iPads Giving a Voice to Children with Special Needs

I am obviously not a Speech-Language Pathologist, but I thought this article was fascinating.  I've worked with my share of nonverbal children and know how frustrated they can become when they can't communicate their desires, leading to tantrums and physical outbursts.  Sadly, I've also known many therapists who become frustrated as well and give up trying to work with them.  This technology will bring hope to so many families!

How an iPad can give a voice to special needs children

Hazards of Inactivity

It is still common thought that resting when one is ill or infirm is the best way to recover.  However, research has shown that activity is a better way to recover because people will be at less risk for comorbidities and will return to their prior level of function more quickly since they do not become so debilitated.

Here are some risks of prolonged inactivity:

• emotional and behavioral changes¹
• decreased intellectual capacity²
• altered sensation, vision, pain perception, and coordination³
• decreased bowel action, leading to constipation and diarrhea from fecal impaction⁴
• decreased ability to cough, leading to a greater risk of pneumonia⁵
• orthostatic hypotension⁶
• venous stasis⁷
• deep vein thrombosis⁷
• muscle atrophy⁸
• osteopenia⁹
• kidney stones¹⁰
• contractures¹¹
• pressure ulcers (AKA bed sores)¹²

 

While someone who is recovering from illness or surgery may not feel like getting up due to fatigue, pain, or general deconditioning, it is best to get them up, change their position, and get moving!  If they are unable to do so on their own, obtain a prescription for Physical Therapy so that the therapist can help them improve their level of physical functioning and provide education to family members and caregivers.

1.  Carek PJ, Laibstain SE, Carek SM (2011). Exercise for the treatment of depression and anxiety. Int J Psychiatry Med, 41(1): 15-28.
2. Ratey JJ, Loehr JE (2011). The positive impact of physical activity on cognition during adulthood: a review of underlying mechanisms, evidence and recommendations. Rev Neurosci, 22(2): 171-85.
3. Positioning in a Wheelchair: A Guide for Professional Caregivers of the Disabled Adult by Mayall and Desharnais. Slack, 1990.
4. Simren M (2002). Physical activity and the gastrointestinal tract. Eur J Gastroenterol Hepatol, 14(10): 1053-6.
5. Arora S, Flower O, Murray NP, Lee BB (2012). Respiratory care of patients with cervical spinal cord injury: a review. Crit Care Resusc, 14(1): 64-73. 
6.  Convertino VA (1992). Effects of exercise and inactivity on intravascular volume and cardiovascular control mechanisms. Acta Astronaut, 27: 123-9.
7.  Broderick BJ, O’Briain DE, Breen PP, Kearns SR, Olaighin G (2010). A pilot evaluation of a neuromuscular electrical stimulation (NMES) based methodology for the prevention of venous stasis during bed rest. Med Eng Phys, 32(4): 349-55.
8.  Coker RH, Wolfe RR (2012). Bedrest and sarcopenia. Curr Opin Clin Nutr Metab Care, 15(1): 7-11.
9.  Krolner B, Toft B (1983). Vertebral bone loss: an unheeded side effect of therapeutic bed rest. Clin Sci (Lond), 64(5): 537-40.
10.  Hwang TI, Hill K, Schneider V, Pak CY (1988). Effect of prolonged bedrest on the propensity for renal stone formation.  J Clin Endocrinol Metab, 66(1): 109-12.
11.  Brower RG (2009). Consequences of bed rest. Crit Care Med, 37(10 Suppl): S422-8.
12. McKinley WO, Jackson AB, Cardenas DD, DeVivo MJ (1999). Long-term medical complications after traumatic spinal cord injury: a regional model systems analysis. Arch Phys Med Rehabil, 80(11): 1402-10.

Melissa and Doug Giveaway!

I'm not huge on all those blog giveaways because they take so much time to enter!  But this one is easy to enter and you could win great toys from Melissa and Doug.  They're great learning toys and are pretty indestructible, considering my boys have had some of their trucks and puzzles for a few years now and haven't destroyed them yet.  So whether or not you enter the sweepstakes, check out their toys to find fun ways to work on fine motor skills, imaginative play, role-playing games, problem-solving...


All you need to do is go to their Facebook page, "like" it, and enter the sweepstakes!

2011 GIFT GUIDE - Gifts for Preschoolers

Preschoolers are such a fun group of kids to work with because their emerging language, cognitive, and social skills make it easier to play structured games and to teach them more advanced motor skills.  Here are some gift ideas for the special preschool-aged kids in your life who may need a little help with their gross motor skills:


Tricycle


A tricycle is always a milestone gift, so if you're not the child's parent, please ask if you can buy one.  Parents may be cherishing the special moment when they give their child their first tricycle and it would be a bummer to deny them that joy.


That being said, tricycles are great for strengthening, balance, coordination, and following directions.  My favorite is the Kettler.  They have many different colors and options, but all of them are very sturdily built and the push handle is very useful when teaching a kiddo how to propel the tricycle.  Kettlers cost a bit more than popular brands like Radio Flyer, but the quality is worth the price, especially if multiple kids will be using it.

Basketball Hoop


Basketball hoops are fun in general, but they also help kids learn to throw underhand, to throw with accuracy, and to tiptoe and jump to slam dunk.  We have the Fisher-Price Give Me Five Sports Center, which includes basketball, hockey, soccer, football, and baseball.  It may be discontinued, which is unfortunate because it's a great toy that "grows" with your child.  There are several kids' basketball hoops on the market, however, so you'll be able to find a suitable one.

Soccer Net


Soccer drills are a great way to help kids practice balance and kicking with accuracy.  You can make a goal out of something as simple as two plastic cups or cones, or you can get something like the Talk To Me Soccer Set, which gives auditory feedback when a child scores a goal.

From Head to Toe Game


Other than being just plain cute, this game is a fun way to help kids practice body awareness and balance as they stomp like elephants, wave their arms like monkeys, and bend like giraffes.

Trampoline with Support Bar

If your child is having difficulty jumping, try one of these fun trampolines!  The support bar allows children to bear some weight through their upper extremities so their lower extremities don't have to work so hard.  The bar also helps them to maintain balance.  These are also great for children who seek the sensory input from jumping and the bar will help them to remain safe and in control as they bounce.

Before shopping, don't forget to consider the trampoline's weight limits.  Some models also have removable bars.

This trampoline from Urban Rebouding is designed for adults, so it has a larger weight capacity.  The support bar is removable, but it a bit high for young children.  Another great feature is that the legs fold inward so that it stores flat.

How Children's 'Play' is Being Redefined

Here is an interesting article about how "play" is being redefined in schools:  How Children's 'Play' is Being Sneakily Redefined.  It seems as though people are forgetting that unstructured play helps children with their motor skills, communication skills, social skills, problem-solving skills, cognitive skills, emotional development...I could go on and on.  Parents, let your kids play!

A great resource is the Your Child At Play series.  This book series discusses the benefits of play, gives great ideas of how to play with your child, and reviews several different types of play. 

Using an Exercise Ball for Hypotonia

Written by the parents of a precious little boy with Down Syndrome: 4 Reasons you should use an exercise ball for hypotonia.  I couldn't have said it better myself!

2011 GIFT GUIDE - Gifts for Infants and Young Toddlers

The following are gift recommendations to help infants up to age 1 with their gross motor, fine motor, and cognitive skills development.  Please keep your own child's individual abilities in mind when you make your gift purchases -- though the age listed on the box may be the same as your child's age, you know your child best and can determine which toys will be most appropriate.  If you are unsure, please ask someone at the store, ask your child's therapist, and check product reviews online. 


The Biddy Belly

I reviewed this product in October and think it would make a cute gift that is both fun for baby and may give mom and dad some peace of mind.

Bebepod


There are a couple of seats like this on the market, but I personally like the Prince Lionheart Bebepod;the best.  It's easy to clean and can also be used for feeding if you don't have room for a high chair.  An added bonus: on the days when baby will not let mommy shower, it's easy to pop baby in the Bebepod and take a shower together!  The seat is not as contoured as the Bumbo Baby Seat, so it encourages baby to use his/her own muscles to sit up.  Another thing to keep in mind is that these seats only come up to mid-back, so if your child needs more trunk and neck support, he or she may have a difficult time using this seat at first. 

Remember, baby should always be supervised in the Bebepod and it should NEVER be put up on a table where baby can fall.

Balls, Balls, Balls


While infants are too young to engage in traditional ball play, it's beneficial to introduce balls to them once they are a few months old.  Just make sure that the balls in your home are too large to fit through a paper towel roll, to decrease the risk of choking.  Young infants can use balls to practice visual tracking, grasping, flinging, and functional mobility.  Smaller balls help with your child's flinging/throwing skills and larger balls help with your child's early ball rolling, corraling, catching, and kicking skills.  Here is a list of different types of balls to consider:

• Edushape Sensory Ball - These balls are great because their nubby outsides provide tactile stimulation to infants, encouraging them to grasp and explore them.  They're also great for children with visual impairments.  They also come in various sizes and shapes.

• Light Up Balls -If your child does not show interest in ball play, try a ball that lights up to attract his or her attention!  Since the balls light up upon impact, they provide visual feedback which makes flinging them fun.

• Balls with a Combination of Textures and Lights - These work well with children who have little to no interest in balls, have visual impairments, or have difficulties with textures.  The lights are often intriguing to children and though the texture may be aversive, they may be more apt to touch and feel this type of ball.

• Suction Cup Balls - These are fun to use when infants and young children are learning to throw.  Tape a target like a hula hoop or use dry erase markers to draw a target on a window or mirror and have your toddler practice throwing for accuracy.  They're light, so you shouldn't be in danger of breaking the glass.

Ring Stacker


I'm sure you wonder how a ring stacker can help a child with gross motor skills and I will get to that.  First, ring stackers help children develop fine motor skills as they try to place the rings onto the toy.  They also help with cognitive development as they problem-solve, sort by size, and identify colors.  I use ring stackers to help children practice walking.  I put the base on one side of the room and the rings on the other side of the room and have the child walk across the room to take the rings to the stacker.  I also use ring stackers to help children practice pulling to stand and squatting to putting the base on a table and the rings on the floor.  The child has to squat down or lower him/herself to pick up a ring, then stand back up again to place it on the stacker base.  My favorite ring stacker is the Fisher-Price Little Superstar Classical Stacker because it plays music and flashes lights when rings are stacked onto the base, which provides children with excellent positive reinforcement.

Convertible Push Toy


Convertible push toys are great because they're multifunctional and can be used for a relatively long period of time.  I really like the Playskool Walk N Ride because it can entertain children from infancy up until 2-3 years of age.  Infants can play with the spinners, roll it back and forth, and open and close the door on the front.  Older babies can use it as a push toy to practice walking with support.  Young toddlers can use it as a ride-on toy to help with balance and lower extremity strengthening.  Both my 9-month-old and 3-year old enjoy playing with it.  Ours stays indoors and has survived 3 very active boys.

Play Table


Though they can take up a bit of space, play tables are great because not only are they fun, but they help with pre-walking.  As your child plays with the various toys on the top, he or she will have to weight shift and cruise around the table.  The toys on top also help with fine motor and cognitive development.  If you purchase one similar to Alex Jr.'s My Busy Town, younger infants can enjoy it and practice upright sitting posture and trunk control as they play with the features on each side.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

I hope that this installment of my 2011 Gift Guide comes in handy for you!  Next week, look for my guide on gifts for toddlers and preschoolers.

PE and Extracurricular Activities for Children with Disabilities

Here's an interesting blog post about Children with Disabilities' Participation in PE and Extracurricular Activities from another pediatric therapy blog.


Some local resources for Special Needs PE and athletic activities are:

• Us Too Center for gymnastics, track, and tap dancing
• Karate For All for karate lessons taught by an Occupational Therapist
• Challenger Little League for baseball
• Shea Center for horseback riding
• Special Olympics Southern California for aquatics, track, basketball, bocce, golf, gymnastics, bowling, floor hockey, soccer, tennis, and volleyball
• The Achievers (Orange County branch of Disabled Sports USA) for skiing
• Casa Colina Outdoor Adventures for camping, fishing, dog sledding, hiking, kayaking, rock climbing, sailing, SCUBA, skiing, water skiing, and white water rafting

If anyone knows of any other programs that offer recreational activities for those with special needs, please add them in the comments.

2011 GIFT GUIDE - Gifts for New and Expectant Parents

As a parent, I want to start off by encouraging people to buy off the expectant parents' registry!  You never know what people already own and they typically register for things that they truly want and need.  That being said, if you need an idea for a gift, or want to know which registry item to buy, here are some ideas:

The Biddy Belly

I reviewed this product in October and think it would make a cute gift that is both fun for baby and may give mom and dad some peace of mind.

Bebepod


There are a couple of seats like this on the market, but I personally like the Prince Lionheart Bebepod;the best.  It's easy to clean and can also be used for feeding if you don't have room for a high chair.  An added bonus: on the days when baby will not let mommy shower, it's easy to pop baby in the Bebepod and take a shower together!  (I do this frequently with my very attached 8-month-old)  The seat is not as contoured as the Bumbo Baby Seat, so it encourages baby to use his/her own muscles to sit up.  Remember, baby should always be supervised in the Bebepod and it should NEVER be put up on a table where baby can fall.

Baby Carriers


I will preface this by saying please do not buy a forward-facing baby carrier!  It is not a natural position and creates poor body mechanics for both baby and parent. 


Good carriers to try are slings and soft structured carriers.  My favorite sling is the Hotslings Designer Pouch Style Baby Carrierbecause it's made of sturdy material and has a padded rail for baby's thighs.  Hotslings come sized, so you may need mom's measurements in order to get a perfect fit!  Other slings to consider are the Peanut Shell Baby Sling;and the Peanut Shell Adjustable Sling, whose material is a bit stretchier than the Hotsling.  If you're looking for a more affordable option, you can consider a Seven Sling, though the material is thinner than the Hotsling's.

 

As for soft-structured carriers, I am partial to mei tais myself, but also like the Ergo Baby Carrier, Beco Baby Carrier, and Boba Classic Baby Carrier.  All of these can be used for both front- and back-carry positions.  Mei Tais are Asian-inspired carriers that are tied on.  It looks a bit tricky, but it's easy once you've done it a couple of times.  Baby rests against the parent in a natural position and because they tie on, anyone can use it without having to make adjustments to the straps.  If you're looking to save money, the Infantino Ecosash Baby Carrier is a nice alternative and it is similar to both a Mei Tai and a soft structured carrier.

Over the Shoulder Bag

I admit, this isn't really something to help with a child's development, but Mom will have better body mechanics while carrying it because its weight is distributed across the body.  Plus, it can also be a real lifesaver when struggling to carry around a baby, a baby carrier, a diaper bag, and your purse.   Thirty-One Gifts carries a cute one called the Pop Crossbody for $49, the smaller version is the Organizing Shoulder Bag for $42.  If you need to carry larger items, try their Messenger Bag for $98.  I like Thirty-One's products because they are well-made, have cute prints and patterns, and can be personalized.

Pop Crossbody Purse

Organizing Shoulder Bag

Messenger Bag

Because it can be carried hands-free and cannot slip off of my shoulder while reaching, this type of purse is the only kind I will carry when I'm out and about with my kids!





~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

I hope that this installment of my 2011 Gift Guide comes in handy for you!  Next week, look for my guide on gifts for infants.

2011 GIFT GUIDE - Introduction

Around this time every year, parents ask me for suggestions for gifts to buy for their children and to suggest to their relatives.  I'm hoping that my gift guide will help out and give you some fun ideas.  Please check this blog weekly during the month of November for gift guides for all ages.

• My number one piece of advice is to start an online wish list for your child.  (I use amazon.com for my kids)  You know what your child already owns, would like, and would benefit from, so don't be afraid to make specific suggestions.  Make sure you fill out the comments section so that people know specifically why you want that gift for your child ("This would help my child with his balance"  or "My child struggles with ball play, so this would really help!")  People want to help out, so if they know that their gift will be put to good use, they will be more apt to buy it.  So if your mother-in-law asks what to buy your child for Christmas, you simply refer her to the wish list.  You can also email the wish list to your family and friends so that they won't have to ask.  If you have a friend or family member whose child participates in PT or OT, ask if they have a wish list before you buy a gift for their child. 

• My number two piece of advice is to try to find toys and games that can serve more than one purpose.  There are several reasons for this, the most obvious being getting the most bang for your buck.  Also, it helps reduce toy clutter and will (in theory) help get more use out of the toy since your child would be less apt to get bored with it.  A toy that operates on its own with the push of a button would not be nearly as beneficial for motor and cognitive development as one that requires some sort of skill or problem-solving to play with.

• My final piece of advice is to look beyond material gifts.  Swimming lessons are great for kids with ADHD, with low tone, with sensory processing disorder, and/or with decreased strength.  Gymnastics, karate, and dance lessons would also be great.  If your family likes the outdoors, consider an annual pass to your local Regional and State parks so that you can hike as often as you'd like.  (The OC Parks annual pass starts at $55.)  Tickets or annual passes to a children's museum would be great, too, since kids would be able to play and explore in a fun new environment.  Try Pretend City, Kidspace, or the La Habra Children's Museum.

Riding a pedal car at Pretend City

The rope web at KidSpace

The "construction" area at KidSpace

The baby room at KidSpace

Digging for fossils at the La Habra Children's Museum

For convenience, all of the gifts I recommend will be available for purchase on amazon.com (yay free shipping!).  You can also purchase great stuff at Lakeshore Learning Stores, Toys R Us/Babies R Us, Target, or other toy stores.

• Gift Guide for New and Expectant Parents
• Gift Guide for Infants and Young Toddlers
• Gift Guide for Preschoolers

Gross Motor Fall Fun!

Take advantage of the autumn weather and enjoy these fun fall activities with your child:

• Have your child help you rake leaves into a pile, then have a great time jumping in the pile
• People cook more this time of year, so have your child help you with the entire process: help push the shopping cart, help put groceries into the card, help carry groceries into the house, help put groceries away, help with child-friendly cooking tasks like stirring and pouring...
• Run into the wind for some weather-assisted resistance training
• Go on a walk in your community to enjoy the changing leaves, making sure you walk on sidewalks, on grass, on dirt, up and down curbs, etc.
• Participate in fall sports like football and hockey
• Turn on some music and have a Turkey Trot dance party

Most of all, have a great time spending quality time with your child!

Interview with Ellen Seidman

Here's a cute interview with a Mom of a child with special needs: Move Foward Monday: Ellen Seidman

Epilepsy Resource Fair

In observance of Epilepsy Awareness Month, the Epilepsy Alliance of Orange County will be hosting an Epilepsy Resource Fair on November 12 from 10-4 at CHOC. Admission is free! For more information and to register, please go to www.epilepsyalliance.org.

Representatives from community assistance organizations will be present to provide free resources, referrals and information, as well as vendors of products and services of interest to people with epilepsy. Short presentations on various topics related to epilepsy will be given throughout the day.

Presentations on Topics Related to Epilepsy:

• Beyond Medications: Epilepsy throughout Life (Diane Stein, M.D.) 12 pm
• Seizure Recognition and First Aid 1 pm
• Diastat® Training 2 pm
• Modified Atkins Diet for Adults 2 pm

Services Offered

I currently work primarily on a contract basis so that I can stay home during the day with my children. 


I have a contract with Regional Center of Orange County, so if you or someone you know is looking for in-home or community-based Physical Therapy for a child aged 0-3 with developmental delays, I can help you out!


I also have a contract with a private PT Clinic in Laguna Hills and am able to see children there.  The clinic accepts private pay or your insurance.


I also provide private pay physical therapy and can come to your home.  As an individual PT, I have not been able to get contracts with insurance companies, but I provide you with a super bill and a blank claim form so that you can bill your insurance.  My rates are negotiable and below the going rate of $125/hour.


If your child needs orthotics, I am qualified to fit him or her with off-the-shelf products from Cascade DAFO.

If you have any questions, please do not hesitate to ask!  I am also happy to give referrals to providers in Orange County who may be closer to where you live.