/social media to attack and humiliate the victim. Teach your child to not be a bystander or support bullying.
  • Talk to your child about resilience and options on how to reach out for support if they are being bullied. If children develop resilience and strong self -advocacy, it can help them further develop their self- esteem and instill courage.
  • Talk to your child about symptoms of depression. 1 in 5 teens experience depression and suicide is the third leading cause of death among 15-24-year-olds according to the CDC. Discussing the issue of suicide does not plant the idea. It creates the opportunity to offer help. Have a conversation with your child about trusted adults in their life that they can reach out to if they need help.
  • Listen to your child’s comments without judgment. Do not minimize or trivialize what you see. If it appears insignificant to you as an adult, remember that this is a daily reality that teens are faced with each day. Allow your child to discuss any issues without judgment or punishment.

In addition, the Jed Foundation has released a great list of additional talking points. You can check those out here: https://www.jedfoundation.org/13-reasons-why-talking-points/

We need to use shows like 13 Reasons Why as a reminder. A reminder to be emotionally present and let children know that they are loved and supported. Children need you to be their secure base, to support their exploration, help them, enjoy with them and watch over them. Make sure to create a space for listening that is nonjudgmental and supportive.

If you need to talk, or if you or someone you know is experiencing suicidal thoughts, call the Suicide Prevention Hotline 1800-273-8255 or 1800-SUICIDE (784-2433).

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale 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!

Social Work

Fidget Spinners: The Bottom Line

A fidget tool is one sensory strategy used to help children achieve self-regulation. Self-regulation is the ability to maintain an optimum level of arousal in order to participate in daily activities.Blog-Fidget Spinners-Main-Landscape (1) Self-regulation is a critical component of learning, as it can impact a student’s attention, emotional regulation and impulse control; a child’s performance in the classroom is directly related to his regulatory state.

A child’s nervous system, specifically the sensory system, needs input to help achieve a regulated state to successfully complete tasks. The theory behind fidget tools is that it provides a sensory experience to increase self-regulation, attention, participation and performance.

During the school day, a child’s body works tirelessly to perform the functions necessary to participate in the classroom. Children need:

  • Muscle control and endurance to sustain a seated, upright position to sit at a desk or on the rug during circle time.
  • Auditory attention to attend to instructions and lessons, while also blocking out surrounding sounds of peers chattering, shuffling papers or chairs scooting across the floor.
  • Visual attention to read work instructions, look at the teacher during lessons and complete written work, while also blocking out other visual distractions around the classroom.
  • Impulse and body control to keep hands, legs and other body parts from touching objects or peers nearby.
  • Emotional control to regulate emotions when happy, sad, confident, frustrated or embarrassed throughout the day.

For some kids, the demands of the classroom environment exceed what their bodies can handle. This isn’t due to a lack of intelligence or willingness to learn; it stems from difficulty coping with a neurologic system that isn’t organizing and responding appropriately to a variety of sensory stimulation from the external world.

The result of a child’s inability to organize his nervous system during the school day is an increase in behaviors that are often deemed inappropriate or distracting in the classroom. Such behaviors may include inability to sit still, wandering around the room, constant touching of objects or peers, laying on the floor, emotional outbursts, not following directions or not understanding how to complete a task.

These behaviors are actually how the child attempts to regulate his body to participate in the classroom. To minimize these behaviors and increase positive participation, it is important that the child is set up for success by providing individualized strategies for him to sustain a regulated state throughout the day.

One of these strategies is the fidget tool. I frequently recommend that my clients use a fidget tool in the classroom to help sustain attention and increase performance. Fidgets come in a variety of forms including Koosh balls, stress balls, small weighted balls, small figurines or fidget spinners.

Fidget tool recommendations are always given with the stipulation that the student must understand that the fidget needs to be used appropriately. I suggest that the parent and teacher review appropriate uses for the fidget with the child (i.e keeping the fidget in the hands, under the desk in the child’s lap), inappropriate uses for the fidget (i.e. throwing the fidget, rolling the fidget, giving the fidget to a friend) and the consequences for inappropriate use of the fidget (i.e. having the fidget taken away). Laying out clear guidelines for the use of the fidget helps students know the expectations and follow the rules.

While several schools have banned the use of fidget spinners in the classroom due to the craze they have caused, as an occupational therapist I support fidget tools as a sensory, regulatory strategy, as long as clear expectations are set and rules are followed. I have seen great success in my clients’ performance and attention when they use fidgets appropriately and not as a toy.

Does that mean my child needs a fidget spinner?

Fidget spinners or tools may not be suitable for everyone. Each person’s sensory system will respond differently to various strategies and may be needed at different times during the day. Some children benefit from fidget tools during writing activities, some may benefit from the tool during lecture periods and others may require use of the fidget more frequently. There may also be children who have difficulty with self-regulation where fidget spinners or fidget tools cause increased distraction or dysregulation. Check out our other blogs for ideas on other strategies that may be incorporated in the classroom to promote optimal performance.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale 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!

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Common Misconceptions About Picture Exchange Communication System

What is a Picture Exchange Communication System (PECS)? PECS is a form of Augmentative and Alternative Communication (AAC) which uses a picture/symbol system to teach initiation ofBlog-Picture Exchange Communication System-Main-Landscape
functional communication. PECS was developed by Lori Frost and Andy Bondy in 1985 to be used with preschool children on the autism spectrum who demonstrated little to no socially-related communication. Examples include: children who avoided interactions with others, did not approach others to communicate, and/or only communicated when prompted to do so.

Myth #1: The Picture Exchange Communication System is strictly used for nonverbal children or children on the autism spectrum.

A common misconception about the Picture Exchange Communication System (PECS) is that it is strictly used with nonverbal children. While PECS and other forms of AAC have proven very useful and successful with nonverbal children, the system services many other populations with the purpose of eliciting and initiating functional communication.

To fully understand the meaning of functional communication, a distinction must be made between actions directed to the environment vs. actions directed toward a person. A child may climb on a step stool to reach a toy car on a shelf. From this action, we could infer that the child wants to play with the car. However, this is not communicative. If this same child looks from the car to his mother, or leads his mother over to the car, this is considered communication. Neither interaction involved speaking, however the distinction is that communication occurs when an action is directed towards someone else to achieve a certain outcome.

Therefore, Picture Exchange Communication System is appropriate, not just with children or adults that are not verbally communicating, but with those who are verbal, yet lack person-directed communication.

Other populations where PECS might be appropriate (to name a few):

-late-talking children (research is showing benefits for the introduction of AAC as early as 12 months)

-adults with aphasia

-Childhood Apraxia of Speech (CAS)

-children with reduced speech intelligibility

-verbal children with reduced social language and initiating

Myth #2: Using PECS will deter my child from communicating verbally

For some children, verbal communication can be a challenge; speech and language are not developing as quickly as would be anticipated and, accordingly, result in accompanying frustration and associated behaviors. Introduction of an augmentative and alternative communication system like PECS can help bridge the gap for children who are not yet verbally communicating but need an accessible means of communication as speech and language develop. Without an effective means of communication, these children are at risk for social, emotional, and behavior problems, including feelings of frustration and isolation.

Often, parents are concerned that using an augmentative or alternative form of communication will replace or deter verbal communication. In fact, research has shown just the opposite:

“Research over the past 25 years has shown not only that use of augmentative communication systems (aided or unaided) does not inhibit speech development but that use of these systems enhances the likelihood of the development or improvement of speech.” (Bondy & Frost, 2004)

The PECS program mirrors the acquisition of typical language development; children are taught one-word labels for frequently requested items before transitioning to formulation of two-word utterances. Verbally requesting and labeling can be targeted in conjunction with the program. The PECS program also details modality transitioning (i.e., transitioning from PECS to verbal communication), if and when it is appropriate.

If your child is using PECS now, this does not mean that you are “giving up on speech”. It is a system that is being utilized to give your child a means of communicating and interacting with others while speech is developing.

Myth #3: PECS cannot be used with children who have visual impairments, fine motor, or gross motor difficulties.

PECS can be used with a wide range of age-groups and disabilities. Accommodations can be made for children and adults with visual impairments, fine motor, or gross motor difficulties, to name a few.

Pictures can be made in various sizes to accommodate visual impairments. Additionally, you or your child’s speech language pathologist can select and modify pictures to suit your child’s needs; photographs can be used instead of clipart or Boardmaker pictures, and images can be modified to create more contrast.

Pictures can also be put on objects (e.g., bottle tops) to make them easier to grasp and pick up from a table or book for children with fine motor difficulties.

Step 2 of PECS involves ‘distance and persistence’, meaning a child is taught to move across a room, multiple rooms, etc. to select a picture from his book and persist when giving it to his communication partner. Students that are non-ambulatory can use a voice switch or a button to request his communication partner in order to perform the exchange.

If you have questions about PECS and if it would be appropriate for your child, please consult with a licensed speech language pathologist.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale 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!

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