Monday, July 27, 2015

Summer Bucket List


Dear Melissa,
Help! My kids start back to school soon. It seems as if the summer has simply flown by and we have not had time to truly enjoy it. What are some cheap/free things we can do as a family before we get back into the school routine?

I can’t lie. Summer is my FAVORITE season. I like nothing better than hanging out on my back porch, either as a family, or alone and curled up with a good book. Heat index 100? Bring it on. That just calls for moving the lawn chair under the shade tree and adding extra ice to my tea!

I, too, begin to feel the panic that sets in after Independence Day. Summer is ending. So much is left to do. How do I prioritize? Here is a list of some of my absolute favorite family-friendly activities that are appropriate for all levels of abilities and require little-to-no money and little-to-know Pinterest savvy!

Water day. It’s a no-brainer. Most people don’t have the luxury of their own swimming pool, but this is no excuse to stay dry on a hot day! Fill random buckets with water and grab a bunch of Dollar Store water soakers and sponges. Spread throughout your back yard and let the water fun begin! Want to get a bit fancier? Adding water balloons to the mix is an obvious choice. Preschool and lower elementary-aged kiddos also enjoy having various plastic bowls/cups/spoons for playing kitchen. Another good choice is having your little Picassos draw with sidewalk chalk, and then use the water cannons to erase their masterpieces. Want even more inexpensive ideas for water day? Visit my Water Day Blog from last year!

Ice Age.  Again, it’s crazy hot outside. You can create a frozen wonderland to cool things off. Take plastic figures (dinosaurs, action figures, etc.) and freeze them in large bowls of water. Then, simply give the kiddos some small hammers, nails, butter knives, forks, etc to chisel the creatures out. (Obviously taking into consideration the fine motor skills and safety awareness of your little ones!) Get buckets of ice water, throw in some sponges, and have a “snowball” fight. Add in an afternoon snack of popsicles or ice cream, and you have created a full afternoon of frozen fun!

Back Porch Time.  This one is super easy. Simply take your favorite frozen afternoon snack, sit outside with our kiddos, and ponder the big questions in life without the interruptions of all of those fancy electronic devices. (The ban on electronics goes for you too Mom & Dad!) So far this summer, my 4 & 7-year-old and I have had some very interesting debates:  evolution vs. creationism, t-rex vs triceratops, Washington vs. Lincoln, Santa vs Easter Bunny, apples vs. pears…you get the idea. Sometimes the conversation will be heavy (and followed by the very necessary point that we DON’T then discuss religion & politics at school!), and other times it is very silly and mundane. The point is that you are talking to your children.

Car Wash.  Do you notice a theme yet? I like to be outside, but I like to be able to keep cool. Park your car in the driveway. Grab some buckets, sponges, dish soap, and your trusty water hose. The kids get to get wet, messy, stay cool...and your car gets clean. Now that's a win-win!  

Tent.  Set it up either outside or inside. Store-bought or home-made from an old sheet.  Help the kiddos set up a tent and then actually spend some time together inside. Read books, tell stories, have a picnic, go crazy! Feeling a bit more adventurous? Grab some sleeping bags and actually spend the night in it!

Write. Ok, you have been meaning to have the kids sit down and do this all summer, but there is no time like the present. As I put it to my own kiddos: “Don’t do it for your mother, do it for yourself. Some day you will be a grown-up, and you will like to remember what you were doing when you were a kid”. It is often too hot to play in the afternoon anyway, so why not take a writing break? For the little ones, have them draw/color a favorite activity or particular interest. For older children, have them write a few sentences on what they liked best about this summer. Even better, have an older child write their own book. Make it a big deal that you are placing this in a “forever spot” to keep and share when they are grown. 

Read. School days will be upon us before you know it. Now is the time to make reading fun. Again, the important word here is fun. Allow even big kids to snuggle on the couch as you read to them. Allow children to read comic books or items of interest that may be below their reading level. Take them to the library or bookstore and allow them to explore. Show them that you too enjoy reading by reading frequently in their presence. It is never too late to foster a love for reading!

That thing. You know…that thing. That thing that you have been wanting to do all summer, but haven’t found the time to do? Well go do it! Make time! You only have a few weeks left.

What are your plans for the last few weeks of summer? 
Do you have a bucket list?  If so, please share!
Resources:
Activities Under $10 That Will Keep Your KidsBusy All Summer Long, Mike Spohr, www.Buzzfeed.com (accessed July 2015)
10 Fun Things To Do With Your Kids This Summer, Kellye Carter Crocker, Parents.com (accessed July 2015) 

Monday, July 20, 2015

Amusement Parks


Dear Melissa,
My family wants to visit an amusement park on our family vacation this year. Any tips for my 6-year-old with Autism to make the experience more enjoyable for everyone?

I have personally been to the amusement park with individuals with both physical disabilities and Autism. In my experience, the staff tends to be extremely helpful and bends over backwards when they see an individual in a wheelchair. But when the special need is less visually obvious, the staff become very suspicious: Does your child really have a special need, or are you just being a whiny guest?  

Therefore, this blog is for children with more “hidden” disabilities such as Autism. Here are some helpful tips to make the most of your next trip to the amusement park: 

Keep Routine
In general, routine is your best friend for all children, and especially children with Autism. As much as possible, keep meal times, snack times, rest/nap time, and bed/wake times the same as a typical day. 

Bring snacks  
Hungry children are grouchy children. Make sure you keep plenty of snacks on hand to ward off both boredom and grouchy hunger pains.  Also, keep in mind special dietary needs or allergies, as your options may be limited once inside the park. It has been my experience that most snack stands will have a book of item ingredients and allergens if you ask. 

Have a plan for long lines
Don’t just have an A and B plan for waiting in line. Make sure you have plans C, D, E, F, and G as well! Fidget toys, snacks, books, handheld games, earphones/music, jumping jacks, eye spy…all can be good distractions for waiting in line. But a word of caution: don’t bring your child’s absolute favorite toy if it can be avoided. There is a high likelihood of it becoming lost in all of the excitement. 

Avoid crowds
Me: “Hey, I hear you are going to Silver Dollar City on Saturday!!!”  
Kiddo: “Um…I don’t like to be around that many people…”  
What? What kind of response is that?  The response of a person who has Autism. If your child has this reaction, try to avoid weekends, holidays, and other times when you know the park will be the most crowded. Some places, such as Disney World, even have crowd calendars so you can plan your trip during less busy seasons. 

Dealing with noise/crowds once you are there
If your child will tolerate ear buds or headphones, consider using these to block out extra sounds. A hoodie can also be pulled over his head to help muffle sounds. In addition, ask around and find a couple of quiet corners of the park where you can take a breath and relax a bit before joining back in the fun!  

Know your child’s ride tolerance 
I am completely guilty of “therapizing” my biological children at amusement parks. I regularly push the envelope (just a bit) and make them ride rides slightly outside their comfort zone.  However, if your child is hesitant to go on the merry-go-round at the park, then he will probably be terrified by a roller coaster. So don’t do it! On the other hand, many kiddos with Autism and ADHD are complete sensory seekers and can’t find a roller coaster fast enough. If you have a sensory seeker, make sure you pair him with an adult who can tolerate these types of rides so nobody gets sick!  Bottom line, know your child and choose rides accordingly. 

Know your child’s walking tolerance 
Normally, I would never put a 7 or 8-year-child in a stroller, but this is totally the exception.  Shoot, I want to use a stroller at the park! If the child can fit in it, then use it!  An added bonus is that the stroller can also help prevent the temptation for the child to wander off.  

Put an ID bracelet on your child 
Have a way to ID your child if he gets lost or tends to wanders off. Use a bracelet with your child’s name, your name, and your cell phone number so staff can find you quickly if your child becomes lost. You may want to check with the amusement park. Many have stations that will provide these ID bracelets for your child and measure your child so you know which rides he is tall enough to ride. But a word of warning: many children are resistant to these wrist bands due to sensory sensitivities. Other options may be to put the wristband on a belt loop, shoe lace, or ankle. 

Role play
As with everything in life, practice makes perfect! Talk about what to expect at the park.  Practice waiting in line. Watch videos of the rides and other aspects of the park. Basically, make sure that the park is a familiar place before you even walk through the gates. 
  
What amusement parks will your family be visiting this summer?  
What worked and what did not?  
Please share! www.share@childrenstherapyteam.com

Resources:
39 Theme Parks with Special Needs Access Passes by Karen Wang (Posted 2013), accessed June 2015
Tips on Enjoying Amusement Parks for Kids with Autism, MetroParent.com, accessed June 2015

Monday, July 13, 2015

Bye-Bye Paci


Dear Melissa,
My daughter is about to have her first birthday, and we want to start weaning her from the pacifier. Any tips?

I too started weaning both my children from the pacifier around 1 year of age. And, in my experience, the final step of eliminating the pacifier completely at 2 years of age was one of the hardest things I have done as a parent!

Again, a pacifier is a strong source of comfort for many infants/toddlers. And for children with Autism and/or Sensory Processing Disorders, letting go of this consistent source of self-soothing can be particularly difficult. Why exactly do we feel it is necessary to take something away that our little ones so dearly love? Well, nobody ever said parenting was easy. We are the adults. We know that pacifier use shouldn’t last forever. As I have discussed in several recent blog posts, extended pacifier use can hamper speech development, social development, as well as dental/oral structure.

Again, this is HARD. There are many tricks you can try to help the weaning process along, but ultimately a child should be weaned from pacifier use by 2-3 years of age to prevent long term complications/delays. What trick(s) you try vary widely depending on the age of the child. Here are a few of my favorites:

Wean early  
If you stop the pacifier “cold turkey” before 6 months of age, the baby hasn’t really developed the chance to voice a strong opinion in the matter. Yes, there will likely be a few days of crying as she learns a different method of self soothing, and you will likely find her wanting to nurse or drink from a bottle more frequently during this time. However, many parents swear that this “cold turkey” method is way easier in infancy than waiting until she has grown into an opinionated toddler. 

Wean gradually 
I personally used this approach. You slowly disallow the pacifier in more and more environments until you are only left with the night-time pacifier (which is hard to give up!).  You might start with “no paci at daycare”, then “no paci while playing”, etc. In my house, we worked pretty quickly to the pacifier only being allowed in the car seat and crib. This makes bedtime and car rides much more enticing, but it is also very hard to wean the pacifier away from these times when soothing is so needed!

 Make it less desirable
This method works so well that the people at the One Step Ahead store have even created a product to mimic it. But, let me save you $29.95 plus S&H! For this method, you take away all of the pacifiers in the environment except for 2-3. The child can have these pacifiers any time she wants. BUT, you begin to very gradually cut off the tips of these pacifiers, millimeter by millimeter, at whatever pace you choose, until the child is only left with the hard plastic part, and nothing left to chew on. (Warning: Make sure that the remaining plastic part is not a choking hazard). As the rubbery nipple gets smaller and smaller, the child will loose interest, and no longer ask for it. Problem solved, no tears!

Give it away
This method is more appropriate for an older child. The child must be old enough to understand cause and effect and be able to participate in simple storytelling. Often this occurs around 2-3 years of age. For this technique, you discuss with the child that she is getting older and is now a “big kid”. As part of the story, she can either give the pacifier away (such as to the baby classroom at daycare), or she can leave it for the “Paci Fairy”.  Better yet, choose to do this around Christmas/Easter and have Santa or the Easter Bunny do their magic. Whatever story you choose, the magical entity takes pacifiers to babies, and your now "big kid" kiddo may enjoy a new "big kid" toy from the Paci Fairy or Easter Bunny. But here is the kicker. Once you make this exchange, YOU CANNOT GO BACK TO THE PACIFIER! If you turn back now, your child will know that they can make you change your mind any other time in the future that you try to set a firm limit. Not a fun situation to get into with a toddler! Another disclaimer with this technique is that you do not want to give the pacifier away to a close cousin or a new sibling. This can just create jealousy and resentment toward the new baby in her life. 

A word of caution
Pacifiers are soothing. And again, they are particularly soothing for children with Autism or Sensory Processing Disorders. If you take away something that is soothing from your child, she will generally find her own replacement item/activity that is self-soothing. Sometimes what your child uses as the new self-soother is even worse than the pacifier! This is a whole different problem on how to fix inappropriate oral sensory seeking. For tips on this, see my previous blog on this issue.

Do you have a question you would like me to address or ideas about pacifier weaning? 
Don't hesitate to share!

Resources: 
Ask Dr. Sears: Weaning Off PacifierParenting.com, accessed July 2015
Are Pacifiers OK...A Dentist's Take, Monday's with Melissa Blog, Children's Therapy TEAM, posted June 15, 2015  
Night Time Pacifier UseMonday's with Melissa Blog, Children's Therapy TEAM, posted July 6, 2015  
Oral Sensory Seeking Help, Monday's with Melissa Blog, Children's Therapy TEAM, posted September 15, 2014
Pacifiers: In or Out?, WebMD, accessed July 2015 
Pacifier MistakesMonday's with Melissa Blog, Children's Therapy TEAM, posted June 29, 2015  
Pacifier Time vs. Language DevelopmentMonday's with Melissa Blog, Children's Therapy TEAM, posted June 22, 2015 
10 ways to help your child give up the pacifierBabycenter.com, accessed July 2015

Monday, July 6, 2015

Night Time Pacifier Use


Dear Melissa,
Whenever my 10-month-old cries at night, I respond by giving him a pacifier. The problem is that he cries 4 or 5 times a night until a pacifier magically reappears in his mouth again. Help, I'm sleep deprived! How do I wean this child from his pacifier?

This one is super tricky. It is one thing to address behavior modification during the day, or even when going to bed at night, but addressing undesirable behaviors in the middle of the night can be extra complicated. First, the child is sleepy and not in his rosiest mood. Second, YOU are tired and impatient, and certainly not in YOUR rosiest mood either. What makes things worse is that your child generally gets the benefit of a nap to “catch up” on the sleep, while the parent simply becomes more and more sleep deprived. Not a fun situation. 

My own son went through this phase when he was a bit older, from about 12-18 months. Whether you are dealing with an infant or a toddler, waking frequently in the middle of the night can be hard on everyone! There is no magic fairy dust to solve this problem, but here are a few ideas that just might help.

Fill up the tank
Infants have the desire for sucking for 2 reasons: for calming (non-nutritive sucking), and for calories/nutrition (nutritive sucking). Use of a pacifier is non-nutritive sucking, but it is easy for a hungry baby to confuse the two. It certainly doesn’t hurt to make sure that your baby has a full tummy before nodding off to sleep to help increase the odds of sleeping through the night.

Create a pacifier paradise
This seemed to work fairly well with my own son. I always put him to bed with multiple pacifiers. After around 6 months of age, a baby should be able to put a pacifier in his mouth. Placing several pacifiers in the crib at once increases the odds that he will find the pacifier himself and solve the problem without your intervention. Not to mention, teaching this self-sufficiency and independence is a useful life skill. One time I moved his crib and found THIRTEEN pacifiers stuck between the crib mattress and the wall!  Yes, this is a bit excessive, but we got sleep!

Make the pacifier less desirable 
Basically, this step is simply making the child not want the pacifier as much in the middle of the night. Some tricks to making the pacifier less desirable:
  • Decreasing/eliminating nighttime feedings (but only AFTER your child’s pediatrician thinks that your child is growing well enough to eliminate them).
  • Manipulating the pacifier so that it is less desirable by slowly cutting more and more of the pacifier tip until it no longer provides the desired sucking effect (modify with caution as to not produce a chocking hazard)
  • Eliminating the overall use of the pacifier so that the child knows that the pacifier is no longer an option (more tips on weaning from the pacifier next week!)
Monitor the situation
The video baby monitor is the best investment I have ever made. Even at ages 4 and 7, I still use it to check up on my kiddos at night! When my babies cried at night, I always had a “head off the mattress rule”. Babies, children, and even grownups can make random sounds, noises and even talk/cry in their sleep. When I heard crying, I would always intently watch the monitor (I promise, I was not simply ignoring my child!). If the baby’s head was still on the mattress, then he obviously was not too upset. This allowed for the possibility that he was simply crying in his sleep.  It also gave the baby the opportunity to self-soothe.  Again, I really feel that you can’t start teaching problem-solving skills too young!  If you are patient and wait just a bit, sometimes, just sometimes, the child learns to soothe himself – either with sucking on his hand, finding the pacifier, or simply moving into a more comfortable position. 

Does your baby sleep through the night?  
What did you do to stop frequent night wakings?  Please share your ideas!

Resources:
Sleep Training 101, Mondays with Melissa Blog, November 2014 
Common Mistakes Parents Make with Pacifiers, Mondays with Melissa Blog, June 2015
Bye Bye Binky, Ending the Pacifier Habit, Marguerite Lamb, Parents, accessed June 2015
Ask Dr. Sears – Weaning Off the Pacifier, William Sears, Parenting, accessed June 2015