Indoor Gross Motor Activities for Kids

Dear Melissa, 
I have 3 boys in Elementary/Preschool. Now that the weather has turned colder, how do I help them use up all of their energy with indoor activities?

When the weather is warmer, it is so nice to simply say, “Let's go outside!” when the kiddos start getting a bit wild and crazy. But, here in Arkansas, winter has officially set in. We rarely get the wonderful snow that is so much fun, and the temperatures often make playing outside less than desirable. Despite what the thermometer says, kids still need to burn energy, work on gross motor skills, and get their bodies moving in general. In addition, multiple studies have shown that 30 minutes of regular exercise is actually more beneficial than medication when treating many mental health issues such as ADHD and depression. Exercise - what a fantastic way to beat the winter blues! The following are a few tips for keeping their bodies moving, even in winter.

Indoor Gross Motor Activities for Kids

• Dance Party!  Have you ever heard dance music floating through the halls at Children’s Therapy TEAM? That would most likely be our creative and energetic Occupational Therapist, Whitney Garrison. Along with being in charge of all TEAM Talent activities, Whitney regularly throws dance parties during her therapy sessions. How about searching for a dance to follow on YouTube? Think Cha-Cha Slide, Macarena, etc. Rumor has it that Miss Whitney even choreographed a dance routine, mandatory for all OT’s, at last year’s TEAM Christmas party. We all had a blast learning new moves to Taylor Swift's “Shake It Off.” If we therapists can do it, anyone can! This is a great way to work on new motor planning patterns and imitation skills. Feeling the need for a little less structure? Simply turn on some music and move!
• Jump.  I love mini trampolines! Not the bigger ones that are outside, but the little ones that can slide under the bed. I use one at home, as well as in the clinic. They are ideal for getting the wiggles out in a fun way, with minimal space requirement. As an added bonus, they are generally inexpensive, costing approximately $25 to $40 at local major retailers and sporting goods stores (Wal-mart, Target, and Academy Sports to name a few).
• Obstacle Courses.  Kids love to help set up and go through obstacle courses! They are beneficial for general exercise, as well as sequencing and motor planning. You don’t even need to buy any special equipment; just use what you have around the house. Jump over wooden spoons. Crawl under the dining room table or under a line of dining room chairs. Use magazines as stepping stones. Zig-zag through plastic kitchen cups instead of cones. Crawl over couch cushions/pillows. Straighten out a scarf and use it as a balance beam. The possibilities are endless! You can even add an attention/auditory processing component by having children retrieve something as they go through the obstacle course and bring back it to you. Just think of anything for which you have multiple colors (crayons, Legos, blocks, etc.), and tell the child what color(s) to retrieve and bring back to you.
• Animal races.  Find a space in the house with some room to move a distance. Think a long hallway, or a circle through several rooms. In my house, we have a continuous path through the kitchen, family room, and dining room. Turn on some fun music, choose an animal, and race around and around (or back and forth) while pretending to be that animal. Again, this is a great way for the parent to get some exercise, too!

Finally, there is always the option of bundling up and going outside anyway.  Layer on several shirts and a coat. Add a hat, scarf and mittens, and your little one should be good to go for a while. Even if you don’t have a super heavy winter coat or snow pants, these other clothing items, (which many people already have or can purchase inexpensively) can really go a long way in keeping the body warm when outside in cold weather. Set a timer for 30 minutes and let them go! Even better, bundle yourself up and head out to join the fun! Fresh air is wonderful!

What does your family do to keep moving when the temperature plummets? Please share your ideas! share@childrenstherapyteam.com 

Resources:
Daley, A. J., Daley, R. J., Copeland, N. P., Wright, A. R., & Wales, J. H., (2006), Exercise Therapy as a Treatment for Psychopathologic Conditions in Obese and Morbidly Obese Adolescents: A Randomized, Controlled Trial, Pediatrics, Volume 118 (5), pp 2126-2134.
Epic Dance Sensations, (March 15, 2013) Cha Cha Slide - KPJ Sterksel, Retrieved from https://www.youtube.com/watch?v=H3Y2W8RmHCg
Mayo Clinic,(2014) Depression and Anxiety: Exercise Eases Symptoms, Retrieved from http://www.mayoclinic.org
Weir, K., (2011), The Exercise Effect, Monitor on Psychology, Volume 42 (11), p 48

MLK Day Activities

Dear Melissa,
My kids are out of school today for Martin Luther King, Jr. Day. Do you have any ideas for fun crafts to help celebrate the day?

When I was in elementary school, our Catholic school actually had school on MLK Day, while the public schools were out. It was a really fun day, because we spent the day coloring pictures representing Dr. King’s life and legacy, writing essays about peace and unity, and watching civil rights videos. The MLK Day activities were a great break from your typical Monday at school. While I am very glad that we take the time to honor Dr. King’s life and work with a National Holiday, I always wonder if I got a better education on equal rights for all while sitting in the classroom, as compared to other children who had the day off and learned nothing of the teachings of this great man.

Therefore, I give a big thank you to my elementary school, Immaculate Conception in Fort Smith, for teaching me about Martin Luther King, Jr. and giving me some great ideas for projects to do with my own children on this day off. I also searched the Internet for other fun, different projects. If you are like me and are doing all of these MLK Day Activities last minute, I am limiting the required materials to those that I currently have on hand in my own art cabinet. However, as an OT mama, I do have quite a large art cabinet!

Handprint Dream Catcher Trace and cut out handprints from different colors of construction paper. This makes for an even better activity if you have more than one child/adult’s handprints. Then take a paper plate and cut out the center. Weave the handprints together with interlocking fingers to create a “dream catcher” and glue/staple the handprints to another paper plate. Tie a string/yarn to the top of the paper plate so that it can be hung over your child’s bed. This craft is to represent how people of all different colors/backgrounds can work together for one purpose. (source: Kids Creative Chaos)

MLK Timeline My son LOVES timelines. He makes them on the history of the earth, the history of the United States, which dinosaurs lived when, you name it! Now, he was a touch grumpy when I asked him to make one at this past morning, instead of getting to watch his favorite TV show, but he ended up being a great sport about it and doing a terrific job! Simply tape a few sheets of typing paper together, Google a few facts about Dr. King’s life, and have your child write down these facts to create a timeline. Finally, your child can illustrate each of these events, and - voila - an MLK timeline!

Your Child’s Dream My daughter was also a fairly good sport when I drug her away from her morning cartoons and asked her to make a craft project to feature on this blog. I simply asked what ideas she had to help people, either now as a child, or what she could do as a grown-up. Then, she drew a picture of this dream. You can either write out the dream for her, or have her write it on her own – an OT will always try to sneak in a writing assignment! Since my daughter likes to build forts in the living room, “Caroline’s Dream” was to one day build houses for people who are homeless!

Multi-Colored Face Poster This one was inspired by Andy Warhol paintings! For this activity, the child simply draws his/her face. Then, photo copy or trace this same face picture into 4 boxes on the same large page or poster board. Next, have your child color each face a different color. The crazier the colors, the better! This activity is a great way to encourage children to think about different cultures or races, and how the exterior may change, but that the exterior colors do not change the person inside. (source: Activity Village)

credit: Activity Village

Colorful Hand Wreath Again, multiple colors of hands working together in one craft is always a good idea, not to mention a beautiful wreath decoration! For this craft, you cut out hand prints in various colors of construction paper. It’s even better if you have hand prints from different people. Staple/glue the handprints together so that the wrist sections are all in the center of the circle and the fingers are all facing outward to create a wreath pattern. Beautiful!  (source: Activity Village)

Color Simple. Classic. Fun. I have added some coloring pages for the occasion. Here are some links to some great MLK Coloring/Activity pages: Activity Village, Crayola, Education.com

Have fun with your kiddos creating these fantastic crafts this Martin Luther King, Jr. Day!  I shared pictures of our families crafts, please share yours too!

Resources:
Kids Creative Chaos: Handprint Dream Catcher  (accessed January 2016)
Activity Village:  Multi-coloured Face Poster  (accessed January 2016)

Head Banging Concerns

Dear Melissa, 
My 3½ year old son has some mild developmental delays, which we are addressing and making progress with through various therapies. However, I am really concerned that he bangs his head against the wall as he is falling asleep at night and has been banging his head more during the day when he is upset. I am worried that he will hurt himself. Can you help me?

Head Banging Concerns

In my years of working with little ones who have developmental delays, I have had this question come up numerous times. Unfortunately, the treatment for head banging is somewhat illusive. Some people say, “Don’t worry, they will grow out of it.” And you will discover as you keep reading, that this answer is partially true. Others say, “Put a helmet on the child.” But, if the head banging is based on the need for sensory input, this often makes the head banging even worse. I had this question posed to me again recently, by a colleague. Instead of offering just my guesses and personal treatments that I have used over the years, I decided to go to the literature.

However, there is really not much research done on this topic. Whether you search the Journal of Pediatrics or use old “Dr. Google”, the research is sparse at best. What you find upon searching usually just discusses which individuals are more likely to engage in head banging, and not how to actually help them stop.

In addition, I find the dates and titles of these articles pertaining to head banging quite fascinating. Once you filter out all of the “head banging” pertaining to heavy metal bands (which totally made me giggle), you will find tons of articles from the late 1960’s and early 1970’s discussing head banging in “schizophrenic children”, the majority of whom were institutionalized. Now, I work in the health care professional field, and in my 12 years of experience, I have not seen a single child (under the age of approximately 16 years) diagnosed with schizophrenia. However, I have a whole caseload of kiddos diagnosed with autism. These articles are just more evidence supporting the well-documented premise that children with autism have always been among us (or, unfortunately, in institutions). In the past, it was diagnosed as “childhood schizophrenia”, and now it is diagnosed as autism.

Back to the posed question, let us define the behavior: What is head banging?
According to an article published in 2013 by Dr. Shailesh Jain, in Current Psychiatry, “head banging” is:

• Rhythmic movement of the head against a solid object, marked by compulsive repetitiveness
• Usually seen in normal, healthy, well-cared-for children
• More common in boys than girls
• Usually starts around 18 months and goes away on its own by age 4 years
• Seen in 5-15% of healthy children
• More likely in children who are blind, deaf, have significant cognitive delays, or are on the autism spectrum
• Often occurs before sleep, lasting a few minutes to an hour
• Is rarely harmful, even though it might leave marks, calluses or bruises

When to Contact Your Pediatrician:
According to the Cleveland Clinic, you should discuss your head banging concerns with the pediatrician when:

• There is injury associated with the head banging
• The noise of the head banging is keeping family members up at night
• You feel like there are other sleep disorders such as snoring, sleep apnea, etc.
• You are concerned about the overall development of your child
• You worry that your child might also have seizures

How to stop head banging:
OK, here is where I will personally weigh in. Since there is very limited research out there on how to help parents address worrisome head banging concerns, let me offer up my suggestions. While it is true that there is no real way to “fix” head banging, it is important for parents to do a little “detective work” to help determine the causes for the head banging, in order to determine a solution for it.

• Is it migraines? I did have a kiddo, many years ago, who was frequently screaming and banging his head at 3 years of age, to the point that doctors told the parents to consider institutionalization. Because this little boy had a language delay, he couldn’t communicate that he was banging his head due to the pain of migraines. Once this was discovered (with the help of a neurologist), and the child was put on proper medication, he became a now healthy, happy, “normal” pre-teen. Watch for squinting eyes and rubbing of the head associated with the head banging to determine whether migraines could be the source. Also, look for the head banging to occur in the middle of the day, and at both predictable (such as with bright lights) and random (as in not associated with a tantrum) times. If you suspect migraines in your child, discuss it with your pediatrician, or a pediatric neurologist.
• Is it sensory seeking? Is your child a “crasher” into everything? Does your child seem to not feel pain easily? Does your child like to jump, swing, spin, climb, fall? If so, your child may just be sensory seeking. If this is the case, provide a significant amount of more appropriate sensory input. If you simply try to get a sensory seeking child to stop an undesired behavior (such as head banging), then they will often replace it with something even worse. Provide lots of opportunity for running, jumping, swinging, spinning, climbing, snuggling, squeezing and wrestling, throughout the day. For more ideas on providing sensory input, see the link to my Star Sensory Handout.
• Is it behavior? Does your child bang his head when he wants something? When he is upset? When you take something away? If your answer is, “Yes”, then it is likely behavior-related. This one might be the trickiest and most difficult. You don’t want to simply ignore this negative behavior. However, you don’t want to provide the attention the child craves by acknowledging the head banging. The best way to deal with this is to praise the child like crazy when he is being “good” and provide lots of positive attention when he is not engaging in head banging. However, when he does become upset and bangs his head, walk away if he is in a safe place (such as banging his head on plush carpet). If you fear he might hurt himself, simply pick him up and place him in a carpeted “safe” room. Don’t make eye contact. Don’t talk to him. Don’t give the attention to the head banging. Simply move him as if you were moving a piece of furniture. The good news is that most children who engage in head banging for attention seeking have appropriate pain neuro-receptors, and therefore, will not bang their heads hard enough to cause injury.

Because there is not much research available to us, let’s share our own solutions. If you have a child who has engaged in head banging either now or in the past, please let us know. Share your tips here!

Resources:
Jain, Shailesh. (2013). Head Banging: Cause for Worry or Normal Child Development? Current Psychiatry, 59.
Head Banging and Rocking, Cleveland Clinic, accessed December 2015.

Resolutions for Kids

Dear Melissa,
In the spirit of the New Year, what do you think about elementary-age children making New Year’s resolutions for themselves? 

I am a huge fan of resolutions, not just at New Year’s, but constantly. I am always telling my children that we all have areas that we are working to improve, every day: to get more exercise, to eat more plants and less “junk food”, to get enough sleep, to do more deep breathing and have more patience. Everyone has areas that need tweaking.

The following are some very attainable, child-appropriate resolutions for kids. Whether your children are toddlers or teens, these ideas apply to them all (and most of them apply to us grown-ups as well!). The resolution recommendations below are mostly taken from older blogs, and are placed in order of importance. Don’t worry; trying them all is way too much! But sit down with your family, pick one or two, and see what happens!

More sleep: The National Sleep Foundation states that children have the following sleep requirements (either all at once during the night, or through night sleep plus naps)

• 1-2 years = 11-14 hours
• 3-5 years = 10-13 hours
• 6-13 years = 9-11 hours
• 14-17 years = 8-10 hours
• 18-25 years = 7-9 hours

When we don’t get enough sleep, we are grouchy, have poor attention, and simply just don’t feel well. Getting an appropriate amount of sleep is definitely on my own personal to-do-list this year! If your child has trouble falling/staying asleep, take a peek at past blogs for advice (Sleep Training 101, Sleep Worries), or discuss this with your child’s pediatrician.

More movement: Research has shown that as little as a 5-minute brisk walk can serve to boost your mood. In addition, research has shown that exercise can help alleviate the symptoms of long-term depression, anxiety, and ADHD, often even better than prescription medications (American Psychological Association). Find something you like to do together with your family or a friend. It doesn’t have to be “formal” exercise. Animal walks (such as crab walking, bear walking, etc.), dance parties, and balloon volleyball can all be done as a family, inside or outside.

Less screen Time: This one will probably be met with some resistance, but I have faith that you can do it! The American Academy of Pediatrics recommends less than 2 hours of screen time per day, with zero screen time for children under 2 years. However, statistics show that the average 8-10 year old has 8 hours of screen time per day! This is a huge difference from recommended time! Higher rates of screen time are linked with obesity, decreased attention, behavior problems, sleep difficulties, and poor academic performance.

Eat more plants: There is so much debate on what is a “good” diet for your kids. However, we could all agree that generally limiting fast foods and processed foods are good things. In my house, I always say, “pick a plant,” and we have some type of plant, either fruit or vegetable, with every meal. Giving your child some choice in the matter of what plants are served can be a big help to getting them to actually eat it. Feeding experts with the Food Chaining Program say that veggies are an “acquired taste”. Don’t give up on the veggies, but know that you may be more successful with fruits, and just keep offering them both! Want more help for your picky eater? See my previous blog on this topic (Picky Eaters).

Diversify your diet: Ideally, this would be diversity to include healthier items, but not necessarily. Many children (and even adults) get used to seeing the same ingredients prepared in the exact same way, and any deviation from this causes panic and/or refusal. For example, I have a kiddo that will eat steamed broccoli all day long, but refuses roasted broccoli. So, think of ways to change up even familiar items.  Think pigs in a blanket instead of a corn dog; a fried chicken leg instead of a chicken nugget, roast veggies instead of steaming, throw preferred veggies in a pasta; you get the idea!

Dinnertime togetherness: Ann Fishel, a Professor at Harvard Medical School, states that this is the “Most important thing you can do with your kids.” And it is really simple. Just sit down and eat! Yes, yes, with all of the after school activities, friend time, etc., it can be hard to make the time. But check out the benefits. According to Fishel, family dinners boost vocabulary skills in younger children, (even more than being read to), are a powerful predictor of academic performance, promote healthier eating, and lower the risk of negative teenage behaviors such as smoking, binge drinking, drug use, school difficulties, sexual activity, depression, and eating disorders.

More snuggle time. So, I confess, I didn’t find any real research on this one. And, I put this one last on the list because hopefully you are already doing this one to the max. Our kiddos grow up too fast. No matter how big your “babies” are, make time to snuggle them! Even your oldest “babies” might be convinced to share a blanket on the couch while watching the newest thriller if you make the popcorn!

Have you made New Year’s Resolutions for your kiddos? 

If so, please share! Just email: share@childrenstherapyteam.com.

Resources:

How much Sleep do we really need? National Sleep Foundation, accessed January 2015.

Picky Eaters, Children’s Therapy TEAM Blog, Melissa Foster, January 12, 2015.
Sleep Training 101, Children’s Therapy TEAM Blog, Melissa Foster, November 3, 2014.
Sleep Worries, Children’s Therapy TEAM Blog, Melissa Foster, August 18, 2014.

The exercise effect.  American Psychological Association, posted December, 2011.

The most important thing your can do with your kids? Eat dinner with them.  Washington Post, January 12, 2015.

Food Chaining with Cheri Fraker and Laura Walbert.