Snow Day Activities for Kids

Dear Melissa,
What are some calm, indoor, fine motor tasks that we can do over the long winter break or on snow days?

The frenzy of the holidays is over. Now it is time to enjoy time off before returning to school to begin a new semester. Whether at home on holiday break or anticipating the possibility of a snow day at home, this is a time of year when kids often have a little extra time on their hands. When we return to school, it’s amazing how kiddos will wake up super early when snow is predicted, just so they can impatiently watch the morning news, hoping and praying that their school’s name will flash on the bottom of the screen.

Snow season is upon us! Here in Arkansas, we don’t get much snow, but when we do see a couple of flakes, everything sure shuts down! I love to put a big fire in the fireplace and have the occasional warm, snuggly snowday with my kiddos. But after a movie or two, then what? Sure, board games, puzzles, and coloring books are all good ideas, but let’s be more creative than that! Here are several ideas for snow day activities for kids my own kiddos love (which is evident by their pictures below). Even better, the majority of the items required for these activities are super cheap, and are items that you are likely to have on hand if a snow day happens to catch you by surprise.  

Snow Day Activities for Kids

• Create a band: Take old plastic bottles and either fill them with dried beans to make shakers, or tap on them like drums. And of course, instruments need to be decorated with your child’s own personal touches! Are your kiddos a bit older? See if they can make whistling sounds by blowing across the top of these bottles, too.
• Marshmallows/toothpick towers: Marshmallows and toothpicks can be even more fun than Legos! Have contests to see who can make the tallest, strongest, or most beautiful creations. This activity is super fun, and also provides a sweet snack!
• Newspaper snowball fight: Take old newspapers, wad each sheet into a ball and let the “snowballs” fly! These snowballs won’t freeze your nose and are generally safe for indoor use.
• Cotton ball hockey: You simply need 2 straws and a cotton ball. Have each child sit at opposite ends of the table and see who can blow the cotton ball to their opponent’s goal. We occupational therapists use activities such as this to improve calming and self regulation with deep breathing. It improves diaphragmatic support with controlled blowing to maneuver the cotton ball, improves ocular motor control by visually tracking the cotton ball, etc. My speech-language pathologist colleagues do this for lip rounding and breath support. Or you can play cotton ball hockey because it is just plain fun!

• Cookies: Ok, ok, this one is not that creative, but it IS tasty. Keep cookie mixes on hand or be a bit more adventurous and make them from scratch. Again, so many skills are addressed in one activity:  reading, sequencing, measuring, fine motor (stirring, manipulating dough, placing cookies on sheet, decorating), sensory defensiveness (to the dough and ingredients), patience, safety awareness, and not to mention yummy-ness.
• Paper plate masks: Kiddos can create a variety of animals and characters with simple paper plates and crayons. Feeling a bit more creative? Use these characters to create your own play. Don’t worry, you have ALL day to work on it!
• Cardboard box creations: I NEVER simply throw away a card board box. I hoard them (probably to an unhealthy degree). I have even been known to nab particularly large boxes that clinic equipment has been shipped in. The possibilities are endless:  houses, ice cream shops, rocket ships, caves, stages for puppet shows, and these are just a few of the things my own kiddos have created! One of my sweeties at the clinic even used her box to create a Rubiks Cube Halloween costume. Crayons, construction paper, box, glue…GO! 
  
• Make your own board game: My son had this as a school assignment once, and we liked it so much that we have done it several times since. Not only does it enable creativity and empowerment on the front end, but then you also have a new board game to play the rest of the day.
• Clothes pin animals: I know not everyone has clothes pins laying around their house these days, but this activity is a favorite at the clinic. Simply draw the body of a creature on an index card. Then clip the clothespins to the cards to create arms, legs, tentacles, whatever appendages you choose!
• Paper airplane race: This one is a new favorite at my house. Folding paper can be surprisingly difficult for little hands. So much so, that it is tested on several of our occupational therapy standardized evaluations. Try out various designs. Does a paper clip on the nose of the airplane really help? What if you tried a staple instead? The possibilities are endless!

So… make that cup of hot cocoa, put a nice warm fire in the fireplace, and enjoy the cozy snow day. Do you have other snow day activities for kids that you like to do with your kiddos?  

Please share at share@childrenstherapyteam.com.

Holiday Chaos

Dear Melissa,
I have a 6 year old son with a diagnosis of autism. We drove 2 hours to my mother-in-law’s house for Thanksgiving dinner, and it was a disaster! My son wouldn’t give her a hug, wouldn’t sit in his chair, crawled under the table, wouldn’t talk to anyone, and wouldn’t eat any of the food because it “looked different”. On top of that, he kept running in circles, making squealing noises. We had planned to go back to visit for Christmas, but I don’t know if I can take it. Can you HELP?

Disclaimer: I promise, if you are a family that I work with, I am not revealing your personal story.

Holiday Chaos

If this sounds like your family, then you are not alone! I have heard varieties of this question many times through the years, from many families who have struggled with family and holiday festivities. Why? Because holidays are hard! To quote my favorite Christmas movie, Christmas Vacation, we set expectations that no family can live up to. If you don’t know what I am talking about, watch the movie! Even without developmental delays, language barriers, sensory sensitivities, or sensory seeking behaviors, holidays can be a stressful time for anyone. There are crowded rooms, unfamiliar houses, cooking disasters, new smells, new foods, and everyone expecting everyone to be on their best behavior. Tricky times!

A diagnosis is NOT an excuse for poor behaviors.
This statement is bolded and on it’s own line, because it is something that I feel very strongly about. I love working with children with autism, ADHD, and behavior difficulties. They are why I get up and come to work every morning. Why? Because we can help them! It makes me sad when a parent says, “Oh, they do that (insert disruptive behavior) because they have autism.” Well, true. But if that behavior is disruptive to the rest of the family, then maybe we need to work on it. It is not fair for the child with autism to simply make excuses for him/her, and allow the child to get ostracized by their community. Yes, the community needs to learn to bend a little, but so does the family/child with autism. We all live together, and we all need to learn to get along.

Communication with others can help!
Again, the community needs to learn to bend, too. It is NEVER okay to bully or be mean to someone who is different. But let’s be honest, does any one of us want to “hang out” with an individual who we perceive as annoying? This is where communication helps. Let’s not make assumptions, but communicate about the situation. If your family knows that there are specific struggles for your child, and that you are taking specific steps to address these struggles, this will help concerned individuals be more sympathetic and understanding. If you can disclose to the family member specifically how you are addressing that challenging behavior, it can help the family be more understanding that you aren’t just simply being a “lazy and coddling parent”. (Because sometimes you know they are thinking that!) In addition, be sure to actually work on the behaviors that you know might be disruptive. Family and friends need to learn that patience is a virtue, AND disruptive behaviors need to not be given a free pass.

Many examples of good communication:

• “We are really working with Johnny on sitting at the table for dinner time. Two months ago, he couldn’t sit at the table for 5 minutes, now we have worked up to 15! I know it is not the entire meal, but it’s progress!”
• “Sally has such a hard time with hugs from anyone other than her parents. I know this makes her seem anti-social at times, so we have really been working on her giving ‘high-fives’ so she can still be able to greet people outside her immediate family.”
• “Judah has really been working hard with a speech therapist to try new foods. He used to gag with simply seeing new foods, but now he will at least allow food to remain on his plate. He will even touch it to his lips every once in a while. We will be bringing him his own food so he doesn’t get hungry or grouchy, but thank you so much for preparing such a delicious meal for our family!” (Just take a deep breath and be careful with this one. People can sure get touchy when it comes to their cooking!)
• “Bella sometimes flaps her hands and spins in circles when she is feeling overwhelmed. With all of the fun, family festivities, she will likely become overwhelmed a bit. Is there a place she can go to flap/spin for a few minutes before rejoining the fun?”

Each of these statements communicates to your family that:

• Yes, the child might do something annoying.
• Yes, I do realize that particular behavior is annoying.
• Yes, we are working on that disruptive behavior.

We are here to help!

• Talk to your child’s occupational therapist. He/she can practice behavior and sensory techniques for family gatherings.
• Talk to your child’s speech therapist. He/she can practice social stories and more social skills for family gatherings.
• Talk to your child’s psychologist. He/she can practice calming techniques.
• Talk to all of the professionals working with your child. They can all work together, with you, and generate a variety of creative techniques to help make family gatherings fabulous (or at least less stressful for all)!

Do you have ideas for making family gatherings more special for your child with special needs? Please share!

Want more specific ideas? See the link to last year’s holiday blog below!
Surviving the Holidays, November 24, 2014, Children’s Therapy TEAM Monday’s with Melissa Blog

Holidays with Children with Special Needs

Dear Melissa,
I want to help my kids feel the real spirit of the season. But, this is hard to do when festivities become a bit overwhelming. What are your thoughts?

I have personally written about this in the past, but refreshers are always very helpful...for all of us! The tips for parents below were initially written by a member of our TEAM as a feature article in Peekaboo Magazine about two years ago. It hits many notes that I agree with so this seemed like a perfect time to share it.

Holidays with Children with Special Needs

For many, holiday noises, lights and crowds are synonymous with the Christmas season. For some children the holidays can be an overwhelming sensory challenge. Children's Therapy TEAM's Occupational Therapists Abby Snyder not only works with children with sensory challenges, but her own daughter experiences sensory difficulties due to spending her early developmental years in an Eastern European orphanage. Abby and her husband adopted their daughter Eva when she was three and a half years old. After years of medical isolation at the orphanage, Eva's under developed self-regulation and language skills make the holidays particularly difficult. While Eva's needs are acute, the insights we glean from her experiences can resonate with many children.

Take time to Relax
Abby's best advice for the holidays came from fellow TEAM therapist Kym Hannah. Kym recommended that when Abby senses Eva's elevated stress, she should hold her close because deep pressure can be calming. Abby carefully watches her daughter for signs of fatigue and is quick to re-direct with something comforting like reading a book, singing a song or relaxing in a rocking chair. For some children, practicing deep breathing or listening to soft music is particularly beneficial. As an added benefit, parents who model relaxation strategies with their children also reap the evident benefits.

Carefully consider the travel vs. stay home conundrum
Carefully weigh the pros and cons of traveling vs. staying at home. If choosing to stay home for the first time, establish special family traditions. To connect with extended family, make an effort to enjoy a festive holiday Skype, Apple Face Time, or the like. Children may enjoy preparing a special carol to sing for relatives in a video message. If choosing to travel, have honest conversations with relatives beforehand about what to expect.

Deck the Halls "like a Kid"
Allowing children to help decorate allows them to be involved with the changes taking place in their home. Try to choose comforting decorations. For example, blinking, colored lights can easily over stimulate some children while soft white lights can be comforting. As an occupational therapist, Abby knows that all children, regardless of their special need, can appreciate having their very own holiday art work displayed in their home.

Designate a Safe Place
Until communication skills are firmly developed, paying close attention to body language and facial expressions is important. For example, children may not be able to say, "My uncle is getting a little too loud for my comfort. I need a break." When Abby observes her daughter beginning to get stressed, she simply carries her to a less crowded area, preferably a room that is quiet and dimly lit. Once her daughter is reassured and feels safe, they slowly make their way back. It can be beneficial to prep a calming "safe space" at your holiday destination.

Tis the Season to Prep Ahead
Abby tries to prepare Eva in advance. She tells her that the family is going to get in the car and go see family. She tells her who she is going to see and talks about what they are going to do. Children can benefit from building a social story about the upcoming holiday that is designed specifically to fit a child's area of need. For example, if transitions are difficult, the story may include packing for a holiday trip, travel to the airport and arrival at a holiday destination. Knowing in advance what to expect helps to ease anxieties. Also consider making a visual countdown chart as children's sense of time is still developing. For a young child, the difference between a week, a day and an hour is likely not clear.

The Special Needs Diet
The fact that many holiday gatherings revolve around food can be difficult for people with special dietary needs. It can be helpful to consult with a child's nutritionist about what level of "forbidden items" can be safely consumed. They may have ideas about the use of probiotics, enzymes or other supplements than can be incorporated to help counteract the rare addition of forbidden items. Because gluten-free and allergen free recipes and products are becoming more readily available, modified holiday foods are easier than ever to serve. If traveling, consider shipping a "care package" of items to your destination in advance. Some gluten-free bakeries ship items directly through on-line ordering.

Simplify Gift Giving
Abby acknowledges that fostering an atmosphere of "less is more" is ideal but challenging. She and her husband recognize that it is a joy to give, and they do not want to take that joy away from family members wanting to give gifts to their daughter. They encourage giving a single gift and making that gift a book, music or adaptive art supplies. These items are relatively inexpensive and leave the gift-giver some room for thoughtful and individualized choices. However, if more than one or two gifts on Christmas morning is too overwhelming, parents can chose to have children open just a few gifts at a time throughout the 12 days of Christmas.

Make Sleep a Priority
All children benefit from a consistent sleep schedule. It is easy to over stretch children over the holidays, allowing later bed times and skipped naps. However, making sleep a priority dramatically decreases the chances of having tantrums, and any tantrums that do occur will be less severe.

Shopping with Kids
While internet-based shopping definitely decreases the need to face holiday crowds, Abby also suggests targeting shopping times that tend to be less crowded. If she and her daughter are out shopping and the store becomes crowded and noisy, she keeps Eva close to her so that she feels safe.  Even if she's riding in the shopping cart, Abby slows down and gets close enough so that she and her daughter are touching.  If it gets really loud and overwhelming, Abby stops, bends close to her daughter's ear, and whispers a familiar and comforting phrase, "You are my beautiful baby, and I love you."

Enjoy the Season!
Take time to treasure these precious holiday moments with your child and family.

Additional Resources:
Great Gift Ideas for Children with Autism, Children’s Therapy TEAM Mondays with Melissa Blog, Melissa Foster, November 9, 2015
Inexpensive Sensory Toy Ideas, Children’s Therapy TEAM Mondays with Melissa Blog, Melissa Foster, November 16, 2015
Surviving the Holidays, Children’s Therapy TEAM Mondays with Melissa Blog, Melissa Foster, November 24, 2015

International Day of People with Disabilities

Melissa,

I recently learned that the UN sponsors an International Day for of People with Disabilities. What are your thoughts?

The big day was just a few days ago on December 3, 2015. But, I would like to think that we live the spirit of the day throughout the entire year, or at least that we inspire others through our actions. Since 1992, the United Nations has set aside December 3rd as an opportunity for nations around the world to be aware of individuals in their society who have disabilities, and the various barriers which prevent these individuals from fully participating in their communities. These barriers can include barriers of the physical environment, language barriers, and barriers related to attitudes.  

Each year, International Day of People with Disabilities has a theme.  This year, the United Nations has announced the theme as Inclusion Matters:  Access and Empowerment for People of all Abilities.  

Did you know that Children’s Therapy TEAM therapists are skilled in working with children who have many different types of disabilities? Some disabilities are more commonly seen, such as cerebral palsy, Down Syndrome, prematurity, and autism; however, we also see children with a wide variety of other disabilities and diagnoses, such as other genetic disorders, torticollis, spina bifida, arthrogryposis, traumatic brain injury, and many more. Often, a child is referred for a general developmental delay, and it is only after we begin working with the child, that the symptoms of a specific diagnosis unfold. I always say, “Call the child ‘green’ for all I care, but what are his difficulties, and how can I help?” A child is not simply a diagnosis. Every child with any particular diagnosis is a unique individual. It is up to the therapists to work in conjunction with the family and the child to identify and overcome barriers in order to help the child meet his or her fullest potential!

Want some examples of how Children's Therapy TEAM supports individuals with disabilities, not only at TEAM, but in our community? Check these out!

Heroes for Kids

Heroes for Kids is an invention of of Dimitri Clark, an innovative teen with cerebral palsy. Through his own experience, he realized children with special needs are often deprived of experiencing the great outdoors with their family & friends, secondary to an inability to acquire the necessary adaptive equipment. This insight motivated the research, development and initiative to create a program benefiting his peers so they might expand their experiences and abilities. One example of this is the dozens of adaptive bicycles provided free of charge to children with various disabilities through the generous support from the Heroes for Kids organization.   

Team Talent

TEAM Talent was created in 2008 by occupational therapist, Whitney Garrison. Her dream was to provide a fun and creative after school outlet for children with special needs. The participation in weekly, one hour sessions provides our actors and artists opportunities for social skill development, creative direction, and life skills enrichment. Each semester ends with an art gallery to display the artistic talents of the children, or a Christmas play to display the children’s acting abilities. While the therapists oversee activities, the children are in charge of the script, direction, and overall production of both the art gallery and the play. This kind of responsibility and accomplishment provides a boost in confidence for our children that is rewarding for both the children and their families. The art gallery and the Christmas play are held in some of the most beautiful venues Northwest Arkansas has to offer.  These are evenings of celebration for the children and their families - celebration of hard work and artistic talents brought to life throughout the semester.

Miracle League of Northwest Arkansas 

Several of our TEAM therapists participate in The Miracle League of Northwest Arkansas, a baseball program created for children with special needs. The baseball fields are adapted for wheelchairs, walkers, and other devices used to assist in walking. The fields and dugouts are barrier free and completely flat.  Children ages 4 years and older, with a broad spectrum of any diagnosis are welcome to enjoy the great American sport of baseball. Each child is paired with a buddy for the level of assistance they need to bat and round the bases. This is a great community opportunity for our kids!

As you can see, the therapists here at TEAM honor the theme of International Day of People with Disabilities everyday!

Resources:  

International Day of People with Disability

TEAMworks website

Children's Therapy TEAM website 

Miracle League of NWA website

National Adoption Awareness Month

Did you know that November is National Adoption Awareness Month? As we have entered the holiday season of thankfulness, it seems only fitting to discuss the importance of family.  

Families can be created in so many different ways. In my work with children, I see many different kinds of families. Yes, there are some families that are the simple Mom, Dad, and 2 biological children. Then there are step parents, half brothers and sisters, foster parents, aunts raising nieces and nephews, grandmas raising grandchildren, domestic adoptions, foreign adoptions, and even more varieties. Each family comes together in its own unique way. And every family that is based on love is beautiful!

November is National Adoption Awareness Month. So, I chose this week's blog to highlight how our TEAM family feels called to support the orphans of the world as they wait to find their “forever families".

TEAMworks International

This branch of TEAMworks is a group of therapists and specialists who travel internationally, seeking to improve the lives and futures of children. Each international team is comprised of various TEAM therapists from multiple disciplines. Currently, we travel to clinics and orphanages in Guatemala, China, and Rwanda. In the past we have also traveled to Ukraine. During these trips, the therapists meet with hundreds of children and and their various caregivers (parents and orphanage staff), offering individualized treatment plans, equipment, and education to improve overall quality of life for these children. By returning to the same clinics/orphanages over and over again, the teams of therapists can build relationships with these communities and create a lasting positive change for these children with special needs.  

Children’s Therapy TEAM Therapists as Mommies & Daddies

Many of our therapists at TEAM have adopted children from foreign countries. Kelly Yates (TEAM Occupational Therapist) recently adopted an adorable 2 year old little girl from China. I asked her a few questions about her perspectives on being a new Mom, as well as the unique considerations involved with being an occupational therapist working with children who have been adopted.

What led to you choose adoption for your family?  

Kelly:  I traveled abroad 5 times as a pediatric occupational therapist, providing assistance at orphanages through our TEAMworks organization. I knew many families, including many coworkers, who had chosen foreign adoption for their families. Each trip abroad broke my heart, seeing those beautiful orphans being cared for in mass by nannies, but never knowing the love of a mommy and daddy. Therefore, my husband and I prayed about and chose adoption. We felt led to love a child, born to a family who could not care for them as their own, knowing that God would place our child in our family as our beautiful daughter. It is an HONOR to be a new Mom to my precious Stella, and we are so, so blessed to make her one less orphan in a sea of many.  

In your opinion, what is one of the hardest things about adopting?

Kelly:  The joy of having Stella is so incredible! But, it remains bittersweet when I think of all the other precious little faces that were in the background of her pre-adoption photos. My daughter has found a forever family full of love. I worry about all the other children who are still in orphanages waiting on for their forever families to come and find them. 

What would you tell other families who are considering adoption?

Kelly: If your heart is being stirred to answer the call to adopt I encourage you to act!!! You will be blessed beyond measure! If adoption is not in the cards for you, consider helping in other ways: fostering, sponsoring, helping to fund others' adoptions, prayer. Borrowed from the great Julie Marvin (another TEAM OT who has adopted internationally):  If you have even the slightest curiosity, pl]lease don't hesitate to ask!  

TEAM therapists in the clinic

Children who have been adopted possess a unique set of strengths and needs that are often different from children in biological families. 

1.  Children who have been in an orphanage often have special needs relating to sensory deprivation in the orphanage. Many babies in orphanages spend the majority of their day in cribs. Likewise, many older children of domestic adoptions come from environments of neglect and sensory deprivation as well. Therefore, when these children are adopted into a loving, sensory-rich environment, it can be a bit overwhelming and scary. Many of these children develop specific sensory sensitivities and sensory processing disorders.  

2.  It is often important to address separation anxiety in children from biological families. However, when a child has come from an orphanage or foster care, the exact opposite approach is taken. Our therapy sessions are used to encourage more bonding with the new parents rather than independence from their parents. 

Both issues with sensory processing and anxieties with bonding with/separating from parents are areas that can be assisted by your occupational therapist.

Did you choose an international or domestic adoption to complete your family?  

Please share your experiences with us! share@childrenstherapyteam.com

Resources: 

TeamWorks

Yates Family Blog 

Adoption.com

Autism & High Prevalence of GI Problems

Dear Melissa,
My 5 year old grandson has Autism, and he has a lot of trouble with constipation. Is this common in the children you treat?

YES! One of the problems with Autism that is not often discussed are chronic issues with the gastrointestinal (GI) system. Constipation, abdominal pain, difficulty toilet training, and severely picky eating are some of the troubles that I see most commonly. When you add in the facts that many children with Autism have low or poor verbal skills AND the fact that many of them have decreased sensitivities to pain, my patients are often in real GI distress before their caregivers realize that there is a problem.

I researched this topic heavily this week so that we could find some real numbers and answers to the topic of Autism and constipation. So lets get started!

Autism & High Prevalence of GI Problems

Frequency
A large meta-analysis study published from Emory University in 2014 looked at previous research on the topic of Autism and gastrointestinal disorders. This study found that individuals with Autism Spectrum Disorder had a greater than 3-fold prevalence of diarrhea and constipation, greater than 2-fold prevalence of abdominal pain, and greater than 5-fold prevalence of “general gastrointestinal concerns” compared to the control population.

When you add food sensitivities into the mix, Virginia Chaidez and fellow researchers at the UC Davis MIND Institute found that individuals with Autism are six-to-eight times more likely to have GI issues than children who are developing typically. In contrast, they found that children with other developmental delays had only a five times more likely to exhibit various GI concerns.

Causes
There are 2 different theories as to why children on the Autism Spectrum tend to have higher rates of constipation and other forms of GI distress:
1. Behavioral: Individuals with Autism are often prone to sub-optimal diets to say the least. Between defensiveness toward taste, smell, and texture, as well as ritualistic behaviors surrounding foods, many people on the Autism Spectrum have extremely limited diets that are generally high in simple carbohydrates, and low in fruits and vegetables. This combined with often having defensiveness surrounding toileting, can be a recipe for chronic constipation.

2. Biological: Preliminary research has also provided some support for such biological factors as altered flora of intestinal microbes, altered patterns of intestinal contractions, food allergies, and gastroesophageal reflux disease. 

Why do we care?
Besides generally wanting to know when our kiddos are not feeling well, why do we care so much that people with Autism have such a high incidence of GI problems? Well…children with Autism often present with “problem behaviors”. Quite frankly, children are often referred to me as an occupational therapist for these negative behaviors long before they are sent to a neuropsychologist for a diagnosis of Autism. But think about it, when your stomach hurts, you generally have poor attention, are irritable, and don’t want to work. Sound familiar? 

Many of my “cranky kids” have negative behaviors that are greatly exasperated by medical causes such as GI distress. Individuals with more severe forms of Autism might also be more likely to engage in self-injury or aggression at times of GI distress as well. AND…When you have low verbal skills, how else do you let those around you that you are in pain?! 

Chaidez's UC-Davis GI Study also found that parents who reported that their child with Autism had abdominal pain, gaseousness/bloating, constipation, and diarrhea also reported significantly more incidences of irritability, social withdrawal, repetitive behavior, and hyperactivity than did those without GI symptoms. As a pediatric occupational therapist dealing with kiddos who have negative behaviors, I always like to rule out medical causes for these negative behaviors such as difficulties with sleep, allergies, or GI distress in combination with my behavioral interventions.

How do you treat it?
If you have concerns that your child has chronic constipation, you should discuss this with your pediatrician, especially if your child is on the Autism Spectrum. While diet modifications alone would be optimal, they are not often effective enough for children with more severe chronic constipation, nor are they practical for children with severe food defensiveness. The recommendations for primary care physicians and pediatricians regarding children with ASD and constipation involve a very complicated algorithm involving medication, diet assessment, behavior therapy, abdominal exam, x-rays, etc, etc., etc. 

Bottom line...chronic constipation in children with ASD is complicated and needs professional help. Don’t hesitate to talk to your child’s pediatrician, and request a pediatric gastrointestinal specialist if you don’t see relief.

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

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

If this week's blog didn't answer your questions thoroughly enough, feel free to delve into the matter further with the links below.
Resources
Evaluation, Diagnosis, and Treatment of Gastrointestinal Disorders in Individuals With ASDs: A Consensus Report, Pediatrics (Jan 2010) 

Gastro Woes More Common in Kids with Autism: Review,WebMD (May 2014)

Children with Autism Spectrum Disorder May Have Increased Rates of Gastrointestinal Symptoms, Jill Jin, News@JAMA, Journal of the American Medical Association (April 2014)
Gastrointestinal Symptoms in Autism Spectrum Disorder: A Meta-analysis, McElhanon et al, Pediatrics (April 2014)
Children who have autism farm more likely to have tummy troubles, Virginia Chaidez, et al., UC Davis Health System (November 2013), summarized in the UC Davis News (2013)

Management of Constipation in Children and Adolescents with Autism Spectrum Disorders, Pediatrics (November 2012)

Inexpensive Sensory Toy Ideas

Dear Melissa,
Do you have any sensory toy ideas for things that are a bit more affordable?

OF COURSE! Some of the best sensory toys are some of the cheapest. Many are even found in the dollar section of your local Wal-Mart or Target store. Others can be found on Amazon. And yes, these are TOYS, not “therapy equipment” so they are fun for everyone, whether you have sensory processing disorder or not. (And really, don’t we all have a some degree of SPD at times??? I know I do!) Most of my picks below are in the $5 and under range and NOTHING is over $10. I will admit, I tried to limit myself to 10 items. However, I found so many great items that I had to finally stop myself at 12. This proves that you don’t need to break the bank to find some fantastic sensory toys!

Inexpensive Sensory Toy Ideas

1. Koosh balls: The classic. Enough said. 

2. Chew necklaces: OK, so this one is a bit more “therapy” than toy. But I know I personally am lost if I am not wearing a sturdy necklace to fidget with throughout the day. I specifically chose the chew necklaces below because they looked more “fun” rather than “therapeutic”. The idea is that the kiddo just gets a cool necklace in his stocking, and doesn’t realize that it is purposefully meant to be sturdy enough for fidgeting and chewing. Pick a shark tooth, kitty cat, dog tags, Legos…whatever floats your child’s boat! Simply search for “chew necklaces” on Amazon and find what your child will LOVE!

3. Slinky: This has quickly become a favorite in my sensory box at work. And I found mine in the dollar section at Target!

4. Silly putty or Theraputty (Amazon): Take this squishy goodness and add beads or pennies to create “hidden treasures”!

5. Water Wiggles: I love how kiddos gravitate toward these squishy things!

6. Water timers: The great thing about these little gems is that they can be used to help with timing brushing, etc, as well as being visually stim-a-rific!

7. Light up toys: This is another favorite in my sensory box. They also often come in a variety of cartoon characters and are often found in the dollar section at Target and Toys-R-Us.

8. Wind up toys: Yes, these wind up toys tend to be fragile, but they also work on fine motor skills as well. Win, Win!

9. Pin Art boards: These can be prickly or soft, depending on how you touch them. Double fun!

10. Etch-a-sketch: OK, I know this is a bit “old school” but my son just got one of these, and it has turned into hours of fun! It is the ultimate fidget toy between the twisty knobs and then shaking for erasing. Bonus? Our ½ sized Etch-a-sketch fits nicely in my purse so it works perfectly for restaurants and road trips.

11. Pop tubes: I will admit it. I don’t get the appeal of these guys. But my sensory kiddos just gravitate toward them! And, at a couple bucks a piece, I don’t really have to understand it!

12. Glitter wand tubes: These water and glitter filled tubes are definitely stim-a-rific. In our family they also double for pretend play as we regularly switch from fairy godmothers to Harry Potter characters. The fun is endless!

Disclaimer: The pictures above are simply examples. In this post I'm not reviewing the quality of actual brands. Feel free to read reviews and choose similar or alternate items. All product images in this post are those shared by Amazon.com.

For ideas for larger toys, checkout my Post on Christmas Gift Ideas for Children with Autism. 

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

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

Christmas Gift Ideas for Children with Autism

Dear Melissa,

Christmas is approaching. Do you have any FUN sensory toy ideas for my 4 year old grandson with Autism?

I love the Holiday Season! Eleven months of the year, I try to make my recommendations to parents as cheap as possible. I love to try to “make due”, get creative, and make equipment with what people might already have on hand. But…when Christmas or a Birthday is approaching, I love to share ideas about sensory therapy toys that may be a little pricy to purchase “just because”, but may be worth splurging on if wrapped up with a shiny bow.  

The items I have recommended are NOT “therapy equipment”. They are TOYS! Yes, each and every one serves a specific therapeutic purpose. However, each of the items was selected because they are simply FUN! Whether your child has sensory processing difficulties or not, many children would love receiving the items below under the tree!

Christmas Gift Ideas for Children with Autism

I have taken a Twelve days of Christmas approach in recommending the 12 items below. 

1. A Mini Trampoline ($50)  

A mini trampoline is my #1 go-to for sensory input.  They can slide under a bed perfectly, so they don’t take up much space and are WAY less dangerous than a standard trampoline. (I do not recommend standard trampolines. Even with nets and other safety precautions, they just are not safe for the little sensory seeker!)

2. Tent ($30)  

Throw in a few old pillows, bean bags, or blankets and you have the perfect “positive time out” space. Tents can be fantastic for calming. They are great for pretend play, and combine with a bucket of fidget toys and your child with have the ultimate calming retreat. 

3. Hippity hop ($25) 

I love these things!  Kids can gain some strong vestibular and proprioceptive input from bouncing on hippity hop balls. In addition, it provides strong exercise which helps with attention to task as well as provides a good cardio workout. 

4. Scooter board ($20)  

Find a hallway, grab some empty 2 liter bottles and go kiddo bowling with a scooter board! Whether sitting on the board or laying on their tummies on the board, kids again can gain a great cardio workout as well as gain sensory input from one relatively inexpensive item. 

5. Body sock ($40)  

Kids love the compression from a body sock's stretchy fabric! It can be used passively while snuggling up and watching a movie, or can be used more actively around the house while pretending to be monsters. 

6. Vibrating animal massager ($10)  

I will be honest, my son asks for one of these every time we see one. Kids tend to either gravitate toward or avoid vibration greatly. If your youngster is one who loves to put his hand on the clothes dryer or chew on a vibrating toothbrush, then a vibrating animal massager is a must have gift! 

7. Gel water scene ($40)  

Ok, ok. This is one that I had given to me, handmade, by a loving intern. She used hair gel and a zip lock baggie. And my homemade one IS super cool, but as someone who is obsessed with sea creatures…this one is WAY cool! Let your future creature-explorer enjoy this gel water scene with its captivating sensory world. It also works as a wonderfully quiet hand fidget. 

8. Doorway Swings ($230 each) 

The doorway swing pictured comes with the doorway bar, sling swing, and trapeze bar. It is listed as appropriate for ages 3-10 years of age.

9. Crash Pads ($175 each)  

This crash pad is huge at 5 feet x 5 feet and is perfect for jumping, crashing, cuddling, and even napping. Perfect for the little “crasher” in your life who may not be safe with a mini trampoline. 

10. Hammock  ($150)  

OK, so I don’t really think of hammocks in the winter either, but you will be glad you have it come spring. Even better that you can crawl in the hammock with your little one and enjoy a good snuggle together! 

11. Bubble light tube ($110)  

At Children's Therapy TEAM our bubble light tube is probably the most popular items in the clinic! The one I have linked to is a large 3ft floor model, but you can gain similar effects with much cheaper lava lamps. Fantastic for calming your wound up child! 

12. Office Chair ($125)

This may seem like an odd choice, but spinning provides strong vestibular input that so many children crave, and it also provides a comfy place for you to get work done too. Win, Win! The prices are really all over the place for an office chair, the one pictured is just an example, but you definitely want one with arms. Feel free to hunt around for the one that looks best to you. 

As a disclaimer, I provided a rough price, website link, and picture for each item above. These are simply examples and generally not actual brands of items that I have tried. Feel free to read the reviews and choose similar or alternate items. In this post, all the product links I have provided are from Amazon.com. All product images in this post are those shared by Amazon.com.