Building Connection without Demands

Embracing kids for who they are without placing a demand for a verbal response is so important to help kids feel connected. It gives them a sense of safety and belonging. Using low-demand connection-based phrases can help your child regulate and build confidence. These are especially helpful phrases to use after school or when your child is burned out. Here are some ideas:

 Connection-based phrase ideas for parents:

• “I love spending time with you”

• “I’m so happy to see you!”

• “I couldn't wait to pick you up from school today!”

• “You have great ideas!”

• “This family would not be the same without you.”

• “I’m so excited to spend time with you.”

• “I thought about you when you were at school today.”

• “I thought about you when I was grocery shopping today, I bought your favorite ____” 

• “I missed you today while you were at school”

• “I love it when you share your ideas with me”

• “Being around you is fun”

• “I love to watch you play”

• “I am so lucky to be your parent”

As parents, it's so hard to hold back our questions when it comes to what your child did at school and how they behaved. It’s totally normal as a parent to want to know if they listened to their teacher or if they got in trouble, but this really adds to the child’s stress and pressure (which is inevitable when you're having a hard time at school). Instead of asking questions about behavior or open-ended questions that are hard to answer, try some of these connection-based questions.

Connection-based questions for parents:

• What was something funny that happened at school today?

• Tell me something that made you happy today.

• What book did you read at circle time today?

• What did you play during recess?

• What was your favorite thing you learned today?

• Tell me something kind someone did today.

• What did you notice today at school that other people probably didn’t notice?

• Were you able to help someone today with a problem?

• What did you try hard at today?

Praise is a great way to build confidence in kids. Providing a variety of praise, especially praise that builds self-esteem, authenticity, and intrinsic motivation, is key. Here are some ideas:

Praise the STRATEGY:

◦ You found a really good way to do it!

◦ I didn't think of it that way

◦ I love how your mind works

Praise with SPECIFICITY:

◦ You really seem to understand multiplication

◦ I like how you organized your room

◦ I love the way you tell stories

Praise EFFORT:

◦ You worked hard on that

◦ I could tell that was important to you

◦ I notice you have been working on that

Every moment spent together, filled with connection-based phrases and thoughtful questions, allows children to blossom into their truest selves. The power of praise, through acknowledging their unique strategies, specific achievements, and unwavering effort, ignites children's and all people’s self-esteem and intrinsic motivation. 

Parenting is challenging, especially parenting neurodiverse children.  Your intentional parenting, embracing their individuality and celebrating the amazing progress they have already made, is helping your child become more confident, resilient, and full of boundless potential. 

Proprioceptive Input for Children

All of us learn about and comprehend the world through our senses. We see things, we touch things, we experience gravity, and we use our bodies to move around in it.  One of our seven senses that enables this is Proprioception.

Proprioception refers to the body's ability to sense movement within joints and joint position. This ability enables us to know where our limbs are in space without having to look.  

What is proprioceptive input and why does it matter?  

Proprioceptive input is the feedback received through any activity that requires effort from our muscles and joints,  providing the deep pressure that they require. “Heavy work” are activities that may involve pushing, pulling, lifting, weight-bearing, and compression of joints. These types of input carry messages from our proprioceptive receptors in our body to our brain, to help us feel grounded, know where our body is in space, coordinate our movements, exert an appropriate level of energy for various tasks,  self-regulate, sustain attention and focus throughout our day.  Every body requires a different amount of input, and some individuals struggling with motor planning, body awareness, self-regulation, and attention may require increased proprioceptive input for daily function.

How do I know if my child requires increased input? 

Requiring increased proprioceptive input can display itself in a variety of ways including, sensory seeking, poor coordination and motor planning, and poor balance.

Sensory-Seeking Behavior Examples

• Playing rough 

• Hitting, kicking or pushing 

• Chewing on objects 

• Jumping and crashing

• Enjoy being loud or engaging in loud tasks 

• Fidgeting, rocking, or seeking constant movement 

• Enjoy bear hugs, tight squeezes of are frequently in others' personal space

Poor Motor Planning and Coordination Examples

• Frequent falling 

• Difficulty coordinating movement during sports or exercises such as throwing, catching or hitting a ball, climbing, jumping jacks, hopping or running

• Difficulty tying shoes

Poor Core Stability and Balance Examples

• Frequent leaning (slumped at a desk, leaning on the wall)

• Propping head up on hand or arm while sitting 

• Laying on belly 

• Slouchy or lethargic appearance 

• Low muscle tone 

• Changing positioning frequently 

Proprioceptive input can be incorporated into daily routines or as part of a sensory diet for your child’s success.                                                                                                                   

our favorite ways to incorporate heavy work

Pushing and Pulling

• Push-ups - o the floor or against the wall

• Chair Push-ups

• Scoot to the very edge of your chair and hold on to the edge tightly with your hands. Adjust your position so your bottom is no longer on the seat and your feet are flat on the floor with a 90-degree bend in the knees. Use your arms to push up and down. 

• Push a heavy box or basket across the room or throughout the house

• Push a heavy medicine ball across the floor or as high as you can up the wall

• Push the doorway

• Stand in an open doorway. Put your hands against the frame and push outward as hard as you can. 

• Build a fort with heavy pillows, thick blankets, and chairs

• Moving heavy furniture around to create the fort is even better 

• Push the grocery cart while shopping

• Break down cardboard boxes (using mostly their hands)

• Rip stacks of unwanted mail in place of a shredder 

• Move the furniture

• Rearrange a room, or move the furniture to clean behind or underneath 

• Yard work: rake leaves, shovel snow, mow the lawn 

• Push or pull a wagon or wheelbarrow 

• Tug of war

• Vacuum the floor

• Mop the floor

Lifting and weight-bearing

• Carry a heavy backpack 

• Carry a stack of books 

• Carry a stack of plates to set the table 

• Carry a full laundry basket 

• Carry the grocery bags 

• Play catch with a weighted ball

• Play on the playground (monkey bars, rock climbing jungle gym) 

• Pour heavy items back and forth (jug of water or milk, rice, beans) 

• Climb a ladder

• Yoga

• Weighted exercises: squats, shoulder presses, or lunges etc. with a weighted ball 

• Carry buckets of water, sand, or dirt

• Take out the trash

• Water the plants with a full watering can 

Resistance and Compression of joints  

• Jump Rope

• Hopscotch 

• Go for a run or march/run in place

• Jump on a trampoline

• Stand on a vibration board 

• Animal walks 

• Jump and crash: Create a crash pad using sofa cushions, pillows, or a mattress and jump to crash into it

• Dig in a garden or pull weeds

• Water the outdoor plants by squeezing and holding the nozzle on the water hose 

• Go for a swim

• Stir a thick batter 

• Knead a thick dough 

• Pedal a bicycle

• Drink a thick beverage through a straw (milkshake/smoothie) 

• Drink from a suction or straw water bottle 

• Blow bubbles 

• Chew gum (if age appropriate) 

• Eat a chewy or crunchy snack 

Note: Activities providing the “compression of joints”, mentioned in this document are not to be confused with the “joint compression protocol”, which may only be administered through licensed professions. 

Ways to incorporate HEAVY WORK into your child’s day

School

• Arrive 15 minutes early to allow your child to play on the playground before school 

• Allow the child to assist the teacher to rearrange the room, and move furniture to set up for an activity or time on the mat 

• Collect the whole class’s lunches in a bucket or wagon and have the child carry them to and from the lunchroom. 

• Allow your child to take a straw or suction water bottle to school 

• Incorporate crunchy and chewy foods into your child’s lunch 

• Incorporate “built-in” movement breaks into the day. Include animal walks, chair push-ups, running in place, and yoga poses

• Have a few class plants, that your child can water with a full watering can, when they need a break 

• If allowed and not a distraction, allow your child to chew gum in school

• Pack your child’s backpack to be appropriately heavy for walking to and from school 

Note: Most children do not want to feel singled out when they require additional help in the classroom. Finding ways to seamlessly incorporate heavy work, like giving the child assigned tasks (ie: carrying the lunch bucket )  or incorporating the whole class during movement breaks are very beneficial. 

Home

• Create a daily chore list incorporating heavy work tasks. Including doing dishes, setting the table, taking out the trash, cleaning the floors, helping with laundry, and watering the plants. 

• Allow your child to help with cooking and baking by carrying heavy items to and from the fridge or pantry, stirring stews and batters, kneading, and rolling out dough

• Have your child help with gardening, weeding, or caring for indoor plants. Heavy work can be incorporated into repotting, watering, pulling weeds, digging, and harvesting vegetables. 

• Incorporate animal walks into daily routines. For example, during their morning routine, your child can do an animal walk from their bedroom to the bathroom, or from the bathroom to the breakfast table.

Play/Leisure

• Incorporate heavy work games into your family game night. Twister or, “do a move” Jenga are great options. Heavy work can be incorporated into most games easily (for example: every time you land on blue, you have to do 5 jumping jacks, then take your turn, or every time you roll a 3 or 5 you do 4 heavy ball slams) 

• Encourage lots of outside play:  digging, climbing, rolling, swimming, biking and building 

• Encourage participation in individual or team sports. Most, if not all sports or dance provide heavy work to muscles and joints 

Social Settings

• Have your child participate in heavy work tasks BEFORE social events when they need to be seated for a while. (church, weddings, school performances, concerts)  

• During prolonged seated events, incorporate movement breaks for your child in the hallway or in a separate area. These can include animal walks, jumping or jogging in place, wall pushups, or yoga stretches

• If appropriate, allow your child to chew gum during social events 

• Bring a container of theraputty for your child to squeeze and stretch during social events with prolonged sitting. 

• Sit towards the back at social events so that the child can easily exit for his or her movement breaks

• Bring chewy snacks (if eating is permitted) during your outing along with a straw or suction water bottle for your child. 

As you try these activities with your child or student, it is important to note which activities calm them, arouse them, or over arouse them. It is very unique to each individual.  You’ll also want to pay attention to the intensity, duration and frequency of each type of proprioceptive input.

Sensory integration is something most of us do automatically.  All of the sensory input from the environment and from inside our bodies works together seamlessly so we know what's going on, what to do and how to behave appropriately in response to what's going on.  For children with Sensory Processing Disorder, Autism, ADD, ADHD, proprioceptive input & sensory input does not hook up seamlessly with all of the other senses.  They can find it difficult to process and act upon information received through the senses, which creates challenges in performing countless everyday tasks.

We hope the ideas in this blog post will help you add proprioceptive input into your child or student’s day & that it helps their self-regulation.  

Children At Play offers workshops for preschool & elementary teachers about the sensory integration approach for classrooms. 

Zones of Regulation in Occupational Therapy for Kids

The “Zones of Regulation” are used in classrooms, by occupational therapists, school counselors & more.   They were developed by an OT, Leah M. Kuypers, MA Ed. OTR/L, and they are a visual & concrete approach for children to learn about feelings.  

At Children At Play, we choose to use the Zones of Regulation as a teaching tool because:

• The program is NEUTRAL and doesn’t project judgment of emotions→ No Zone is labeled as “good” or “bad.” Everyone has feelings, and that is OK!

• Promotes a feelings-awareness including body cues, trigger awareness, and development of self-regulation, sensory strategies, and calming strategies.

• Children will often encounter it in other places & the zone language is known by a lot of adults which will help the child’s communication be understood.

There are 4 Colored Zones for self-awareness and triggers for the different states of arousal:

1) Blue Zone: Describes a low state of alertness; sad, tired, sick. When one’s body/brain is moving slowly, and might need more rest breaks

2) Green Zone: Describes a regulated state of alertness, when one’s body feels “just right;” we are ready to listen and learn. Calm, happy, focused, proud, comfortable, relaxed. (This is the Zone we practice sensory/calming strategies in.)

3) Yellow Zone: Describes a heightened state of alertness, with slightly elevated emotions/states. We begin to feel like we could lose control of our bodies. Stress, frustrated, overwhelmed, worried/anxious, over-silliness, nervousness, wiggly, sensory seeking. This is the zone that we need to pick a strategy.

4) Red Zone: Describes extremely heightened states of alertness or very intense feelings. Out of control, angry, furious, upset. We might yell or throw toys, our heart beats fast, and our muscles get tight. We likely need an adult to help us calm down.

At our clinic, our occupational therapists implement & modify the program to be “the just right” fit making the presentation of information appropriate for different levels of learners. The information is always neuro-diversity affirming.  We also like to add sensory components to feelings education for further integration and expansion of concepts. Feelings are felt and discussed while swinging, tactile play, sorting activities, and more. 

The Zones of Regulation help children gain skills in the area of self-regulation.  They said it wonderfully: “Self-regulation can go by many names, such as self-control, self-management, and impulse control. It is defined as the best state of alertness of both the body and emotions for a specific situation. For example, when a student plays on the playground or in a competitive game, it is beneficial to have a higher state of alertness. However, that same state would not be appropriate in the library. The lessons and learning activities are designed to help the students recognize when they are in the different Zones as well as learn how to use strategies to change or stay in the Zone they are in. In addition to addressing self-regulation, the students will gain an increased vocabulary of emotional terms, skills in reading other people’s facial expressions, perspective about how others see and react to their behavior, insight into events that trigger their behavior, calming and alerting strategies, and problem-solving skills.” - from the Zones of Regulation Website

Because colors are so effective at helping children understand feelings there are many common resources, many of which have slightly different color schemes.  Red is always angry, Blue is usually sad, but after that, the colors are less consistent.  Happy, calm, fear, love are all represented differently in different books, programs and resources.  We always use Zones of Regulation, but if your child confuses the colors someone may have just read them the “Color Monster” or the “Crayon’s Book of Feelings.”  

If you’d like to learn even more about the Zones of Regulation you can read their one-page explanation here,  or check out the Zones of Regulation Website.   To learn about the specifics for implementing the Zones of Regulation, click here to contact us.

What to Expect at your Occupational Therapy Consultation

Welcome to our clinic! We are so glad you are here!

ARRIVING

You can park anywhere in the building’s parking lot. Parking is free. We are on the 2nd floor. You can walk up the stairs or take the elevator in the middle of the building. We are located on the right, backside of the building in both suites 207 & 209.

Ms. Sam and another therapist will be waiting for you in the lobby of Suite 207.

Did you arrive early? 

There is lots to do in our waiting area! We have games, toys & children’s books. Parents are welcome to enjoy our bookcase with a variety of books and magazines about parenting, occupational therapy, the sensory system, and some lighter reading. 

Hello & The Tour 

After everyone is introduced, the tour will begin!  We will ask you and your child to remove your shoes for the tour or to avoid walking on the mats. Kids roll, lay and play on our very high-quality padded mats, it is important to us to keep them very clean. Plus, let’s be honest, “no shoes” is always more fun!

Children At Play has 4 play gyms, 2 restrooms, and 1 kitchenette. 

Play gym two is our largest gym with a suspended obstacle course that we reconfigure every week.
Play gym one is the best space for swinging, crafts, games, and grounded obstacle courses.
Play gym three is set up for our younger and shorter friends to get their just-right challenge with lots of open space; perfect for games, motor skill fun & sensory play.
Play gym four is in our second suite, 209, making it a more private & quiet play gym. It has a large open space ideal for gross motor challenges and social groups.

We will let them explore a bit during the tour with the promise that after the tour they will get to play even more!

Play Gym 4 is where you will get to spend your time during your first appointment!

Assessment and Interview 

After the tour, your child will get to play in gym #4 with a therapist who will guide them through an array of age-appropriate activities designed to evaluate their balance, coordination, fine motor skills, dexterity, ability to plan and organize their movement, reflexes, and ability to follow directions. For example, through a fun craft, we will assess a variety of fine motor skills. Gross motor skills can be assessed as they play on the obstacle course. Emotional regulation will be assessed during a game.

While your child plays, you will be in the office with Ms. Sam discussing your child’s strengths and challenges and your concerns. There is a large glass window connecting the office & the gym so you will be able to see your child while we are talking.

Prior to your appointment, you will be given documents to complete, to help us learn about your child. On the documents, we ask detailed questions about your child’s medical history, motor skills, sensory processing, eating habits, hygiene routines, sleep, emotional regulation, social interactions, and their likes/dislikes for activities involving movement and touch. We will be reviewing those documents together and may ask for additional details. Please feel free to bring your own list of concerns and questions. This is your time to tell us about your child and your family’s concerns & needs. We are very aware that no form can capture all the uniqueness of a child, so please know we are open to talking about everything you want to discuss.

Finally, Ms. Sam will review your child’s assessment with the other therapist for a few minutes. (Many parents use this time for a bathroom or coffee break.) Then Ms. Sam will make a recommendation for the best plan of treatment for your child.  

Some of the fun that we have during our therapy appointments.

FAQ:

How DO YOU RECOMMEND I TELL to MY child about THE upcoming Consultation:

Every child who comes to our clinic is so different and has a vast variety of strengths and weaknesses. Generally, when children at here for their first appointment we tell them they are here to “play and see how their bodies work.” We want to see how strong they are and what types of things they like to do. You can use our website, Instagram, or Facebook to show your child pictures of different activities and equipment that we use in our clinic.

Our main goal for this first appointment (and every appointment) is for kids to have fun and want to come back! So let us know if there is something we can do to make this better for your family. Our appointments are fun— and we aim for every child to enjoy their time here!

How should i prepare MY CHILD for the OT Consultation?

You can prepare your child for the consultation by letting them know what to expect: they will meet a couple of therapists, take a tour of a play gym, and then they will get to play and explore the kid’s gym. Let them know that after the tour they will play with the therapist while you and the adults talk separately.

Do I need to Bring Anything to the OT Consultation?

You do not need to bring anything with you but your child. We will have your New Patient Forms that you completed online at least 48 hours before your consultation. If you’d like, you are welcome to bring any additional assessments that you feel give an accurate picture of your child or a list of your questions and concerns that you want to make sure get discussed.

What should my child wear?

Your child should wear anything that they are comfortable moving in! They may be hanging from bars, getting on their hands and knees, jumping, and swinging in all different directions! Restrictive clothing like tight jeans will not allow us to see the child’s full range of motion and movement patterns properly. Shoes don’t matter because they will be taking them off.

If you have any questions that we didn’t answer here, please email us. (That’s where the FAQ section came from!) Our appointments are always flexible and we will do what works for your child. We want you and your child to be comfortable. Sometimes this means everyone staying in the same room, not doing any assessment during the first appointment, cutting our appointment short, or meeting you at the car for your consultation. We meet our families where they are and grow from there.

Sensory Adventurers Social Groups

Our Sensory Adventurers social groups for toddlers & preschoolers will be offered Tuesdays & Fridays from 11a-noon starting in September. The activities will be tailored to the needs of the children each week but will include obstacles courses, (gross motor skills) games, (turn-taking & sharing) messy crafts (fine motor skills & tactile defensiveness) & so much more!

Call or email for specifics & to see if your child is a good fit for these groups.

OT Dressing tips, tricks and fun ways to practice!

ReCap on dressing

This month our OT focus was dressing— and boy did we have a lot of fun with it! A child’s ability to dress gives us a lot of information about their foundational skills. Dressing requires motor planning, balance, body awareness postural control, and fine motor skills. Independence with self-care helps kids feel independent and confident in their abilities.

Tips for working on dressing at home

1. Start with undressing

2. Dress and undress in front of a mirror

3. Play dress-up

4. Save practicing for bedtime (and have enough time so that you are not in a rush)

5. Practice putting on and taking off slippers

6. Have your child wash themselves in the bath- to help with body awareness

7. Caterpillar Laces- to help with shoe tying.

Tips for working on dressing in the clinic

1. Using loops of lycra, Thera-band, or pop tubes- to put on like pants or overhead like a shirt

2. Using rubber bands or scrunchies to practice socks.

3. Button and Snap chains (like these)

4. Large ropes, caterpillar laces, different color laces to practice and learn shoe tying.

5. Practicing getting in and out of a body sock.

School At Home

Whether your family is doing virtual school or homeschooling, here are some best practices from Occupational Therapy that can reduce unnecessary challenges for your kid and help them focus on meeting their potential.  

Learning Space
Schools and OT gyms have furniture that fits the size of the child.  At home, we tend to have furniture that fits adults.  For kids, trying to work in a space that is too big can cause lots of squirming and wiggles and promote poor posture that impacts their handwriting.  The obvious but most expensive solution is to get a table and chair that fits your kid.  You can also give them a clipboard and have them sit on the floor with their back against the wall or sit at a coffee table on a pillow. Or do all of these because one of the benefits of learning at home is that your child will be able to change positions frequently!  

Look for:
-feet flat on the floor or grounded on a step-stool, footrest, stack of books, etc.
-back rests on the back of the chair (use a pillow if the chair is too big!)
-knees & hips are bent at 90-degrees

A lot of kids transition better when there is a dedicated space for schoolwork.  They know when they are in the space, it is time for learning.  Your workspace should ideally be well defined, well lit, free of distractions, and have ready access to all the supplies needed.  

If you don't have the ability to make a dedicated space here are some creative ideas:
-use tape on the floor to give a visual clue of where to stay
-use a special school time only placemat
-use a rolling cart with all the supplies that only comes out during school time

Suggested Supplies
Pipsqueak Markers
The smaller size allows less room for mistake and awkward grasp patterns.
https://www.amazon.com/Crayola-58-8146-16-count-Pip-squeaks-Markers/dp/B0015IN0XK/ref=sr_1_7

Scissors
Small, lightweight, and with an easy squeeze these training scissors work well for preschoolers & for building confidence while developing fine motor skills.
https://www.amazon.com/dp/B07R6R8RFQ/ref=cm_sw_r_sms_api_i_BqrwFb367X5PZ

Short Pencils
Short sharpened pencils with erasers - are a very easy way to minimize mistakes with grip and allow for more pencil control for small hands.   
https://www.amazon.com/Madisi-Pencils-Eraser-Pre-Sharpened-Count/dp/B07HFQFF72/ref=sr_1_2_sspa

Slant Board
Using a slant board helps kids for a variety of reasons-- but mostly it puts the wrist/hand in an optimal position for writing-- and helps reduce visual fatigue.
https://www.amazon.com/Superficie-para-%C3%B3ptimo-aprendizaje-escritorio-portapapeles/dp/B01BZI4BU0/ref=sxts_sxwds-bia-wc-p13n1_0

This year is going to be challenging in new ways for all of us.  If your child has difficulty paying attention, sitting still, staying focused, or getting upset easily, OT has the potential to help.  We can work with you and your child to set up a program to meet your child's needs either through OT sessions in person or via telehealth consultations. 

SIPT certification training

Mrs. Sam spent Thursday-Monday in Los Angeles at the University of Southern California completing course 2 of 4 of the Sensory Integration and Praxis Tests (SIPT) training. The SIPT measures the sensory processes that underlie learning and behavior. It is a great tool for guiding therapy and determining the specific underlying sensory processes that are affected in children. The SIPT is standardized for children 4 years to 8 years, 11 months. In August, after two more trips to LA, Mrs. Sam will be certified to give the SIPT :)

During Mrs. Sam's time in LA, she was able to tour Pediatric Therapy Network (PTN) and the building where Jean Ayres pioneered sensory integration therapy over 40 years ago. Seeing a part of OT history was truly amazing. 

Children at Play is a firm believer in continued education and staying current on research and techniques to best help our clients. Mrs. Sam can't wait to get back and use all of her new information and knowledge to continue to help the kids! 

King of Swings workshop

Last Sunday, I attended a wonderful hands-on workshop in Stafford, VA at Helping Hands, Inc. It was a great course focused on occupational therapy interventions for helping with sensory processing. In true OT fashion, the course was completely hands on, and we all sat on the floor and observed, demonstrated, and tried out various interventions. 

Alex demonstrating the use of 2-pointed swinging with a bungee for increased prone extension, motor planning, and coordination. 

Workshops are such a great opportunity to learn new things and get the creative juices flowing. Thanks to Alex Lopiccolo & Helping Hands, Inc. for making this workshop happen.

This week I had the opportunity to try out some of these new ideas and interventions and the kids absolutely had a blast. 

Crawling over therapy balls to increase postural control, stability, motor planning and provide proprioceptive and deep pressure tactile input for self-regulation. 

View fullsize

Using bungees with the harness to provide intense vestibular and proprioceptive input for self-regulation-- its also a ton of fun :)

Swinging while maintaining flexion under the bolster swing to increase core strength, motor planning, timing and provide intense vestibular stimulation. 

Children at Play Presents in Howard County

This week Children at Play had the pleasure of presenting about sensory integration and home solutions for parents of 3-5 year olds in the Howard County Public School System. It was such a great experience getting to speak in an intimate setting with parents. We reviewed information on the tactile, proprioceptive, and vestibular system- and how they impact the nervous system. We focused on activities and techniques that parents could use at home. For me, the best part was a 45 minute discussion of real life behaviors and problems that parents experience, with practical solutions to make children more successful and comfortable in home and school settings. Looking forward to doing more parent education sessions in the future!