The Holidays Are Here!

Image result for snowman clipartThe holidays are here and with this very special time of year comes holiday parties, music, dressing up, lots of food, visitors and traveling!  While these can be very exciting things to some people, to a child with sensory processing issues the holidays can feel more like loud noises, uncomfortable clothing, sitting for long periods of time at dinner, unfamiliar foods, unexpected hugs and a change in routine.  For those of us who are challenged adjusting to daylight savings time when that alarm clock goes off 1 hour earlier, imagine the challenges of the holidays when a typical day suddenly doesn’t feel quite so typical.  Thankfully, there are ways to prepare and navigate these changes so that everyone can participate in the holiday cheer.

In order to prepare for travel:

  • Discuss the specifics of traveling before the trip.  This will help your child prepare for what to expect on a plane, train or car including when to sit with a seat belt on, when they can get up and walk around, and when they have to stand in a line, etc.  See your occupational or speech therapist for additional ideas on stories that may help guide your travels.
  • If possible, visit the airport or train station in advance.  Visit the ticket counter and watch the planes take off and land.Image result for airplane clipart
  • Make a scrap book with your child that includes one page per day of your travels.  Each page should include the people that you may meet (use real photos if you can) and places that you may go.  Review the book before your trip and then take it with you.  While you are on your trip, take some time at the end of the day to reflect and have your child draw a picture of their favorite thing they did or saw!  This may help motivate them to continue to use it throughout their trip.
  • If your child has difficulties with dressing or wearing certain clothing, have them help pack their clothes.  Trial the clothes at home so that they know what they have packed and also that the clothing items are tolerable.  If the weather will be different than home, show them a visual of the weather at your vacation spot.  This may help guide your packing and help them understand why shorts may be necessary over snow boots.
  • If your child has sensitivities to clothing and you purchase new clothes for your trip be sure to wash the clothes several times before trialing and wearing them.
  • Prepare with reading materials, fidgets and comfort items such as blankets during the flight or drive.
  • Make a calendar countdown to your trip.  Take a calendar with you to help them visualize how long the trip will be and to assist in transitioning back home.

In order to prepare for the return home:Image result for calendar clipart

  • Use the calendar to prepare for which day you are leaving to head back home.  Discuss how many days before you get home, return to school and back to your regular schedule.
  • Gather souvenirs during your trip to add to the scrapbook.  Discuss bringing it in to show friends, other family members or bringing the book into show-and-tell at school.

In order to prepare for religious services:Image result for music clipart

  • If your family is planning on attending services in a temple, church, mosque, etc., prior exposure to the religious environment can be helpful for your child. Every location has its own practices and rules.
  • Rehearsing routines that your family may encounter, including singing songs and prayers, sitting on tight benches, etc. will create an opportunity for your family to participate in the religious community and feel pride.

 In order to prepare for mealtime and family gatherings:Image result for family dinner clipart

  • Provide movement breaks as often as possible, especially before mealtime and traveling which should include 5-10 minutes of heavy work.  Finding a quiet space for a break may be beneficial as well. *See list of heavy work ideas below.
  • Allow your child to assist with setting the table (plates, soda bottles), cooking (stirring, kneading dough), and moving chairs to the correct placements (or pushing them in/out).  Set up a designated space for the children to help that includes extra dough, cookie decorating and/or different textured items to provide tactile experiences for them.
  • Determine a signal (secret code) between you and your child that will indicate that they need a break when they are in an environment that is challenging for them.
  • Prepare other family members of your child’s needs by explaining the implications of loud voices and unexpected touch.
  • Bring preferred food items to family gatherings to ensure your child has an option to eat. Try to encourage healthier options as this time of year can be filled with an abundance of sugary treats.
  • Inquire about interests of other children attending the gatherings to see if they share common interests with your child – you may also find new activities that might be intriguing to your child!

Heavy work ideas:Image result for child wheelbarrow walking clipart

  • Any activity that involves pushing, pulling, dragging, lifting or jumping- carrying laundry, boxes with books, grocery bags, pushing a vacuum, etc.
  • Pull or push boxes (more resistance on a carpeted floor)
  • Carry boxes of items to donate
  • Play “magic carpet” and have a sibling or family member pull the child on a sheet, mat or small rug
  • Play Twister!
  • Have a dance party to holiday music
  • Practice cooking with your child – have them stir the pot or knead thick dough
  • Make holiday-themed play dough, such as gingerbread or pumpkin spice.
  • Have the child pull pillows or couch cushions into a “mountain” pile in a safe place for them to jump in and climb through and under.
  • Roll your child up in a blanket or yoga mat like a burrito or hot dog
  • “Make a pizza” by rolling a large yoga/therapy ball over your child while they lay flat
  • Pull weighted items in a wagon or cart
  • Make a “sandwich” with them in between two pillows while pressure is provided
  • Give big hugs and squeezes
  • Wheelbarrow walking or animal walks- bear walk, frog jump, commando crawl, or log roll
  • Engage in exercises such as wall push-ups, sit ups, planks, or jumping-jacks – incorporate exercises into a game of “Santa Says!”

Keep in mind what your child might need in order to be comfortable.  Be prepared to review your plans with your child several times as they might need the repetition in order to feel comfortable with the change of routine.  Children need structure and routine and benefit tremendously from maintaining eating and sleeping schedules.  We hope that these suggestions will help support your child and your family throughout the holiday season.  We wish you all safe travels, happy holidays and a healthy, joyful new year!

From your BAC Family!

Evidence Based Treatment at the Boston Ability Center: Torticollis and Plagiocephaly

I recently traveled to Connecticut to attend the “Torticollis & Plagiocephaly: Assessment & Treatment of Infants & Children, Pulling It Together” course by Cindy Miles. Congenital Muscular Torticollis is characterized by side bending of the head to one side and rotation of the head to the opposite side due to a tight sternocleidomastoid muscle.  You may see your child preferring to tilt to one side and/or preferring to turn their head to one side.  Plagiocephaly is flattening of the head on one side.   

The incidence of Torticollis and Plagiocephaly has increased since the rise of the Back to Sleep campaign.  There are estimates that 1/6 infants have Torticollis.  Torticollis affects the entire child including visual tracking, sensory awareness, gross motor skills, head shape, feeding, and the vestibular system.  To decrease an infant’s risk for Torticollis and Plagiocephaly, parents should place their infant on their tummy to play starting on day one of their life.  Additionally, an infant should receive at least 60 minutes of supervised tummy time per day.  This position increases the baby’s strength and control of their muscles as well as provides sensory input to the face and oral motor area. 

During this course, I learned additional examination techniques as well as interventions including stretching, positioning, and strengthening to help infants with these diagnoses.  Receiving physical therapy early leads to good outcomes.  If you suspect your child has Torticollis and/or Plagiocephaly, come see us at the Boston Ability Center to schedule an initial physical therapy evaluation.

Jenna Szilagyi, PT, DPT

The Importance of a Plan

Making a plan is just as important as therapy itself. Kiddos have the opportunity to self-generate ideas and organize their thoughts into a plan. The ability to follow and complete a plan is a reward in itself and allows the child to feel accomplished and in control.

Try making a plan at home! Use white board or a piece of paper. Older kiddos can draw the plan and practice their fine motor skills too 🙂 Cross off items as you complete them. For kiddos who need support generating ideas (or if you have ideas you want to get completed) provide binary choices, such as “Do you want to do X or Y?”

Parent Resources… Finding A Needle in the Haystack, Part 1

An autism diagnosis can be extremely overwhelming on a lot of levels. There is A LOT of information out there, some helpful, some downright toxic. This topic will be part of a 2-part series to allow caregivers the opportunity to fully explore resources available instead of being overwhelmed by the amount of information.

So where does BAC guide parents? Here are a few places to start …

Continue reading

Why do we utilize play-based intervention?

By: Ariel Schuman, MS, CF-SLP

Parents of children who attend the Boston Ability Center may find that our clinicians frequently appear to be “playing” with young clients. While our therapists are certainly playing and having fun with children, they are simultaneously targeting their language development. Using bubbles, Pop-the-Pig, and countless other toys allows our clients to increase their language development in natural contexts. Researchers have found that play-based intervention styles result in a systematic increases in language skills that are maintained after treatment. While our clinicians play with your child, they also utilize the following approaches to increase and support language.

 

Parallel Talk: Our clinicians use what is referred to as “parallel talk” to encourage children to describe their actions during play. Using parallel talk supports children in their ability to make connections between their language and what they are doing. If a client was playing our popular game, “Pop the Pig”, this might sound like, “The pig is so hungry! We need to feed the pig hamburgers. He needs to chew, chew, chew! What do we need to do?”

 

Expansions: Expanding what our clients are saying, while using appropriate syntax and sentence structure, assists with children’s grammatical development. If a child was playing with bubbles and said, “open”, this might sound like, “Yes, we need to open the bubbles.”

 

Extensions: When our clinicians comment on children’s utterances they are adding semantic information. This provides clients with ways to expand and elaborate their language, in addition to teaching grammatical development. If a child was playing with bubbles and said, “open”, this might sound like, “Yes, we need to open the bubbles. We will blow big bubbles up towards the sky!”

 

Mileu Teaching: Through Mileu Teaching, the clinician can arrange the child’s environment to increase interactions that the therapist can use to model appropriate language and play schemes. Our clinicians may give a child a bottle of bubbles with the lid screwed on tightly. This provides the child with an opportunity to ask for help or request assistance, and the clinician with the opportunity to model how to utilize this specific language (e.g. “I need help” or “help me”).

 

Script Therapy: Using “scripts”, or language embedded in a familiar routine, can reduce cognitive demands on children as they are working towards increased language development. Scripts can be utilized through repeated book reading, or during familiar games. A common example may be singing “clean up” as our clients clean up toys at the end of a session. Singing this song while pausing and allowing the child to fill in words such as, “up” is an effective way to use this method.

Researchers have found that these play-based, or naturalistic interventions styles, are successful in improving children’s functional, everyday language. Teaching these skills in natural contexts, or through play, has also been found to increase children’s spontaneous use of language. At the Boston Ability Center, our clinicians use these techniques in order to support both function and fun for our patients.

For more information regarding play-based intervention, specifically Mileu Teaching, follow the link to the research article below: http://jslhr.pubs.asha.org/epdf.aspx?doi=10.1044/jshr.3706.1320

Reference:

Kaiser, A. P. & Hester, P. P. (1994). Generalized Effects of Enhanced Milieu Teaching. J Speech Hear Res, 37(6), 1320-1340. doi: 10.1044/jshr.3706.1320.

Why is Inferencing and Predicting Important?

By: Ariel Schuman, MS, CF-SLP

Filiatrault-Veilleux, et al. (2016) studied 3-6 year old children and their ability to comprehend inferences. They found that this skill typically emerges early in development, between the ages of 3 and 4. Inferential abilities continue to develop gradually until children are about 6 years old. Researchers have determined that this period, between the ages 3 and 6 years, is important for the emergence and continued development of inferencing and prediction skills. Furthermore, this skill is also important in aiding children in their later reading comprehension abilities.

At the Boston Ability Center, we target inferencing and predicting through various activities. A popular project that many of our clients enjoy involves creating special crafts and/or conducting different experiments each week. Often times children complete these activities with a peer, simultaneously encouraging the development of their social pragmatic skills. As our clients create beaded dragon flies, flour-filled stress balls, pool noodle pumpkins, and countless others, they utilize pictured supports in the form of photographic images. These pictures can help children predict what the next step in the sequence may be. Our clinicians stop periodically throughout the activity to ask clients questions such as, “What do you think we will do next?” or “Why do you think we will need to use a funnel?” These conversations support comprehension of WH-questions, and encourage children to utilize their inferencing skills to make decisions and plan accordingly.

Books are another great way to learn about inferencing and making predictions. Below are also some wonderful books to support your child’s development:

 

What is Social Thinking?

By: Caroline Curran, MS, CCC-SLP

Social Thinking is a teaching framework developed by speech-language pathologist Michelle Garcia Winner to help those with social learning challenges better understand the dynamic nature of social communication. For those of you who have spent time in our waiting room, it is likely you have already been exposed to bits and pieces of the curriculum concepts and vocabulary. For example, the “group plan”, “expected” and “unexpected” behaviors, and being a “flexible friend” are common concepts we teach as part of the curriculum.

But what is it about this curriculum that is effective in helping children develop social problem solving skills and overall social competencies?

The Social Thinking methodology is developmental and incorporates aspects of behavioral and cognitive behavioral principles. It takes into account personality, cognitive abilities and evidence-based concepts to create conceptual frameworks, treatment frameworks, specific strategies, and motivational tools.

Here at the Boston Ability Center, we regularly incorporate these frameworks and strategies into treatment for our patients of all ages. We utilize the “We Thinkers” storybooks with our younger patients to introduce concepts such as flexible and stuck thinking, following the group plan, size of the problem, and understanding hidden rules. With our older patients, we incorporate the Superflex teaching curriculum to promote self-regulation, social thinking, and related social skills.

For more information about Social Thinking visit: www.socialthinking.com

Sources: https://www.socialthinking.com/research