Autism is a neurological condition characterized, in part, by restricted, repetitive patterns of behavior, interests, or activities. Someone with autism may insist on adhering to the same routines and rituals – and any attempt at changing the slightest element can set off a major meltdown. But the fact is: We live in an ever-changing world. As Fort Myers occupational therapists, one of our primary goals when treating children with autism spectrum disorder is to teach them flexibility.
Flexibility is the quality of being easily bent but not broken. It’s not a natural skill for any of us. Think about your reactions when events take a sudden, unexpected (and unwanted) turn. But the ability to be flexible is what allows us to move on from the big emotions of that and continue with the task or the rest of the day.
Change is just an inherent part of the world we’re in. Lots of kids with autism struggle with this – and often for seemingly very minor things. Helping them learn to get themselves “unstuck” is critical for functioning in daily life.
Yoga and occupational therapy go hand-in-hand. The word “yoga” literally means “to yoke” or “unite.” As pediatric occupational therapists, we’re often seeking to “unite” children’s physical, cognitive and emotional selves – always treating the whole child, rather than their compartmentalized sets of eyes, ears, legs and hands.
Occupational therapy focuses on the development of:
- Gross motor skills
- Fine motor skills
- Sensory processing
- Behavior regulation
- Social skills
Yoga uses breathing techniques, mindfulness and poses to help a person’s body become calm and energized. It helps to develop:
- Bilateral coordination
- Processing of sensory information
Yoga is also great for helping teach focus, self-regulation and calming the mind and body. It helps foster imagination too. Of course, kids don’t know they’re working on all of this – especially when we’re using fun games and poses and tools like Cosmic Kids Yoga. That’s why our Fort Myers occupational therapists LOVE using yoga in sessions, and encourage parents to do so at home too. Get down on the floor with your child and turn it into family fun time!
Many of the children we treat at FOCUS have some sensory processing issues. These are difficulties organizing and responding to information that is “read” through the senses. Some kids are undersensitive (sensory seeking), some are oversensitive (sensory avoiding) – and some are both, depending on the sense and stimuli. When a child has trouble managing sensory input, it can have a significant impact on learning and everyday life. One of the things our Fort Myers occupational therapists frequently recommend to help children with sensory processing issues is called “heavy work.”
Heavy work is a strategy we use in therapy and recommend to parents to target a sense called proprioception, with the ultimate aim of:
- Improving attention and focus.
- Decreasing defensiveness.
- Helping to calm/regulate.
Heavy work can actually benefit all children, not just those with sensory processing difficulty. Our occupational therapists have found it especially helpful to have kids do heavy work just before or at the very beginning of our sessions.
Worrying about your child’s safety is something with which all parents are familiar. If your child is typically-developing, these concerns usually lessen as he or she gets older, becomes more mature and gains better judgment and safety intuition. However, children with autism and other special needs may be delayed in acquiring the skills necessary to navigate unsafe situations – if they are able to acquire them at all. That doesn’t mean there is nothing we can do. There are many ways that parents, caretakers, teachers and public safety officials can work together to create safer environments for children and adults with autism – both for individuals and on a broader scale. It is also something we can work on with our young patients in occupational therapy and ABA therapy at FOCUS.
Safety skills are life skills – and they are important. However, there is no single approach to safety that is going to work for every single child on the autism spectrum – because every person on the spectrum is different. Plus, some safety issues might be present throughout a person’s life, some might build over time, some may fade and others could become more complex. Like any other life skill, safety skills will take time, effort and different approaches to master. That’s why we advise early intervention with therapy and frequent practice.
Learning to read is not simply about gaining knowledge. Literacy (which is not just reading but writing, speaking and listening too) touches everything we do, from finding our way around to learning new things to staying informed. It’s one of the core ways in which all of us engage, communicate and connect. When a child has reading difficulties, it can result in anxiety, frustration, social isolation and even depression. One longitudinal study of 4,000 students found that kids who don’t read proficiently by third grade are four times more likely than proficient readers to drop out of high school. Pediatric occupational therapists work to support child literacy and help kids who are struggling to learn how to read.
Literacy often begins at or even before birth. Many kids are exposed to books and stories before they even know what to do with them. Sometimes for children with disabilities, it’s tougher because their early years are filled with doctor appointments, day care issues, therapies and other challenges. This is beyond the family’s control, but it unfortunately leaves less opportunity for literacy development.
Our Fort Myers occupational therapists at FOCUS work with many children who have a broad range of challenges that can interfere with learning to read and other aspects of literacy. It could be fine motor skill problems that impact one’s ability to manipulate a book. It could be a visual processing difficulty where the child has trouble tracking pictures or letters in a story. It might be auditory processing difficulty, where a child struggles to process and understand what he hears. They may have attention problems that make it hard to sit long enough in a lap to read a book. It could also be sensory issues like tactile defensiveness that make it arduous to interact with printed materials or writing utensils.
The way we address it in our OT sessions is first to break down these challenges into bite-sized pieces that can be addressed in smaller steps. From there, we turn our attention to finding what interests the child. Then we incorporate activities and tools that will help strengthen their abilities.
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.
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.