What is the Mid-America Accessibility Summit?

Melissa,
I saw fliers for the Mid-American Accessibility Summit in the waiting room last week. Can you give me the scoop?

Yes! It has been exciting to see the buzz and excitement surrounding this inaugural event. It is being hosted by our TEAMworks non-profit so many of my Children’s Therapy TEAM colleagues as well as several talented TEAM teens are working hard to make it happen. The Mid-America Accessibility Summit (MAAS) is a regional exhibition drawing on sponsors from a tri-state area (Arkansas, Oklahoma and Missouri). To get the latest, I interviewed two of the event coordinators, Tabitha Mayberry (TEAM Speech Therapist) and Kelly Yates (TEAM Occupational Therapist).

So what will this event look like?
Tabitha: The Summit is a fantastic (and FREE!) way for the community to explore a wide array of vendors, products, and services geared to individuals with a variety of special needs including both physical and mental disabilities. What’s so fantastic about this event is that all of these services will be under one roof so patrons can discover possible services that they had never known about before.

Can you describe some of the vendors attending?
Tabitha: This event is not just about wheelchairs. It is to help the community learn about services for a wide variety of special needs. There will be MAAS Vendors for Veterans (Soldier on Service Dogs), Extracurricular activities for children with special needs (TEAM Talent), Adapted Vehicles (Presidential Conversions), Physician offices (Pediatric Orthopedic Surgery Associates), Wheelchair vendors/equipment (Action Seating and Mobility, Permobil), Financial services (Special Needs Planning Center) and much, much more.

Are there other events besides the vendor booths?
Tabitha: So much More! Throughout the entire day we have a fantastic line-up of speakers. Each session will be approximately 1 hour and will allow time for questions from the audience. A new speaker will be showcased every hour. (See full list of presenters here).

Kelly, why do you think an event such as MAAS is needed in Northwest Arkansas?
Kelly: We were able to locate events such as MAAS on the East and West Coasts, but there really wasn’t anything available anywhere close to our area. As an occupational therapist who really tries to look at the whole person, I help families navigate and access services, but sometimes I don’t know everything that is out there. This is a great way for healthcare professionals, clients and families to all stay up-to-date on the latest services available.

How does this event fit with the mission of TEAMworks?
Kelly: The mission of TEAMWorks is to help orphans and individuals with disabilities both locally and internationally. It is really fitting that this fundraiser for TEAMWorks can serve both as a service to the community as well as a fundraiser to further assist the needs of the community.

Kelly, what are you most excited about at MAAS?
Kelly: I am really excited to hear Dr. Ganesh Gupta speak. He is giving a presentation about the current research on the relationship between gut bacteria and overall health and a second presentation on helping parents make medical decisions for their minor children. I am also very curious to see what types of services are provided from Soldier On Service Dogs and Equestrian Bridges. The healing power of animals has been a keen interest of mine throughout my career as a Pediatric Occupational Therapist.

Thank you Tabitha and Kelly for sharing! Remember, the Summit is Saturday, September 12th and is FREE to the public. Hope to see you there!

Sensory Appropriate Classroom Design

Dear Melissa, When I went to my child's open house I personally felt overstimulated by my child's classroom. I know OT's are gurus of classroom design. What are your thoughts? 

I know school system budgets are tight and teachers often do not have the luxury of consulting their school OT for many of the sensory kiddos in their classroom. Here are some simple modifications that can help kiddos who are 1) over-stimulated and sensory defensive OR 2) kiddos who are under-stimulated and need extra sensory input.

What doesn't work for kids with SPD

Way back when, while I was in OT school, I had the privilege of being a literacy tutor. I attended masters-level classes with teachers. As an OT student I remember listening to lectures and often feeling like the techniques conflicted with what I was taught as an OT student. One example of this was the common guidance to teachers to design "welcoming" classroom environments that were overstimulating (see example below).

 an overstimulating classroom

The classroom above is bright, colorful, kid-friendly, and very inviting, right? Unfortunately, this is far from the ideal classroom for a child with sensory processing disorder (SPD). While all of the bright colors and patterns are inviting, they are often too stimulating for children with SPD. My advice: De-clutter! A much less distracting room would look something like this: 

a sensory appropriate classroom for a child with SPD 

Yes, I know some might call this “boring”, but it allows for the child to focus on the task at hand rather than being distracted by the walls. Teachers might not be able to de-clutter to this extent, but several of the following simple techniques can help: 1) adding cabinets, 2) adding simple shelves with uniform bins, 3) covering materials with solid curtains, 4) using solid rugs, 5) decreasing extraneous patterns and pictures on the wall. Such adjustments can help locate the middle ground between inviting and over-stimulating. 

Ideas about increasing sensory input

Theraband on chair legs and wiggle discs in chair seats  
Kicking against the theraband and sitting in a wiggle seat allows a child to move his body without ever leaving his seat!

Exercise
Brain Breaks (YouTube has some great examples), dance, jumping jacks, frog jumps, walks to the office, stacking chairs, carrying stacks of books, yoga, etc.  All of these will get their bodies moving, and all are free! Mounting scientific evidence shows the effectiveness of exercise for improving attention to task. 

Fidget toys
Koosh balls, stress balls, finger traps, Slinkys, velcro stuck to desks… all will help keep little fingers moving while their eyes are on you, listening to the lesson. 

Gum/chewing
Many children seek out calming oral input by chewing on their shirts, pencils, or other inappropriate objects. Gum is often the best way to achieve this calming oral input. Consider chew tubes or pencil toppers if gum is not allowed.

Ideas about decreasing sensory input

Preferential seating
Many interpret this term to mean sitting in the front of the class, but this is not always the case. Look for distractions such as windows, doors, pencil sharpeners, trash cans, or other high traffic areas that may distract the child and position him away from these. Also, many teachers have a gift for figuring out how to position a less attentive child next to a “positive peer” who can help keep him on track!

Cardboard study carrel

If you can’t eliminate distractions from the environment, create a personal environment for the individual child. Make it bright, colorful, and inviting on the outside but solid in the inside to help the child focus during quiet study times. 

Quiet Corner

Everyone needs a quiet space to get away for a few minutes. It can be simply a few bean bags or throw pillows in a corner, or it can be a full mini-tent. Here is where you can get creative and let your imagination run wild! ALL of the children in your classroom will enjoy curling up with a good book in this inviting space. 

Headphones/ear buds/hoodie

A student can create his own personal quiet space with headphones, ear buds or a hoodie pulled up to help damper out extra sound which may be distracting. 

  

What approach works best when addressing sensory classroom concerns with your child's teacher? I will address this in the coming weeks. 

Do you have a question you would like me to address?

Don't hesitate to share!

share@childrenstherapyteam.com

Resources:

Working with Schools, Sensorysmarts.com (Accessed August 2015)

Sensory Strategies for the Classroom, Occupational Therapy Advance (Accessed August 2015)

How Sensory Processing Issues Affect Kids at School, The Child Mind Institute (Accessed August 2015)

Backpack Safety

Dear Melissa,

My son is entering the 5^th grade this year.  It seems like he is cramming more and more stuff into his backpack every year. Do you have any recommendations to keep his young back safe?

You have the notebooks and pencils, but how do you know if that backpack from last year is the best fit for your child again this year? Yes, children seem to LOVE to pick out the coolest trends in backpacks every year, whether it has Elsa & Anna from “Frozen” or is the latest style in a hiking backpack. But, are these the safest options? According to the American Occupational Therapy Association, heavy loads carried by more than 79 million students across the U.S. can cause lower back pain that often lasts through adulthood. In addition, according to the U.S. Consumer Product Safety Commission, in 2010 nearly 28,000 strains, sprains, dislocations, and fractures from backpacks were treated in hospital emergency rooms and physicians’ offices. 

As an expert on school ergonomics and healthy growth and development of school-age children, Karen Jacobs, EdD, OTR/L, CPE, clinical professor of occupational therapy at Boston University says,“A child wearing a backpack incorrectly or that is too heavy can be contributing risk factors for discomfort, fatigue, muscle soreness, and musculoskeletal pain especially in the lower back.” Because of the concern, the American Occupational Therapy Association has established a “National School Backpack Awareness Day”. This year it is on September 16, 2015.  

I have summarized the recommendations by the 

American Occupational Therapy Association below:
   

Appropriate size

The height of the backpack should extend from approximately 2 inches below the shoulder blades to waist level, or slightly above the waist.

Shoulders
Backpacks should have very well-padded shoulder straps that can be worn on BOTH shoulders for proper balance.

Hip belt
Backpacks with a hip or chest belt take some strain off sensitive neck and shoulder muscles and improve the student’s balance.

Fit
Just as your child will try on clothes and shoes when back-to-school shopping, it is important to try on backpacks, too. According to Karen Jacobs, “The right fit should be your top criteria when selecting your child’s backpack. If you order online, be sure that the seller has a return policy just in case the backpack is not quite the best fit for your child and needs to be exchanged.”

Total Weight
Check that the child’s backpack weighs no more than 10% of his or her body weight. This means that a child that weighs 80 pounds should have a backpack that weighs no more than 8 pounds. Get out your bathroom scale and check it out! If it weighs more, determine what supplies can stay at home or at school each day to lessen the load. If the backpack is still too heavy for the child, consider a book bag on wheels.

Weight Distribution
Use different compartments appropriately to distribute the weight by placing the heavier items closest to the body and lighter items in the smaller, external pockets.

Watch for Stress
Watch your child. Ultimately each child is different, and his body will react differently to repetitive and prolonged backpack use. Warning signs that the backpack is too heavy include:

     1.  Difficulty putting on/taking off backpack

     2.  Complaints of pain or tingling

     3.  Red strap marks over the tops of the shoulders

     4.  Changes in side-to-side posture while wearing the backpack.

      

Check out the websites below for loads of tips on how to help keep all backpack-wearers in your household as safe as possible. 

Backpack Shopping 101: Tips to Avoid a Pain in the Neck, American Occupational Therapy Association  (Accessed August 2015)

1, 2,3’s of Basic Backpack Wearing, American Occupational Therapy Association, Accessed August 2015  

Backpack Strategies for Parents & Students, American Occupational Therapy Association  (Accessed August 2015)

Top School Supply Pics

Dear Melissa,

The school just sent us our school supply list. Do you have any other recommendations for back-to-school supplies for my 1st-grade son with ADHD?

Back to school time! The smell of new crayons and paper always makes me giddy! Along with the new notebooks and pencils, there are additional items that can keep your young scholar more organized and focused this school year! Here are a few of my favorites.

Broken Crayons

This is a secret of OT's. We all have art boxes full of broken crayons. Shhh!  Don’t tell anyone!  A broken crayon is a fantastic little tool which magically turns almost any funky, immature grasp into a proper, mature tripod grasp. No therapy required! See for yourself in the pictures below taken just seconds from each other.  

Now the magic effect of the crayon only lasts while the child is using this shortened crayon; the child will likely go back to a more immature grasp when using a longer pencil. However, the more a child gains practice with a proper grasp with the broken crayon, the more likely the child will transfer this skill to other writing instruments. 

Looking for one more OT magic trick to teach a proper grasp? Tape the picture to a vertical surface, such as the wall, or have the child write on a vertical chalk board. Again, no instruction required, just an instantly better grasp!

Pencil Grippers

A variety of pencil grippers will help to create and reinforce proper grasping patterns to make writing easier. Even though I work on handwriting with kiddos on a daily basis, it is generally trial and error to see what works best for your child. Here are a few of my favorites (all can be picked up at your local school supply store or Amazon.com). 

  

Chewing items

School days can be crazy and stressful. Chewing is calming.  If your child tends to chew on his pencil, fingers, or shirt, these are the items for you! Consider chew pencil toppers, s chew necklace or a chew zipper pull. 

                              

Visual Timers

Learning to stay on task and to complete assignments on time sometimes requires a little extra support. These tools can help. 

                                                                    

                                

    

Picture Schedules

Parents and teachers can work with a child to make a picture schedule binder for home and during the school day. They can simply be made with wallet-sized pictures, clear contact paper and Velcro. With Velcro on the back of each picture, the schedule is rearrange-able. Additional photos of various activities can be kept in a pencil case inside the binder.  

   

Writing Paper

I can’t tell you how many times I have had a parent/teacher complain about a young first or second grader's handwriting skills! Then, when I ask for a writing sample, I am given a sheet of typing paper with the child’s letters written in all different sizes all over the page. This example reminds us that kids need structure! I personally like dashed-line paper. It comes in all different letter heights and line colors. There are versions where the bottom half of the line is highlighted in yellow to help children discern the difference between the “regular” letters and the “tall” letters; you can also purchase paper with raised lines to help keep letters from sinking below the lines. Again, check out Amazon.com or your local school supply store. 

Resource:

What’s in My Therapy Box?: 60+ Supplies for School-Based OT’s  (accessed July 2015)

Do you have a question you would like me to address? 

Please don't hesitate to share: www.share@childrenstherapyteam.com

Kindergarten Transition

Dear Melissa,

My daughter will start Kindergarten in a few weeks and she seems a bit anxious about it.  Do you have any tips for making this transition easier? 

The big day is coming. Your little one is beginning “real school.” Apart from starting college, this is probably the biggest school transition your child (and you) will face. Even if your child has previously been in a preschool or daycare setting, there can be much anxiety about the first day of school. Here are a few tips to ease some of those butterflies. 

Pretend Play

Use dolls, puppets, drawings, and plays to help act out what kindergarten will look and feel like. This has a fantastic two-fold benefit. First, it helps your child to know what to expect. Second, pretend play can help to show you, the parent, what fears your child may have about making this big transition.  

Visit the School/Teacher

Many schools have “back to school nights” where your child can meet the teacher, see the classroom, and become more comfortable with their new school setting. You can also go and play on the playground at the new school in the weeks before school starts so that your child has something familiar to look forward to.

Write a Social Story

A social story is a magical tool often employed by speech therapists. In a social story, the adult and child work together to create a story about a situation in which the child is the main character, and the ending of the story results in the child mastering the tricky situation. I have included a resource link with tips for writing social stories at the end of this blog.

Interview a Big Kid

Make a playdate with an older child in the neighborhood, family friend, sibling, etc. - and take time to discuss the new school. What does this older child like about this school? What can students do at the school that is not available at home or preschool? Focus on questions that reinforce the positive, fantastic “big kid” benefits of the new setting.

Read Books

Your local library will have dozens of books on starting at a new school and many specifically about starting kindergarten. Have your child pick out a few, and then cuddle up to read! This will help greatly with shaping expectations, raising the comfort level of your child. 

Talk Time

Try to focus on the positive as much as possible, but certainly don’t close the door on your child expressing her fears. Allow her plenty of time and encouragement to talk about this transition. Use leading questions such as: “What do you think?” or “How do you feel?” For example, say “What do you think will be the best part?”, not "Tell me what you are afraid of.” If you sense apprehension, you can delve in further and definitely validate her concerns when appropriate. But it does NO good to plant negative ideas into her head by asking “Are you afraid you won’t make any friends?” when she was actually excited about meeting her new classmates. Focus on your child’s concerns, not your concerns. Sending off “your baby” (whether it’s your oldest, youngest, or somewhere in between) can be tricky for moms and dads.  Many parents feel sad and apprehensive about letting their little ones go to a “big kid school”. However, I personally think that these feelings are best discussed with your family and friends, NOT in front of your child. We want our children to feel confident and excited about school, not guilty that they are making their parents sad. 

Consider Special Needs

Kindergarten teachers are especially trained to accept a wide variety of abilities into the classroom and take it in stride. However, if your child has already been identified as having a special need or is currently in therapy for a developmental delay, it can be in the child’s best interest to let the school know ahead of time. If you think your child will need special interventions in kindergarten, and she does NOT have an IEP (Individual Educational Plan), it is helpful to contact the school before school starts (or even better, before the beginning of summer break). If you need help setting up school services for your child, talk to your child’s therapist(s) or contact Arkansas Support Network (link below) for additional assistance. 

So load up those brightly colored crayons in the backpack and pick out the coolest lunchbox, because we are off to school!

What did you do when your “baby” went off to kindergarten to help ease the transition?  Please share! Please share! www.share@childrenstherapyteam.com

Resources:

How to Write a Social Story, Vanderbilt Kennedy Center, accessed July 2015

12 Ways to Help a Child Make the Transition to Kindergarten, Anne Densmore, Harvard Health Publications, Harvard Medical School (2013), accessed July 2015

How to Help Your Child with Special Needs Transition from Preschool to Kindergarten, Christina Vercelletto, NY Metro Parents (2015), accessed July 2015  

Arkansas Support Network, 479-927-4100