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Sleeping in crib

Sleeping Safe Baby

It’s getting chilly out there! Are you wondering how to keep your baby warm and safe while sleeping? Here is a quick guide on how to keep your baby safe while sleeping in warm and cold weather!

4 simple steps

1. Place your baby on their BACK during naps and at night.

2. Use a firm mattress in a safety approved crib.
3. No bedding, pillows, bumpers, toys, and stuffed animals in the crib.

4. Baby can share your room but NOT your bed.

sleep arrangement

These simple steps are recommended for any season and time of the year by the CDC and National Institute of Child Health and Human Development.

Always remember! BACK to sleep & TUMMY to play! Click here for more information about the importance of Tummy Time!

Can my baby sleep in a swing or car seat?

Consumer Reports states, “car seats are safe for travel, not prolonged sleep. Parents and caregivers should feel confident that using an infant car seat is essential in a car, but a baby shouldn’t be left unattended in a car seat, it shouldn’t be your baby’s primary sleep space.”
If your baby falls asleep in their car seat, swing, bouncer or any other place that is not a flat firm surface, it is recommended to gently remove your baby from the “container” and place them in a safe sleep space. This allows your baby to move naturally which is essential to typical development. “Container” sleeping is not only unsafe for prolonged sleeping but linked to primitive reflex integration deficits, torticollis, visual deficits, plagiocephaly, toe walking, and delayed milestones.
 

Is my baby warm enough?

To determine if your baby is too warm or cold, feel their chest or back of their neck. They should be warm, not hot, clammy or sweaty. Babies have poor circulation so hands, feet, cheeks, and ears can be cool to the touch during sleep and does not necessarily mean they need more layers. The ideal temperature for a baby’s room to sleep in is between 68-72F (20-22C).

Can my baby wear a hat, socks or mittens?

No, it is not recommended for baby to have any clothing that can come loose to avoid suffocation. Hats are not necessary if baby is dressed appropriately for temperature. Mittens should be avoided as babies use their touch to learn and self soothe. You can clip or file nails often to avoid scratches. Footy PJ’s are a great alternative to keeping baby toes warm.

Can my baby have a blanket?

No. To reduce risk of suffocation avoid using blankets or ANY soft items in the crib. Instead use a sleepsack which is a blanket that baby wears. Be sure to look at the TOG rating of the garment to assess which sleepsack should be used depending on the room temperature. Remember to dress baby for the room temperature and not the temperature outside. It is suggested that you get a room thermometer because baby monitor temperatures can be inconsistent. What is a TOG rating? Thermal Overall Grade (TOG) is a standardized unit of measurement that calculates the thermal insulation of warmth of a textile. Keep in mind every baby is different and always check your baby for warmth with touch as described above. This chart is a general reference of how to dress baby with a sleepsack depending on the temperature.

According to the CDC, In 2019, there were approximately 1,250 deaths due to SIDS, approximately 1,180 deaths due to unknown causes, and approximately 960 deaths due to accidental suffocation and strangulation in bed.  Take these simple steps are the best known ways to reduce the risk of SIDS and allow baby to sleep safely and comfortably.  If you are concerned about your baby’s sleep, tummy time, feeding or any other infant development reach out to your pediatrician and your local pediatric therapists. Have questions?  Schedule an appointment with a pediatric therapist for a free infant screening at BDI playhouse!
Written by: Dana Bukala, PTA
Potty Accidents

Potty Accidents

Why is my child having potty accidents?

Potty accidents aren’t fun for anyone. It can impact a child’s relationships with their family and friends.  Here are 5 common reasons children have accidents

Constipation 

Chronic constipation is the main cause of pee and poop accidents in children that have been potty trained. This is a great handout to see if your child has any of the main signs of constipation. Did you know that pooping every day doesn’t mean they aren’t constipated? “The Poo in You” is a video with a great explanation of what happens inside the body. 

Lack of Awareness 

Many kids may not have any idea that they have to go. They may not realize that they have to use the bathroom until it’s too late, or until they’ve already gone. Knowing what is happening inside the body can be a hard concept for kids with difficulty with sensory awareness. 

Poor Potty Posture 

Poor potty posture makes it hard to clear out the bladder and bowels. The Squatty Potty  or other step stool helps support the feet which lets the pelvic floor muscles relax. Therapists can also help with postural awareness and strength to help with the proper potty posture for successful toileting.

Scary Bathrooms

The bathroom can be a scary place for kids! Sitting with dangling feet, the noise, and the smell can all make kids avoid the potty. Many children avoid public bathrooms because of these fears. 

Medical Reasons

There could be a medical reason your child is having accidents. If you have concerns about your child’s accidents talk to your pediatrician. They can help decide if a referral to gastroenterology or urology is needed.

 

Who can help my child?

If you think your child might have constipation or is struggling with accidents, please reach out for a free screening! Sometimes, you may need the help of a physical, speech, or occupational therapist to help identify the reasons for your child’s accidents and/or constipation. 

Pediatric Therapists

Therapists trained in pediatric incontinence can provide treatment with:

    • Core strengthening
    • Biofeedback
    • Bladder re-training
    • Behavior and diet strategies
    • Body awareness to help realize the urge to go 
    • Posture training
    • Increasing fiber rich food intake 
    • Increasing variety of foods
w sit example

W Sitting Alternatives

W Sitting.  Why do children W sit? Simply, because it’s easy! Kids like W sitting because it creates a large base of support like a pyramid. 

Why do we want to correct the W sitting? 

  • W sitting allows kids to sit and play by using very little core muscles.
  • It prevents trunk rotation. Trunk rotation strengthens the muscles necessary for typical movement. 
  • This posture discourages the use of midline hand crossing with play.  Movements that cross our midline improves communication with both sides of the brain and eventually help develop a dominant hand. 
  • If your child has a diagnosis that causes high or low tone it is important to discourage W sitting to improve their postural control and prevent muscle inbalances.  

5 alternative ways to sit on the floor!

criss cross sitting

  1. Criss Cross. Sometimes referred to criss cross applesauce.  While W sitting discourages trunk rotation and midline crossing, criss cross legs do just the opposite! The legs are crossed through midline and does not restrict trunk rotation. 
  2. Side SittingEncourage side sitting on both the left and right side to stretch and strengthen their core muscles. 
  3. Kneeling and Tall kneeling.  Children who kneel will also move in and out of tall kneeling or standing on their knees. Try putting legos on the floor next to a coffee table to encourage kneeling to tall kneeling to improve leg, hip and core strength!
  4. Tummy Time.  Tummy time is not just for infants. We should always encourage our kids and to get back to our bellies to improve our back strength and head posture. 
  5. Wiggle seats.  Balance pads are great for kids to sit on for added cushion and improve trunk stability. It also helps with our sensory kids who love to move. https://www.amazon.com/s?k=child%27s+wiggle+seat&i=sporting&ref=nb_sb_noss

 

Sitting in a variety of positions is helpful to strengthen different muscles that support our child’s whole body. Poor posture can limit our child’s attention, dexterity, vision, digestion, participation, and so much more! So fix those legs!

If you notice your child is resistant to moving out of W sitting or has other postural deficits that you are concerned about, BDI Playhouse offers free screenings https://bdiplayhouse.com/physical-therapy/ and we can help with strategies for core strength, postural alignment and trunk stability.  

 

Written by Dana Bukala, PTA

 

play games

Learning to Play Games

Does your child struggle to play simple games, take turns, or is a sore loser? I often work with children who hate losing games or do not have the attention to wait for their turn. This blog will highlight some strategies I use to help children learn to play a board game with the whole family. I’ll break down the steps in how to take turns, select an appropriate game, and dealing with sore losers. 

Taking Turns

The first skill that is important for any type of game is taking turns. While some kids might have the patience to wait their turn, others may think it is life-shattering to watch their sibling move a game piece. Here are some ideas you can use to help your child understand to wait their turn: 

    1. Carpet Squares: have your child sit on something like a piece of carpet, towel, or piece of paper. This is their spot to keep their body for the game. 
    2. Sit at the Table: if your child has trouble sitting still on the floor, then move to the table. Have a firm chair that allows their feet to rest on the floor or footrest.
    3. Take a Break: playing a 5-minute game may be too long for your child to handle at first. Simply take play 1 or 2 rounds of turn-taking then take a break! Then go back to the game where you left off or end the game. If your child successfully takes a couple turns without becoming upset or distracted, then you can always end the game. 
    4. Use your Words: To help a child understand turn-taking, use your voice to label “my turn” and “your turn”. At the beginning of each turn, the child can say whose turn it is. This will help them understand that there are times when they have to wait. 
    5. Change the Rules: Some games involve stealing pieces, losing a turn, or more complex rules. Make the rules easier by eliminating complex rules or make up your own rules to allow for simple turn-taking.  
  • Work in Teams: Use the buddy system to have your child play with an adult or an older sibling who can help them follow the rules.

Selecting a Game

Choose a game appropriate for your child’s physical and cognitive level. If you find that age level games are too difficult, then move to easier games! This is not a one size fits all. First, start with a simple cause and effect game that your child is motivated to play. As you read down the list the games will become harder. 

Cause and Effect Games (Pop Up Pirate)

If you are just starting out teaching your child to play a game, choose simple cause and effect games. Cause and effect games offer quick responses to the child’s action and often do not require a lot of skill. There are simple games that involve quick turn-taking and moving pieces.

Simple Games (Candy Land, Pete the Cat Groovy Button Game, Sneaky Snacky Squirrel)

Now that your child has mastered taking turns, can count 1-10, and knows their colors, you can start with simple board games. 

Medium Difficulty Games (Guess Who, Don’t Break the Ice, Spot It

Here your child is learning to use strategy skills to win a game. The games may involve more rules to follow than before.

Strategy Games (Connect 4, Uno)

Finally, you are ready to play games with complex strategies or require more time to complete. 

Card Games (Phase 10, Go Fish, Games for Standard Deck of Cards)  

There are several varieties of card games available that range in difficulty from easy to complex. Card games are a great way to work on matching, fine motor manipulation skills to move the cards, and executive functioning skills to use strategy to win.

Sore Losers

One major barrier to family game night is that no one wants to play with a sore loser. We’ve all played a game with a child, or even an adult, who is a sore loser- it’s not fun for anyone! Here are some ideas: 

  • Practice What to Say: Before the game even starts, role-play what everyone would say if they lost or won a game. “Good game!” “Better luck next time!” “Maybe next time I will win!” “That’s ok, I tried my best”. You also need to practice letting your child lose! Do not let them win every game. 
  • Be the Role Model: If you win against a sore loser, so those phrases above that you practiced during the game. Do not have the winner have a big party. The winner can be excited but does not need to be over the top to hurt other’s feelings. 
  • Team Games: Play in teams so a child that has trouble playing a game can win every once in a while. 
  • Stop: If your child is becoming out of hand- stop the game and start later when they are calm. 

If you find that your child continues to have difficulty with fine motor skills to operate pieces, understand steps and sequencing to play games, or continue to have tantrums over losing, then we invite you to request a free consultation to discuss how occupational therapy, speech therapy, or physical therapy may help your child want to play games. 

Written by: Megan Wilkison, Occupational Therapist

 

Gift Guide

BDI Playhouse is thrilled to share its 2020 gift guide.  This list is compiled by BDI Playhouse’s therapists specifically for children of all abilities.  The toys are shown through an Amazon Idea List but shopping around and shopping second-hand is highly encouraged!  A variation of each one of these toys can be found at BDI Playhouse’s clinics and are used on a daily basis.  The first list contains items that can be bought at the store or sent straight to your house.  The second list contains experience based gifts.  Both are intended to help your child grow in many areas!

Gifts for Growing Minds and Bodies

Amazon Gift Guide

Gifts that Keep on Giving

  1. Season passes: zoo, museum, aquarium
  2. One-time passes: movies, bowling, swimming, theatre performance, Disney on ice, circus, ice skating, roller skating
  3. Subscriptions: KiwiCo, National Geographic Kids Magazine, Little Passports
  4. Class/Season of Lessons: swimming, sports, gymnastics, dance, karate, musical instrument, pottery class, art class, craft class, horseback riding lessons

Thanks for stopping by!  If you have any questions on the best way to use these toys, check out one of BDI Playhouse classes where we demonstrate how to use these materials or schedule a free screening to talk to one of our therapists!

 

Twas’ The Night Before… Let’s Go to Sleep

Twas’ the night before… anything (Christmas, Halloween, going to DisneyWorld, birthday, or for me, Great America for the first time). I remember how hard it was for me to fall asleep when I got to do something super fun the next day or stay asleep at night. With holiday season here, we may see increased sleep issues in our kiddos. However, many kiddos (and adults) have a difficult time with sleep, not just at the holidays, but every night.   This will detail sleep for both the holidays and every night sleep.

Let’s start with the basics…

What does a sleep deprived child look like?

  • Babies sleeping less than 14-16 hours in a 24 hour period

  • Toddlers sleeping less than 13 hours

  • Preschoolers sleeping less than 12 hours

  • School age kids sleeping less than 10 hours

  • Teenagers sleeping less than 9.25 hours

 

What do a sleep deprived child’s behaviors say?

  • Difficulties controlling their body and impulses

  • Difficulties getting a long with others

  • Hard time managing emotions

  • Inability to stay focused and perform well

  • “Wired” at bedtime: The need to stay awake is so strong in some children that instead of getting drowsy many get ‘wired’. They appear to have ‘wild’ behavior as long as they have stimulation levels high enough to keep them awake. Once the stimulation decreases they create their own commotion to keep themselves awake.

What do kids need to sleep?

  • In order to sleep a child must feel SAFE. If a child does not feel safe they will have more anxious emotions and a rise in stress hormones which will make falling  asleep even more difficult.

    • What can make a child feel unsafe? – Sleeping in a new environment, changes to their nighlty routine, new or unfamiliar people in the house, unfamiliar lights or sounds.

  • Children need CALM to sleep.  Anything that upsets your child’s sense of well-being will raise their arousal and pull her system in the opposite direction of sleep.

    • What impact’s children’s well being? Parental stress, separation, major life changes, upsetting events, lack of sleep, overstimulation, overscheduled days, anticipation, growth spurts, pressures to perform.

  • Children need to DROP THEIR BODY TEMPERATURE to sleep.

    • Humans need to drop their core body temperature 2-3 degrees in order to initiate sleep. When kids are physically active after 6pm it raises their body temperature, making it harder to initiate sleep.

  • Children need consistent ROUTINE to sleep

    • They need a transition to indicate it’s time to get ready to sleep. This is something that happens every night. (ie: snack, dimming lights, picking up toys)

    • They need a connecting and calming activity. This can be reading together, drawing together, giving your child a massage.

    • They need a cue activity..something that happens every night before bed while the child is in bed. This can be a song, a prayer, turning off the light, or turning on the fan which signals it’s time to sleep.

 

How do we unintentionally disrupt sleep in our kids?

  • Irregular schedules: If there is more than a 30-60 minute difference between when a child woke up/went to sleep it can throw our kids into jet lag. Even changes in meal time can affect their circadian rhythms.

  • Light: Strong morning light is very important to a child’s body clock keeping a consistent rhythm. If a child is exposed to too much light at the wrong time of the day it sends the wrong signals to the brain about when to sleep. Too many lights on in the house and too much LED screen time before bed is incredibly stimulating to child’s brain and reduces signals for the body to prepare for sleep.

  • Exercise: Not enough or exercise at the wrong time of the day. Children need at least 60 minutes of physical activity during the day. Too much exercise too late at night overheats the body when body temperature should be dropping.

  • Stimulants: One can of soda is the equivalent of an adult drinking 4 cups of coffee. It takes a long time for caffeine to leave a child’s body.

 

Are there certain times we should expect more difficulties sleeping?:

  • 2 to 3 days before and after holidays

  • Time surrounding growth spurts

    • Growth spurts happen every 6 months in 2+ year olds, much more frequently from birth to 2

  • Troubling events

    • Sometimes it can take up to 6 months for a child whom you otherwise thought was able to cope with a difficult situation to show their stress. Big life changes due to COVID are a perfect example!

  • Vacations

    • The anticipation of, disruption of routine, new environment can all cause difficulties sleeping.

When you know what to expect you can better respond to and care for your child when they are having difficulties sleeping.

How can you help your child sleep?

Sleeping girl

It starts during the day!

 

  • A rushed or stressful wake up in the morning (well all know how short tempered we can be when running late!)can leave your child feeling stressed and disorganized throughout the day.

  • Keep a consistent wake up time in the morning, and predictable timing for naps

  • Schedule meals an hour or two before bedtime and keep consistent meal times during the day. Research shows it’s best to not have a heavy meal right before bed.

    • In your child’s diet include complex carbs; this includes fruit, vegetables, whole grains

    • Reduce simple carbs like candy, cakes, cookies, soda and fruit juices.

  • Provide exposure to morning and daytime light.

  • Make sure your child gets exercise during the day! During the cold long winter months there are many indoors activities you can do with your child to meet their need for movement. Our Occupational Therapists have some great ideas including;

    • Heavy work; this includes pushing, pulling, lifting, carrying, anything that puts those muscles to use.

    • Playing hide and seek.

    • Creating an indoor obstacle course.

    • Pretending the floor is ‘lava’ and your child has to jump on pillows/couch cushions to get from one side to another.

    • Jumping on a small trampoline.

Night time tips to promote sweet slumber:

  • Eliminate screen time at least after dinner- blue light shuts down sleep and suppresses natural melatonin production. If a night light is needed make sure the light is indirect and use a pink light, or warm yellow colors. Turn off the light when the child is asleep.

  • Dim lights around your home after 6pm to signal to your child’s brain that the time to sleep is approaching.

  • Keep a consistent bedtime. Cortisol (stress hormone) increases when a child goes to bed past the appropriate time. This impacts sleep due to increased stress of fight or flight phenomenon.

    • Give your kiddo a hot bath before bed then have child in bed no more than 30 minutes after bath, right after bath is most beneficial. The warm water from the bath helps to draw heat away from your child’s core, lowering their body temperature and signaling to their brain’s it’s time to sleep.

  • Towel dry with firm pressure to give your child sensory input.

  • Provide comfy pj’s and the coldest room possible. Listen to your child, if they tell you a tag is bothering them or their PJ’s feel scratchy find something that will make them feel comfortable. We all know how annoying a scratchy tag can be!

  • Ideal placement of bed is in a corner or against wall looking towards the door. Think about how your child’s bed can become a safe ‘nest’. A bed that sits on the floor with no distinction between the floor can feel to open and vulnerable to a child.

  • Try lavender or vanilla essential oils (therapeutic grade) to assist with sleep.

  • Use a white noise machine to block out distracting noises.

  • Keep the bed away from window so your child isn’t exposed to lights or noises from outside.

  • Use blanket rolls to make  canoe or nest for increased input in the bed. Most of the time when a child crawls into bed with mom or dad they are seeking the pressure they feel from mom and dad’s body against theirs.

  • Consider a weighted blanket or bean bag on child to increase the pressure and sensory input on your child during the night.

  • A massage before bed can help your child feel connection to you their parent and helps their body to calm and meet needs for touch and sensory input.

  • Use a visual schedule. This helps to set expectations for your child and reduces the stress than can occur when your child does not know what will happen next.

We have learned a lot through education, clinical experience, and through reading! A great book full of resources for childhood sleeping strategies that we found invaluable in learning about sleep for this blog is “Sleepless in America” by Mary Sheedy Kurcinka ; “Sleepless in America” by Mary Sheedy Kurcinka.  If you would like more information or need help with implementing these strategies, please schedule a free screening with one of our skilled pediatric Occupational Therapists.

Written by Jessica Frederick COTA/L and Amy Stumpf, M.S., CCC-SLP/L, CLEC

How is a Developmental Optometrist Evaluation Different than a Vision Test?

We often hear from parents that their child “passed their eye test” which was most likely offered at school or at a well baby visit in the pediatrician’s office.  Sometimes our Occupational Therapists identify that although a child’s visual acuity test may not have shown a deficit, there are some visual skill deficits that may be present. Difficulties with vision skills often contribute to the challenges that are addressed by an Occupational Therapist, which is why we will occasionally recommend a Developmental Optometrist Evaluation. Today we welcome a guest writer to our blog from the developmental optometrist offices of Dr. Marini & Dr. Campbell to help our parents understand the importance of this referral! Dr. Marini & Dr. Campbell are two of the excellent doctors featured on BDI’s trusted professionals list who specialize in this area, have worked with us often, are eager to collaborate with us, and consistently help our kids achieve great results!

Website: Drs. Marini & Campbell Website

Facebook: Drs. Marini & Campbell Facebook

What is a Developmental Optometrist?

A developmental optometrist is an eye doctor who has more specialized training than regular optometrists. To gain the distinction of Developmental Optometrist, one must complete several extra years of post-graduate training. Like regular optometrists, developmental optometrists check acuity and health of patient’s eyes, but they also run additional tests to determine if patients have the visual skills necessary to perform tasks regularly required in daily life, especially at work or school. Due to these tests, developmental optometrists specialize in diagnosing and treating delays in visual skills, amblyopia (lazy eye), and strabismus (crossed) or wandering eyes.

When to See a Developmental Optometrist

There are certain symptoms that may be indicative of vision problems, especially in children. These include: squinting, eye rubbing, and excessive blinking. Other warning signs may occur when, and immediately after, reading. Some of the most common behaviors that are indicators of visual difficulties are: head tilting, closing or blocking an eye, headaches, dizziness, or nausea.

Besides physical clues, there are also performance-based clues, as well as secondary symptoms and specific labels that children with vision problems have. Generally, children with visual difficulties display one or more of these visual performance clues: avoidance of near work, difficulty copying from the board, and poor handwriting. When reading, these children may consistently: lose their place, have poor comprehension, omit, insert, or reread letters and words, confuse similar looking words, and fail to recognize the same word in different sentences. This can lead to the development of secondary symptoms such as: seeming smart in everything but school, as well as significant frustration, stress, and fatigue with written work, as well as a child being mislabeled as a slow learner, working below potential, or as having Attention Deficit Disorder.

If your child is displaying any of these symptoms and you would like some help specific to your child, please contact Dr. Marini & Dr. Campbell’s office to set up an evaluation or consult with one of the Occupational Therapists at BDI Playhouse Children’s Therapy to find a trusted doctor near you.

Written by: Julie Metzler, Manager of Vision Therapy
Child in a speech therapy session with therapist

Language Development in Children

Language development is a key component of childhood.  We are teaching our children the rules of language from the moment they are born.  But what should you do if your child is not crushing their language milestones?  When families come to Talk and Groove or for a free screening at BDI Playhouse, our speech language pathologists often send them home with a few tweaks to their home environment before recommending an evaluation.  None of our recommendations require purchasing of toys or materials because we want it to be a natural part of your routine!  Here are the top 3 recommendations we make!

Withhold

Withholding highly motivating items is a common strategy used to encourage language development through requesting.  There are many ways children can use body language to request an item.  Children can communicate a request through simple eye gaze, pointing, and dragging you to the item they want.   However, what happens when a child cannot get past pointing for something they want?  We withhold.  Withholding the desired object sets you up to model and have your child request the item, through verbalization or sign.  However, the key is to read your child for the best opportunity to do so.  If your child is already “edgy” or “on the brink of a meltdown”, now is not the time to withhold in order to teach your child to use a sign or verbalization.  We have the rule of 3 tries.  Let your child try to imitate 3 times before moving back to an easier attempt to avoid frustration.  For example, if you child has progressed to sign cookie and you are trying to get her to say “cookie”, after 3 tries, accept the sign and try again later!

Sabotage

This is a pretty harsh word for a fabulous technique but the word gets a lot of giggles out of our parents.  Sabotaging your child for language development means taking an everyday activity and letting your child problem solve using language.  An example of sabotaging your child would be to only give them a few cheerios in order to create the opportunity to ask for “more cheerios”.  Another example would be to put their favorite toys inside a clear box or bag that requires assistance in “opening”.  The beauty of sabotaging is that you can start with simply signing open all the way to creating phrases and sentences “Mama, open the box please”.   

Take a trip

As much as we wish that this tip means you should get on an airplane and fly to Europe, it truly is as simple as taking a trip outside of your “normal day”.  Think about your day-to-day life and all that your child is exposed to.  Now, think about a “trip” that could be new.  It could be as simple as walking to a different neighborhood and watching for dogs.  Take a trip to a pond and see if there are any ducks.  Drive around looking for buses and trucks!  

Language Development is such an amazing experience to witness and be a part of.  We are eager to see if these 3 techniques were successful for you and your child!  If you would like some more personalized ideas or need additional help with putting these techniques to use, please reach out and schedule a free screening with one of our skilled Speech Language Pathologists.  We’d love to be a little part of your journey! 

 

Written by Jessica Keenan, MA, CCC-SLP/L, CLC

 

Busting Behavior Challenges: Behavior Management Strategies

Behavior.  Something sets off your child, and the screaming, throwing, crying, or hitting behavior begins. We have all been there. Your panic rises. Somehow, you make it through the moment and on to the next, but there may be chaos left in the wake of the meltdown as a result of negative behaviors. Occasionally, negative behaviors become more than occasional. When your child is displaying persistent negative behaviors, there are a few strategies you can take to get back on track.

Sensory Strategies:

Addressing the sensory system is a powerful tool in behavior management and redirection. Engaging in these strategies throughout the day can be a preventative means of managing behaviors, where as bringing these strategies into the moment can assist in calming down an escalated child.

    1. Wiggle Jiggles:

      Have your child lay on the floor on their back.  Take hold of the child’s feet and push the feet towards their head/pull towards you. This shifting will cause the head to bounce slightly up and down in an organizing bobbing movement. This also allows pressure to be applied to the spinal column and joints in the legs in a rhythmic manner

    2. Squeeze something:

      Playing in putty, play dough, slime, stress balls (store bought or homemade!) allows for compression of joints and tension release. 

    3. Turn down the lights:

      Bright light wakes our system each morning. Dimmed lights/darkness calms us each night. You can dim lights or move your child to a darker space to reduce stimulation. 

    4. Declutter the environment:

      Having too many things around can be distracting or overwhelming for children.

    5. Stomp your feet:

      Get quick input by a simple movement such as stomping your feet or performing animal walks (bear crawl and crab walk).  

    6. Play quiet/wordless background music:

      Keeping an environment calm with music is a simple way to facilitate play and organization throughout the day. These can include classical music, tones/white noise, or piano versions of favorite songs.

    7. Lotion/Scents:

      Putting scented lotion on yourself or the child, or spritzing scented sprays/lotion can be a preferred way to calm the sensory system and maintain mental clarity.

    8. Chew something:

      Gum, crunchy or chewy snacks such as apples, carrots, celery sticks, thick rod pretzels, trail mix, or thick smoothies/milkshakes through a straw allows for the management of our taste buds and behavior.

    9. Provide a safe/quiet place:

       A safe place or quiet space can be found in a back seat of the car, a tent, a closet, a corner with bean bags, or anywhere that is enclosed. When overwhelmed, a child benefits greatly from having space to themselves to decompress.

    10. Join a class: Movement and engagement throughout a child’s day is extremely valuable.  Sign your child up for a community class such as gymnastics, swimming, karate, or soccer will get the muscles moving and the body calm!

Behavior Strategies:

 

Managing behavior through reinforcement and consequence strategies can be very effective for young children that are prone to outbursts or misbehavior:

    1. ABC Charts:

      Charts help document and remain objective about what behaviors we observe.  ABC charts help us determine the cause of negative behaviors. Write down the antecedent (A) what happened before the behavior, the behavior (B) in detail, and the consequence (C) that followed the behavior. Having this data allows us to develop the most effective intervention for behavioral challenges.

    2. Schedules:

      Visual (Picture) schedules or verbal schedules given throughout a day help provide guidelines for the day’s events or task expectations. This allows the child to understand what the day or activity will entail. It also allows the child to process what the day/week/month will hold so they can prepare themselves, their bodies, and their abilities.

    3. Countdowns/Timers:

      Using a timer allows the child to understand with warning that an end to a task is coming. The preparation a child can do mentally when forewarned about a transition will increase ease of moving on to the next thing!

    4. Behavior charts:

      A child benefits from a clear goal.  This can be achieved by giving a child direct and concrete feedback about their performance through a “behavior chart”. 

    5. Having a job:

      Give a child something special to do (teacher helper, passing out papers, retrieving a special item, making something specific). This gives children ownership in their actions and helps keep behavior on track! 

    6. Working for….:

      When we find that “Just-right” motivation for a child, we can allow them to work and behave accurately to achieve the motivating item/action! 

    7. First/Then:

       “First this activity, Then that activity” strategy tells a child clearly and completely what the expectation of behavior is and doesn’t allow for questions or confusion. 

    8. Rewarding positive behavior:

      Providing your most engaged, thrilled, and enthusiastic praise to your child for the behavior you expect and appreciate, with clapping, cheering, smiling, hugging, etc. will encourage your child to perform at their best again and again!

    9. Clear expectations of desired behavior:

      When telling a child “STOP behavior!”, they may only hear or process the behavior you have highlighted, and/or may not completely understand what you are asking of them. Rephrasing corrective statements to “Do” instead of “Don’t” actions can be helpful. For example, instead of saying “Don’t dump the cars out of the bucket!”, tell them “Keep the cars in the bucket”. Or, instead of staying “Stop running!”, tell them “Use your walking feet!”.

    10. Remain calm (Yourself!):

      Finally, the most important thing you can do when you encounter negative behaviors is to keep yourself in a calm state. As our level of excitement/frustration increases, so does our children’s. This causes us to lose our ability to correct with a clear and sound mind. Taking a deep breath, finding our center, and taking a moment to calm ourselves is often the most important step in the path to managing negative behaviors.

Managing challenging behaviors can be extremely difficult, but achieving success in this area can be life changing. If these strategies are not proving to be effective enough to get your days back on track, please contact BDI Playhouse Children’s Therapy for a free consultation to get your child out of the behavior blues!

Written By: Margaret Lord, MS, OTR/L

 

How does Posture Impact Scoliosis?

Scoliosis

Scoliosis is a curve in your spine that visually appears to move from side to side. A common misconception is that a scoliosis curve is 1 or 2-dimensional. It actually occurs through a 3-dimensional curve with changes in the bones at the apex of the curve. This 3-dimensional shape is seen all throughout the body! It is similar to the 3-dimensional shape that allows your hips and lower back to move in separate directions. These 3-dimensional changes occur all the way from when and how your foot contacts the floor to how your head and neck are positioned.  

Impact of Scoliosis in Children and Teenagers

Children and teenagers who have scoliosis will notice that these changes impact their posture and how they move.  Normally, the bones in the spine are rectangular and are evenly spaced from side to side. Children and teens who have scoliosis will have at least three bones in their spine that are larger on one side than the other. This is what contributes to the shape of the spine.   

Due to structural and postural abnormalities associated with scoliosis, it is important to maintain an upright posture and to avoid repetitive bending and twisting at the spine.  If your child maintains poor posture or rests into their curve, they can experience back pain and their curve may even worsen.   This will also cause more rotation of and stress on the bones of the spine. Your child or teen will need to maintain a neutral pelvis and upright posture.  This will prevent the worsening of scoliosis and overall posture.  A skilled Schroth-certified therapist can create a customized treatment program to help them learn how to use healthy posture and movement habits during their everyday activities.

Importance of Posture

So why is it important to develop and maintain a neutral posture? Think of a spine and the way it moves like a broken pearl necklace like in the image below. In this picture, the pelvis is the triangle and the spine is the string of pearls. Without a stable pelvis, the bones in the spine follow the path of least resistance and move further into a curve like when you drag the end of a pearl necklace and all the beads follow the path of the first bead.

However, if you take the end of the pearl necklace and hold it with one hand and then pull the other end with the other hand the pearl necklace will straighten. The same thing will happen when you learn to find a neutral pelvis and work on lengthening your spine with an upright posture.

Physical Therapy for Scoliosis

At BDI Playhouse, a Schroth-certified physical therapist can work with you and your child to learn ways to improve their posture while playing, doing sports, socializing, and during everyday activities at school and home. Schroth-certified therapists have special training to help children incorporate good posture into their everyday activities. This will stop curve progression, improve physical appearance, and improve health and functional abilities. We can work with you and your child to achieve any goal through the development of a healthy posture. To learn more about how we can work together to make those goals a reality, schedule a free screening  or call us at (708) 478-1820.