BY KCC OCCUPATIONAL THERAPY STAFF

By the time October rolls around, kids have about a month of school under their belts and are starting to feel the effects. Many students have trouble with the increased workload and longer periods of sitting in school, especially after a relaxing summer.

Sensory input can help to organize and regulate children for continued success in school and at home. And fortunately, beautiful fall weather and seasonal activities provide a variety of sensory fun.

• Raking leaves provides proprioceptive input to children’s muscles and joints, which increases body awareness and strength. Running and jumping into the pile provides both vestibular (movement) and proprioceptive (body awareness) input.
• Hide familiar objects in a pile of leaves and have your child try to find them (tactile input). To make it more difficult, have them try to find objects with their eyes closed and guess what they’re feeling.
• Facilitate a tripod grasp for better handwriting by having your child make a rubbing of a leaf using small or broken crayons. Go on a nature hunt, asking your child to pick up items with tweezers or tongs to increase grip strength and precision. This activity also works on visual perceptual skills and discrimination.
• To promote body awareness, have your child make a leaf person by gluing different-shaped leaves on a piece of paper and drawing on arms, legs, and other parts.
• Provide oral-motor input by giving your child a straw and challenging them to a leaf-blowing race.
• Have your children race while carrying a pumpkin to help with motor planning and agility as well as providing vestibular and proprioceptive input.
• Try bowling with pumpkins! This also provides some object manipulation skills from rolling it toward a target.
• Carving a pumpkin (with assistance) facilitates fine motor skills as well as provides a great wet tactile activity. Have your child scoop out the inside and play in the mess. Picking out the seeds helps develop a pincer grasp.
• Bike riding is a fun activity while the weather is nice and is a great way to provide your child with movement while working on bilateral coordination and balance.
• Pulling a wagon is an excellent form of proprioceptive input through heavy work. Placing heavy objects in the back of the wagon intensifies the input and helps with strengthening.
• Finger painting provides great tactile input. Have your child make a tree trunk by putting brown finger paint on their palm and forearm and pressing it on the paper then use various fall colors to put “finger print” leaves on the branches. Allow children who are more sensitive to tactile input to use a paintbrush or have a towel ready for them to clean their hands.

BY DIANE NANCARROW, MA, CCC-SLP
Speech-Language Pathologist

The start of each school year means new classmates, changes of classrooms, and sometimes even different schools for children, which often leads to anxiety. This unease may last for a few months as the child makes friends and gets used to their new environment. However, each academic year also offers another chance to find a special friend, be a special friend, and make meaningful connections with others.

Feeling accepted socially not only makes children feel happy, valued and secure, but has been shown to improve academic skills related to group work, class participation, problem solving, reading comprehension and creative writing.

Many children develop social skills instinctively while others need explicit teaching to improve communication. This is especially true for students with attention deficit/hyperactivity disorder, autism, auditory processing disorder, hearing impairment, nonverbal learning disorder and language impairments.

Social language skills groups provide inclusive environments where children can increase their confidence by practicing communicating with their peers.

Targeted skills include listening and accepting different ideas and perspectives; understanding slang, figurative language and idioms in conversation; self-regulation and emotional control; giving and receiving compliments; contributing to a conversation, staying on topic, taking turns speaking and recognizing when a chat is completed; and many other social facets.

Parents can help to reduce interpersonal anxiety by reinforcing these social skills in kids with special needs:

• Remind your child of situations where they enjoyed being friendly.
• Point out their successes.
• Practice welcoming a familiar person or a new student, or asking a friend to sit with them, walk together, or to play at recess.
• Practice actual topics to talk about with a friend.
• Practice talking and being with others through play dates or involvement in sports, clubs, classes and charities.
• Talk to teachers and other professionals about supporting your child’s engagement with others.

All students benefit from social engagement for academic and interpersonal satisfaction. Special needs students have the same need to engage and socialize with others. As skills increase, confidence will increase as well.

BY RUTH HABERKORNHAM, MA, CCC-SLP
& MARLA ZERBIB, MA, CCC-SLP
Speech-Language Pathologists

If your child needs speech-language therapy, the goal of a speech-language pathologist (SLP) is to make significant and positive impacts on the child’s communications skills. But while professional treatment is critical, it is not the only factor in helping ensure speech therapy success. Parents play an important part.

Here are seven ways parents can ensure they are doing everything they can to get the best speech-language results for their child:

1. Observe your child’s sessions. If there is no easy way to do this without being intrusive, ask the SLP to record the session for you to view.

2. Communicate and learn from the therapist. Ask your SLP to provide specific suggestions to establish a strong – and fun – home program.

3. Share what your child loves with your SLP. These would be lists of favorite foods, drinks, toys, activities, people and pets’ names, characters and places. This will help the SLP develop a requesting or commenting vocabulary to help your child communicate their most desired items and activities. SLPs also use the child’s favorites as “reinforcements” after they have provided a requested behavior.

4. Practice through play. Practicing your child’s target goals outside of therapy sessions allows for generalization in their everyday environment. For example, if your child is working on the target word banana: Give your child one piece at a time, encouraging them to say banana or their best approximation of the word (ba, nana, ba-nana) each time they want another bite. Find books that include bananas and ask your child to label them each time they appear on the page.

5. Ask for help. If your child is struggling to perform any of the goals or tasks at home, have your therapist assist you with hands-on techniques and methods.

6. Provide feedback. Share your child’s performance at home with the therapist, so they know how your child is progressing with targeted goals outside of their sessions.

7. Stay in touch and request feedback. Be your child’s advocate. Communicate your questions and concerns with their SLP to ensure success. Ask questions when challenges and concerns arise.

BY JEANETTE JONES, MOT, OTRL, MOT, OTRL
Asst. Director of Occupational Therapy & Sensory Programs
Occupational Therapist

Fall is here and due to COVID-19, parents have more to contend with than ever before. Whether you have opted to send your child back to school for face-to-face learning, are keeping them home to learn online or some hybrid of the two, one thing is the same: Supporting a child’s learning is more important than ever.

Sensory input is a wonderful way to help children of all abilities focus on their schoolwork by helping them become what we call “regulated.” This means they are calm, organized, attentive and better able to meet environmental and social demands.

And what’s even better ­­­— there are tons of fun ways to help a child move their body and maximize learning. Here are some suggestions for home, some for school and some that help in both environments.

• Create obstacle courses using household objects such as pillows, sleeping bags, office chairs, stuffed animals, etc. to help children gain proprioceptive (muscle and joint activation) and vestibular (movement) input to support their organizational needs.
• Take frequent sensory breaks in between tasks, for example, walking like different animals around the house or doing simple exercises like squats, planks, jumping jacks, arm circles and running in place.
• Strengthen fine motor skill development, including pencil grasp and dexterity skills, by engaging with small manipulatives like beads, pom poms, cotton balls or coins. You can also use the pieces to explain math concepts.
• Support handwriting skills with fun themes such as writing out scavenger hunts for siblings and parents around the house, writing pen pal letters to friends or completing Mad Libs.
• Use tactile (touch) experiences to help with learning new skills, such as drawing shapes, lines or letters in play dough, shaving cream or sand.
• Do exercises like push-ups against a wall or with a chair to improve the upper body, which benefits fine motor skills and task performance.
• Improve focus with a “move ‘n sit” cushion or therapy ball, which provides movement input during seated activities. Deep pressure provided by weighted lap pads can be very calming.
• Give kids helper jobs that include pushing or pulling heavy items across the room, such as carrying books at school or moving laundry baskets at home. These types of heavy work activities can help kids feel centered.
• Take fun sensory breaks by playing familiar card games that can be combined with motor activities. Try playing UNO but assign each number or color an activity to complete when the card is played.
• Use a visual timer and schedule to assist with task completion and setting expectations for kids. This allows for predictability, which helps with task participation and follow-through.

We hope these suggestions help as you and your children face school this fall. In times of uncertainty and change — and especially to help your child focus on the new school year — sensory input is always a benefit!

BY ALBIONA RAKIPI, MA, CCC-SLP
Speech-Language Pathologist

Parents of young children are faced with countless questions about their development. Some of the most common concerns are about their speech and language skills. Are they delayed? Are their errors age appropriate? When should they be evaluated?

A quality speech and language evaluation should be a thorough observation and assessment of your child’s communicative functioning. Deciding to initiate an evaluation for a very young child can be difficult, but it’s often the best decision. In some cases, it may reveal that the child is demonstrating age-appropriate skills. If a delay or disorder is discovered, early intervention is paramount.

If your child is age 2 and not talking, you should schedule an evaluation. This is also recommended if your child:

• Has difficulty following spoken directions
• Repeats back words and phrases without comprehension
• Frequently uses memorized phrases or sentences
• Demonstrates unintelligible speech
• Has trouble using appropriate grammar
• Seems reluctant to engage in conversation
• Does not make eye contact and/or does not answer to his or her name
• Misinterprets social cues

If your child attends preschool, ask the teachers if he/she is a successful communicator. Do they ask and answer questions? Do they engage with peers? Is their speech understood or are they frequently asked to repeat themselves?

Keep in mind that a child may seem to understand spoken language at home because it is routine, predictable and repetitious. Try giving your child directions they haven’t heard before, without pointing or using any visual support, to discern if they are truly comprehending language.

Parents often think that their child must be school age to receive services through their local school district. Each county in the state of Michigan has an Early On program that services all children under the age of 5. Part of their role is to conduct evaluations and determine whether a child is eligible for speech and language services.

You can also seek answers or an evaluation from a private practice like the Kaufman Children’s Center. As speech-language pathologists who work with young children, research informs so many of our decisions. We know by intervening early, with quality therapy, we can help every child reach their greatest potential.

BY JEANETTE JONES, MOT, OTRL
Asst. Director of Occupational Therapy & Sensory Programs
Occupational Therapist

Summer break is right around the corner, which means vacations are on the horizon for many families. Traveling with children is almost always tricky but traveling with kids who have special needs adds an extra element of planning. Here are some tips to help make getting there easier:

• If your family is flying to your destination, sit down with your child ahead of time to watch airplane videos and role play airport procedures such as security checks, handing over tickets and boarding the plane. You might even visit an airport to get your child accustomed to and anticipate the protocols. Many children have an easier time if they know what’s ahead.
• Prior to getting on the plane or in the car, have your child participate in physical “heavy work” activities to promote a calm state and help them be able to sit for longer periods. These activities can include helping to push/pull the luggage around the airport, do arm push-ups on chairs or walls, and do frog-jumps or jumping jacks at the gate area. Deep-pressure hugs and squeezes from mom and dad are also helpful.
• Be sure to pack plenty of sensory supports! These are a must and will help your child feel calm in an overwhelming environment. They can include: calming music, such as familiar kid songs or classical music selections; chewing gum, which can also combat nausea; weighted blankets or lap pads for calming deep pressure; tactile fidgets for input through the hands (stress balls, hair ties, twisty toys, rubber band balls).
• Bring simple activities like puzzles and LEGOs. Hiding small objects inside a ball of putty for the child to find is another low-demand way to pass the time.
• Attach small clothespins to your child’s seat and all around their travel area as a simple scavenger hunt.
• Provide fine-motor tasks while on the plane, such as sticker books, coloring books and dry erase boards to keep your child engaged.

We hope these tips will decrease the stress of traveling and allow you to focus on the fantastic memories you’ll make on your trip. Have a great time!

BY AMANDA PRATER, MA, BCBA
ABA Program Director
Board-Certified Behavior Analyst

Just as every child is different, the interventions chosen to help those experiencing autism spectrum disorders (ASD), depend on his or her individual needs. However, the most common therapies sought by parents are applied behavior analysis (ABA), speech-language therapy and occupational therapy.

Unfortunately, too often these three disciplines are managed separately, even though evidence has shown that a team approach to treatment is critical for best managing the complex needs of a child with ASD. At Kaufman, we are able to offer families all three services in one location. This allows our therapists to communicate and collaborate to offer our patients the best possible treatment.

Here are some examples of how the three types of therapists work together for the benefit of a child with ASD:

• During ABA therapy, the board-certified behavior analyst (BCBA) provides support during speech and occupational therapy sessions, using preventative strategies to reduce problem behaviors and increase the productiveness of each session. These include token boards or point systems, visual schedules, timers, most-to-least prompting, etc.
• The occupational therapist guides some goals implemented in ABA such as cutting, handwriting and strategies to increase independence with activities of daily living.
• The speech -language pathologist (SLP) helps the BCBA to select targets for emerging vocal communicators, shaping vocal approximations to words with better articulation and selecting a communication system best suited for a child.
• The SLPs also aids in selecting goals to extend existing receptive and expressive vocabularies. They join ABA team weekly or bi-weekly meetings regarding the care of each patient and occasionally attend meetings with parents.

As you can see, the coordination between these three pillars of autism therapy allow targeted goals to get a multi-pronged approach. Too often autism treatments are done without the knowledge or cooperation of all of the therapists who are employed to help the child. We at Kaufman Children’s Center have committed to change that approach for the betterment of the child and his or her outcomes

BY KERRY PETERSON, MA, CCC-SLP, BCBA
Speech-Language Pathologist
Board-Certified Behavior Analyst

Every child with autism spectrum disorder is unique and not all need the same combination of treatments to make progress. Much depends on a child’s individual strengths and needs. What is generally the same across the board is that parents of children with ASD, like all parents, want their children to reach their highest potential.

Although many treatments claim to improve outcomes, applied behavior analysis (ABA) continues to be the first treatment recommended following a diagnosis of autism. Because it has been studied for decades and has the largest body of research to support its efficacy, it is considered the gold standard in autism treatment.

ABA treatment is designed to establish and increase skills across many areas, including but not limited to communication, cognitive skills, activities of daily living (such as dressing and toileting), social skills and play/leisure skills. Early ABA intervention significantly improves a child’s long-term outcomes.

Treatment is typically delivered intensively at 25-40 hours per week. This is considered a comprehensive ABA program and is intended to “close the gap” between where a child is functioning compared to his or her peers. Not all children will need this many hours of treatment, especially if they appear to be benefiting from more naturalistic learning opportunities.

ABA treatment can also effectively reduce challenging behaviors that negatively impact the quality of life for children and their families. Many children with autism struggle with transitions and tolerating limits, and often exhibit severely restricted eating and sleeping habits. They may also have physical behaviors that pose safety concerns. A focused ABA treatment plan targets specific behaviors that are in need of reduction in order for the child to have an improved quality of life.

Family involvement is critical for the success of ABA treatment. Skills must be generalized across all settings and among people in the child’s life to become and remain established. Parents must understand that their behavior and the home environment are important factors to help ABA treatment be successful.

BY AMY HENGSTEBECCK, OTRL
KCC Director of Occupational Therapy & Sensory Programs
Occupational Therapist

Cold temperatures and snowy weather can make everyone feel cooped up in wintertime, which makes it a difficult season for children. That’s why it’s so important to get outside and enjoy winter activities whenever possible.

Whether they have known sensory issues or not, kids need year-round outlets for all of that energy! To that end, focus on input such as vestibular (movement), proprioceptive (body awareness and muscle input, often through “heavy work”), motor planning (conceiving, planning and carrying out activities) and other, more self-explanatory types of input.

Here are some ideas for outdoor winter activities that will help in this regard, while providing a great time for everyone.

• Have your child put on their own winter gear – such as snow pants, coat, hat, gloves, scarf and boots – as a different opportunity to work on dressing skills. Try to allow them to do as much as they can by themselves. Pulling on these added heavy layers also provides kids with proprioceptive input, which increases body awareness and strength.
• Build a snow fort or igloo together to provide proprioceptive input through heavy work. This also helps a child work on motor-planning skills.
• Sled down a hill for vestibular input through movement. Have your child pull you or another child on the sled for heavy work.
• Make a pile of snow and take turns crashing into it for proprioceptive input.
• Have your child shovel snow with a shovel that’s just their size to provide both shoulder strengthening and heavy work.
• Have a snowball fight or throw snowballs at targets to work on hand-eye coordination and object-manipulation skills.
• Hide brightly colored objects in the snow and have your child use their visual scanning skills to try to find them all.
• Make snow angels and compare and contrast the differences in sizes and shapes.
• Fill squirt bottles with food coloring and water. Spray the snow different colors to make fun patterns on the snow and work on fine-motor strengthening.
• Build a snowman to provide heavy work while rolling the snow into balls. Add as many features as possible to help build body awareness.