Sensory Tips for Parents and Teachers #1 – Those Winter Clothes

As we now head into fall with winter right around the corner, many parents of children with SPD are beginning their seasonal struggle to dress their child for the cold weather.  Many children with SPD experience sensory defensiveness, especially tactile defensiveness.  This tactile defensiveness manifests as an over-sensitivity to touch information.  These individuals often do not like light or unexpected touch, yet may crave deep touch pressure and heavy muscle work (proprioception).  Because of their sensitivity to light touch, clothing can be a problem.  We all know that friend that only dresses in soft, sloppy clothes because dress clothes are just too constricting.  The girlfriend that would not be caught dead in nylons or panty hose because she JUST CAN’T STAND THEM.  These friends probably have a bit of touch sensitivity.  In children with SPD this preference for certain kinds of clothing can be particularly strong.  The child may avoid wearing socks or underwear.  They may wear the same shirt or outfit over and over until it is way past too small or is worn thin from washing.  Seasonal clothing transitions from short pants to long pants and vice versa may be problematic.  In cold months, keeping hats, mittens, coats and scarfs on the child may be a challenge.  So what’s a parent to do?

Some Solutions:

1. Have your child be a part of the clothes finding process.  As adults we have total freedom in deciding what we wear and when we wear it.  This control allows us to feel more comfortable.  Don’t buy clothes for your child without them trying it on first.  Have them be an active participant in selecting items in their wardrobe.

2. Natural fibers tend to be easier to tolerate.  When selecting clothing, natural fibers, especially 100% cotton, tend to be easier for the defensive child to tolerate.  Avoid scratchy synthetics.  Go for soft knits and fleeces.

3. Avoid those tags and watch those seams. Try to get shirts that have printed tags rather than sewn in tags.  If you need to cut out a tag, be sure to get all of it and don’t leave sharp edges behind.  Also check seams for irritating tags and make sure that your child can tolerate the seams in any given garment.  Elastic waist pants can often be easier to tolerate than pants with zippers and waistbands.  Purchase socks that are seamless, these are much easier to find in stores like Walmart and Target these days or by Googling on the internet.

4. Prepare early for seasonal changes.  Weather changes can be unpredictable in fall and spring, but it behooves parents to start the clothing transitions earlier rather than later.  With the child select those long sleeved shirts and long pants in early September before the cold weather sets in.  If possible, on cooler days have the child wear the new clothes to get used to them, even if it is part of a day.

5. Pre-wash and soften new clothes.  Pre-wash and soften up any new clothes.  Take advantage of that early preparation and wash the new clothing several times before expecting your child to wear them.

6. Find a coat the child will tolerate.  OK, easier said than done, right?  Think about coat choices and have your child help select one.  Avoid wool coats.  Will your child handle a puffy fiber-fill jacket or would he or she do better with a thinner fiber?  Is a waist-length jacket better or does your child prefer a longer hip or knee length coat?  Is a double-breasted button-up too much fabric?  Is a zipper easier to manage?  Will your child wear a hood or is that too much irritation on their head or neck?  Also think about whether your child will or will not layer up on clothes.  A somewhat lighter coat may suffice if the child will wear a warm sweatshirt or sweater on a regular basis under it.

7. What about those hats, scarves and mittens?  The need for hats, scarves and mittens may depend on the jacket or coat preference of your child.  If he or she has a jacket with a snug collar and a hood, does he/ she really need a hat or scarf?  Again, think of the fabric of these items.  There are also options in the hat and scarf lines.  A cowl style may give warmth and be able to be pulled over the head without being constricting.  Ear muffs or head bands may provide sufficient warmth versus a full cap.  Will a ball cap be enough cover for most days?

For hand covering, consider mittens over gloves.  Can you attach mittens to the sleeves of the jacket.  Are the jacket sleeves long enough the child can pull their hands in the sleeves rather than wearing mittens?  Again check the tolerability of the fabrics of the mittens.  You may love Aunt Susie’s home made mittens but they may drive your child crazy.  Consider washing mittens as well to soften them up.

Clothing changes with the seasons can be hard on both parents and child but some preparation and respecting a child’s clothing preferences as much as we respect our own can go along way to making the transitions easier.

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Spiral Foundation’s NEW!! Book Club

In our ever-growing attempts to provide resources and materials to professionals and parents, the Spiral Foundation has partnered with Amazon to bring you our NEW! A-Store.  In our A-store/ Book Club you will find recommended reading for parents, professionals and children.  By purchasing your books…paper or Kindle versions alike!…through our store, you not only get a great recommendation, but also help support research and education activities in sensory integration.  So make us your first stop for your sensory-related resources!

Today for professionals we would like to highlight two wonderful MUST HAVE resources by Dr. A. Jean Ayres.  If you want to know more about praxis pick these up today!  Click on the pictures to go to our store.

 

Ayres Dyspraxia Monograph, 25th Anniversary Edition

Ayres Dyspraxia Monograph

This monograph is THE resource on beginning to understand the complexities of praxis.  This updated version includes bonus information by praxis expert, occupational therapist, Dr. Sharon Cermak as well as a new extensive bibliography of praxis references.

The Adaptive Response

The Adaptive Response

This classic DVD is the only resource from Dr. Ayres fully explaining adaptive responses in sensory integration intervention and detailing the various levels of adaptive response.  This resource is a MUST HAVE for every therapist practicing in the area of sensory integration or mentoring other therapists or students in sensory integration.

Happy reading and viewing and watch this blog as well as our Facebook page for more great resources.

In Memorium – Jane A. Koomar, PhD, OTR/L, FAOTA

Jane KoomarMany people are already aware that our beloved friend and colleague, Dr. Jane A. Koomar, passed away this year on February 23, 2013 after a three year battle with breast cancer.  Jane was the heart and soul of her private occupational therapy clinic, OTA The Koomar Center (previously known as OTA-Watertown).  She was an icon in her field and changed for the better the lives of thousands of children, parents and therapists.  The Spiral Foundation deeply mourns her loss but endeavors to continue her work with our research and education activities.

To see  a lovely memorium written by OTA and Spiral Foundation staff please visit our website, http://www.thespiralfoundation.org, or by clicking here.

Donations in Jane’s honor may be made to the Spiral Foundation to support research in sensory integration.

What’s the relationship between DCD and dyspraxia?

Many are understandably unsure of the relationship between Developmental Coordination Disorder (DCD) and dyspraxia. Though I’ll try to clear the issue here, I admit, it’s complicated.

First, the definition of “dyspraxia” is not always very clear and its current usage is not exactly synonymous with conceptualizations of praxis in general. I actually try to avoid the term dyspraxia altogether these days because it is not a terribly useful term due to its lack of clear definition. I prefer the term “praxis deficits,” which is more accurate. Praxis deficits may include problems with ideation or motor organization issues of motor planning, bilateral coordination, sequencing, or projected action sequences – all of which are aspects of praxis. Dyspraxia tends to refer only to motor planning problems and depending on the profession, can be even more restrictively defined as only problems with imitation of gestures. This is far more restrictive than our current understanding of praxis in general which can include problems with tactile-based motor planning, vestibular/prop-based bilateral coordination and sequencing problems, and ideational deficits.

The term was originally developed to try to standardize identification of motor performance problems (including praxis issues) in children so there was some uniform terminology and assessment for researchers. DCD was eventually included in the DSM as diagnosis. As a diagnosis, DCD is used very broadly and is usually perceived as an umbrella term that encompasses praxis deficits. The problem with the research and the hard core DCD people is that the gold standard assessment of DCD is the Movement ABC which, from a sensory standpoint, only taps into vestibular issues and does not address tactile-based motor planning. So, the majority of children identified in the DCD literature, if they only use the M-ABC, will be those with bilateral coordination and sequencing problems and not those with tactile-based motor planning. The hard core DCD people tend to make a distinction between “motor coordination” problems (which they usually identify as issues of balance, running, ball skills, etc. – what we identify as bilateral coordination and sequencing and projected action problems) and “motor planning” or “dyspraxia” problems (which they identify as problems of imitation of gestures).

So long answer to the question – the answer is not clear. DCD is generally perceived by OTs as a larger umbrella diagnosis with praxis deficits such as motor planning problems (dyspraxia) falling under the umbrella. However, your hardcore DCD people, including many in Canada and the UK, can be quite adamant that they are different issues. The DCD research literature will capture problems with praxis but they will largely focus on children with more vestibular/ bilateral coordination/ sequencing problems; though you have to read carefully as an OT will use the DCD term but may make a point of capturing kids with tactilebased issues as well.

There is amazingly little research specifically on praxis and even less recent research. Most current articles are in relation to imitation skills in children with autism. I think it is most important to realize DCD research will reflect mostly skill-based vestibular activity and, unless done by an OT, will not reflect specific problems in tactile-based motor planning.

For more stories, info, resources, facts and tips, go to www.thespiralfoundation.org

 

 

The Most Overwhelming Place On Earth? My Sensory Child At Disney World

The Disney World Resort in Orlando bills itself as “The Happiest Place on Earth.” But if your child has difficulty with loud noises, crowds, lights and the physical sensations associated with amusement park rides, is there still magic to be found at one of Disney’s theme parks? The answer is a qualified “yes,” and perhaps my family’s experiences at the Magic Kingdom and EPCOT can help you plan your own Disney vacation.

The most important tip is to set realistic expectations for yourself, your child and any other family members with you. Understanding our son’s capacity to withstand the onslaught of sensory information tempered our thoughts of hours and hours of rides, parades and fireworks. Set smaller goals and build on the success of each day. Our first day we spent in the hotel pool and talked about what we’d see and do. The second day we walked around EPCOT for two hours and rode the ferry boat between our hotel and the park. Each day we planned to do a bit more, and on our last day we spent almost seven hours at EPCOT and rode six rides, including “The Test Track,” a roller-coaster style ride that simulates car endurance tests.

Disney is very welcoming to all of their guests, especially those with special needs. We learned to obtain a “Guest Assistance Pass” before our first park visit. The pass was a golden ticket to a great trip: flashing the pass before entering any ride queue grants special access for your child and family members, cutting waits from hours to minutes unobtrusively. To get the pass we went with our boy to a Guest Services booth, located at the entrance to any park, explained our situation and let them know how long we’d be at the resort. Bring a doctor’s note to help ease the process. One pass covered our entire stay, it cost nothing and was an absolute godsend. Also, keep in mind that quiet rooms and medical stations are hidden around the park and available in an emergency. Just find a uniformed employee—or “cast member”—and let them know what you need.

Pack a bag with snacks and water. This is more economical and easier than concession stands or restaurants, which are often very crowded and always very expensive.

Plan ahead for meals. Our son has a limited diet, so we brought food to Florida and learned the hard way that getting an in-room microwave may come at a steep cost. We stayed at The Dolphin Hotel, and after several phone calls to the concierge we were presented with a microwave and a room service bill for nearly $400! After a few more calls to the concierge the matter was settled amicably. Overall the Dolphin Hotel was a great option: cheaper than a Disney resort and close to many Disney attractions, so please check it out. But next time we’re buying an inexpensive microwave on Amazon.com—about $70—and having it shipped to our attention at the hotel. You may be able to do the same with your child’s favorite non-perishable foods to save space in your luggage and prevent an expensive and unwanted cab ride to a local supermarket. If your child has a wider diet, make sure to make reservations each day for lunch and dinner. During peak times the wait for meals at walk-up eateries can be long, and in the case of sit-down restaurants you may not even be able to get in without a reservation. While this may appear to limit your fun, nothing is less enjoyable than standing in a line with an unhappy kid.

Rent a stroller. The Magic Kingdom covers 107 acres. EPCOT is almost three times larger, and the other attractions are also quite large. Kids we saw melting down were usually on foot. One- and two-kid strollers are available for rent just inside the park entrances, and buying a multi-day ticket brings down the per-day price to about $30. You can’t take the stroller outside the park, but can get another at no additional cost by presenting your receipt if you leave and go back to a park later.

Take frequent breaks. If you can, get an early start and head back to your hotel mid-morning. If you can’t, camp out in a shady spot away from the crowds (there are quite a few!). The parks get especially busy in the hours leading up to lunch and again after dinner. However you and your child recharge your batteries, take extra time to be rested and prepared for the crowds, noise and myriad distractions back at the parks.

Lastly, take time for yourself and your partner. Disney offers tons of activities for kids and adults, from scuba diving to wine tasting to garden tours! Swap shifts watching the kids for some time on your own. Hire a babysitter for an evening or two. Since our son is stand-offish with strangers, our babysitter arrived after he fell asleep (the going rate is about $17 per hour plus tip and parking). On certain nights the parks are open into the wee hours of the morning, so make the most of your time there to capture some magic of your own.

For more stories, info, resources, facts and tips, go to www.thespiralfoundation.org

Our Senses Take No Holidays: Three Steps For Simplifying Holidays With Your Sensory Child

By Matthew Bauer, Executive Director of the Spiral Foundation at OTA Watertown

Being the parent of a child with special sensory needs, I found the holidays could be particularly challenging. A time that I looked forward to sharing family traditions with my son became a source of worry instead: would he act up? Would other family members understand what was going on with him? Is his meltdown going to be my only lasting memory of this holiday season?

To help you answer these questions, here are three tips for preparing yourself for the holidays. I’ve found these helpful for myself, my family and, most of all, my son when we’re planning for big family gatherings or other special events.

Gear Up To Answer Your Child’s Needs
It’s a simplistic statement, but in truth a complex concept: knowing what types of sensory inputs your child needs to remain balanced will help you plan. My boy craves lots of proprioceptive input (which helps him feel himself in his body) as well as vestibular input (his sense of his whole body in gravity).  But he avoids novel smells, new foods and certain types of visual stimuli. As a result, when we pack the car to travel to my family’s Christmas celebration, we bring along toys and games anyone can play with him: a mini-parachute, weighted blanket, astronaut spinning board, as well as small stuff that he finds calming and centering, like favorite videos, books or toys.

We found it’s also great to have a small space set aside where he can go to have a break. It’s easy to forget just how overwhelming the holidays can be, and for someone who already has difficulty discriminating sensory stimuli, the combination of music, lights, food smells, hugging, crowds, and loud voices can be overwhelming and may trigger behavioral responses.

Set Expectations For Yourself
Family traditions don’t always leave a lot of room for flexibility. In my own house growing up, Dad made a special soup that was served at every Christmas dinner since he was a little boy, and not eating some of his soup could be a cause of embarrassment or shame. I found taste and smell and even the sound of the soup hitting the bowl to be disgusting—my senses of taste, smell and hearing are all extremely sensitive—but would choke it down for the sake of being a good sport.

Today I couldn’t imagine forcing my son to eat something he didn’t want for the sake of tradition, but kids don’t always feel capable of making such choices for themselves. So I recommend picking one or two elements of the holiday that you would like your child to participate in: Maybe opening presents and a family meal are the two biggest events of the season. Perhaps a long walk outside and baking cookies are the memories you’d like to have of your child from the season. Whatever those things are, help prepare your child for participating in those activities with a visit to a snowy playground for some intense swinging before the neighborhood holiday party, a quiet break reading a book before opening gifts, or laying under a weighted blanket for a while before dinner. Whatever it takes to prime your child’s sensory pump–even if it seems strange or extreme to you–will help ensure that the special event will be enjoyable for everyone.

Think Long Term
Just as there are no quick fixes to helping a child with sensory issues get into balance, there is no quick fix to getting a sensory kid to engage in the overwhelming whirl of the holidays. So work with your child to take small steps each year. After a successful holiday think about some options to add for the coming year’s holiday season and plan accordingly. If you can talk with your child, ask him or her what else looked like fun, or what he or she would like to try the next year. If things didn’t go so well, discuss what might be a better activity, or how you can prepare better next year. With some forethought and preparation your child may even try Grandpa’s yucky soup next year.

Happy holidays from the Spiral Foundation at OTA-Watertown!

For more stories, info, resources, facts and tips, go to www.thespiralfoundation.org

Sensory For The Holidays: Five Low-Cost Gift Ideas For Sensory Kids

Gifts for kids with special sensory and motor needs purchased from a specialty retailer can be expensive. But sensory-beneficial playthings need not be “clinical-strength” equipment.  Here are a few gift ideas–including several that can be made at home–which can be both fun and functional.

First it’s important to keep in mind the recipients particular sensory profile. A child who is easily overwhelmed by sensory stimuli may not get the same enjoyment or benefit out of an item suited for a sensory-seeking child and vice-versa. Talk with the child’s parent or occpuational therapist (OT) for some suggestions.

Wonderfully Weighted
Heavy items provide deep touch pressure and proprioceptive input. An easy and inexpensive option–especially if you’re handy with a needle and thread–is to purchase a floppy stuffed animal, remove some of the stuffing, and insert beanbags or a fabric bag loosly packed with fish tank gravel (use the white kind as colored gravel can bleed when washed). Depending on the child, this toy can be great for snuggling, laying under or placing on his or her lap to provide the grounding input some kids crave. Even simpler: Some slightly heavy beanbags and a two play buckets can also be the start of carrying or tossing games.

Calm, Cuddly & Quiet
Think of items that can be used to build a kid-sized, quiet sensory space: sleeping bags, fun shaped or printed throw pillows, a play tent, an area rug with an unusual texture. A few items like this can turn a space in a child’s room or other living space into a favorite place to relax and regroup.

Treasure Hunt!
Fill a 16-ounce (or larger) plastic storage tote three-quarters full with dried red beans, available in bulk from the grocery store. Bury small toys–plastic dinosaurs, toy cars and the like–in the beans and dig for treausre. Throw in some beach toys for scooping. This is a favorite activity that OT’s have in their clinics, but it’s easy to replicate at home for not much money. Note: it’s a good idea to place a large blanket or bedsheet on the floor while playing with beans to catch any that come out of the tote.

Bright Lights, Big Colors
Lava lamps aren’t just for dorm rooms! Black-light or other colored lightbulbs, flashlights covered with cut-out cardboard silhouettes, and the old dorm-room standby lava lamp can be great for kids who seek visual stimulation. Likewise, items like aquarium lamps (which mimic the look of fish swimming in water) or glowsticks can be fun and, depending on the child, quite calming. Keep in mind that bigger items like lava lamps are often made of glass and can get hot, so choose light-up items with the child’s particular situation in mind.

Swing, Swing, Swing!
Most kids love to swing, and it provides valuable input into the vestibular system located in the inner ear. For families who have an outdoor swing-set, it’s easy to make a stretchy hammock from six or nine yards of heavy-duty lycra spandex material, ususally available at fabric stores. With a couple large carabiners from an outdoor store, the fabric can be tied into a large loop and suspended from the existing outdoor swingset or between two large trees. For indoor use, we recommend a doorway swing support bar, which is available from therapy stores for under $100. Before setting up swings or other suspended equipment, talk with an OT for guidance on how to set up and play with a doorway swing safely.

While a doorway swing bar is not cheap, it can be extremely useful in places where weather prevents kids from going to outdoor playgrounds. Providing easy access to an indoor swing is good for kids who need intense vestibular input, and great for parents and caregivers who would prefer not to dash through the snow to an indoor playgym.

Speaking of playgyms, membership to an indoor play space is a great gift for kids with sensory needs. Some incorporate imaginative and physical play, while others cater specifically to gross-motor activities such as swinging, jumping, sliding and bouncing. Memberships can be extremely valuable not just because of the access to a safe play environment; members may also find they have more access to a wider variety of playtimes and activities.  At times these play places may be overstimulating for sensory sensitive children, so check with the child’s parents to see if this is a good match.

No matter what you choose, check with the child’s parent or occupational therapist for feedback before selecting and purchasing a sensory gift. Happy holidays from everyone at the Spiral Foundation at OTA-Watertown!

For more stories, info, resources, facts and tips, go to www.thespiralfoundation.org