Right now we are all feeling a little (or a lot overwhelmed).  Kids are the same.  Their lives have been turned upside down.  As everyone continues to try to "find a new normal", kids are getting more and more frustrated.  They just want to play with their friends and do all their favorite things again.   When kids are frustrated it comes out as behaviors, yelling, and sometimes a child you don't recognize.  You may be saying "She never used to act like this" or "why can't you just calm down?" Often we are caught off guard, and something that seems like it should be "no big deal" turns into a massive meltdown.  This affects not only the child, but the entire family.
We have certainly had these struggles at our house, and likely you are having the same problems. As a parent it is maddening to try and figure out what is wrong. Sometimes kids can't tell you; they just know they are frustrated.  They are struggling with control.  
Self control is the ability to control your own emotions and behaviors.  Another name for is self regulation or sensory regulation.  Sometimes kids struggle with self control because of difficulties with sensory processing and sensory modulation.  Sensory processing is how our nervous system take in sensory information from the environment and makes sense of it.  Sensory modulation is controlling the amount of sensory input that comes into the nervous system.  Some kids are sensory seekers and some are sensory avoiders.  When there is a disconnect between the sensory information coming in, and the child's ability to process it, there is often difficulties with self control.
Other times difficulties with self control stem from struggles with emotions and external circumstances.  This is likely the case for many children right now.  There are lots of tools you can use to help children learn about their own emotions and come up with strategies to calm themselves when feeling overwhelmed.   I often use How Does Your Engine Run and Zones of Regulation. The picture above is a great visual to teach kids about self control.  First you STOP what you are doing, THINK about the different options you have, after you chose the options you can reACT.  
If we equip our children with simple tools to help them think through different options, they are empowered to realize they are in control. They can learn to think before reacting. This will be so powerful to a family when a child can have better self control. 
Pediatric occupational therapists are one of your best resources in teaching children self control.  They are uniquely positioned to look at the child from a neurological (sensory) and behavioral perspective.  
​For more information about occupational therapy services that are available in Lincoln Nebraska please reach out at 402-413-1356 or kristen@connnectpediatrictherapy.com

Halloween is less than 2 weeks away.  Many times this holiday is met with excitement and fun.  For children with sensory processing challenges Halloween is stressful and frustrating.  Children with sensory processing challenges experience the world very differently.  Their bodies often over respond to sensory input.  Noises and certain fabrics can send them into a panicked fight or flight state.  
Imagine having to walk around in the dark in a wet swim suit with the sound of fingernails running down a chalkboard, and ants crawling all over your body......sensory overload.  This is how a child with sensory processing difficulties may feel if forced to wear a costume and trick or treat. 
Many well intentioned parents may think "you'll have fun if you just try" and force their child to put on a costume and go out with siblings.  Unfortuatnely this child will only become more overwhelmed until eventually a meltdown will happen.  It is not that the child doesn't want to go, it's that they can't handle all the confusing messages coming into their nervous system.  Additionally they see friends and siblings having fun, and struggle to understand why Halloween isn't fun for them.

Below are some ways to make Halloween costumes more sensory friends so that all children may enjoy the fun.

• Let the child decide-let you child decide if they will trick or treat, answer the door or simply watch from afar.  Halloween is full of unpredictableness- so letting the child be in control of what they participate in will help them feel at ease.
• Pay attention to material- many store bought Halloween costumes are made from polyester.  This material is not breathable and ends up feeling like Saran Wrap on some kids.  Instead chose softer materials like fleece or cotton (t-shirts, sweatpants etc are great base for building a costume).  If your child has an outfit they wear all day-you can also avoid the difficult transition involved in changing clothes. 
  
• Non-traditional costumes-the costume can be as simple as a sticker on their shirt that says "I am Elmo", a hat, a headband.  Pajamas make an excellent costume.  There are lots of character sleepers.  There are no rules that say costumes have to be big and elaborate!  Most importantly LET YOUR CHILD DECIDE THE COSTUME! You will have a much happier night overall.

Do you have a clumsy kiddo?  Do they fall down more than peers? Do they seem to get lost when they are supposed to be getting dressed?  Do they seem to struggle to achieve motor milestone like a riding a bike later than peers?

If you answered yes your child might have a praxis problem.

I found myself getting frustrated when my daughter would get lost on her way to get her shoes on.  How hard could it be??!  Eventually my pediatric OT brain kicked in over my frustrated mom brain and I figured out she was struggling with praxis.  She got stuck in the planning part-she could think of what she was supposed to do but could make a plan that would successfully carry out the action in a timely manner.

If you've searched the web for ideas about how to help you may have run across the term dyspraxia, poor body awareness, difficulty with motor planning. What all of this means is that your child has a hard time coordinating their body for action.  Praxis is how  thought (cognition) directs movement (Ayres, 1985).  Praxis is a latin work that means "doing or action".  This is a simple definition for a complex set of events that have to happen in order for successful movement to take place.
The steps of praxis:

• Ideation-thinking of what to do
• Planning-planning how you are going to do the action
  • success is based on knowledge of body in space
• Execution-performing the action
• ​​Motor Organization/Sequencing-organizing body to move through space
• Evaluation/Feedback-reflecting on how successful movement was and making changes

​
So as you can see coordination of movements from start to finish is a VERY COMPLEX process!  It's not as simple as "go get dressed".  That involves knowing what that means, figuring out how you will get the dirty clothes off your body, get clean clothes out of drawer, orient them correctly on your body and maneuver your body so clothes will go on and then decide-do my clothes match, am I wearing clothes that will be appropriate for the weather and are my clothes on my body correctly.  Many kids struggle with knowing where their body is in space.  When they are asked to get dressed they get lost with their own body. Clothes end up being backwards, wrong season or the child just won't get dressed because the job is too hard.

Imagine how stressful it is living in a body that is so lost?  Self esteem issues are common as children get older and cannot seem to coordinate their bodies like their friends.  They start to be made fun of because they can't keep up.

​ But how would I know if my children are having difficulties with praxis?​ 

• Slow to achieve developmental milestones
• Avoid tasks requiring good manual dexterity (eg. puzzles, intricate construction or fine motor tasks such as writing and cutting)
• Clumsiness (eg. constantly bumping into things or falling over)
• Messy eaters (may not be aware of food around face and continues to feed with fingers)
• Difficulty riding a bike
• Lack of or limited imaginative play
• Difficulties coordinating both hands together (eg. managing fastenings)
• Difficulties during physical education
• HIgh levels of movement, limited concentration
• Slow to complete class work
• Problems with self-help skills such as using cutlery, dressing or tying shoelaces
• Difficulty forming relationships with peers, sometimes preferring company of adults

Great news-help is near!
Pediatric occupational therapists are a great asset in working with your child to help with praxis difficulties.  Find a pediatric OT in your area that can help provide intervention and home program activities that can help your child develop a better awareness of their body and improved ability to move through their world with success.

If you have questions, need additional resources or want to schedule an appointment in Lincoln, NE please call Dr. Kristen or email at kristen@connectpediatrictherapy.com

Have mealtimes turned into a battleground at your house?  Many kids go through a "picky eater stage" between the ages of 2 and 4.  This is a very normal part of development. Typically children are trying to learn about their environment and finding ways to exert control.  Picking what they will eat is an easy way to gain control!  Sometimes kids won't grow out of this phase, or end up with a very limited diet.  Then its time to get help from a feeding therapist (typically an occupational or speech therapist). I have treated kids with feeding delays for the last 10 years.  I can tell you with absolute certainty that the earlier you get started with feeding therapy the quicker the progress.  There are a lot of different reasons kids might be picky.  The best thing to do is see a specialist who can help you sort it out. There are lots of strategies to help picky eaters move through this phase quickly.  There are also lots of resources and strategies to help problem feeders turn into happy eaters!

Here are some important questions to ask that will help distinguish the difference between a picky eater and a problem feeder:

• How many different foods will your child eat?
  • Picky eater=will eat at least 30 different foods
  • Problem feeder=typically restricts themselves to fewer than 20 foods
• Will your child eat food from all categories (sensory and nutrition)
  • Picky eater=eat at least one food from most food groups and textures groups (crunchy, smooth)
  • ​Problem feeder= Refuses to eat entire texture groups, color groups, or nutrition groups 
    • example: will not eat anything that is crunchy, or anything that is green, or any proteins 
• Can your child eat the same foods at the family
  • Picky eater=will eat different food than family but will eat at same time
  • ​Problem feeder=will eat different foods and often needs to eat at different time or place
• Will your child try new foods?
  • Picky eater=may need to be exposed multiple times but will eventually place in their mouth
  • ​Problem feeder=introduction of new foods results in meltdown/tantrum and complete refusal
• How long have your thought of your child as a "picky eater"
  • Picky eater=typically a phase that shouldn't last more than 3-6 months
  • ​Problem feeder=difficulties will be reported consistently to doctor; lasts for greater than a year

​

If you have questions or want additional resources reach out to Dr. Kristen at 402-413-1356 or kristen@connectpediatrictherapy.com

Going back to school looks a lot different this year.  Many kids that would traditionally be heading back to school are instead doing remote learning.  In order for them to be as successful as possible it is important to set up their space to support his/her learning. Here are some helpful hints to think about.

• Have a dedicated space in the house for remote learning or home school.
  • If possible have a desk or table that can stay setup for learning
• Fit the space to your child's sensory needs
  • distracted visually= then the space should be free of clutter, blank walls
  • distracted by sound=quiet space, noise cancelling headphones
  • needs movement=standing desk (working at counter), sitting in rocking chair, frequent movement breaks built into learning time
  • access to crunchy and chewy snacks can be alerting and organizing
• Organized and predictable place for supplies
  • Have everything setup to eliminate wasted time looking for things
• Post a schedule and have a clock visible
  • Kids need to know what to expect and a clear beginning and end
• Let the child help design
  • ​This provides them with a sense of control in a time that feels out of control
    
• Fun school supplies
  • ​Having writing utensils or a fun notebook can be very motivational 
    
• Have access to comfortable headphones
  • Many kids are doing zoom calls-make sure they want to wear the headphones so they can be excited to participate instead of avoiding it

As many kids are headed back to school they will have one additional accessory this year; a mask.  This is an essential piece of their wardrobe in order to keep everyone as safe as possible.
This is a polarizing issue and people feel strongly about whether kids should or should not head back into classrooms.  I hold respect for people on both sides of this issue and respect that everyone needs to make the best decision for them.   My kids will be headed back to the classroom.  For our family, the educational and psychological benefits of being in a classroom with a teacher outweigh the risks of exposure.   This blog isn't about convincing anyone, but instead serves as a resource to help parents teach children to wear a mask. 
This virus is not going away anytime soon-so most likely no matter whether your children are headed back to the classroom or not; they need to learn to wear a mask. Wearing a mask for several hours can create sensory challenges.  Breathing is different, glasses fog up, the texture of the mask makes a difference, the mask "smells".  Whether your child has sensory processing difficulties or not, they need you to help them learn to wear the mask.  Here are some tips to help ease the transition.
1. Practice now

• Don't wait till the first day of school to have your child wear a mask for more than 15 minutes
• Have them wear it around the house or in community for several hours
• Use a timer and add several minutes each time

2. Practice what you preach

• Kids are watching-all family members need to wear the mask
• Talk to your kids about why they need to wear the mask-we take it for granted that they understand

3. Give kids power to choose

• Let kids try out several masks and pick the fabric that feels the best to them
• Add essential oils or sprinkle scant amount of spices on mask to add pleasurable smells
• Ask kids what bothers them and have them problem solve a solution (change the elastic on ear pieces, tighten it up so glasses don't fog up)

    **the more input your child has the greater the likelihood they are    
​    "buy in" and wear the mask


Have a great school year whether your child goes to school, home schools, or does remote learning....we wish you the best!

Let us know what other fun ideas you have for helping kids wear masks.