Most children have at least a little anxiety about the dentist. The bright, fluorescent lights, sharp tools, the smell/taste of oral products, touch on the face and mouth and masked strangers – the combination would have anyone on edge. For those with special needs – especially those with sensory disorders – going to the dentist can seem an overwhelming impossibility. The good news is a combination of occupational therapy to prepare a child AND the increasing availability of pediatric dentists giving special consideration to patients with disabilities makes these necessary visits not only possible, but successful.
How Dentists Are Trying to Improve Services for Patients With Special Needs
The American Dental Association reports there are a significant number of people with developmental and cognitive conditions that can make dental procedures or even routine visits very difficult. Among young children, these primarily include those with autism spectrum disorder (95 percent of whom have a sensory processing disorder), Down syndrome and spinal cord injuries. Complexity in treating this population has led to an evolution of a whole new specialty in dental care.
When does picky eating become a disability? Fort Myers OT (occupational therapy) services for children may be necessary for picky eaters when severe aversions to certain foods morph into “problem feeding,” a significant hindrance to healthy growth and development.
Parents of picky eaters can easily feel consumed by mealtime battles. They aren’t alone.
An 11-year longitudinal study of 120 kids published in the journal Eating Behaviors revealed that at any given time, between 13 and 22 percent of kids were reported by parents to be “picky eaters.” (Other researchers have put the figure as high as 50 percent.) About 40 percent of picky eaters kept it up for 2 years or more. This was different from those who simply went through short-burst phases of strong dislike for one food or another.
Instead, as our Fort Myers OT providers have seen, truly picky “problem” eaters consume an extremely limited variety of foods, even requiring it to be prepared in certain ways. They tend to show much stronger dislike for most foods and throw major tantrums. Some simply refuse to eat.
“What we see is their pickiness is extremely restrictive,” said Fort Myers OT Krystle Hofstetter. “They’ll eat just two or three items – and that’s it.”
The good news is: We can help!
Many of our Fort Myers occupational therapists at FOCUS Fort Myers believe in a holistic approach to treating children with a wide range of delays and disorders. What that means is we focus on “the whole child,” and not just a series of symptoms or conditions – and treat with evidence-based therapeutic strategy and (hopefully, where it’s possible) avoid the need for pharmaceutical intervention. Part of this can involve essential oils, powerful plant extracts that have proven effective in a wide range of applications from boosting focus and attention to promoting relaxation and calming.
Often referred to as “aromatherapy,” (and many do smell very good), our occupational therapists wouldn’t bother to mention it if it were simply expensive potpourri. Far from a gimmick, the truth is there is real science to support the effectiveness of essential oils in numerous applications – from promoting healing in prematurely-born infants to helping a child who struggles with transitions calm and self-regulate.
Exploratory Study Promotes Essential Oils as a Benefit for Children With Autism
On analysis conducted by researchers at AirAse found that certain combinations of therapeutic grade essential oils applied topically every night for several weeks were associated with positive improvements in children’s behavioral, cognitive and emotional well-being.
Early Intervention Speech, Occupational, ABA Therapy Preparing Wave of People With Autism for Workforce
As rates of autism diagnoses climb steadily, roughly 500,000 teens with autism are poised to enter the workforce over the next decade, according to advocates at Advancing Futures for Adults with Autism. Yet the majority of those people with autism struggle to land their first job, and 4 in 10 won’t work at all in their 20s. The spectrum is incredibly broad, so each comes to the table with their own strengths and challenges, but there is no question those who receive early intervention ABA therapy, speech and language therapy and occupational therapy fare much better long-term.
Last year, the U.S. Centers for Disease Control and Prevention updated autism prevalence rates by 15 percent to 1 in 59 children. That’s more than double what the rate was in 2000. Part of this has to do with improved awareness, earlier diagnoses and improved treatment models. Research published in the journal Frontiers in Public Health indicated early diagnosis (before 24 months, as early as 12 months) leads to earlier eligibility for intervention services (like ABA therapy), and other evidence-based research has indicated clear indication early intervention is causally related to better prognoses – including success in education and employment.
The AFFA reports that while most adults with autism want to work, fewer than 60 percent can land a job. The Americans With Disabilities Act prohibits employment discrimination on the basis of disability. Yet an adult deprived of early intervention therapies as a child has missed out on a critical development window to address significant challenges associated with everyday function and independence. This isn’t to say it’s ever entirely “too late” to initiate intervention strategies, but our ABA therapy team members know it’s most effective when it starts before age 5 (and the earlier the better).
Identifying, Treating Pediatric Vestibular Dysfunction Involves Occupational, Physical Therapy Collaboration
Once upon a time, vestibular dysfunction in children was thought to be exceptionally rare. Our occupational and physical therapists know, however, that pediatric vestibular disorders, which affect as many as 35 percent of adults, are increasingly being identified earlier than ever. Symptoms include chronic dizziness and imbalance. In children, vestibular system disorders can also cause problems in early development, impacting:
- Ability to maintain an upright position when sitting;
- Delays in crawling and walking;
- Difficulty with steady vision when moving the head (for example when copying words or letters at a chalkboard when seated at a desk);
- Diminished balance and motor function.
Long-term, this can have significant and painful social, educational and economic impacts for kids. Professionals on our FOCUS Fort Myers occupational and physical therapy teams are committed to identifying and addressing these issues early on, promoting the highest possible level of relief and function and ultimately mitigating the worst adverse impacts.
What is the Vestibular System and How Do I Know if My Child’s is Dysfunctional?
Premature babies (aka “preemies”) born earlier than the 37th week of pregnancy, are more likely to survive today even compared to the 1990s – and they are more likely to have less severe disabilities. That’s according to research published in the British Medical Journal. Globally, about 15 million babies every year are born before the 37th week, placing them at higher risk for conditions like cerebral palsy, delayed language, speech and motor skills. Study authors further concluded preemies who receive early intervention therapy have a much better chance of catching up to their peers.
Preemies are already starting out behind the curve. The earlier a baby is born, the higher the risk of serious illness and disability. The U.S. Centers for Disease Control and Prevention reports preemies who survive those early weeks and months in the NICU (neonatal intensive care unit) may still struggle with breathing trouble, intestinal/digestive problems (including feeding and swallowing) and developmental delays. About half of all children born more than eight weeks early or at a very low birth weight develop problems with language, learning and executive function.
As our FOCUS Fort Myers therapy team can explain, early intervention therapy involves a combination of separate but interrelated services, tailored to meet the specific needs of each child, with the core aim of helping a child develop skills that will allow them to reach their full potential. This generally includes some combination of speech and language therapy, feeding therapy, occupational therapy and physical therapy. Although many preemies benefit from this therapy up to age 5 and sometimes beyond, commitment to therapy now reduces the struggles preemies will face down the road.
As FOCUS Fort Myers occupational therapists, we help children with disabilities overcome impediments to independence, adapt to the world around them (or adapt the world to them) and acquire the tools necessary to navigate each day. One key component of this is learning appropriate socialization – particularly with peers. Through play-based approaches, our clients learn to recognize personal space, read body language, handle greetings, manage unexpected interactions, participate in conversations, take turns, avoid conflicts and understand and express their emotions.
Problems with socialization for children with disabilities can be compounded when peers’ reactions are overwhelmingly negative. To be fair: It’s natural for any child to be curious, hesitant or possibly even scared when encountering notable differences for the first time. Every parent has at least one story about the time their child said something mortifying in pointing out another person’s differences (usually very loudly, in public, and in a line where there is no quick escape). But the truth is: They’re still learning socialization skills too. It’s a teaching moment.
Talking to your kids about peers with disabilities increases understanding and acceptance, encourages inclusion and can even help reduce bullying (to which children with disabilities are especially vulnerable).
Long-practicing occupational therapists in South Florida know it wasn’t so long ago children with disabilities were far more isolated from society in daily life. The 13 percent of Americans with disabilities were often taught in different classrooms, denied accommodations allowing them access to the same facilities and arbitrarily boxed out of many career choices. The good news is that’s changing, most recently with the U.S. Department of Education’s new policy statement on inclusion in early childhood programs. The DOE policy declares unequivocally that inclusion of children with disabilities from a young age offers maximum benefit and should be every district’s goal.
That means if he or she is not already, your child will soon have daily interaction with at least one peer who has a disability. Helping them understand differences – and framing those differences in a positive way – can make a big difference.
Many of our FOCUS pediatric speech therapists were initially drawn to this field in part because we share a love of language. Sure, some of us are self-professed grammar nerds and logophiles, but in working with kids with special needs, we’ve seen that the real beauty of language is the way it facilitates communication and sparks connections. That’s a universal truth of language, but in helping children overcome speech delays, receptive language deficits or phonological disorders, we’ve come to appreciate language on a whole new level.
In stacking the developmental blocks for communication, social interaction and connection, one of the best (and easiest) things any parent can do: Read bedtime stories. This is especially true for kids with special needs, for whom language doesn’t come easily. Frequent storybook sessions help children learn new words, recognize the importance and subtle differences of tone, inflection and pitch, explore complex feelings and confusing interactions in a safe space and better grasp the intricacies of the world around them.
Most children – even if some have shorter attention spans – love bedtime stories. (Although story time can be anytime, bedtime is ideal – especially if you’re child is antsy – because you’re more likely to have a captive audience just before bed, as opposed to morning or mid-day, unless they still nap. Plus, many parents who work find it difficult to nail down a story time routine in the morning rush or simply can’t swing it on their lunch hour.) Making stories-and-snuggles part of the nightly groove works best for most, gives kids something to look forward to and a chance to wind down. And, as most parents of kids with special needs know, having a routine is a lifeline.
Even if your child doesn’t seem to understand the stories, follow along or pay much attention, research shows they still glean advantages from the one-on-one time, routine and mental exercise. Most speech, ABA and occupational therapists would argue children who struggle with expressive and receptive language skills may even need those bedtime stories more than most.
“Tummy time” is a cute little phrase referencing an essential infant exercise that our pediatric occupational therapists know so many parents come to dread. Per the American Academy of Pediatrics, tummy time should start when your child is a newborn, placing your child (always supervised) on their tummies. This begins with short, 2-to-3-minute increments three times a day and eventually extending it for longer periods of 30-to-40-minutes as they get older.
The whole concept of “tummy time” started back in the early 1990s, when the AAP first began recommending that babies be put “back to sleep,” placed on their backs during naps and at night to reduce the incidence rate of sudden infant death syndrome (SIDS) – which has really worked! Researchers around the globe report SIDS deaths have decreased 40 to 50 percent since the Back to Sleep campaign began.
The problem is this has been accompanied by a rise in other problems physicians and pediatric occupational therapists believe is related, most commonly plagiocephaly. In layman’s terms, this refers to when infants develop a flat spot on the back of their skull. The American Academy of Physical Therapists reports an “alarming rise” of skull deformation, with one analysis published in the Cleft Palate-Craniofacial Journal finding it rose approximately 600 percent from an incidence rate of 5 percent prior to 1992 (when the “Back to Sleep” campaign began) until now. “Back to Sleep” is almost certainly a driving factor, but also the increasingly inordinate amount of time infants spend in car seats, strollers, etc.
Almost all our FOCUS families are looking forward to a little down time spent with loved ones over the winter holidays. But – You Better Watch Out! As our occupational therapists can explain, a break from the routine of regular school, sports, occupational therapy and other activities for three full weeks can be enough to throw any child off-balance. It’s especially true for children with sensory processing disorder, exacerbated when in lieu of those routines, they’re feeling the sensory overload of parties, people, music, lights, recitals/ plays/ shows, decorations and different foods.
Reducing the risk of over-stimulation and the kind of routine disruption that leads to major meltdowns, our Fort Myers pediatric occupational therapists urge parents to “ease through the season.” That doesn’t mean your child can’t participate in or won’t enjoy your family’s much-cherished traditions. In fact, this time of year can be an excellent learning opportunity for those with sensory challenges or social anxiety. It just means that to maximize the time you have, plan ahead when possible and be mindful of the ways in which your child is experiencing these same events.
Occupational Therapists Want to See a Merrier Season for All
Although it’s been said many times, many ways: Prepare, prepare, prepare. It doesn’t necessarily have to be a huge ordeal, but just take a few minutes to consider where you’re going, whether you’re traveling, how many are likely to be there and what sensory obstacles can you reasonably foresee. For example, if you’re planning a busy day with lots of activities or an extended trip, a weighted or compression vest might go a long way. Keep sensory tools handy. And even if you think your child may not fully understand, take a little time to explain the plan – the night before, the morning of, on the way there and just before you get there. That way they aren’t completely caught off guard.