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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.

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

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.

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.

Sensory processing disorder

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Dyspraxia

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Autistic Spectrum Disorder /Asperger’s Syndrome.

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ADHD and other neuro diverse conditions.

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Rates

1 hour costs £125

2 hours cost £250

3 hours cost £350

Courses offered:

1. An introduction to Sensory Processing Disorder  (1 hour, 2 hours or more practical 3hour sessions dependent on what you need.)
2. Sensory processing and attachment difficulties.
3. Introduction to different conditions such as DCD, Dyspraxia, ADHD, ASperger’s ASD and more.
4. Developing and Supporting Handwriting  : this will present why handwriting is a problem, what techniques help develop skills from a physical perspective, fine motor perspective and use of different programs, such as Handwriting without tears, Speed up program etc.

Not all, or even a majority of such experiences, result in this disorder.

Attachment disorders can be treated using an innovative new type of working with children and their carers called Sensory Attachment Intervention “SAI”. I have had specialist training with the founder of this whole practice called Eadiaone Breathnach who is truly inspiring and has given me a different way of approaching difficulties.

I am able to offer Sensory attachment intervention for children and parents and the usual course would be anything from 6 weeks to 12 weeks. Working with the child from a sensory perspective is fascinating and can help address many difficult behaviours through sensory strategies applied at home.

Please call for more information if you are a parent, adoptive parent, foster parent and require support in this matter.

Read about more diagnosed conditons

Often parents of children with difficulties may have similar issues to their children but due to the way things were dealt with in the past your own issues were never assessed or treated.

Please do not give up hope I am able to assess and treat you as an adult in your own right.

Assessment and treatment can be similar using a sensory motor/integration approach.

If you have suffered with trauma as a child through abuse then there will be much that can be done through treatment to help you resolve feelings (both physical and psychological.) I hope to be able to help. Please call for a free consultation on the phone. 07814 633926.

see post on sensory attachment intervention.

Full Assessment.(3hours). Parents and school staff are asked to complete a number of questionnaires prior to visit. Assessment will look at and consists of clinical observations, handwriting, fine and gross motor skills, sensory processing assessment. The child usually enjoys the session as there is fun equipment available to use alongside a structured task orientated session. Observation is key to understanding behaviour. During assessment I often pick up on behavioural problems and ask parents to complete questionnaires prior to visits to enable less questioning during session. Liaison with school is helpful and schools are asked to complete questionnaires prior to assessment. I also find it useful to read copies of other professionals reports prior to visit especially Educational Psychologists, OT etc.

Mini observational assessment. (1.5 hours) Parents will be asked to complete questionnaires and an informal assessment will consist of clinical observations and play in sensory integration environment. Verbal feedback is given so parents are asked to bring a pad and paper to make notes. This is often a quick and useful way to get a quick basic breakdown of strengths and difficulties but I do recommend full assessments as can cover everything in much more detail.

Reports. A report is completed ideally within a 2-4 week period and sent directly to referrer which is often the parent. Parents are then free to distribute to who they would like. Sharing information is essential if attending other health professional clinics. E.g. If any child is being seen by NHS OT services the staff should be aware of each other’s involvement and this is primarily the reponsibilty of parent to share. N.B. I am able to offer legal reports required for tribunals and have qualifications to do this.

Sessions available.

1:1 :I will see children following a basic or full assessment for individual direct OT sessions and this can be done weekly or monthly dependent on the child’s needs. It is a valuable way to update programs and parents to feel involved in helping the child. Working on “ How does your engine run- The Alert Program” is excellent in this format and I would recommend at least 6-8 weeks to cover it successfully.I am also able to work on handwriting programs such as “Handwriting without Tears.”

Groups: Children are seen in groups of 4 in approximate age bands (and ability levels). Sessions are held on Saturdays and times vary dependent on needs of families. Groups start working together on similar skills e.g hand eye coordination, eye tracking,  and then break off into action stations where the child works with the parents on different skills such as balance, gross motor control, spatial awareness, bilateral integration and postural stability. This enables parents to learn with the child and I endeavour to intervene to get the best quality actions from each child with ideas to take home to work on over the week. Practise makes perfect and ideally daily practise for at least 15 minutes makes a big difference. Parents often worry about handwriting and although we do not specifically work on writing sessions will improve handwriting as the child’s whole body awareness and spatial abilities is better.

Home/School visits. It is often vital to see a child in both home and school environment. This is important from an observational perspective to look at concentration levels, sensory behaviours and ability to socialise. Children with severe autism dislike transitions and change so need to stay in their safe place while observation and interview of parents is the best form of assessment.