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.
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.
“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.
Children love to play, and good thing too because it’s great for their development! Our occupational therapists can cite decades of research detailing the ways in which play is a critical to facilitating physical, cognitive and language development for children. It’s one of the reasons FOCUS Therapy Fort Myers makes every session with children one in which we invite our clients if they want to”come play” rather than “come and do some therapy.” We find ways to engage children that they find interesting, while also working on strengthening their deficits.
Outdoor play in particular has many benefits. Children commonly assigned occupational therapy, such as those Down syndrome, autism, cerebral palsy, premature birth or fetal alcohol syndrome, are at high risk for poor motor development. Engaging them in “motor play” as early and often as possible is important. Once they are ambulatory (i.e., moving), children should be given more opportunity to explore the world outside. Not only do they get a fun chance to work on those motor development skills, they can connect with parents, siblings and other peers and are also less likely to become obese later in life (sparing them a host of health problems in the long-run).
Substantial research concludes children who spent time outdoors do better with interpersonal relationships with peers, have less aggression and more effectively self-regulate. Occupational therapists know children with delays and disabilities especially thrive with outdoor play because they get an opportunity to work on essential development of strength, reflexes, concentration and balance while having fun doing it.
Handwriting is a part of our daily lives, whether we’re jotting down a shopping list or taking important notes at a meeting or filling out forms at a bank. Right or wrong, people make judgments about us based on our handwriting, and a failure to conquer this skill can prove a hindrance in basic tasks. Fort Myers occupational therapists at FOCUS are committed to helping children in Southwest Florida master the skill of handwriting.
January 23rd marked the recognition of National Handwriting Day, as designated by the Writing Instrument Manufacturers Association in 1977 – coinciding with John Hancock’s birthday. (You may remember from history class John Hancock was one of the signers of the Declaration of Independence who infamously penned his signature in an over-large font).
It’s not just our signature that says a lot about us. Handwriting is a form of communication, and our occupational therapists believe it’s essential for the promotion of clear thought. Issues with handwriting can be a red flag of certain developmental problems in children, and it can potentially hinder one’s ability to learn because so many instructors rely heavily on written coursework to grade progress. While it’s true that an increasing amount of our communications are conducted via keyboard these days, handwriting has not been abandoned. We see it in medical notes, prescriptions, journalistic work and more. The ability to write legibly helps us not just in student coursework, but in many tasks of everyday living – and that’s ultimately what occupational therapy is all about.
Motor planning is the ability to plan and carry out motor tasks. As our occupational therapists in Fort Myers know, this can be especially difficult for children with cerebral palsy. Early intervention is critical because motor planning is essential for every day functioning. When one has a deficit in motor planning, it’s going to result in motor behavior that is slower, clumsier and inefficient. It can mean physical activities are tougher to learn, retain and generalize. They may end up appearing awkward when trying to carry out a specific task. Occupational therapy helps children with cerebral palsy by working on these skills day-in, day-out, using fun activities to help them master each element of the activity.
A recent longitudinal study published in the Journal of Clinical Neuropsychology explored this connection between motor planning and cerebral palsy. Researchers closely followed 22 children with cerebral palsy alongside 22 other neuro-typical children of the same age. Each child was asked to perform a task that required those involved sacrificing their initial posture comfort to achieve an end-state comfort. Researchers made repeated observations over the course of a year.
What they discovered was that children with cerebral palsy showed poorer end-state planning when achieving critical angles. Further, unlike those children in the “control group,” those with cerebral palsy did not display improved motor planning skills over the course of a year. Researchers recommended more efforts be made to intervene and enhance motor planning skills for children with cerebral palsy.
At FOCUS Therapy in Fort Myers, we can offer help from both occupational therapists and physical therapists, teaming up together simultaneously or working from the same plan of care, to help a child improve their motor planning skills.
Occupational therapists use proven clinical strategies to promote physical and mental well-being and health. A child’s “occupations” can include anything from activities of daily living (basic hygiene, getting dressed, eating, etc.) to education – and yes, playing.
For victims of childhood trauma, these functions may not come easily.
According to the American Society for the Positive Care of Children, approximately 1,825 children are abused or neglected in the U.S. every day. In all last year, there were 6.6 million children reportedly abused or neglected in the U.S. – and those are only the instances that were reported to state or local authorities. To us, these are not merely statistics. They are precious individuals who deserve to be surrounded by compassion and support. The proper response to their suffering is not to shy away from it. Rather, it demands action.