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New Year’s Resolutions

With a new year comes a new year resolution. One of the most common New Year’s resolutions is adopting a healthier life style. This week I am going to highlight some key points on how to create a healthier life style for you and your child.

Choose my plate is a fantastic resource for learning about nutrition. In order to adopt a healthy life style you need to adopt healthy eating habits. Choose my plate has tons of resources on how to do this. They have tips and tricks for picky eaters and also give ideas for well balanced meals and snacks for kids of all ages. They also have different games, activities, and recipes to help make eating healthier fun and exciting.  Check out the Choose my plate page here and get started on a healthier life style https://www.choosemyplate.gov/children

The second half to adopting a healthier life style is to exercise. It is important to limit a child’s screen time and to encourage a more active life style. If you remember from last week’s blog I talked a lot about gross motor activities. Those are great ways to get kids up and exercising. Walking is another way to get kids moving, and is a great form of exercise.  Here are some other websites with great exercise activities

http://handsonaswegrow.com/gross-motor-activities-preschoolers/

http://www.ot-mom-learning-activities.com/gross-motor-activities.html

http://www.stillplayingschool.com/2015/01/active-fun-games-indoor-kids-gross-motor.html

Like any other change it is going to take time. Small changes should be made over long periods of time. This helps to build a routine and consistency. Changing everything all at once usually leads to too much of a drastic change and often causes people to become frustrated and give up. With a life style change it is important to take little steps and to stick to them.

-Matthew D’Antonio, PT, DPT

Pediatric Physical Therapist

Indoor Activities to Develop Gross Motor Skills

Gross motor skills are body movements such as walking, running, jumping, throwing, etc. In order to develop gross motor skills we must be able to coordinate our large muscle groups (arms, legs, and core) to work together. Practice and repetition are the best ways to develop and fine tune gross motor skills. In this week’s blog I am going to give you some fun indoor activities to help develop your child’s gross motor skills.

Crab Soccer = Get into the crab position and kick a ball. You can divide up into teams and kick towards a goal or simply just kick it back and forth between one another.

Hop scotch = Build a hop scotch board inside with pillows, tape, or with paper plates. Working on jumping with 1 foot and 2 feet and be sure to alternate between the left and the right.

Bubbles and Balloons = You can blow bubbles and have your kids try to pop them all, or blow up several balloons and have them keep them off the floor. Both of these are great ways to improve hand eye coordination.

Activity Dice = Create dice out of wood blocks and write a different activity on each side such as hopping on 1 foot, running, balancing on 1 foot, crab walking, etc. Then make another die with all different numbers. Have them roll both dice and do the activity the set number of times.

Walking balance = Build a balance beam with your child and practice walking different ways such as forward and backward.

These are just a few different outdoor gross motor activities that you can try. Below are a few links that have tons of other different ideas.
http://www.earlylearningactivities.com/PDF/og.pdf
http://codenamemama.com/2011/08/11/gross-motor-games/
http://handsonaswegrow.com/


-Matthew D’Antonio, PT, DPT
Pediatric Physical Therapist

OT Toy Guide

The holiday season always sneaks up on us, as we balance visiting with friends and family, preparing wonderful meals, participating in fun and heartfelt family traditions, and exchanging gifts with loves ones. As children make wish lists for Santa, and friends and family request gift ideas for your young ones, it can be hard to come up with the perfect gifts. When deciding on gifts for my own or other children, I like to consider a few details:

• Quality over quantity: Rather than having mountains of toys, several of which will be neglected while new favorites are discovered, invest in a few toys that are of high quality, and will last. This also helps to reduce sensory overload, both on Christmas morning and in the days and weeks that follow as you attempt to organize a play area. 
• Multiple ways to play: Toys are expensive, and children’s skills and interests are always changing. Find a toy that can be played with in multiple ways so that play can develop as your child grows and changes. 
• Developmentally appropriate: Think about the age of your child, but also consider where they are developmentally. Does your child need more practice with fine motor skills? There are plenty of fun games and toys to develop specific skills. Is he a sensory seeker? Christmas is a great opportunity to give him the tools he needs to self-regulate!

There are some great blogs and resources out there that suggest toys and gifts for children at specific developmental stages and with a variety of special factors in mind. Here are a few of my favorites:

• Mama OT has numerous OT-related lists, like Stocking Stuffers to Help with Pencil Grasp and the Ultimate List of Gifts for Sensory Seekers.
• Check out Sugar Aunts’ suggestions on Gifts to Promote Scissor Skills and Toys and Tools to Promote Visual Tracking.
• This guest post gives OT-recommended toy suggestions broken down by age.

When it comes to where to shop, you don’t have to go to a special retailer to find toys for children with special needs (although some of the toys, games, and equipment available at sites like Fun and Function and Special Needs Toys are awesome!). The blogs listed above name numerous ‘mainstream’ toys that can cater to specific needs and skills. One of my absolutely favorite toy companies is Fat Brain Toys, with tons of unique and fun ideas!

For a little extra guidance, check out Toys“R”Us’s Toy Guide for Differently-Abled Kids. Using this guide, you can search for toys that promote skills development in numerous categories, including auditory, creativity, fine motor, gross motor, language, self-esteem, social skills, tactile, thinking, and visual. The website also includes links for Tips for Toy Buying and Toy Safety Tips.

Another great resource is the National Lekotek Center, a nonprofit organization that provides an array of services to improve the lives of children with special needs through the utilization of toys and play. They publish the AblePlay website, which offers research, ratings, and reviews of toys and products appropriate for children of all abilities, focusing on the developmental areas of physical, sensory, communicative, cognitive, and social/emotional abilities of a child. They also publish this guide for lots of toy ideas!

By Krista Flack, MS OTR/L, Pediatric Occupational Therapist

Christmas Parade Information

It is that time of year again! The Christmas Parades are right around the corner. Below is all the information for the parades. We can’t wait to see everyone out there!

Bluffton Christmas Parade

• Saturday December 2nd at 10:00 am
• Streets to begin closing at 8:00 am
• Parade Route = https://www.townofbluffton.sc.gov/pdfs/christmas-parade-route.pdf

Beaufort Christmas Parade

• Sunday December 3rd at 3:00 pm
• The parade will go thru the streets of downtown Beaufort

This year’s float theme is about therapy being a team sport. We will all be wearing jerseys for our favorite football team! If you and your child wish to walk with us in the parade please see Krista Flack at the Port Royal clinic or Matthew D’Antonio at the Bluffton clinic for more information!

-Matthew D’Antonio, PT, DPT

Pediatric Physical Therapist

Holiday Calming Kit

With the holidays upon us, there is a lot of extra stimulation for our bodies to take in.  Crowded stores, long lines, family gatherings, holiday programs or services, and car rides are just a few examples of situations that can lead to both boredom and over-stimulation, a dangerous combination.  Finding something to keep little minds, bodies, and hands busy while waiting can be tough – here are a few ideas to keep on hand!

First off, let’s talk storage!  One of my favorite ideas out there is to use pencil cases like these to store each individual activity.  They can be clipped together using binder rings, stored in a binder, or kept individually.  Either way, each activity is contained and easy to transport and find.  A similar option is to store each activity in a small container (like Play-Doh cups), or even in zip-loc bags.  For older kids, using a hard pencil case or old wipe container can contain all items in one place.

To improve self-regulation:

• Putty – silly putty and other doughs provide heavy work for the hands and fingers, which can have a calming effect.
• Fidgets – there are so many fidgets out there (many of my favorites can be found here), and your child’s OT can help you decide which ones are best for him or her. 
• Chewing gum or hard candies – sucking and chewing motions can be calming, as they provide heavy work for the mouth, cheeks, and jaw!
• Sunglasses, a hat, ear plugs, headphones, or other items that help reduce visual and auditory input when there is so much going on!
• Bubbles – while some children can become overly excited when bubbles are around, many children respond positively to both the oral motor work (blowing) and the calming visual stimulation provided by bubbles.
• Calming scents – while some people swear by essential oils and aromatherapy tools, other simply find that certain scents are calming or alerting.  Scented markers, play-doh, and other items can provide just a faint scent, which may be enough to calm an overly excited child.
• Weighted items, while not as easy to fit in a small space, can be incredibly calming when over-stimulated.  For some, keeping all items in a backpack might provide enough weight when worn by the child.  Weighted blankets, lap pads, and shoulder pads can also be made (or bought).  Talk to your OT about guidelines for weight limits and use. 
• Last, having note cards or pictures of activities that don’t require equipment but can be calming is a great way to make sure you don’t forget about some useful tools.  Jumping jacks, animal walks (crab walk, bear walk, wheelbarrow walk, etc.), push-ups, and other activities can provide proprioceptive and vestibular input to calm wiggly bodies.

To stimulate the mind and pass time (quietly), here are some fun activities to keep on hand.  While these activities do not necessarily have a direct sensory connection (although every activity stimulates some part of our sensory system), they are great at keeping little ones busy:

• Manipulatives – Legos, blocks, k’nex, and other similar building items can keep some busy for hours.  For younger ones, even twisting and connecting pipe cleaners can be engaging.  I also love this easy-to-make Velcro popsicle stick or block set!
• A cookie sheet and magnets can provide entertainment for all ages.  Shapes, letters, and numbers are easy to find at dollar stores and similar places, but also consider sets that are more interactive, like these.  Or, attach a magnet to the back of puzzle pieces to put together!
• Lacing boards, button strings, and crazy straws with shapes can be a fun way to get some fine motor practice in as well!
• Crayons, paper, stickers, and other simple art supplies are easy to pack and use.  WaterWow books and similar products can be sure to minimize mess!

PT Recommended Toy

Christmas is approaching fast! In this week’s blog I am going to highlight some great toy ideas that are not only fun to play with, but also help your child improve their gross motor skills, strength, increase activity levels, and much more.

1. Toys to promote standing
Getting your child to stand can be a difficult task. Most kids once they stand to get the toy want to sit back down to play with it. Play tables such as a water tables, art tables, or train tables are a great way to get your child standing and keep them standing. This will not only work on LE strength, but it will also help balance as children become more confident they will begin playing with two hands instead of worrying about holding on. Here is a link for some different standing toys http://blog.dinopt.com/standing-101/

2. Balance Beams
Balance beams are a lot of fun for children of all ages. They can be used to work on standing and moving balance. One of my favorite balance beams is the Curve-A-Beam set. The pieces can be taken apart and arranged in many different ways to keep games fun and entertaining. Check out this blog for some specific activities relating to the Curve-A-Beam set and other balance beams http://blog.dinopt.com/five-fun-activities-with-balance-beams/

3. Tummy Time Toys
Tummy time can be a daunting task for children, and most kids can only handle a little bit of time tummy before crying. Mirrors are often a great toy to lay on the ground to help keep a child’s attention. I also use a piece of cardboard that is wrapped in metallic wrapping paper. The shimmer and crinkle of the paper help to keep the child’s attention for much longer. Here is a list of great tummy time toys from Dinosaur Physical Therapy http://blog.dinopt.com/best-tummy-time-toys/

4. Active Play
Getting kids up and moving around is so important for physical development and to improve gross motor skills. Plasma cars and roller racers are great toy ideas to promote activity. Not only do they get kids out of the house, but they also work on endurance, core strength, upper body strength, and coordination. Other great active toys are bikes, scooters, and trampolines.

Here is a link from Dinosaur Physical Therapy with tons of toy recommendations for all different ages and goals. http://blog.dinopt.com/category/toy-recommendations/

Also, be sure to check out Krista’s blog for some toys that are recommend from an occupational therapy perspective.

-Matthew D’Antonio, PT, DPT
Pediatric Physical Therapist

GERD Awareness Week

GERD Awareness Week is November 19-25, 2017. Gastroesophageal reflux disease, or GERD, is a very common disorder. Each year around the week of Thanksgiving, IFFGD encourages people experiencing the symptoms, which may be GERD-related, to consult their physicians and to contact us to receive information and support regarding the condition.

Gastroesophageal reflux is the backflow of stomach contents into the esophagus. Under normal circumstances, the lower esophageal sphincter (LES) acts like a valve to prevent backflow.

During the first year, "spitting up" is a normal phenomena in infants. It generally takes about a year for the LES to mature. If reflux persists beyond the first year, it can lead to a failure to gain weight adequately, irritation of the esophagus, and aspiration with respiratory difficulties.

Gastroesophageal reflux disease (GERD) refers to symptoms or tissue damage caused by gastroesophageal reflux.

If you suspect your child may be suffering from reflux, the first step is to consult a physician and obtain an accurate diagnosis. The diagnosis of GERD can often be made based upon symptoms and may be confirmed by one or more tests.

Some dietary and lifestyle changes can reduce GERD-related symptoms.   No single diet can prevent all symptoms of GERD, and food triggers are different for everyone.  To identify your individual triggers, keep a food diary and track the following:

• what foods you eat
• what time of day you eat
• what symptoms you experience

Keep the diary for at least a week. It’s helpful to track your foods for a longer period if your diet varies. You can use the diary to identify specific foods and drinks that affect your GERD.  Below are some general guidelines that can be used in conjunction with your food journal and recommendations from your doctor. The goal is to minimize and control your symptoms.

1. Avoid chewing gum and hard candy. They increase the amount of swallowed air which, in turn, leads to belching and reflux.
2. Do not lie down immediately after eating. Avoid late evening snacks.
3. Avoid tight clothing and bending over after eating.
4. Eat small, frequent portions of food and snack if needed.
5. Elevate the head of the bed six to eight inches to prevent reflux when sleeping. Extra pillows, by themselves, are not very helpful.
6. The following foods aggravate acid reflux, and should be avoided:

National Epilepsy Awareness Month

Epilepsy is the 4^th most common neurological disease in the nation according to the Epilepsy Foundation. 1 in 26 people will be diagnosed with epilepsy at some point in their lifetime. Seizures can happen to anyone and can occur anytime. The goal for this blog is to explain seizure first aid and what you should do if you experience someone having a seizure.

1. Always stay with the person until the seizure is over

• Seizures are unpredictable in nature and it is hard to tell how long they will last or what will occur during them
• A seizure may lead to loss of consciousness or fall causing another injury

1. Pay attention to the length of the seizure

• Time the seizure from beginning to end
• Time how long it takes the person to recover and return to their usual activity

1. Stay calm

• Most seizures only last a few minutes
• Remaining calm will help the person stay calm as they recover from the seizure

1. Prevent Injury

• Move nearby objects out of the way
• If you can’t more surrounding objects or a person is wandering or confused help steer them clear of dangerous situations

1. Make the person as comfortable as possible

• Help them down to a safe place
• Support the person’s head to keep it from hitting the floor

1. Do not put anything in the person’s mouth

• Jaw and face muscles may tighten during a seizure causing the person to bit down
• If there is an object in the mouth they could be at risk to swallow it or break their teeth
• A person can’t swallow their tongue during a seizure

1. Make sure breaking is ok

• If they are lying down turn them on their side with their mouth pointing to the ground in order to keep saliva and vomit from blocking the airway
• Rescue breathing or CPR is generally not needing during a seizure

1. Do not give water, pills, or food by mouth unless the person is fully alert

• If they are not fully alert they can swallow incorrectly causing things to go into the lungs rather than the stomach

1. Call for emergency medical help when….

• The person has never had a seizure before
• A seizure lasts 5 minutes or longer
• One seizure occurs right after another without the person gaining consciousness
• Breathing becomes difficult or the person appears to be choking
• Seizures occur closer together than normal
• The seizure occurs in water
• Injury may have occurred
• The person asks for medical help

Here are some links for more on seizure safety

https://www.cdc.gov/epilepsy/basics/first-aid.htm

https://www.epilepsy.com/learn/seizure-first-aid-and-safety/adapting-first-aid-plans/seizure-first-aid

https://www.epilepsysociety.org.uk/10-first-aid-steps-for-convulsive-seizures

-Matthew D’Antonio, PT, DPT

Pediatric Physical Therapist

Lowcountry SC Walk for Apraxia

While most children almost miraculously learn to speak without effort, children with apraxia struggle mightily to accurately produce sounds, syllables and words. While their understanding of language is usually much better than their ability to express it, children with apraxia have difficulty planning and programming the movements which underlie speech. At the heart of it, speech is more than knowing what you want to say. Rapid and finely graded movements of speech structures (the lips, tongue, palate and jaw, etc.) occur which allow us to clearly articulate our ideas. But for children with apraxia, ideas are often stuck inside, unspoken or not understood, because of apraxia. Childhood Apraxia of Speech is considered rare among speech disorders in children and particularly challenging to overcome.

Each year a growing number of families, friends and supporters of children with apraxia come together at towns and cities throughout North America to participate in the Walk for Apraxia. While the walk is a tremendous avenue to raise awareness about apraxia and raise critical funds for programs and research, it is also so much more. At its heart, the Walk for Apraxia is about the children. Walk day is a chance to celebrate the efforts, persistence, and resilience of children with apraxia. On their special day, children with apraxia get a chance to shine brightly - our shining stars. Many of them do not have the opportunity in other activities to be held up for their accomplishments, but on their Walk for Apraxia day? Well, these children are proudly front and center! Finally, the Walk for Apraxia is a reminder to not only the kids, but also to their families, that they are not alone. At the walk, relatives, friends, neighbors, co-workers and community members surround them, creating connection and a web of support.

Come support and raise awareness for apraxia this Saturday, November 4, 2017 at Pigeon Point Park in Beaufort!  Register here: http://casana.apraxia-kids.org/site/TR?fr_id=2295&pg=entry

 

By Krista Flack, MS OTR/L, Pediatric Occupational Therapist

Jack's Roast

Progressive Behavior Consulting and the Corner Perk have teamed up to raise money for Lowcountry Autism Foundation. The Corner Perk has created a special blend of coffee called Jack's Roast. By purchasing a bag of Jack's Roast you are helping families obtain diagnostic evaluations for their child, parent support groups, community events, and ongoing support services! Check out this video about Jack's Roast https://m.youtube.com/watch?v=0s4qmQvyzuI 

Lowcountry Autism Foundation (LAF) is located on Hilton Head Island and helps to provide resources for children with autism and their families. All programs and resources are FREE and covered by LAF. Click here (http://www.lafinc.org/access-our-services/) to sign up and receive free programs and resources. Below is a list of the different resources and programs offered by LAF.

Family Support Services

This program provides families with multiple resources based on the specific diagnosis a child receives. The program features a one on one relationship with you and a LAF representative. LAF provides information, service coordination, and direct assistance to families affected by autism spectrum disorder and other developmental disabilities. The group meets on the 4th Tuesday of every month from 6-8 in Summerville, SC, and childcare and refreshments are provided. For more information on this program click here http://www.lafinc.org/family-support-services/

Art Therapy

Art therapy is a mental health profession that uses the creative process of art making to improve and enhance the physical, mental, and emotional well-being of individuals. The Art Therapy Program integrates the fields of human development, visual art, and the creative process with models of counseling and psychotherapy. Art therapy is provided with a standard of 10 hours. After the 10 hours the therapist will re-evaluate the child to see if additional sessions are necessary. For more information on this program click here http://www.lafinc.org/art-therapy-program/

These are just a few of the programs and resources available thru the Lowcountry Autism Foundation. For more information on LAF and the programs they offer click here http://www.lafinc.org

Matthew D'Antonio, PT, DPT