Saturday, October 20, 2012

Everyday Therapy: Movement therapy inside the home

Sleeping baby

When we lived in San Francisco Bay Area, the weather was almost always good enough to go outside every single day.  Winter weather was really somebody else's Fall weather.  So it was never a problem finding a playground to get our sensory integration treatment...especially the swing.

New England weather is not going to be the same.  Extreme weather conditions may become our reality.  So I've been creating a veritable OT Gym inside our apartment.  My first priority was to install a swing, without creating gaping holes, yet safe for my little guy.

Ikea has been my favorite furniture store since they invaded the States with their amazing build your own furniture system.  They also have a great children's section, including this swing.  It no longer seems to be on their online catalog, but they had it in the store.  I grabbed one before I even knew if I could install it.

Baba was afraid of it at first.  However, he's intense curiosity overcame his fear and eventually asked to swing by standing in front of it and looking at me.  He promptly fell asleep.  He has been taking a nap in this swing ever since.  He also falls asleep in it, before being put to bed.

It's definitely not Sensory Integration Therapy, but it's certainly relaxing and comforting.  He has figured out when he needs to sleep and will now ask to swing when he wants to sleep.  Amazing!  It's been really wonderful to see that he is learning to read his own body and taking action to fill his own needs.

Ikea swing with platform swing
I didn't know that the air bag was sold separately, so I had to improvise using a small platform swing I bought on Amazon.  Eventually, I will buy the air bag and use the platform swing separately.  But for son thinks it's his sleeping tent.  I'm okay with that.

Since Baba is so small and this was not a clinic, I chose to use the Ikea attachments to install the swing, using very heavy duty screws.  It turned out, that our ceiling is held up with steel beams.  So I feel extremely safe with this arrangement.

If you plan to put up a swing, make sure to get a very knowledgeable person to help out.  It's important that they take into account the amount of pressure exerted on the screws as the swing moves.  In a clinic setting, we usually account for 1000 pounds of pressure.  It's strong enough for an adult to use the swing safely.  Our swing would probably take 300 pounds of pressure, safe for up to a 50 pound child.  Since Baba is 28 pounds, this is good enough for now. 

If your child will be using the swing, independently, more safety measures may be necessary.  I bought attachments from Southpaw Enterprises, so I can take the swing down easily.  If you have plenty of room for putting up a swing and leaving it there, you won't need anything fancy. 

I'll be posting more information on using the swing as therapy soon, but I thought I'd put this idea out there.  Apartment Therapy has a great "do it yourself" post on putting up a simple swing here.  Design Mom's "Living with Kids" series showed one home with three swings in the playroom here.

So if you have an area with 6 feet radius of free space, consider putting in a swing for the long winter months.  It might just make you a parental star in the eyes of your child!

Monday, October 15, 2012

Everyday Therapy: Gross motor and sensory fun outside

Going outside with your child is probably the easiest "everyday therapy".  There are many opportunities for practicing skills.

Baba has some mild sensory issues that affect his ability to eat, to tolerate sounds, and try new things.  However, when he's outside he shows a remarkable ability to tolerate sensory input.  It also motivates him to try new things and practice his gross motor skills.

getting muddy
Normally he wouldn't touch anything wet or muddy, but he was inspired to walk through mud on this day!  He got the mud all over his feet.  Of course, he was unhappy afterwards and I had to wipe them.  Several weeks later, he walked in on his bare feet and didn't mind that his feet were covered with mud!

This is typical of children with sensory issues.  They are more willing to try new sensory experiences, when they can do so on their own terms, when their neurological and mental systems are prepared.  They also have days when their systems can tolerate more sensory input and days when they can't tolerate much at all.  Their body is affected by sleep, diet, stress, developmental stages, etc.  This is true of adults, but we have more coping skills to help us when we wake up on the wrong side of the bed.  Children are in various stages of learning these coping strategies.

walking on grass
It took Joshua a long time to start walking on grass.  He really didn't like how it felt.  We started with completely covered shoes, then the fisherman sandals above, and now he can walk on grass barefoot!  He had trouble with both the uneven ground and the feel of the grass.  He still has days when he can't tolerate it, but he no longer goes out of his way to avoid it.

beginning to run
Being outside, helped Baba learn to run.  I would write the numbers in chalk and he would walk from number to number, until he slowly began to run.  In this picture, he is still mainly walking fast.

vestibular/movement therapy
Baba hated the swing when he was younger, but watching other babies increased his curiosity, until he agreed to get on himself.  Now he loves the swing.  We recently installed one at home, so we wouldn't miss this important treatment during bad weather days.  Vestibular/movement treatment is one of the "big guns" for sensory integration treatment.

trying different things
Baba is very cautious and reticent of trying new things, especially if they involve possibly falling.  Yet when he's outside, he regularly tries new things.  In this picture, he decided to take the ball to the grass area, which required climbing over the barrier.  It's beautiful to see your child try things they might not try at home, when they feel inspired.

climbing a hill
There is a much larger variety of surfaces and inclines outside, giving your child more ways to practice or learn to challenge their balance.  In this picture, Baba practices going up and down a steeper incline, on a slightly slippery surface.

Even if your child is not really walking, they can still benefit from being outside.  If they're crawling, let them crawl on different surfaces.  It's a great sensory experience.  If they are using wheelchairs, walkers, or any other device, the different surfaces outside give them opportunity to challenge their skills.  Even if your child is not moving much, let them lay on a blanket and take in the sights.  They might just love it!

Why not enjoy the outdoors, while you still can?

Saturday, October 13, 2012

A quick apology

I'm not sure what's happening, but for some reason blogger is publishing posts without my assistance.  Please forgive the intrusion into your emails.

I am writing a post and I'm not sure if somehow it's mistaking my saving the post, as publishing it.  I'm not sure how an old post got re-published, as I haven't even looked at that one in a long time.

Please accept my apologies.

Monday, October 1, 2012

Therapy Secrets: How to incorporate therapy into your everyday

Chasing Mama=gross motor

Incorporating therapy into your daily life was not easy, especially in the beginning.  Like all change, there's a steep learning curve.  Yet it is definitely worth investing time to make therapy a part of your everyday life.  When therapy becomes a seamless part of your day, it just becomes a different way of doing things.  It slowly becomes a new habit and habits are easier to maintain.  Once therapy is regular way of doing things, it can also make things easier overall.  It's also important to remember that we're in this for the long haul, so balance is key. 

Since I used to preach this with fervor, I was quite surprised at how hard it was to put this ideal into practice as a special needs mom.  But I can honestly say that it is worth the effort, which is why I decided to share my personal experience.  I hope that my "techniques" may prove useful to other special needs moms.

I am going to start another series called "Everyday Therapy".  These will be short little ditties with ideas and examples of how I incorporate therapy into my day.  Hopefully, these will be shorter, thus easier to write and I will be able to share information more frequently.  Well, that's my hope anyway.

On this post, I will share 10 general tips, which will soon be followed by posts of actual examples. 

Overcoming obstacles=gross motor
  1. Write down or think about your child's current goals.  Is it independent dressing?  Is it handwriting?
  2. Think about how you can help your child achieve their goals.  Brainstorm with your OT about activities   that would improve strength, coordination, endurance, motor planning, etc.  Ex.  Let's use independent dressing as an example throughout this post.  Activities that improve your child's body awareness, motor planning, sequencing, spatial awareness, and coordination will also improve their ability to dress themselves. 

    Body awareness can be improved by a variety of activities.  Perhaps your child could push the shopping cart?  Maybe they can help organize the books and carry them to the new location.  Maybe they can jump on a trampoline?  Perhaps hiking up a mountain would catch their interest?  Maybe they would like to decorate a life-sized outline of themselves?  Perhaps they can use a rough loofah to wash their body parts in the bath, while naming each body part.  Virtually any activity that increases sensory information to their bodies and helps them feel their body will help improve body awareness. 
  3. When possible go outside.  Something about being outside gets everyone moving.  There are things to see and things to explore.  It naturally gets us moving and it is the best and easiest form of therapy.   
  5. When possible, let your child do things as independently as possible. 

    For some, this may be pushing their arms through the  shirt, pulling their shirt down in the front, wriggling their leg through the pant hole, and pulling up the sock the rest of the way.  It may take 15-30 minutes to dress, instead of 5, but you can consider it a chunk of therapy time.
  7. Start slow.  Work with your therapist to figure out which area would be most fruitful to start: dressing, exercise, play, standing, or therapeutic techniques.  Start with one area, practice until it feels like a habit ( usually 25 days), then add another.  Over time you'll start to think like a therapist and it'll feel more natural.
  9. It's okay of you need to take a break now and then.  If your child has special needs, this is a long term investment.  It won't hurt to take a short vacation.  Besides, your child needs you to stay healthy and happy.  Taking care of yourself is part of the package.  Yeah, it's hard not to feel guilty, but you really need the occasional break.  You deserve it!
  11. If you start to feel burned out, change activities or focus on a different aspect of therapy.  I'm currently taking a break from the Masgutova Method, but focusing on feeding and language.  I just needed a break after 16 months! 
  13. Everything therapeutic should feel like play!  Play is the medium by which children learn.  So tap into your inner child, what gets you excited?  What makes you giggle uncontrollably?  If you're not at least smiling, than you're probably not having fun.  If you're not having fun, you're probably not playing. 
    Try to find common interests with your child and play together.  This will take some of the stress off your shoulders and you'll both have fun. 

  14. Share the joy with others.  Don't be the only one responsible for therapy with your child.  Get the rest of the family involved, this includes any interested extended family and friends who are interested!  Therapy may help the other family members bond with your child.  They may feel like they don't know what to do with your angel.  Show them.  Inclusion starts at home. 
  15. Re-evaluate how things are going at least once a month and make adjustments as needed.  Write down what progress you see your child making.  Discuss it with your family, friends, therapists, and doctors.  Celebrate the successes, no matter how tiny.  It will help you stay sane and happy for the road ahead.
Swing time=vestibular therapy

Honestly, it's not easy.  Sometimes, I wonder how long I can keep this up.  Yet I keep focused on the big picture.  Helping my son become independent will make him happy, but it will also make things easier down the line.  It's hard to focus on the big picture when exhaustion begs us to stop, but it's the big picture that motivates us to keep going.  Right?  All we want is our children to be happy, functioning at their potential, and included in the community that surrounds us.  The effort we put in now, will make that dream a reality in the future.