Wednesday, April 29, 2009

Sensory Adaptations, Developmentally Disabled Children and the Dentist

New research published in the Journal of Pediatrics reports that 16 children (ages 6-11 years old) with developmental disabilities had decreased anxiety during dental visits when a sensory adapted environment was used. The study compared developmentally disabled children to typical peers. During the first dental visit, no environmental adaptations were used. During the second dental visit, each group experienced a sensory adapted environment of
1. color lamp
2. examiner wore LED headlamp aiming light directly at patient's mouth
3. soothing music
4. wearing a heavy vest to give feeling of a hug
5. vibration in the dental chair.

During the second visit, anxiety levels were decreased in all children. The children with developmental disabilities experienced a more significant decrease in anxiety.

These are very simple adaptations to try during a dental visit. Keep in mind, that each child reacts differently to certain sensory stimuli. For example, one child may like the vibration and one child may find it to be noxious. A trained occupational therapist could offer further suggestions on an individual basis for children with developmental disabilities.

Reference: Michele Shapiro OT, MSca, b, , , Harold D. Sgan-Cohen DMD, MPHc, Shula Parush OT, PhDb and Raphael N. Melmed MD, FRCPd Influence of Adapted Environment on the Anxiety of Medically Treated Children with Developmental Disability The Journal of Pediatrics
Volume 154, Issue 4, April 2009, Pages 546-550

Tuesday, April 28, 2009

ASD, Google Sketch Up and Life Skills

Here is a video on 4 children with autism and how they use Google Sketch Up. This is a great program for visual spatial learners. If anyone has used this with older children on the spectrum please comment. I would love to hear how it worked.

Monday, April 27, 2009

How to Make Your Own Ink Dabber

Here is a slide show on how to make your own ink dabbers. The great thing about this idea is that you can modify the dabber for children with varying abilities. This works well with our electronic book DOT Letter and Shapes.

Friday, April 24, 2009

Brain Gains Documentary

If you are interested in how exercise effects learning in the classroom this documentary is a must see video. It is about 15 minutes long. It covers a special education classroom in Canada that use treadmills followed by academic sessions. The teacher reports excellent results. Here is the link - http://www.cbc.ca/national/blog/special_feature/brain_gains/brain_gains_2.html

Hippotherapy and Autism

Here is a video of one child's story on hippotherapy and autism from CBS news.


Watch CBS Videos Online

Thursday, April 23, 2009

Assistive Technology Links

I am not usually one to support a web page full of links but this is an informative one. Disability Info website has a great page of links for assistive technology articles and publications to access. It is jammed pack with links but it is easy to weed through the information. There are links for AT that are disability specific, links for parent guides, links to the laws and more. There are way too many to list. It is a great spot to check out. Go to DisabilityInfo.gov at http://www.disabilityinfo.gov/digov-public/public/DisplayPage.do?parentFolderId=187

Wednesday, April 22, 2009

Focus and Gum Chewing

Lots of news today regarding a recent study indicating that chewing gum improved students scores on math testing (read more at NBC).

Need some more justification to teachers and parents as to why you recommend chewing gum for certain children, check this out. Click on bottom right to view in full screen.

Self Regulation and Obesity

Archives of Pediatrics and Adolescent Medicine published research that indicated children who lack self regulation exhibit excessive weight gain. This was a longitudinal study of 1061 children. The children participated in self regulation tasks at ages 3 and 5 years old. They were then followed until 12 years of age with body mass index (BMI) being measured 6 times throughout that time. The children who exhibited a decrease in the ability to self regulate had the highest BMI and the most rapid weight gain.

Curious to know do you observe this trend in children with a lack of self regulation?

Reference: Lori A. Francis; Elizabeth J. Susman
Self-regulation and Rapid Weight Gain in Children From Age 3 to 12 Years
Arch Pediatr Adolesc Med. 2009;163(4):297-302.

Pediatric Physical Therapy in the News

Tuesday, April 21, 2009

Occupational Therapy Blog Carnival

Your Therapy Source Inc. is the host for the next Occupational Therapy Blog Carnival. A blog carnival is a collection of articles on a specific topic. There have been two previously done on occupational therapy. All you have to do is submit your favorite OT blog post to the carnival at http://blogcarnival.com/bc/submit_6317.html. You must submit your blog article by Friday, May 1st. The OT Blog Carnival #3 is set to publish on May 4th.
Email me if you have any questions. If I can't answer them, I will ask the primary host of the OT Blog Carnival at E-nableOT blog.

Monday, April 20, 2009

Earth Day Activities for Pediatric Therapists

Earth Day is this Wednesday, April 22, 2009. Why not incorporate the theme into your therapy sessions. Here are a few suggestions:

1. Earth Day Crafts: Create collages out of recycled materials. The children can cut up recycled cardboard or magazines to create a collage. Perhaps think of a theme such as healthy foods or exercise. Maybe write the child's name in large bubble letters and glue on the recycled pictures.

2. Earth Day Challenge: Who can create the tallest recycled tower? See how many recycled boxes or containers you can stack before it falls over. Depending upon where you place the boxes, this activity encourages the child to squat down, reach high, motor plan and more.

3. Earth Day Signs: Create signs with the children reminding them of energy conservation. Example#1: Turn Lights Off when you leave a room - cut out pictures of light bulbs from magazines to glue to sign. Or cut out circles from white scrap paper to be light bulbs. Example #2: Turn off water when brushing teeth. Try using a toothbrush to paint with for the tooth brushing sign.

4. Recycle Carnival: Create carnival games out of recycled materials. For example, recycled, clean yogurt cups stack well for a target. Newspapers rolled up can hit objects for eye hand coordination. Put newspaper rolls on floor to jump over.

5. Practice energy conservation: Discuss how energy can be conserved by walking to school or stores. Practice different forms of transportation - walking, jogging, running, bike riding and scooter riding. Discuss which one required the most energy.

6. Protect the earth's animals: Act out movements of endangered species such as elephants, gorillas, wolves, and tigers.

7. Milk Scoop Jugs: Most everyone knows how to make a milk scoop jug. Just cut off the bottom of a gallon milk container leaving the handle intact. Get a tin foil ball. Throw and catch it in the plastic container. Put colored tape on it to protect any sharp edges.

8. Clean Up Stroll: Take a walk outdoors, wear gloves and clean up any trash.

Anyone else want to add to the list?

If you would like more themed sensory motor activities check out our collection of sensory motor electronic books for the seasons.

Friday, April 17, 2009

Going Outdoors to Improve Attention Span


A recent article in the Journal of Attention Disorders, reports on the benefits of walking in a park to increase attention span. A small group of 17 children with ADHD, participated in a study comparing walks in a park, downtown and a neighborhood. The walks in the park resulted in a significant difference in concentration as scored on the Digit Span Backwards (DSB).

The article also discusses Attention Restoration Theory (ART). The basics of this theory is that interacting with nature results in a type of restoration for the body and the brain. Try to remember a recent event when you spent time outdoors in a natural environment. You may walk slowly and attend to all of your visual surroundings - a bird chirping, a sunset, the green grass of Spring. When you return indoors, you feel relaxed and calm. Now to try to remember that last time you were outdoors in a busier environment, perhaps a city. Your attention may be focused on planning when to cross a street, avoiding cars and other city obstacles. These two environments rely on your brain to use two different types of attention - involuntary and voluntary. Concentrating on topics that interest you or something that grabs your attention involves involuntary attention. Concentrating on blocking out distractions to focus on the topic at hand involves voluntary attention (which can fatigue easily). When the brain experiences involuntary attention it allows voluntary attention to rest and recover.

The authors of this study question whether children with ADHD experience deficits in voluntary attention resulting in the fluctuating attention span that you see in children with ADHD. Therefore, the Attention Restoration Theory when applied to children with and without ADHD can perhaps be very beneficial. Walks in nature are simple to carry out on a daily basis. The "restorative" action of the walks which call upon involuntary attention can possibly help to improve voluntary attention.

With the amount of television and computer time that children are exposed to daily, more time spent outdoors is essential. Here are several ideas to encourage increased nature time for all children:

1. Take hikes and short walks in the woods. If you need a wheelchair accessible path, search state parks for handicapped accessible trails or try bike paths that are paved.
2. Go letterboxing - Letterboxing is a great family activity for people of all ages. You can go to www.letterboxing.org for a list of clues throughout the USA. You print off the clues, walk to find them and stamp a marking in your log book.
3. Gardening - plant a garden with children. Plant seeds in pots so that all children can assist.
4. Go on scavenger hunts for outdoor materials - check out Scavenger Hunts e-book for ideas
5. Allow children to play outdoors in dirt, mud and puddles.
6. Go on a bug hunt - see how many different bugs you can identify
7. Start a nature collection such as rocks, acorns, leaves or pine cones.
8. Go fishing, frog hunting, horseback riding or birdwatching.
9. Build a structure out of natural materials i.e. fort, collage made out of sticks or leafs.
10. Encourage teachers and therapists to plan lessons outdoors.

Fresh air makes everyone feel healthier, relaxed and perhaps improves attention. It is a simple way to improve concentration with no side effects (except skinned knees).

References:
Faber Taylor, Andrea, Kuo, Frances E. Children With Attention Deficits Concentrate Better After Walk in the Park J Atten Disord 2009 12: 402-409

Cimprich, B Attention Restoration Theory: Empirical Work and Practical Applications Retrieved from the web on 4/17/09 at http://www.umb.no/statisk/greencare/meetings/presentations_vienna_2007/cimprich_cost_pres_71007.pdf

Wednesday, April 15, 2009

Collaborate with Teachers To Develop Multi-Sensory Lessons

Traditionally, a classroom lesson is delivered as verbal or written material. The student relies on auditory and/ or visual input to understand the concepts. The student is expected to sit for extended periods of time and remain on task. For many of the students who receive related services, this can be a frustrating method of comprehending academic material. If a student exhibits deficits in auditory or visual input, failure may ensue. On the other hand, if a teacher uses a multi-sensory approach to teaching material this student may succeed. A multi-sensory lesson allows for a student to learn using the various senses of the body instead of just auditory or visual. School based therapists can play a large role in helping teachers to incorporate additional sensory input such as tactile, proprioceptive, vestibular and motor skills when presenting academic material.

Occupational and physical therapists have a strong understanding of the large role that sensory input and sensory output plays in a students life. By offering that expertise to teachers when planning lessons, all students receive the benefits of multi-sensory learning. In addition, the students who receive related services will be able to experience improved carry over of therapeutic interventions.

By employing multi-sensory strategies in the classroom, information is delivered to the brain from several sensory systems. This spreads the load on the brain over several systems which may result in improved memory. Students can improve problem solving skills and retain more information by touching, feeling and moving to learn a new concept When physical activity is included in the lesson plan, students are able to release energy, reduce stress, increase level of alertness and practice motor and coordination skills.

Here are some basic steps to follow when creating multi-sensory lessons.
1. Infuse lessons with physical movement whenever possible including proprioceptive and vestibular activities.

2. Offer suggestions to include tactile experiences for students such as Wikki Stix®, tactile paper, modeling clay and salt trays.

3. Promote kinesthetic activities such as air writing to reinforce academic concepts.

4. Encourage fine and gross motor activities to enhance the lesson. Provide manipulatives that promote fine motor skills. Offer suggestions on how to include gross motor skill practice such as jumping, hopping or skipping during the lesson.

5. Include bilateral coordination activities to improve ability for students to cross midline.

6. Encourage the use of assistive technology to transform traditional lessons.

When the lesson is complete, see if it includes sensory input from the following areas: auditory, visual, tactile, proprioceptive and vestibular. If all five categories are included, you have achieved an excellent multi-sensory lesson that will be most likely a benefit for all students.

Thursday, April 9, 2009

Upper Extremity Splint Compliance and AT Use

Here is some information on an intriguing study in the Developmental Neurorehabilitation on children with hemiplegia and their use of upper extremity splints and assistive technology. The study reports that 56% of the children were prescribed UE splints but only 48% of those children were using the splints. In comparison, 46% of the children were prescribed assistive technology and 98% of those children were using the assistive technology provided to them. What a difference!

In my experience, compliance with orthotic use is frequently an issue. Some children dislike wearing them for various reasons - discomfort, appearance, parental dislike, etc. I attempted to find more research articles on compliance with upper extremity orthoses and came up empty handed. Does anyone have any articles to recommend regarding orthotic compliance in children?

I have heard educators and parents complain that at times assistive technology does not get used to its fullest potential due to lack of training with different products. It was promising to see that in this study this was not the case - 98% user rate is extremely high.

Reference: Russo, Remo Nunzio, Atkins, Renae, Haan, Eric, Crotty, Maria Upper limb orthoses and assistive technology utilization in children with hemiplegic cerebral palsy recruited from a population registerSN - 1751-8423
2009 Developmental Neurorehabilitation 12 (2): 92-99 URL - http://www.informaworld.com/10.1080/17518420902783223

Wednesday, April 8, 2009

Motor Planning and Graded Movement Activity Idea

Here is a new activity video to encourage grading of movements, motor planning and eye hand coordination. You will need balloons, cardboard tube or soft bat, and old box to do the activity. Reminder: Balloons can be hazardous to children. Do not allow children under 8 years old to use balloons unsupervised. The child pretends to guide the pretend animals (balloons) behind the fence (cardboard box). This is an activity from our ebook 50 Sensory Motor Activities for Kids!

Tuesday, April 7, 2009

10 Things to Do to Celebrate OT Month

There is a lot of buzz going around about OT Month. Here are 10 suggestions to celebrate OT Month in a school or pediatric setting:

1. Host the Occupational Therapy Olympics - invite school staff, parents and students to participate in the OT Olympics. Try relay races to get dressed, get down objects using reachers, wheelchair obstacle courses, scooterboard races, sculpt objects with clay and more.

2. Have an OT Art Exhibit - showcase OT projects that the children have made. Hang up signs next to each projects describing what skills the child worked on to complete the project.

3. Create an OT Contest - For example - Put a bunch of beads in a jar. Guess how many beads are in the jar. The closest to the number of beads wins an OT t-shirt.

4. Create an OT Quiz - Distribute an OT quiz with many questions regarding what OT is and how it helps children. Every person who fills out the quiz gets a small prize.

5. Do an in-service on the benefits of OT to the school staff and parents.

6. Plan an OT Month Party! - Allow the kids to vote on a party theme such as fine motor, sensory or activities of daily living. Create games around that theme.

7. Volunteer for the Career Fair at the school. Educate prospective college students on what OT is.

8. Have an Adaptive Equipment and Assistive Technology Fair - demonstrate different types of equipment that OT's recommend for students to school staff and parents.

9. Hang up a large poster in the hallway about occupational therapy.

10. If you do not have time for any of the above ideas here is the easiest - just ask to make an announcement over the loudspeaker of the school about OT month. Inform the school in a few sentences about occupational therapy.

Check out our motivational section on our website for certificates, awards and signs for occupational therapy.

Any one else have any ideas? Please comment.

Monday, April 6, 2009

Motor and Mental Skills in Toddlers with CP

Developmental Neurorehabilitation published research on the association between mental and motor functioning in children with CP. This study looked at 78 toddlers with a diagnosis of cerebral palsy with GMFCS I-V. The researchers determined that when motor and mental functioning did not develop at the same time, it was always motor functioning that was more delayed than mental functioning. No children performed better on the motor section than the mental section.

This study can help therapists in everyday practice. I think first and foremost NEVER assume that a child's mental age is equal to their motor age. It is our job to inform parents and school staff of this important information for young children with cerebral palsy. Any other thoughts on how the information can be put into practice?

Reference: Lotte Enkelaar ; Marjolijn Ketelaar; Jan Willem Gorter Association between motor and mental functioning in toddlers with cerebral palsy Developmental Neurorehabilitation, Volume 11, Issue 4 2008 ,pages 276 - 282 .

Saturday, April 4, 2009

Search Engine for Visually Impaired

Did you know Google has a special search engine for the visually impaired? This was news to me. Anyway, the benefit it that it attempts to find websites that work the best with screen readers. Here is the link http://labs.google.com/accessible/
This has potential to be a nice resource for the visually impaired, as well as auditory learners.

Now once you get to the pages, clean up the pages but reducing visual distractions such as advertising and images. Paul Hami's blog suggests trying TidyRead or Readability. I have tried both of these and they both work differently on different sites. You will have to play around to see what one works best for the student or for you.

Friday, April 3, 2009

Hyperbaric Oxygen and Autism

BMC Pediatriccs has published an interesting study on hyperbaric treatment for children with autism. According to the authors of this study, this is the first randomized, double blind controlled trial using hyperbaric oxygen in children with autism. The study had 62 children with autism ages 2-7 years old. The treatment group consisted of 33 children who received hyperbaric oxygen at 1.3 atmosphere (atm) and 24% oxygen. The control group was 29 children who received slightly pressurized room air and 21% oxygen (room air oxygen rate). Both groups received treatments 2x/day for 60 minutes for 5 days/week over 4 weeks. This totalled 40 sessions. The results indicated significant improvements for the treatment group (1.3 atm with 24% oxygen) compared to the control group in the following areas:

1. Overall functioning, receptive language, social interaction and eye contact on the Physician scored Clinical Global Impression Scale
2. Overall functioning, receptive language and eye contact on the Parent scored Clinical Global Impression Scale
3. Total score, irritability, stereotypy, hyperactivity and speech on the Autism Behavior Checklist (larger differences seen in irritability)
4. Sensory/ cognitive awareness on the Autism Treatment Evaluation Checklist (ATEC).


Additional results indicated that children over the age of 5 and children with lower autism severity exhibited greater improvements from the hyperbaric oxygen treatments. This study did not follow the long term benefits of the treatments.

For pediatric therapists, this information provides updated information on the potential benefits of hyperbaric oxygen for children with autism. The significant improvements in sensory/ cognitive awareness is promising. Although, the ATEC section on sensory/ cognitive awareness is very general. Some of the sensory/ cognitive components listed on the test are: danger awareness, initiation of activity, exploration of environment, curiosity, dressing self, does drawing/ art, plays appropriately and more.

In addition, the health section on the ATEC also includes some sensory items such as sound sensitivities, food habits, hyperactive, decreased pain awareness and more. There was no difference seen on the health section of the ATEC.

To view the full study go to BMC Pediatrics.

Reference: Hyperbaric treatment for children with autism: a multicenter, randomized, double-blind, controlled trial Daniel A Rossignol , Lanier W Rossignol , Scott Smith , Cindy Schneider , Sally Logerquist , Anju Usman , Jim Neubrander , Eric M Madren , Gregg Hintz , Barry Grushkin and Elizabeth A Mumper BMC Pediatrics 2009, 9:21doi:10.1186/1471-2431-9-21

Thursday, April 2, 2009

Communication Technology for iPhone

Proloquo2Go is a new augmentative communication application for the iPhone or the iTouch. It has picture symbols, text to speech and over 7000 vocabulary words. Currently, it is only $149 (obviously you also need to purchase the iphone or itouch). What a bargain compared to a traditional augmentative communication device. Not only is the price great, it is small, fits in a pocket and cool to carry. Not bad!

Free Hands Free Camera Mouse

Heard about this one on Twitter from @assistivetechguru - www.CameraMouse.org. This is a free download for a mouse that works using only head movements. This is for children who can not use their hands but they do have reliable head active range of motion. For the program to work you do need a standard USB webcam, Windows Vista or Windows XP.

Wednesday, April 1, 2009

Are Schools Exacerbating ADHD?

Previously, I have discussed how important physical activity is for school children (podcast, articles and blog posts). In my opinion, physical activities are being ignored as a potential reason for decreased test scores and behavioral problems in school districts. When children are made to sit all day long, they will act out, be inattentive and their minds wander. Sedentary lessons ignore kinesthetic learners and students with bodily kinesthetic intelligence (Gardner's Theory of Multiple Intelligences). This is for typically developing students. Now let's consider students with ADHD and sensory seekers. It makes it even harder to pay attention and learn while having to sit still most of the day.

It appears as if this situation is only getting more dire than better. The Center on Education Policy as part of No Child Left Behind, reported in February 2008 that schools are shifting to more instructional time on English language arts (ELA) and math. This of course occurs at the expense of other subjects. The report shows that on average, schools have decreased recess time by 28% and physical education time by 35%.

Let's now take a look at ADHD rates. According to the Centers for Disease Control and Prevention, the rates of ADHD have increased on average 3% per year from 1997-2006. As of 2007, 4.5 million children have been diagnosed as having ADHD. This brings us to the question is decreased physical activity time exacerbating ADHD symptoms? Some recent research helps to support the idea that sitting in school all day is detrimental to overall learning.

Neuroscience reports on a study of 20 children who did treadmill walking followed by cognitive testing. The results indicated that following 20 minutes of treadmill training, the children exhibited improved attention and academic performance. Research has also indicated a relationship between amount of time spent outdoors and improved attention in children with ADHD. To view even more research regarding this topic go to www.YourTherapySource.com/articles and click on the Bulk Up the Brain article.

So what can we do? Let's join the No Child Left Inside (NCLI) this April. Go to the website to find the details and suggested outdoor activites for students of all ages and subject matter. Spread the word and let's get all children moving and outdoors!

Need activity ideas for in the classroom or group activities? Check out our Sensory Motor Activity books.

Reference:
C.H. Hillmana,M.B. Pontifexa, L.B. Rainea, D.M. Castellia, E.E. Hallb and A.F. Kramera The effect of acute treadmill walking on cognitive control and academic achievement in preadolescent children Neuroscience Volume 159, Issue 3, 31 March 2009, Pages 1044-1054

Center on Education Policy Instructional Time in Elementary Schools
A Closer Look at Changes for Specific Subjects
retreived from the web on 4/1/09 at http://www.cep-dc.org/_data/n_0001/resources/live/InstructionalTimeFeb2008.pdf

Centers for Disease Control and Prevention ADHD Data and Statistics retrieved from the web on 4/01/09 at http://www.cdc.gov/ncbddd/adhd/data.html

Taylor, A. Kuo, Sullivan COPING WITH ADD The Surprising Connection to Green Play Settings. Retreived from the web on 4/1/09 at http://www.cbf.org/site/DocServer/Coping_with_ADD.pdf?docID=13323

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