December 16, 2020
Tactile Defensiveness and Concerns
How many parents are absolutely filled with dread and terror at the first sign of snow? If you know what I mean read on…
Some of our littles (and bigger ones) experience challenges transitioning or just outright wearing snow gear – just a certain piece or the whole thing.
If morning and school recess battles are regular occurrences with emotional meltdowns (this includes parents and caregivers who may be frustrated, overwhelmed and confused by what is happening), we are here to help!
In our practice, this concern is common and we would be happy to support dressing and create solutions to improve comfort for everyone! As OT’s we help to solve problems of daily living and enable children to participate in activities. We can do this in many ways. Sometimes it is through parent coaching and helping them understand the unique needs of their child (think a bit sensory sensitive, needs extra structure and predictability, participates in clothing choice, acknowledges that sensory differences and sensitivities are ‘real’ with backing in research).
Sometimes we help by offering suggestions on how to change the environment and objects (think clothing type, location of dressing). Sometimes we help by playing and doing with the child (think let’s dress up the teddy bear and practice how we can help our body be calm or practice with a certain piece of ‘grumpy’ clothing). Sometimes we use ‘smart neurology’ strategies that counteract sticky grumpy sensory overload (think deep pressure, movement).
We offer a variety of ways to assist with tactile defensiveness and other tactile concerns. Reach out if you need some support!
December 12, 2020
Evidence-Based, The Best Practice?
Evidence-Based. Best Practice. Randomized-Control Trial. Many years ago, I was introduced to these terms during my graduate training in speech language pathology. These concepts have followed me and influenced my practice in some way, shape, or form since receiving my degree over 14 years ago. While these terms have guided my practice and resulted in some very successful outcomes for clients, they could have potentially limited me in my journey as the mother of a child with special needs.
Henry is my middle child. He came into this world a bundle of joy and a much anticipated younger sibling to his big brother. He was my second born. My easy baby. I left the hospital 3 days sooner than I had with my first. “You already know the drill” I was told. “You’ll be great”. We were great. Henry ate well. He slept well. He was a quiet baby. But as the months passed by, I started to question my easy baby. Nine months came and no babbling. No crawling. Twelve months came and went without a first step. Fifteen months. Eighteen months. Nothing. Henry was not keeping the pace of his older brother. “Give him time” they said. “He’s a second child. He will catch up”, “you just know too much”. Maybe. But my gut also told me that something was off.
At our 18-month well-baby visit, my doctor confirmed my worries. “He’s a little behind. No harm in making some referrals”. Within a little less than a year from that appointment, we were well on our way to putting together a team that consisted of, at various points in time, a speech-language pathologist, a Communicative Disorders Assistant, an Occupational Therapist, a Physical Therapist, and a Developmental Pediatrician. Overwhelming? Yes. Appreciated? Immensely.
Life got busy. Weekly speech sessions and OT/PT consultations both at preschool and our children’s treatment centre. Communicative Disorders Assistant visits to the preschool to help with communication and social support. A visit with prosthetics and orthotics to fit Ankle-Foot Orthotics to address toe-walking. And finally, a diagnosis: Developmental Coordination Disorder, a condition which explained the difficulty and delays Henry was experiencing. Not news to me. I, of course, had already started putting the pieces together.
We continued our therapies, addressing the toe-walking with orthotics, the balance issues with stair and curb walking, the social concerns with the help of an adult model, self-regulation issues with visual schedules, the fine motor coordination with shoelaces, beads, toothpicks, and tongs. Henry was making progress but there was still something beneath the surface that we weren’t addressing. It was always there. When we were at the store and Henry would scream at anyone in our aisle. When we walked up a hill and Henry lost his balance, reaching out for support. When Henry would calm at the beach but lose control in a crowd. When Henry would ask for something only to turn around and refuse it. When Henry just could not take “it” anymore (we were gradually coming to learn the many “its” in our life) and would become lost in a wave of tears and emotional dysregulation.
Our therapies were missing something. We were not addressing the “big and bouncy” Henry. Nor were we addressing the “seeking and avoiding” Henry. The little boy who would so desperately seek input that he would bury his face in sand, eat dirt, bounce and crash. We were not addressing the boy who could not look us in the eyes. Nor were we addressing the boy who intensely feared balloons, would run from noise, screamed at the sound of singing, would rip off a waffle knit shirt, and had trouble adjusting when his expectations failed him or plans changed without notice. There was something else there. Something that our funded therapies were tiptoeing around, sometimes poking but never really addressing.
I, of course, felt lost. I turned to my many professional contacts, many of whom assured me that we were on the right path. But I continued to watch my little boy struggle. Desperate to learn more, I attended a 2-day workshop that had randomly come to my attention via my inbox. A conference topic completely outside my professional realm of knowledge but, as I would soon find out, not all that far from my realm of experience. A workshop presented by a well-respected and experienced Occupational Therapist. Her course, titled “Is it behaviour or is it sensory?” spoke to the internal debate I was having with myself on an increasingly daily basis.
I think that I was not more than 15 minutes into the conference when I texted my husband.
“This is Henry. This is him.” I felt like I had struck gold. A room full of professionals discussing a topic that we had been circling for almost a year. There is a name for this? Yes. There is treatment for this? Well, sort of.
It didn’t take me long to realize that the cases being discussed and the therapies being used in the world of sensory integration therapy were not widely accepted. The children who transformed before my eyes in a series of case videos were not part of a larger research base that would validate the therapies used to help them. My understanding is that this is a professional debate that reaches far beyond the scope of our story. Needless to say, I knew that we would not be accessing these therapies within the walls of our children’s treatment centre.
On the recommendation of the workshop presenter, we attended our first private therapy session with a Physical Therapist well versed in many of the techniques presented during the 2 day course. Again, we weren’t more than 15 minutes into our session when I realized that we were where we needed to be. My big and bouncy, sometimes oppositional, bundle of energy had found his happy place. A crash mat, a weighted blanket, some whistles, some heavy work, and an astronaut board used to treat the vestibular system. “I’ve not seen many children seek this level of input” I was told. I watched as Henry’s body slowly melted with each crash on the mat and spin on the board. He was calm. He was grounded. He was getting what his body had been craving so desperately for the past 3 years. Henry slept the full hour on our drive back home while I shed a few tears, finally feeling like we were scratching beneath the surface.
And so began almost 2 years of private therapies, a switch to part-time work for me, a hit to our personal finances, and thousands of kilometres on the odometer to bring us to therapists who are able to provide the therapies that Henry’s body, and brain, needs. The therapies that I quickly learned are not a part of the “best practice” provided at our local children’s treatment centre but are part of a huge collection of interventions that “show promise for some”. I later learned that these therapies are built on a growing foundation of “practice based evidence”. Evidence that suggests promise but not enough evidence to receive funding and recognition from the policy makers and funding agencies that make our health care system run.
After our first session of spinning I knew we had stumbled upon something. Henry’s body eased. He relaxed. He asked for more. And more. We were on to something. Not evidence-based. Not best-practice. But definitely doing something to the little boy who could not walk over a bridge or up an open staircase without completely losing his cool. Within 3 sessions, Henry was no longer seeking the crash mat. He was following instruction. He was calmer. He was down on his feet. He was making eye contact.
From there, our journey brought us to an Occupational Therapist, versed in sensory integration therapy. Another gym. Another set of Lycra swings. But this time, there was music. Seemingly strange, modified music. As we got back to our car from our first session, I quickly googled “Therapeutic Listening”. No published evidence. No group studies. The professional in me had been taught to be leery of such programs- to stick with what is proven, what follows an “if you apply X, then you can expect Y” approach. But the mom in me had already watched my son calm while spinning on an astronaut board. Had watched my son bring his eyes to the PT rather than glance sideways to make “eye contact”. There was my evidence. If that had worked, this Therapeutic Listening might just help too.
We are now over a year in to our Therapeutic Listening journey. First, music to help calm and regulate. More recently, music designed to “modulate” and “fine tune” some of the cognitive and perceptual skills that underlie Henry’s difficulties. And along the way, as needed, our quick shift album designed to be a situational remedy, to bring Henry back to balance “on the go”. Every two weeks our albums change. Some weeks we see huge changes in Henry. Some weeks we see very little. The fact of the matter is that we are seeing change – being caught off guard by the sudden appearance of a skill or development of an ability. What does our “evidence” look like? It is the piece of artwork hanging in our hallway that finally came home as recognizable after years of scribbles. It is a child who now looks me in the eyes when talking to me. It is a boy who is able to pull out of a sensory meltdown with some deep breathing and heavy work. It is a boy who participated in his first team sport this summer. It is a boy who is happy, is engaged, and who is now able to initiate an interaction. It is a boy, who according to his developmental pediatrician, is not the same little boy we knew a year ago.
While some may argue that something else is at play, the truth of the matter is that the changes we have seen have often been swift, coming out of left field and catching us completely off guard. No warning, but much celebration. Do these “fringe” therapies account for all of our son’s progress? Probably not. I would hope that the evidence-based interventions that we continue to pursue account for some of it. But, had we not been able to help our son to better regulate, focus, and calm at a more basic, neurological level, he would never have been in the position to benefit from the supports being offered by our public system. Our preschool teacher once told me that if there is one thing I can count on with Henry, it is to continually be surprised. While this is true of my son, it is also true of the journey that we embarked upon so many years ago at our well-baby visit.
I have had many teachers in my life, most of them behind the doors of academia. I have had mentors, I have had colleagues, I have had clients, and I have had friends. I have learned a great deal from these people- ideas, concepts, and theories that have advanced me in my professional practice. What I didn’t expect was that I would birth one of my greatest teachers. It is Henry who has challenged me to evaluate that which I thought true as a professional. My training did not prepare me for the overwhelming experience of seeing something outside the realm of “evidence based” work so clearly and intensely as Henry’s sensory integration and therapeutic listening work has done. I am left with a vivid memory of a poem I read many years ago in my high school English class. The poet Robert Frost, so eloquently captured what I would eventually learn to be true. Frost wrote that “Two roads diverged in a wood and I took the one less traveled by, and that has made all the difference”. While I certainly would never dismiss the well-worn and experienced path that we travel as evidence-based professionals, my journey along the path less travelled has made me a better clinician. More importantly, it has led my child to a place where he is better equipped, and able, to benefit from the road travelled by most.
December 2, 2020
Occupational Therapy focuses on developing many important skills, while always striving to support the mental health of clients.
November 25, 2020
It can be difficult to stay positive and hopeful during these trying times. This quote talks about the importance of resilience and training your mind to bounce back!
September 17, 2020
Great video about the importance of tummy time from Körplay!
September 11, 2020
September 5, 2020
Autumn Fine Motor Craft Ideas
September 2, 2020
Make your own worms – fine motor activity!
August 26, 2020
Get ready for writing activities with finger aerobics!
August 20, 2020
August 13, 2020
Great ideas for Socially Distanced Greetings!
August 9, 2020
“How Daniel Tiger Helps Teach Social Skills to Preschoolers”
August 7, 2020
Mindfulness videos for kids from the The OT Toolbox!
July 29, 2020
Delicious sensory motor activity for learning letters!
July 22, 2020
Fun activity for learning about and discussing emotions!
July 15, 2020 Benefits of Swinging!
July 6, 2020
CNN & Sesame Street: “Coming Together: Standing Up to Racism — A Town Hall for Kids & Families”
Clever outdoor fine motor activity from @atelierdayhome.
CNN & Sesame Street: “Coming Together: Standing Up to Racism — A Town Hall for Kids & Families”
June 25, 2020 kidsTherapy Network Garden!
Cheerful strawberries in the kidsTherapy Network garden! Looking forward to when we can start up our Little Sproutlings gardening program again.
June, 24 2020, Tips to Help Children Wear Masks for COVID-19 Protection
Sesame Street Is Teaching Kids ‘Belly Breathing’ and Calming Techniques
June 17, 2020, 21 Anti-Racism Videos to Share with Kids from We Are Teachers.
These videos help explain complex topics to young audiences.
May 20,2020 Telehealth Truths #6 and #7
Missing everyone! Stay safe.
Who hasn’t put their face or eyeball up to the webcam yet?!
May 16, 2020 Telehealth Truth #5
Understanding the reason your client is so engaged in the session…
May 12, 2020 Telehealth Truth #4
Flashback to 1970s TV days. Oddly comforting…
May 7, 2020 Telehealth Truth #3
Realizing your 7 year old client is better dressed than you are…
May 1, 2020 Detective Bumbledore and the Red Ribbon
Support our front-line workers and show them your appreciation by taping a red ribbon on a tree or other creative place!
April 28, 2020 Telehealth Truth #2
Continuing our telehealth journey we discovered another disturbing truth.
April 27, 2020 Telehealth Truth #1
In our journey with Telehealth, we have made some discoveries. We give you Telehealth Truth #1. Until we can get haircuts again, we have found new hairdos to make do. Enjoy this fabulous example and stay tuned for more truths!
April 21, 2020 Detective Bumbledore Learns Some New Breathing Techniques for Relaxation.
Special guest Hermione Whole-Grain-ger teaches Detective Bumbledore some calming and fun breathing activities. Hermione got a little too “toasty” at the end of the video but she says, “not to worry” because she did some deep breathing, which helped her “cool down”!
April 16, 2020 Sensory Exploration: Our Sense of Taste
Special Guest Bread Weasley and Detective Bumbledore explore ways to change bodySPEEDs(c) using our sense of taste.
Here is a tasty activity that can be tried at home:
April 14, 2020 Mindful Breathing and Craft Activity
Guest star Hermione Wholegrainger helps Detective Bumbledore learn a new breathing technique while creating a springtime bunny craft.
Thanks to One Little Project at a Time for the project idea and instructions!
For more information and research on breathing and mindfulness, check out the Mindfulness in Schools Project.
April 9, 2020 Gratitude Garden
Detective Bumbledore chats with Carrie Snotter about a calming and creativite painting activity to thank our front line healthcare workers! If you decide to make this project, we’d love for you to email us some pictures of your artwork to firstname.lastname@example.org so we can post them to our website! Stay safe and healthy everyone!
Here are some pictures from the Gratitude Garden at Guelph General Hospital:
To learn more about the Gratitude Garden, visit CBC.
April 6, 2020
Elizabeth shares some exciting KTN updates about our upcoming video mini series! We’ll give you a clue, it rhymes with Dumbledore!
March 19, 2020
Thank you to our associate, Nicole Raftis, OT Reg.(Ont.), for putting together this resource review for coping with the uncertainty and anxiety of these unprecedented times:
Have you seen our very own Elizabeth Bell featured in the documentary film Beyond the Spectrum?!
February 2, 2020
“I have started to witness every day how small changes – a smile, a listening ear, a change to the environment – can have a huge impact on a patient. I see my job a bit like completing a jigsaw, putting the story of an individual’s life together piece by piece.” – https://buff.ly/32tgIMC
Can you relate? OT Reg.(Ont.)