Saturday, May 30, 2009

Written Language Disorder


Pediatric occupational therapists have vast experience of working with children who have written language disorders. Symptoms of written language disorder can include problems with grammar, spelling, organization and handwriting. School based therapists see how far reaching this problem can be. In many school districts, teachers and administrators primary focus is how to improve reading skills. Why is it that reading is the focus? Perhaps because previously there were no epidemiology studies on written language disorders. In the May 2009 issue of Pediatrics, researchers report on the "forgotten learning disability...written language disorder".

The researchers found that written language disorder was present in 6.9% to 14.7% of the 5718 children followed depending upon the formula used. Boys had written language disorder 2-3 times more often than girls. Of the children identified with written language disorder, 25% did not have a reading disability.

This study reveals that a large amount of children are affected by this disorder. Although there are some limitations - the children had similar demographics (white, middle class Minnesota children. Regardless, this indicates that written language disorder is more common that society perceives it to be.

Pediatric occupational therapists can help to spread the word about written language disorder by:
1. Educating school staff on the signs of written language disorder.
2. Teaching staff how to prevent some of these problems early on through different handwriting instruction methods.
3. Encouraging school staff and parents to address written language disorders along with reading and math disabilities.
4. Introducing assistive technology at an early age to help students with severe written language disorder.

References: Katusic, Slavica K., Colligan, Robert C., Weaver, Amy L., Barbaresi, William J. The Forgotten Learning Disability: Epidemiology of Written-Language Disorder in a Population-Based Birth Cohort (1976-1982), Rochester, Minnesota
Pediatrics 2009 123: 1306-1313

Looking for handwriting activities? Check out our electronic books for fine motor, visual motor and handwriting activities at www.YourTherapySource.com

Friday, May 29, 2009

Walk On - ESPN Video Inspiring!

Heard about this from @Empower4all on Twitter. Here is an inspiring video on a man's love of golf. This is such a GREAT story.






Stretch Break for Kids - FREE!

Stretch Break for Kids: This is a free download to put on computers to remind children to take a break from computer time and stretch. There are a few great things about this program:
1. It's free!
2. You can program the sequence and frequency of the stretches.
3. There are a few stretches that are great proprioceptive warm-ups for children.
4. It can be done with no adult assistance.
5. Did I mention it is free!
Here is the link to get it: http://www.paratec.com/sbform/kidsform.htm

Wednesday, May 27, 2009

SPD in the DSM-V

The Sensory Processing Disorder Foundation needs to get 20,000 signatures in support of continued research to get diagnostic recognition of sensory processing disorder (SPD) in the DSM-V (Diagnosis and Statistical Manual). Most therapists are aware that SPD is not a recognized diagnosis. Others may not be aware which causes confusion among health care providers, parents, teachers and insurance companies. It makes it very difficult to get reimbursement for therapy sessions for people with sensory processing disorder. If you support Sensory Processing Disorder in the DSM-V, please take the time to sign their petition at http://www.spdfoundation.net/petition.php

Tuesday, May 26, 2009

Empower Children with Disabilities By Creating Works of Art

Here is some motivation to get children with disabilities to express themselves through art. The Anne Carlsen Center is sponsoring Accessing the Artist Within. This purpose of this program is to introduce children with disabilities various ways to express themselves through art using assistive technology. The submitted artwork will be displayed on a website. In addition, 10 works of art will be chosen to be exhibited at the Closing the Gap Conference in October 2009. Two important rules are that the children must be ages 5-21 years old and use some assistive technology to create the art. Artwork submitted can be of various types such as paintings, digital art, music compositions (try www.creatingmusic.com), photographs and more.

This seems like a great project for school based therapists to promote. This is an opportunity to practice using assistive technology tools while creating a piece of art. In addition, you will be teaching the child a life long leisure skill.

Go to the website for further details at http://www.annecenter.org/news_events/adaptive-art.html.

Sensory Motor Groups in Children with Down Syndrome

The current issue of Pediatric Physical Therapy has published research on sensory motor groups for children with Down Syndrome. The researchers compared 2 groups of children with Down Syndrome (10 children total ages 13-29 months of age). One group received only individualized interventions and the other group received the individualized interventions along with 10 weekly sessions of a sensory motor group. Children in the cluster that received the weekly sensory motor group interventions exhibited significant improvements on the Gross Motor Function Measure in the following sections: lying and rolling, kneeling and total score. Significant improvements were also seen in Goal Attainment Scaling. The researchers concluded that sensory motor group interventions resulted in greater improvements when compared to only individualized interventions. They recommended further research in this area.

For sensory motor group activity ideas check out Sensory Motor Group Activities A to Z. Need activity ideas in a hurry - 25 Instant Sensory Motor Group Activities.

Reference: LaForme Fiss, Alyssa C. PT, PhD, PCS; Effgen, Susan K. PT, PhD; Page, Judith PhD, CCC-SLP; Shasby, Sharon PhD, OTR/L Effect of Sensorimotor Groups on Gross Motor Acquisition for Young Children with Down Syndrome. Pediatric Physical Therapy. 21(2):158-166, Summer 2009.

Thursday, May 21, 2009

Wow! Wow! WOW!

Once again thank you @pediastaff on Twitter for finding this video. This is very motivational and inspirational. It is also a huge reminder. Therapists, teachers and health professionals should NEVER say or assume that a person can not accomplish something.



Thanks again @pediastaff.

Wednesday, May 20, 2009

Robotics Use in Cerebral Palsy

Found out about this news story from @pediastaff on Twitter. For gait training, this takes treadmill training to the next level. Worth a look for any therapists who works with stroke clients or children who have cerebral palsy.



To read an article from MIT on this topic go to http://web.mit.edu/newsoffice/2009/robotherapy-0519.html

Wijit Voyager

Perhaps this is not news to some of you, but I found this product so innovative that I wanted to share it. The Wijit Voyager is a a driving and braking device that is attached to the wheelchair wheels. This device allows wheelchair users to manually propel the wheelchair with greater ease and ergonomic positioning. It can be mounted on a 20" size wheel making it available for children and teens. Here is a video of someone using them on her wheelchair. I have not seen this product is action myself but I can think of quite a few children who would benefit from using the Wijit system. Does anyone have any comments to share on this product?

Tuesday, May 19, 2009

Turn Fine Motor Skills into Gross Motor Skills

Here is a sample activity idea from our electronic book, Motor Magic: Turn Fine Motor Skills into Gross Motor Skills. This is a fun, outdoor activity that encourages fine motor skills, eye hand coordination, motor planning, gross motor skills and balance. The electronic book has 25 activity ideas incorporating fine and gross motor skills and is available at www.YourTherapySource.com/motormagic.

Saturday, May 16, 2009

Speech Recognition Software Evaluation

Heard about this from @KarenJan on Twitter. Speech recognition software enables computer users to use voice commands to control the computer such as typing and mouse functions. Some students with dysgraphia, physical or learning disabilities use this type of software. If you are thinking of recommending speech recognition software for a student, you may want to check out this website - www.customtyping.com. They have created a short evaluation form to determine if the student has the ability to use speech recognition. This type of assistive technology requires training and considerable practice (not to mention money for certain programs). This evaluation tool helps to determine the level of assistance and training a student will need to learn how to use voice input.

Friday, May 15, 2009

Benefits of Short Bouts of Physical Activity

A recent study in the International Journal of Pediatric Obesity offers some exciting research regarding physical activity in boys. The researchers studied physical activity levels in 47 boys(ages 8-10 years old)using accelerometry for seven days. After the seven days they measured waist circumference, aerobic fitness and microvascular function. The researchers discovered that the boys performed short physical bouts of activity rather than long, sustained periods. This was consistent with previous research which indicated that children normally perform short bouts of physical activity. The frequency of short bouts of physical activity was associated with waist circumference, aerobic fitness and microvascular health. There was no correlation with blood pressure. The researchers recommend further studies to determine if overtime the results remain and if the physical activity patterns are the same for girls.

Here are some suggestions to apply this research:
1. Encourage children to participate in any amount of physical activity (short or long).

2. Research has shown that children normally move in short bursts therefore keep that in mind during sporting practices if children are losing their focus.

3. Break up sedentary time with movement breaks whenever possible. Try our Mini Movement Breaks - this is a collection of physical activity breaks for children that can be performed with no equipment indoors or outdoors. Below is a video of how to create the mini movement break notebooks or shoe boxes. Download the breaks and create these notebooks to pass out to teachers and parents. Even better, have the children help to create the notebooks or shoe boxes to include fine motor skill development practice!



References:
Stone et al. The pattern of physical activity in relation to health outcomes in boys. International Journal of Pediatric Obesity, 2009; 1 DOI: 10.1080/17477160902846179

University of Exeter (2009, May 13). Sporadic Play Activity As Beneficial To Child Health As Continuous Bouts Of Exercise, Study Suggests. ScienceDaily. Retrieved May 15, 2009, from http://www.sciencedaily.com­ /releases/2009/05/090511101652.htm

Thursday, May 14, 2009

Easy Stand Bantam

Here is a short video on the benefits of the EasyStand bantam. Would love to hear in the comments section what therapists and parents think of this product - likes or dislikes.

Tuesday, May 12, 2009

Kite Flying - Spring Outdoor Activity


Children absolutely love to fly a kite. They love the challenge and the thrill of getting the kite up and in the air. Then they progress to the challenge of keeping the kite in the air and out of the trees. Kite flying requires eye hand coordination, motor planning, body awareness and gross motor skills. Try out these activities today:

1. Make a kite out of a brown paper lunch bag. Decorate, punch 4 holes in corners where bag opens. Tie string and you are ready to fly it.
2. Not windy enough for a kite? Draw, decorate and cut out a kite. Tie ribbons to the end of it. Tape it onto the top of a long stick. When the child runs with it, the kite will fly!
3. Raining today? Print and complete our FREE kite activity, Jump Up, Up and Away, to encourage sensory motor skills.

Monday, May 11, 2009

Bilateral Coordination, Eye Foot Coordination and Motor Planning

Here is a four year old boy working on bilateral coordination, eye foot coordination and motor planning skills. He has velcro attached to his feet. We are using a velcro ball from velcro catch game. Try this is standing for older children to really challenge their balance (SUPERVISE CLOSELY).

Friday, May 8, 2009

Inclusive Sports Participation

Adapted Physical Activity Quarterly reports on research indicating that persons with intellectual disabilities frequently join inclusive sports but do not continue with the inclusive sports overtime. Parents reported rejection by staff and other participants. In addition, parents felt there was a lack of contact and understanding of people with intellectual disabilities.

Physical activity for persons with disabilities is extremely important. It is disappointing to hear that parents find inclusive sports not appropriate for children with intellectual disabilities. School based occupational and physical therapists can be instrumental in promoting physical activity for the disabled. Try to schedule a presentation on inclusive sports for your community or school. Here are some tips to help any children with disabilities participate in inclusive sports programs:

1. First and foremost make sure that the sports program is accessible for the child. If not, offer some modifications that can make the program accessible.

2. Educate the coaches and volunteers on the child's disability. If a coach does not know what to do this can make participation very difficult.

3. If any modifications require adapted equipment, make sure all sports staff know how to use it.

4. Offer suggestions on how to present the directions or rules in different formats instead of just verbally. Maybe the coach could provide written rules or visual demonstrations.

5. Inform sports staff that the child may need accomodations such as more time to complete a skill.

6. If a child requests additional help, perhaps assign a partner (peer or adult) to help.

7. Do not assume a child can not do a task. If possible and safe, always let them try first before determining that something can not be accomplished. Most likely, sports staff will be amazed at what children can accomplish.

8. Remind staff of safety precautions that be necessary for specific disabilities such as a visual or hearing impairment.

Based on your own expereinces, what have you done to support inclusive sports? Please comment.

Reference: Eva Hiu-Lun Tsai, Lena Fung. Parents’ Experiences and Decisions on Inclusive Sport Participation of Their Children With Intellectual Disabilities
APAQ, 26(2), April 2009.

Wednesday, May 6, 2009

Simulated Hippotherapy

Researchers at Baylor University have created a mechanical horse to mimic the actions of a real horse. The goal of the project is to have a machine that children or adults can use if they are scared of horses or if they can not get up high on the horse. This mechanical horse is the first of its kind to use a three dimensional system. It is meant to be a complimentary therapy or a tool to progress to riding on a real horse. Additional research is planned for the mechanical horse.

I am not very well versed in hippotherapy but I have to say with no horse there is something missing. It is my opinion, that one of the benefits of hippotherapy beyond the physical benefits is the bond that a child creates with the horse. The experience of being outdoors riding on a real horse also offers benefits.

I would love to hear from therapists who specialize in hippotherapy on this topic.

Reference: Baylor University Baylor Researchers Build Advanced Mechanical Horse For Therapy Retrieved from the web on 5/6/09 from http://www.baylor.edu/pr/news.php?action=story&story=58672

Monday, May 4, 2009

Project ACES - Gets Kids Moving

May 6th is the date for Project ACES (All Children Exercise Simultaneously). Project ACES was started to help celebrate in May for National Physical Fitness and Sports Month. The goal of the project is to encourage physical fitness through daily exercise and to live healthy lives. This is a great way for school based therapists to educate the school on the benefits of physical fitness.

It is simple to participate. Organize the event at your school (big or small crowd). Explain the details of Project ACES. Then, EXERCISE in any way for 15-45 minutes starting at 10:00am local time. You can get more information at http://lensaunders.com/aces/aces.html

Teacher Appreciation Ideas

May 5th is Teacher Appreciation Day. Depending upon the types of children that are in the classroom try some of these ideas:

1. Give the teacher a basket of fidgets to use in the classroom as a sign of your appreciation

2. Offer to host a party. If the children earn enough rewards, have a therapy party for the class. All the kids can try out equipment, games and activities. (Check with your school administrator regarding liability issues).

3. Have a student(s) make their footprint on a poster, banner paper or t-shirt and write “You Lead, We Follow” on it

Anyone else have any ideas?

Occupational Therapy Blog Carnival Edition #3

Your Therapy Source Inc is the host this month for the OT Blog Carnival Edition #3. This is a summary of the blog posts that were submitted for the Blog Carnival. There was no specific topic for this edition therefore there is a variety of topics discussed. I have started with the pediatric posts since our blog focuses on pediatric therapy.

1. Barbara Smith OTR, submitted a post from her blog, HorseOT, which shares hippotherapy ideas and resources. Her post is a book review of The Horse Boy . She submitted this topic because she thought that this book poses many questions of importance to occupational therapists, as well as all therapists involved with hippotherapy.

2. Alison M. Bodor, OTR/L, submitted Wii for Pediatrics posted at OT-Advantage.com. This is an overview on how pediatric clients can benefit from the Wii.

3. Margaret Rice, PT, submitted from Your Therapy Source Inc, a sensory integration quiz to test your knowledge of sensory processing.

4. Karen Dobyns, an OT student submitted from Occupational Therapy Students Belong blog a post on her impression of ADHD.

5. Rintu submitted from Me and Occupational Therapy blog an article on the role of substance abuse in OT.

6. Ventan Mailoo also submitted a post on substance abuse from meta-OT blog entitled Drunkenness is Stupid.

That is it for submissions. Although, I wanted to include one more item. A funny comic strip on occupational therapy - Agnes.

Want to be included in the next OT Blog Carnival? Submit your article now at Blog Carnival.

Friday, May 1, 2009

FDA Report on Botox and Cerebral Palsy

The FDA has added some updated information regarding the use of Botox in children. They are now requiring that all manufacturers of Botox add a box warning "regarding the risk of adverse events when the effects of the toxin spread beyond the site where it was injected". The manufacturers also have to come up with a Risk Evaluation and Mitigation Strategy. This is to measure whether the benefits outweigh the risks. THE FDA has reviewed new data regarding the use of Botox in pediatric cases. This is the summary:

In pediatric postmarketing adverse event case reports, botulinum toxin products were mostly used to treat muscle spasticity in cerebral palsy, a use that has not been approved by the FDA. The reported cases of spread of botulinum toxin effect beyond the site of injection were described as botulism, or involved symptoms including difficulty breathing, difficulty swallowing, muscular weakness, drooping eyelids, constipation, aspiration pneumonia, speech disorder, facial drooping,double vision, or respiratory depression. Serious case reports described hospitalizations nvolving ventilatory support and reports of death.


The FDA continues to support the recommendations that they made previously on Feb 8, 2008 which you can read below.

On February 8, 2008 the Federal Drug Administration (FDA) issued a report on the use of Botulinum Toxin Type A and Type B in children and adults. They have received reports of severe adverse reactions (which may be botulism) to botulinum doses including hospitalization and death in children. These adverse effects have occurred mostly in children with spastic cerebral palsy. Doctors are currently using Botox off label in children with cerebral palsy for the drug is not approved for this use in the United States. The FDA is presently reviewing: data from pharmaceutical companies, medical research and evaluating cases from its reporting system. Currently the FDA reports that most of the pediatric cases were children under 16 years old with cerebral palsy limb spasticity.

The FDA recommends that any professionals that work with clients who receive botulinum should be aware of the symptoms of botulism. Some symptoms of botulism are:

difficulty swallowing

weakness

difficulties breathing

voice changes

shortness of breath.


They should also inform the clients of these symptoms so that they are aware of potential side effects and to seek immediate medical attention. In addition, the FDA reports that these symptoms of botulism have been reported to occur as quickly as one day after Botox and as late as several weeks after the Botox treatment.

If you have had experience with serious side effects of botulinum, the FDA would like you to report it by filling out a form at http://www.fda.gov/medwatch/report/hcp.htm.

Reference:
US Food and Drug Administration UPDATE Follow-up to the February 8, 2008, Early
Communication about an Ongoing Safety Review of Botox and Botox Cosmetic
(Botulinum toxin Type A) and Myobloc (Botulinum toxin Type B)
Retrieved from the web on 5/1/09 at http://www.fda.
gov/CDER/Drug/early_comm/botulinium_toxins200904.htm

US Food and Drug Administration. Early Communication about an Ongoing Safety
Review Botox and Botox Cosmetic (Botulinum toxin Type A) and Myobloc
(Botulinum toxin Type B). Retrieved from the web on 3/19/08 at
http://www.fda.gov/cder/drug/early_comm/botulinium_toxins.htm.
Disclaimer: These pages are not intended to provide medical advice or physician/therapist instruction.
Information provided should not be used for diagnostic or training purposes. Consult a therapist or physician regarding specific diagnoses or medical advice.