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June, 2011:

Useful Equipment


List Price:
Price:

Therapy Balls
Therapy Balls are really useful for balance and strengthening shoulders. They can be used for rolling over and doing push ups, also for being squished. To get the right measurement for your child measure from arm pit to wrist and this should be correct. Many children improve with their handwriting by playing on the balls.





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Weighted blankets
Weighted blankets can be perfect for helping children sleep through the night, they provide extra deep pressure which is comforting and stimulates proprioception. Many children will use them as a comfort wrapped them when watching tv and relaxing. They can help calm an overanxious child. Some parents say it is the first good night’s sleep they have had ever!!!(both child and parent)





List Price:
Price: £199.99
“Cosy weighted blanket” by Carol Stock Kranowitz

Imagine the warmest coziest robe or towel you have ever felt, combined with the soothing hug of a loved one. This weighted blanket provides the input for a child who has poor sleep patterns and who crave and seek proprioception input.





 


List Price: £23.99
Price: £18.46

mov’n sit cushion
These fidget cushions are fantastic for children who cannot sit still in class or assembly. They can use them sitting on a chair or the floor. It enables the child to move and satisfy their vestibular sense. Especially good for hyperactive children. Some parents have noted how long their active child sits during assessment when using one. Can also be used at home for mealtimes. Allowing the child to move frees up their ability to concentrate better otherwise they have to work hard at not fidgeting.





List Price:
Price: £29.99

Lycra resistance band
Resistance bands can be a fantastic way to calm down. Tying them around table or desk legs to pull against while sitting and listening can help. Pulling (tug of war) type games can also be fun. Be careful not to let them spring back in your face though.





List Price:
Price: £59.99

sensory seekers combo kit
Quick easy ready made sensory box to meet your child’s oral and tactile needs. A brilliant resource to have in all households and classrooms will benefit sensory seeking children. Teachers may sometimes think this may be distracting but infact will have more focused alert pupils.





List Price:
Price: £12.37

looped scissors
Easy to use looped scissors for children who find accuracy with normal scissors too difficult. Children achieve success and neatness with these. A must for those who struggle.





List Price:
Price: £1.05

looped scissors
Great pencil grips for children who grip their pencils too hard and get sore hands from writing. These allow the child to place fingers in the correct position. Excellent.




Chew’lery from Special.direct.com
Chew’lery is a great way to keep kids from chewing on their clothes, while letting them work through their chewing tendencies.

It’s also great for oral-motor stimulating activities.

Use with adult supervision. Non-toxic, colourful, plastic jewellery that ‘stretches’.

Handwriting Without Tears. HWT.com
Go onto this site for some useful downloads about handwriting and information for parents, teachers, therapists. An excellent resource.

organisation skills ideas

Therapy Space Handout.

COPING STRATEGIES TO IMPROVE ORGANISATIONAL SKILLS  useful for all neurodiversity conditions

FACT SHEET

Timers – use an egg timer when working on a piece of homework, and set it every fifteen minutes to remind the child what this ‘feels’ like.  A timer in the shower or bathroom set for ten minutes will act as a reminder that their time is up.

Digital watch – these are often easier to read than a traditional watch and can be set to alarm at certain times to remind the teenager to complete a certain activity.

Buzzer key reminders – there are all sorts of reminder key rings and pens available that can remind you at certain times.  There is a pen with a rewinding tape and a key ring that can record about 15 seconds of tape.  They can be useful in just saying ” remember the German book” for example, and can be played back at home to check the books back in to the bag to go back to school as well.

 

Laminated timetable – this can be put in the child’s room to remind them to get out the appropriate clothes and sports kit for the following day.  Another copy can be on the inside of their school bag and a third one in their locker acting as a reminder at key points.  If you can get this before the child moves to the school this also acts to prepare them for the change.

Key on a chain – losing your locker key is a problem when it happens more than once.  Putting in on a string around the child’s neck may be dangerous.  Using a key ring on a plastic ‘curly’ chain means it is where he will need it.  If the trousers don’t have a belt loop, sew a piece of tape inside a pocket for the key ring to be attached.

Mentor or buddy – a new school day is very stressful.  A buddy that knows their way around can make all the difference.  They can take them from class to class.  They can also remind them to check their books into their bags at the end of the day and also help them to make sure they have the correct equipment for each class.  This can be a problem if the other children think that the child is having extra help all the time, and it does need to be handled sensitively to make sure the child doesn’t n become bullied as a consequence.  An older child as a mentor, perhaps someone in the sixth form, can be very supportive.  The sixth former can talk to the class teacher if there are problems, whereas the child may be reluctant to do so, especially if they are new to the school.

 

Appropriate clothing – labelled, and in drawers that are labelled -at home make sure the child is well prepared for the day.  Drawers should be ordered and labelled in a way that makes it easier and logical to find clothes.  The child should be part of the process of organising this, as this will reinforce for him, where items are.

 

Pencil case – use a clear plastic pencil case where the objects can be seen from the outside.  A list of the contents can then be stapled on the inside, but facing the outside of the case.  At the end of the lesson all the items can be checked back into the case.  This reduces the chances of losing items.  The pencil case should contain the bare minimum to get through the school day (less to drop etc.).

 

Use a ruler with a ridge – or an architects metal ruler with a handle, as this will make it easier to place the ruler on the paper.  Place Dycem on the end of the ruler so it grips to the paper.

 

A selection of pens – and pencils with and without grips should be tried out to see what suits the child.  There are some pens with a rubber area to grip on to, that can be quite comfortable.  The child with ligamentous laxity may find that a gripper makes it harder not easier.

 

Make sure there is a spare set – of all equipment at home which stays there, so that the school pencil case can stay in the child’s bag ready for the following day.

 

Use scissors – that are the appropriate size for the child and if they are left handed, get left handed scissors.  If the child cannot use scissors well, think about using artists cutters or dressmakers scissors (Peta roll cut scissors) which may be easier to manipulate or even battery operated scissors.

 

Have a homework diary/message book – that can be checked in and out with the timetable clearly written on the inside cover.  Have another book for difficult to spell words, tables etc.  Break tables down into small steps.

 

Money – buy a purse belt or round the neck travel wallet.

 

Keep work tidy – have plastic folders for work sheets.

 

Forgetting things – use post it notes or other visual cues.

 

Homework – have a phone number of a helpful friend for queries.  Agree level of help with school.  Use alternate lines if work will have many errors (white space improves presentation).  Allow 15 minutes to unwind after homework, before giving any instructions (e.g. drink, snack, bath, music or video).

 

Problem solving use the 4 point plan – to encourage confidence to think through situations and problem solve independently.

–          What is the problem/what am I supposed to do?

–          What is my plan/how can I do it?

–          Am I using my plan?

–          How did I do?

Problem solving with help – task analysis – when faced with a situation that cannot be worked through independently, following the task analysis format with another person.  This structures the external help and provides opportunities for independence.

–          Name the task.

–          Break down the task into small steps.

–          Write down the steps onto cue cards.

–          Read through the steps aloud.

–          Practice the task using the cards as visual prompts.

–          Talk through each step as you go.

–          Any feedback?  What went well/could have been better?

–          Use as form of checklist.

 

Temper outbursts – work on temper reducing activities, have a selection planned in advance e.g.

–          Go swimming, play in the park, provide food, drink, cuddle, T.V. punch bag, drawing, music, time alone to cool down.

–          A small favourite toy on string pinned to the inside of pocket can be reassuring and calming.  Count to ten.

Traffic light codes –  Aim –

–          To help with expression of views at the time of an incident.  Use of the traffic light code can enable him/her to instantly make his/her feelings known regarding a given situation.

–          Red – I’m very cross

–          Amber – I’m not happy

–          Green – Everything is O.K.

 

Expressing him/her self appropriately

–          Emotional confrontation – use of the DESC script could help order his/her thoughts and feelings in certain situations.

–          D – describe the problem

–          E – explain why and include your emotions

–          S – say what you want to happen

–          C – give the consequence and conclusion

–          (the script can be quickly rehearsed on the spot and the acronyms used as prompts).

 

Rewards – Have a system of rewards planned.

–          Your attention

–          A joint activity.

–          Do not underestimate the value of a cuddle.

 

Communication – Speak in the positive

–          “Hold the scissors by the closed blades”, rather than “don’t hold the scissors like that”.

–          Say what answer you would have liked to have heard e.g. “Yes Mum I’d love to clear the table”.

for further information and ideas call Linda Plowden OT 07814 633926

 

 

Tactile sensory system

 

THE TACTILE SYSTEM

Definition:

¨       We get tactile information through sensory receptors located in the skin.

¨       The tactile system provides us with information about touch sensations: pressure, vibration, movement, temperature and pain.

¨       The tactile sense is made up of two components: the protective (or defensive) system and the discriminative system.

 

Why is the processing of tactile information important?

¨       The tactile sense or sense of touch is a huge sensory system that gives us information needed for visual perception, motor planning, body awareness, academic learning social skills and emotional security.

¨       The function of the protective / defensive system is to alert us to potentially harmful stimuli. We need it for survival. The receptors for this system are in the skin, particularly the hairy skin on the head and genitals. Light touch is the stimulus that causes the receptors to respond.

¨       The function of the discriminative system is to tell us what we are touching / where on our bodies it is touching us, and the properties of that touch, i.e. size, shape, texture, temperature and whether the touch is light or deep. The receptors for this system are found in the skin, especially of the hands and fingers, soles of the feet and the mouth and tongue.

¨       As an infant develops into childhood, the discriminative system suppresses the protective / defensive system, although not completely. Both systems work together to enable us to interpret tactile information throughout our lives.

¨       Tactile dysfunction is the inefficient processing in the central nervous system of the sensations perceived through the skin.

 

Functional Implications:

Over-responsive to touch: Tactile Defensiveness  /Hypersensitivity:

¨       Child has a tendency to react negatively and emotionally to unexpected, light touch sensations

¨       May dislike having hair washed and brushed and nails cut

¨       May display hostility / or withdraw from situations requiring lots of tactile input: i.e. getting dressed, in the playground

¨       Overreaction to physically painful experiences: make a “big deal” about a minor scrape

¨       Fuss about clothing, such as stiff new clothes, shirt collars, elasticated waists, hats and scarves. May prefer short sleeves and shorts, even in winter to avoid the sensation of clothes rubbing on the skin / OR prefer long sleeves even in summer to avoid having skin exposed

¨       Avoidance of messy play activities i.e. finger painting, clay, sand and water play / fastidious about washing every bit of dirt from hands

¨       Excessive ticklishness / avoidance of kisses preferring hugs

¨       Seeks out deep pressure sensations which are easier to process and can be calming and organising

Under-responsive to touch: Hyposensitivity: (i.e. The child who is not processing enough movement information)

¨       Craves extra stimulation and is constantly touching objects and people

¨       May show no reaction to pain from scrapes, bruises, cuts or injections

¨       May be unaware of messiness around the mouth / nose: may not notice a runny nose

¨       May hurt other children or pets during play, seemingly without remorse but actually not understanding the pain that others feel

¨       May drop things without realising

Poor tactile discrimination (i.e. The child’s brain does not register information about how things feel)

¨       Difficulties using tactile sense for complicated purposes like learning at school

¨       Child may be unable to identify which body parts have been touched without looking

¨       May be afraid of the dark

¨       May be a messy dresser i.e. twisted waistbands, shoes untied etc.

¨       May be a messy eater

¨       Difficulties with tool use: i.e. cutlery, scissors, pencils, paintbrush etc.

¨       May avoid initiating tactile experiences i.e. picking up tools / toys

N.B Remember: your child may be both HYPERSENSITIVE and HYPOSENSITIVE, i.e. s/he may be extremely sensitive to light touch, moving away from a light tap on the shoulder, but indifferent to the deep pain of an injection.

Strategies to Help Improve the processing of Tactile information:

1.     Where possible, avoid surprising your child with unexpected light touch sensations i.e. brushing past them, approaching from behind and touching them.

2.     At school, make sure that your child is not sitting at the end of a the desk next to the main walk way in the classroom, so as to reduce the likelihood of unexpected light touch.

3.     Provide opportunities for your child to experience deep pressure sensations as these help to suppress sensitivity to light touch sensations. Deep pressure can be provided by a bear hug, being rolled up and squashed in a duvet, through rough and tumble play, massage, press-ups etc. Any activity that provides pressure to the joints can be very calming and may help prepare your child for a difficult light touch activity, i.e. hair washing / tooth brushing.

4.     Use sheets on the bed that can be tucked in tightly to make your child feel secure. Some children feel safer sleeping on their beds in a sleeping bag

5.     Brushing with a surgical brush (ask your Occupational Therapist for advice on this technique) can help to reduce your child’s sensitivity.

 

Activities to reduce Tactile Defensiveness:

  • When directing a movement – use firm touch.  Firm pressure can help reduce tone, calm and organise a child’s movements.
  • Avoid light brushing or intermittent light touches.
  • Give verbal cues to prepare a child.
  • Sometimes activities that emphasise joint compression (e.g.. jumping, dangling, pushing, pulling, weight bearing) may help.  Heavy muscle work often reduces sensory defensiveness.
  • Use a variety of texture experiences on the skin.  Start dry and progress – wet materials, e.g. sand, rice, pasta, packaging foam.
  • Small toys hidden in a bucket full of paper / sawdust / material for the child to find.
  • Activities that involve all over body pressure; pretend the child is being painted with a paint roller or get him/her to roll him/herself up in a rug, sheet, etc.
  • Brushes and scourers (not too rough) are useful to have in and out of the bath e.g. nailbrushes, paint, scrubbing and cosmetic brushes.
  • Playdoh – for rolling, patting, poking and modelling.
  • Outdoor play – encourage swinging on a tyre or swing – try on tummy pushing with legs.
  • Play catch and throw with weighted materials, e.g. Beanbags, heavy padded balls.
  • Wet activities – body painting
  • hand lotion / shaving foam on mirror or tray.  Also include cleaning as part of activity
  • When completing puzzles and activities indoors try getting your child to work on their tummies with elbow support
  • Cooking / baking activities involving handling ingredients and experiencing different textures
  • Gardening activities: planting / watering seeds: handling soil etc.
  • Self care activities: Hand washing – Try using liquid soap and a nailbrush.
  • Bath times – Encourage use of different textured bath mitts to wash parts of body.  Afterwards, firmly rub down with a thick terry towel.
  • Encourage the child to rub hands and body with lotion.

 

Vestibular sensory system

THE VESTIBULAR SYSTEM

Definition:

¨       The vestibular system is the most sensitive and one of the most important sense organs. It is stimulated by movement of fluid in the structures of the inner ear, in response to movement by the head.

¨       The vestibular system provides us with information about where our body is in space and whether the movement is up, down, fast, slow or angular.

¨       Even when our eyes are closed we know the position of our head. The vestibular system also allows us to keep our balance with our eyes closed.

 

Why is the processing of vestibular information important?

¨       Input to the vestibular system is important for regulating muscle tone, joint stability, bilateral integration, spatial awareness, eye movements and balance and equilibrium mechanisms. These all affect our ability to maintain good sitting posture i.e. at a desk.

¨       Good postural stability serves as a basis for fine motor control (i.e. handwriting).

¨       The vestibular system sends information to the part of the brain that regulates attention and arousal levels. It also provides a calming effect (i.e. gentle rocking)

¨       The vestibular system ‘talks’ to every other system and is closely linked to the proprioceptive system.

 

Functional Implications:

Over-responsive vestibular system: (i.e. The child who perceives too much movement information)

¨       Gravitational insecurity: excessive fear of falling / of heights / and of feet leaving the ground

¨       Overly frightened by movement / dislikes playground activities

¨       Difficulty mastering environmental obstacles such as stairs or uneven terrain

¨       Intolerance or adverse reactions to movement, motion sickness, nausea, giddiness

Under-responsive vestibular system: (i.e. The child who is not processing enough movement information)

¨       Craves movement, swinging, rocking

¨       Moves excessively, using momentum to compensate for poor balance reactions

¨       Does not get dizzy until they have had an enormous amount of movement

¨       Poor bilateral integration and co-ordination

 

Activity suggestions to Help Improve Vestibular Processing:

1.     Swinging / rolling / rocking / swaying (the best effects are gained when these activities are self activated, i.e. let the child swing / spin him/herself)

2.     Jumping on a trampoline (with supervision)

3.     Balancing on a balance beam or line on the ground

4.     Rolling across the floor, over a variety of textures and objects / in a blanket or towel. Then try with eyes closed

5.     Sledding or rolling down a hill

6.     Spinning around a post / in a chair

7.     Sit ‘n’ spin / pogo stick

8.     Playground activities: see saws, swings, slides, merry go rounds

9.     Bilateral activities: jump rope, swimming, skipping, riding a bike, star jumps, stilts etc.

10.   Movement activities: e.g. Exercises, keep fit, martial arts, dancing

11.   Walking over uneven surfaces

 

WARNING: Encourage the child to choose spinning activities to do independently. Too much swinging / spinning can have a negative effect on the child. Watch carefully for signs of dizziness, nausea, changes in breathing etc. Stop when the child asks to stop the activity. Never swing / spin the child excessively.

 

Recommended Book List

Book References and useful websites

Sensory processing disorder


List Price: £15.95
Price: £10.08
“The Out of Sync Child” by Carol Stock Kranowitz

This is a fantastic starter book when you are just getting to grips with sensory processing. It relates to young children mostly but is an excellent introduction. Written by a teacher who has input from OT it is insightful and brilliant and compares normal with dysfunctional sensory processing.





 


List Price: £14.95
Price: £14.95

“The Out of Sync Child has Fun” by Carol Stock Kranowitz

This is a follow up book from the one above with loads of excellent ideas for home therapy ideas, it gives good descriptions of each of the sensory systems and checklists for parents. A really useful book. A therapy bible.





List Price: £14.38
Price: £14.38

“Sensory Integration and the Child” by A.Jean Ayre

This was written by the founder of the Theory of Sensory Integration and is invaluable to understand the basis of this amazing understanding of children with sensory processing problems. It is quite scientific so not for laymen but for therapists needing to understand more it is fantastic. wholly recommended.





List Price: £10.83
Price: £9.55

“Too loud, too bright, too fast, too tight- what to do if you are sensory defensive in an overstimulating world” by Sharon Heller

This book is fascinating when looking at the perspective of adults with sensory processing problems. They are able to describe how hard it is to function in daily life and how inhibiting it is when sensory problems persist and interfere.





List Price: £9.99
Price: £9.99

“The Sensory Sensitive Child” by Karen Smith & Karen Gouze

Wonderful and moving story related to a true story. Enlightening is one of the words to sum it up.





List Price: £12.99
Price: £12.99

“Understanding Sensory Dysfunction” by Polly Godwin Emmons & Liz McKendry Anderson

A small A5 book easy to read with lots of useful checklists and definitions. Brilliant as an introduction to sensory processing.





List Price: £13.99
Price: £13.99

“Living Sensationally” by Winnie Dunn

Written by the brilliant Winnie Dunn who designed the Sensory profile often used by therapists to identify problems. She relates how we all live sensationally and has various types of descriptors for different types of sensory processing such as seekers, avoiders and so on. very good to help understand from layman’s perspective.





List Price: £12.32
Price: £12.28

“Sensational Kids” by Dr Lucy Miller

One of the best books read yet about the subject with up to date terminology and diagnostic criteria. Extremely useful and lots of references for OTs and parents to use endlessly. A must buy in my opinion.




Dyspraxia


List Price: £9.95
Price: £9.95

“Developmental Co-ordination Disorder” by Morven F Ball

Developmental Co-ordination Disorder (DCD) is a term used to describe children who have difficulty with movement and specific aspects of learning, and includes dyspraxia, Asperger Syndrome and associated conditions. This booklet seeks to answer commonly-asked questions about DCD and presents information to aid parents, carers and professionals in selecting the best options for their child; sometimes correcting the little things can lead to big results.





List Price: £13.99
Price: £13.99
“Dyspraxia: Developmental Co-ordination Disorder” by Dr Amanda Kirby

An excellent very readable book to start you off on your journey to understanding the condition.





 


List Price: £12.99
Price: £11.44
“Living with Dyspraxia: A Guide for Adults with Developmental Dyspraxia” by Biggs, Colley

An excellent guide for adults and lots of useful information about rights in education and employment.





 

 

Autistic Spectrum Disorder /Asperger’s Syndrome.


List Price: £13.95
Price: £13.95
“Asperger Syndrome and Sensory Issues: Practical Solutions for Making Sense of the World” by Smith Myles, Cook, Miller

This is a wonderful introduction to sensory issues with Asperger’s Syndrome. It has many useful ideas and practical solution with examples in the back of the book, brilliant for home and classroom management and understanding the source or trigger of problem.





 


List Price: £21.50
Price: £21.50
“Asperger Syndrome and Difficult Moments: Practical Solutions for Tantrums, Rage and Meltdowns” by Smith Myles, Southwick

This book is a must for any parent or teacher of a child, adult with Asperger’s or ADHD as many of the strategies for both are similar. It gives practical solutions and encourages the adults to be aware of their own behaviours and how this can exacerbate emotional blowouts. It talks about rumbling behaviours and knowing what to look out for. In my opinion this is one of the best out there for anger management strategies.





 

 


List Price: £26.50
Price: £26.50
“Building Bridges Through Sensory Integration: Therapy for Children with Autism and Other Pervasive Developmental Disorders ” by Aquilla, Sutton and Yack

This is a brilliant book with loads of photocopiable sheets, checklists, therapy ideas and masses of information to help understand autism and how it affects individuals and why sensory behaviours occur.An excellent resource for schools and therapists.





 


List Price: £12.00
Price: £12.00
“Martian in the Playground: Understanding the Schoolchild with Asperger’s Syndrome ” by Clare Sainsbury

This is an eexcellent book written by people with Asperger’s with anecdotal evidence about how it feels to have the syndrome when at school and growing up. A real eye opener, very moving to read.





 

ADHD and other neuro diverse conditions.

 


List Price: £9.99
Price: £9.99
“The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children ” by Ross Greene

A wonderful introduction to the types of behaviour children with inflexible conditions such as ADHD and other neuro diverse conditions. Very useful to understand how to manage their behaviours and how it differs to typical parenting skills.





 

 


List Price: £16.24
Price: £16.24
“Kids in the Syndrome Mix of ADHD, LD, Asperger’s, Tourette’s, Bipolar, and More!: The One Stop Guide for Parents, Teachers, and Other Professionals ” by by Martin L. Kutscher; Tony Attwood; Robert R. Wolff

This is a brilliant book giving examples of some all the neurodiverse conditions. It looks at more subtle symptoms that are not often appreciated by professionals especially relating to conditions like ADHD. A very good resource book. One of my favourites





 


List Price: £12.99
Price: £12.32
“How to Detect Developmental Delay and What to Do Next: Practical Interventions for Home and School” by Mary Mountstephen

An excellent book which looks at primitive reflexes and their effects on learning and the special education system. Lots of useful information in very readable language. Mary is a wonderful colleague whose work is invaluable.