Summer Ideas for Encouraging Healthy Emotional Development in Children Ages 3 to 5 years

Let's face it. Most adults struggle with emotional regulation. So, it is hardly fair for adults to expect children to independently stifle feelings that are disruptive to daily routines 100% of the time. We're just talking about children ages 3 to 5 years. This is an age group who should be past the common emotional breakdowns witnessed during infancy. However, life gets difficult to cope with and young children are still allowed to break down, cry, scream out loud, throw themselves on the floor in fury, and so on and so forth.

As time goes on and these children approach an age where they now qualify for prekindergarten or K-12 schooling outside of their own home. Therefore, tightening down on their emotional regulation is more than appropriate. In fact, many childhood experts insist on it. Children who can't regulate their emotions well at school seriously compromise their learning opportunities as well as other students in the classroom. Although many teachers have very well-rounded training, they should not be expected to dedicate abnormal amounts of time de-escalating a child's behavior as their focuses are academically geared.

Parents and caregivers, this is where you come in. Teach them the skills at home now, 2 to 3 years before school even starts so that they can spend more time learning and less time in meltdown mode. No, it's not going to be perfect and you can expect a few phone calls from the school eventually.

First things first. Set some realistic goals for your child based on their typical age group and what is expected regarding emotional development milestones. According to PBS.org (2019), here are some examples of milestones for this age group that you can reference for your own goals:

3 years old:

  • Uses familiar adults for security when playing (i.e., wanting mom to come over with the child to a friend's house).
  • Begins to develop personal preferences and a sense of ownership over things.
  • Can verbally label their own feelings as well as others based on their facial expressions.
  • Can express feelings and opinions well when things get difficult and may still fall apart when situations get stressful.

4 to 5 years old:

  • Gets better at tolerating a familiar adult's absence and starts to role model their behavior.
  • Can cope with the absence of adult by appropriately expressing their feelings through language and through drawing.
  • Increased sense of self and their capabilities and talents.
  • Increased understanding of other's emotions and what causes them to express certain feelings
  • Adopts their own coping strategies with stressful situations. Examples include talking about difficult situations through pretend play (acting out a fight with her brother with her stuffed animals).

In summary, some sample goals for your child could include: learning how to cope with stressful situations, learning how to read others' emotions, and learning how to verbally express their own emotions. The following information is a list of summer ideas in which parents could apply during those long hours at home with their children with the central focus being on emotional development:

  • Yoga. Believe it or not, yoga is not just for adults. Many clinicians are incorporating the use of pediatric yoga to teach young children how to cope with stressful situations.
  • Mindfulness. Similarly, mindfulness is not just used for adults anymore. Teaching a child how to be mindful and present in the moment works wonders for emotional regulation.  Just do your research online to locate a handful of mindfulness strategies.
  • Breathing exercises. Teach your child how to effectively take deep breaths when life gets hard. Breathing exercises only have to take up to a few seconds and can be used for times when your child is losing emotional control.
  • Reading books that focus on emotional expression. Frequently read books to your child while purposefully pointing out and describing characters' facial expressions.
  • Play dates. Your child can learn a lot from other children about what it means to express their own emotions.
  • Waiting. Incrementally teach your child how to wait for their favorite things. Start with several seconds and work your way up to a short few minutes.
  • Keep up on nutrition and sleep. It is unfair to ask our child to keep things under control when they are hungry or tired. Make sure to maintain a structured feeding and sleep schedule.
  • Quiet time. Allow for some time during the day where your child can sit and play quietly by themselves in order for them to teach themselves how to cope with and process the day.
  • My turn, your turn. Teach your child how to share their toys, whether it's with you or with other siblings or friends.

Please note that there are some children who are going to need some extra, clinical attention for emotional regulation. This can involve many children with a wide variety of developmental disorders including (but not limited to): autism, ADHD, Down syndrome, anxiety disorder, etc.  If your child has a developmental condition that negatively impacts their emotional growth, immediately consult with your pediatrician BEFORE school begins

Reference

  1. Child Development Tracker (2019). PBS Parents. Viewed on April 9, 2019.

When going outside is not an option: Activities to Occupy a Child’s time Indoors – An OT’s List of Tips

It is that time of year, when the eerie cold slithers in and the blizzards come rushing by. Or for maybe those situated on other parts of the globe, it's that time where perpetual rainfall floods the yard or the blazing hot sun melts your shoes. In any of these scenarios, serious weather implications can drastically change a child's daily activities, especially if that child lives for the outdoors.

So, what can parents do to assist their child in participating in meaningful activities inside their homes all day, potentially for several days in a row? First, consider some of your child's preferences by asking yourself the following questions:

  • How old is my child and what indoor activities are appropriate for their age?
  • Does my child enjoy completing activities alone? With siblings? With friends? With me? All of the above?
  • What types of body demands does my child tend to participate in? Heavy lifting? Wrestling or rough-housing with others? Swinging? Running? Jumping? Drawing or coloring? Reading? What's a good mix of mellow and movement-demanding activities for my child?
  • What activities do I need to be around to supervise or should participate in with my child?
  • Should I let my child get bored and for how long can they tolerate it before I need to intervene with an activity for them?

The goal of the following list is to provide parents and caregivers with ideas that pull their children away from the cop-out activities such as watching T.V. or using the I-Pad to kill time. In moderation, there is nothing wrong with letting children veg out in front of a screen for an hour or so. However, the latest research has shown the repercussions of exposing children to over-stimulating screen time, details of which we will not be discussing in this article. 
Note: before structuring your child's day with a list of activities to keep them busy while indoors, remember that it is alright to allow for some down time in which your child will experience "boredom".  As a parent or caregiver, it is not your responsibility to keep your child occupied 24/7. Allowing your child a few minutes to an hour or so of down time gives them opportunities to come up with their own creative ways to occupy themselves. With that in mind, here's some indoor activities that you may be able to apply:

  • Stairway games: Set up games that require your child to run up and down the stairs several times (i.e., retrieving balls from the bottom of the stairs and running up to place each one in a basket). It will only be a few minutes until your child gets worn out.
  • Drills: Simple army drills can be very fun, especially if your child has siblings or friends to complete routines with (i.e., push-ups, sit-ups, jumping jacks, knee lifts, squats, etc.).
  • Kid's yoga: Hop online and look up some basic yoga routines that you can participate in with your child. It will surprise you how early on in age you can start with your child.
  • Reading time: Sit down and read an enjoyable book or two with your child. If you want to go the extra mile, have you and your child dress up or act out the parts of the book.
  • Stage time: Create a small space in your house that can provide a stage setting in which your child can act out their favorite or their own original stories. Encourage them to go all out with costumes. Video record them so that they can watch their own play.
  • Drawing and/or craft time: Sift through your favorite Pinterest pages and come up with several arts and crafts activities that you and your child can do together. 
  • Fort games: Using tables and other pieces of furniture, drape several blankets to form a tent. Fill the tents with pillows, toys, and flashlights and let your child go to town.
  • Paper-shredding: Find old bills, junk mail, and other paper products that you no longer need and place them in a pile. Have your child tear up the paper and toss the pieces around.  Depending on how much paper you have, this could create quite the mess but luckily paper scraps are relatively easy to clean up.
  • Bath time games: Lengthen bath time and fill it with water games.
  • Dance and Karaoke party: Turn on YouTube or other sources for music and have a dance party with your child.
  • Board games: If your child is old enough, yank out some classic board games.
  • Messy party: Buy a cheap mat or tarp and place it on a floor surface that is easy to clean (tile, wood, linoleum, etc.). Have your child dress up in their swimsuit and bring out messy products such as finger paint or shaving cream (whipping cream for small children who put everything in their mouth).
  • Cardboard cars: Pull out saved up cardboard boxes and make a crude-shaped car for your child to race around the house in.
  • Sock skating: Have your child slip and slide around on the smooth floor in their socks.
  • Hide-and-seek: An old-fashioned game of hide-and-seek can keep your child occupied for several hours, especially if you invite friends over to join in.
  • Treasure hunt: Hide toys around the house and award small prizes for locating a certain number of objects.
  • Baking: Some kids absolutely love it when their parents let them help with baking or cooking a meal.
  • Pillow fights: Pillow fights can release all sorts of wiggles and can include other deep-pressure activities like jumping into a pile of pillow, wrapping the child in a blanket burrito, etc.

Choose activities based on your child's interests as well as what you would like to accomplish. Create a healthy mix and experiment with all sorts of activities to alleviate boredom, to create exercise opportunities, to resolve hyperactivity, or to just let your child have fun.

Am I talking enough to my Child? An OT’s Perspective

Good, proactive parents have one common fault: coming down hard on themselves because despite everything they do for their child, they feel that it's never enough. This is so true when it comes to communicating with little kiddos. Parents or guardians who are at home full time with children under the age of 3 may ask themselves some of these questions: Am I talking with my child enough? Why isn't my child talking yet? Is this normal or should I be concerned?

First off, slow down and breathe. Remember that every child is different and most of the time the words start spilling out of their mouths at different ages. If your child is not quoting Shakespeare by their 2nd birthday, then the good news is they are very typical for their age group.

WebMD (2019) states that the most crucial years for brain development is during the first 3 years of life. In fact, 80% of the brain's physical development occurs during this time. Your child is making all sorts of neural connections for language, movement, emotional regulation, sensory system regulation, executive function (reasoning, problem-solving), and so on and so forth. Much of a child's brain development relies on input from their environment, and that includes parents.

The following information includes a few tips on how to better communicate with your child, especially if you are one of those parents who don't think you are doing enough.

  • Put down the phone. As adults these days, we are constantly connected to our devices: phones, tablets, laptops, you name it and we're glued to it. Put down your phone in the presence of your child, even when they are in their infancy. Additionally, reduce how much time your child spends on the phone or TV. Your job is to teach them how to interact with other human beings appropriately, and a screen may feed your child effortless information about the world, but it won't teach them about reciprocating conversation.
  • Talk out your thoughts. Are you alone at home with your child, a young child who can't stir up a fascinating conversation with you quite yet? It's difficult to be talkative during but go ahead! Talk out what you are thinking! Let your child watch you talk, even though you know they can't understand you. You are still providing them the building blocks of verbal communication through simple observation.
  • Be silly. Instead of asking yourself, am I talking enough to my child, change your question to: am I interacting enough with my child? Language development is heavily influenced by all sorts of communication outlets. Young children and infants learn so much from parents who will sit with them and make faces, play with them, etc.
  • Sing! Children are extremely receptive to songs and rhymes because the format is intriguing and easy to memorize. Don't be afraid to sing to your child, out loud and in front of other friends and family.
  • Dance! Talk and sing while you make silly movements with your own body. "Head, shoulders, knees, and toes" is not just a fun song created to kill time. It's movement-based songs that helps teach a child about words to identify basic body parts. This is a similar goal for all sorts of dances and songs, so fill your repertoire!
  • Do not excuse potential developmental concerns: Even good parents get upset when a professional, a friend, or a family member remotely mentions the possibility that there could be something WRONG with their children. Although the majority of kiddos develop at a typical rate, a handful of children have struggles. One of the worst traps a parent can fall for is believing that their child is healthy and perfect while dismissing basic developmental concerns.

Research and refresh your knowledge about child development. Then compare your child's language and social skills to those of their typical-growing age group. Remember, developmental charts are only an estimation and every child will vary. However, if you get the feeling that your child is behind in their language development seek out a professional consultation immediately. Talk to your pediatrician, an occupational therapist, or a speech-language pathologist. Get help now and as your child's first three years of life.

References

  1. How to Talk to Your Baby (2019). WebMD. Viewed on March 19. 2019.

Do Children with Autism understand Consequences? Tips for Countering Misbehavior in the Home

Typically developing children get to a certain age where they have the cognitive capacity to understand consequences of their actions. They also begin to understand that certain actions based on bad behavior leads to discipline (i.e. hitting another sibling or a parent leads to getting favorite toys taken away from a certain time). The lines are fuzzy when determining the best age range to start disciplining your child with negative consequences if you are relying on information from parent and children’s health blogs. So, we go to the evidence-based research for answers.

According to the Canadian Paediatric Society (2004), typical children between the ages of 3 to 5 years old begin to understand that bad choices or behavior leads to negative consequences. Although their language capacity is still small, they can partially appreciate basic rules and why parents discipline them with timeouts or small punishments. So, if 3 to 5 years of age range for “typically” growing children, what does this mean for children with autism spectrum disorder? Does a young child with autism understand discipline for their actions similarly to their peers?

Many parents seasoned in autism-related literature and research may already understand what impairments are featured in autism spectrum disorder (ASD) cases and how those impairments impact fully understanding rules and consequences. For those parents who are still grasping for answers, let’s first break down what it means for a child to receive a diagnosis of ASD. The DSM-5 states that a child can be diagnosed based on the following criteria:

Persistent deficits in social communication and social interaction across multiple contexts

  • Deficits in social-emotional reciprocity
  • Deficits in nonverbal communicative behaviors used for social interaction
  • Deficits in developing, maintaining, and understand relationships

Restricted, repetitive patterns of behavior, interests, or activities

  • Stereotyped or repetitive motor movements, use of objects, or speech 
  • Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior
  • Highly restricted, fixated interests that are abnormal in intensity or focus
  • Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (American Psychiatric Association, 2013)

Besides social communication impairments and restrictive patterns, cases of ASD can also be paired with intellectual and language impairments which contributes to the severity of each case. In more simple terms, a child with ASD does have to exhibit symptoms laid out in the DSM-5, but each child’s severity varies thus their ability to understand things on any cognitive level will be different in each case.

What does this mean for disciplining a child with ASD who is misbehaving? If your child has ASD, you cannot expect typical punishments and durations to work. For a typically developing to understand consequences set up by parents, several factors need to line up including: the bond between the child and the parent, the child’s communication and language abilities, the child’s ability to understand what is “fair”, and the child’s ability to learn discipline from parents in order to self-discipline in the future (Canadian Paediatric Society, 2004).

Children with ASD not only have limited or different understanding of discipline, but they also “misbehave” for completely different reasons as compared to their peers. Poor behaviors such as self-inflicted injuries, hitting other family members, throwing toys, spitting out food, screaming at the top of their lungs, or refusing to complete tasks set up by parents and/or teachers often stem from internal processes that aren’t obvious. This may include: pain, sensory processing disturbances, anxiety, and stress. Typical methods for discipline not only may NOT work, but could also worsen the child’s behaviors.

Occupational therapy as well as many other disciplines can assist parents and their children with ASD by providing tailored plans for their family to counter poor behaviors. Consult with a specialist (i.e. pediatrician, psychologist, behavior specialist, occupational therapist, speech therapist, etc.) if your child is struggling with behaviors that you are at a loss for how to resolve on your own.

References:

Effective discipline for children (2004). Canadian Paediatric Society. Paediatric Child Health, 9(1): 37-41. www.ncbi.nlm.nih.gov. Viewed on Feb. 4, 2019. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.

Food Allergies: How a Pleasant Eating Experience for a Child May Have Hidden Adverse Effects on Behavior

Self-feeding should innately be a pleasant experience for any human being. Ingesting foods and liquids nourishes the body and mind, jumpstarting a person to continue on with their day and to participate in other activities that matter to them. For children, having healthy diet plans provides them with energy to complete school work, to play outside, to take part in sports, to finish their chores, and to participate in other daily living tasks (i.e. dressing, toileting, showering, sleeping, etc.).

Unfortunately, self-feeding doesn’t always have happy results especially if parents and caregivers are unaware of finely masked problems with food: food allergies and food intolerance. According to WebMD (2018), the terms “food allergies” and “food intolerance” have very different meanings and are often mistaken for each other. A food allergy occurs when the immune system is actively fighting against something in the body when it doesn’t need to. Food intolerance produces symptoms of discomfort (i.e. indigestion), but the immune system isn’t actively doing anything (Food Allergy Intolerances). Of course, food allergies and food intolerance produce a long list of symptoms depending on the child’s body type and can include: skin reactions (i.e. hives, rash), respiratory problems, flu-like symptoms, indigestion, headaches, and other body aches to name a few. These reactions can range from very mild to extremely severe. In this article, we will be focusing on the connection between childhood food allergies and changes to behavior.

Physical reactions to food allergies and intolerance can rightfully make a child very moody or angry due to discomfort or pain. Common foods that children struggle with may include: dairy, wheat, gluten, barley malt, sugar, soy, nuts, shellfish, and eggs. Additional elements found in food that may be a cause for problems include preservatives, food dyes, foods high in salicylate (i.e. which is found in aspirin), and pesticides.Dr. James Greenblatt (2017) wrote an article regarding dietary elements that influence behavior in children, particularly those with ADHD. He discusses and references several studies about how the following food compounds increase behavioral problems: sugar, casein (a milk-based protein), gluten, and food dye. Some of these compounds, when ingested, have been found to increase the likelihood of an ADHD diagnosis in children as well as the following: anxiety, brain fog, hyperactivity, inattention, impulsivity, aggression, and delinquent behaviors.

Health Day News (2018) references a study that involved almost 200,000 children in the United States from ages 3 to 17 years. One finding emphasized how children with autism were more likely than their typical peers to have food allergies (Allergies More Common In Kids With Autism ). Another article referenced a renowned naturopath and acupuncturist, Duane Law, who has heavily researched food allergies causing inflammation and a stress response (Dunckley, M.D., 2013). He made a connection between inflammation in the digestive system and sending the body into fight-or-flight mode. For children with autism, this inflammation and stress response can be a cause for endless behavior problems especially because some of these children are unable to verbally communicate or describe their symptoms or reactions.

As far as food allergies go, what does this mean for parents and caregivers?

Food allergies and food intolerance are issues that all parents and caregivers should consider for their children, even in the absence of other medical diagnoses. For parents of children with developmental or psychiatric disorders, consider that your children may be at higher risk for having food allergies and intolerances. Observe your child. Make note of what their behaviors are like before and after meals. Write out a daily log about foods and liquids that your child ingests, the portions, and the subtle behavioral changes. Some behaviors may not be food-related at all, but it is best to log everything. Do your research. If your child does have a diagnosed medical, psychiatric, or developmental disorder then read up on highly reviewed material about allergy risks associated with your child’s condition. Consult with a professional, particularly an allergy specialist, before making drastic changes to your child’s diet. Appropriate testing may reveal information about your child that you would not have seen otherwise in regards to their diet.

Reference: Greenblatt, J. (2017). Dietary influences on behavioral problems in children. Viewed on Nov. 12, 2018. Stephens, K., Dunckley, V.L. (Ed). (2013). Food, Inflammation, and Autism: Is there a Link? Viewed on Nov. 12, 2018.

Summer Activities promoting your child’s mental Health: Ages 3-5 years

As parents, when we contemplate our child's overall growth and development, how many of us get caught up in their mobility and physical capability that we forget about their mental growth? Mental health is already a realm approached with caution and stigma in the adult world, so it's fair to say that we shy away from this topic when it comes to children.

The CDC (Centers for Disease Control and Prevention) reveal that 1 in 5 U.S. children from ages 3 to 17 years old have a diagnosable mental, emotional, or behavioral disorder. Only 20% of these children receive an actual diagnosis and 80% do not get treatment. (Generation at risk: America's youngest facing mental health crisis) This data collection does not just include the typically heard of childhood diagnoses such as autism and ADHD. This information encompasses children who are battling depression and anxiety disorders as well.

Hold on. Some parents may think that depression or anxiety cannot possibly be concerns for children this young. However, the signs are more prevalent during this time of life than we think. The symptoms just manifest themselves differently compared to adults with depression or anxiety. If these conditions aren't appropriately addressed during childhood, then behaviors escalate and turn into unmanageable challenges during the teen years. For example, according to the CDC, serious depression is worsening in teenagers and the suicide rate among specifically teenage girls reached a 40-year high in 2015.

So, how do you know if your child's mental health is less than optimal? By comparing their behaviors to other children their age. The Child Mind Institute (2019) provides a wide variety of tips for parents regarding what signs to look for in children 3-5 years old with behavioral problems:

  • Is your child having more serious tantrums than typical kids their age?
  • Are they abnormally more exhausting and difficult to manage>
  • Have they been suspended from early school programs or excluded from play dates?
  • Are they intentionally withdrawn from those around them?
  • Is your child's behaviors seriously disrupting family life and straining other family members?
  • Are you concerned about your child hurting siblings or others?
  • Is your child's behavior converting your relationship with them into a negative one? (Problem Behavior in Preschoolers)

Ages 3 to 5 years is the prime time to focus deeply on positively influencing your child's mental health because just in a short while after, they will be in school when managing behavior becomes increasingly more difficult. Please consider the following tips pertaining to helping your child stabilize their mental health in the form of a summer activity schedule:

  • Make your own observations. Put down your phone and "busy hands" work and study your child throughout the day. Watch how they participate in the day-to-day activities, whether it's alone or with other children. Ask thoughtful questions without judgment about their feelings and about whether certain activities and people help their mental health or set them off into a ball of stress and anxiety.
  • Consult with a professional. If you as a parent are not experienced in behavioral assessments, consult with a professional who can give you a second opinion about your child's behavior. Yes, some tantrums and ballistic behavior is normal for kids of this age group, but a professional will have an eye for details that go unnoticed by most parents.
  • Take goals one week at a time. Identify only one item that you want to work on with your child in order to better their mental health.  Examples include: anxiety, outbursts at home, outbursts in public, shutting down or withdrawing when activities get too difficult, etc. Choose just one item and take it one week at a time. Mental health is delicate and it is easy to bombard a child with too many techniques which can make matters worse.
  • Apply breathing techniques. Teach your child active breathing techniques. When things get tough and you can see the tension in your child bubbling, get them into a pattern of breathing slowly, deeply, in through the nose, and out through the mouth. Tell your child why they are actively breathing and how it reduces anger and stress.
  • Try out some summer yoga. Yoga for children is growing and becoming a very popular technique to self-manage difficult behavior. If you are already a yoga guru, research some new techniques that you and your child could use together. Get on your computer and look up community resources for pediatric yoga. (Poses for Kids)
  • Try out some mindfulness strategies. Like yoga, mindfulness is growing in popularity among children to reduce stress and anxiety. Research mindfulness strategies (Mindfulness Activities for Children And Teens: 25 Fun Exercises For Kids) on your own or consult with a professional who is certified or educated in providing mindfulness sessions for children.
  • Assess your own mental health. Keep your own mental health in check because your child will only feed off of your own stress and anxiety.  Find a stress-reducing strategy that works for you. Make time to treat yourself every once in a while. Get adequate sleep and food/water intake. Your child may learn to mimic the self-care that you provide yourself.

Mindfulness and Children

Before your imagination runs wild, keep in mind that the term “mindfulness” is not a dismissive practice used by hipsters among the adult population. Mindfulness has become a well-respected practice used by many skilled professionals (i.e. occupational therapists, social workers, psychologists, etc.) as well as laypeople and caregivers. Mindfulness can be defined as the following, according to a Psychology Today article:

  • Returning to the present moment
  • Letting go of taking things for granted
  • Self-regulation of attention with an attitude of curiosity, openness, and acceptance. (Niemiec, 2017)

Another relevant definition also can include:

“Mindfulness is the basic human ability to be fully present, aware of where we are and what we’re doing, and not overly reactive or overwhelmed by what’s going on around us.” (Mindfulness Staff, 2014).

In a more functional description, applying mindfulness to daily activities looks like purposefully slowing down in order to mind and to experience things for everything they are. For example, mindfully eating a raisin would include appreciating everything about the activity with all senses: what does the raisin smell like, look like, feel like between the fingers and on the tongue, sound like when being chewed, etc.

Mindfulness is used to pull ourselves out of the automatic mindset, so instead of doing our day-to-day tasks mindlessly (which is easy to do for repetitive activities such as eating, showering, toileting, performing work-related tasks, etc.), we thoughtfully consider all of the elements that go into one or all of these tasks.

So, why should we even use mindfulness? What health benefits does it address? According to Davis and Hayes (2012), mindfulness can provide individuals with the following: increased focused, enhanced working memory, decreased stress, reduced rumination (or reduced deep thought that can lead to unhealthy and persistent distress), increased emotional regulation, improved satisfaction in relationships, and increased cognitive flexibility.

Mindfulness can be inadvertently advertised to the general population as a technique used solely by adults. In fact, mindfulness has become well-researched in its uses and benefits among children. Although adults experience daily problems that can stress and other jabs to their mental health, children are just as susceptible to mental and emotional strain. Depend on what a child is going through, he or she can experience stress, anxiety, irregular emotional issues, and depressive symptoms that hinder their ability to perform activities that are most meaningful to them (forming friendships, completing homework, participating in sports and other extra-curricular activities, playing in their free time, etc.).

David Gelles is an author who has practiced mindfulness for the last 20 years. He published an article with the New York Times regarding mindfulness and children. Aside from providing some fantastic resources and insight about using mindfulness with children, he proposes that mindfulness techniques can be used with children as young as infancy. Of course, little babies are not going to be able to participate in mindfulness strategies on their own because they lack developed movement and language skills. Mindfulness in infancy is only effective when parents and/or caregivers actively use mindfulness techniques themselves which then can be shared with the baby. Examples include:

  • Putting away all distractions (i.e. phones) in order to fully engage with the baby. This means making consistent eye contact, making faces, talking to your baby, or any other communication forms that mean that you are connecting with the child.
  • Practicing a sense of calm when your child is distressed (dirty diaper, gassy, hungry, sleepy, hurting, etc.)
  • Finding ways to move and to meditate during the baby’s down time or when the baby does not require your immediate and consistent attention.

Mindfulness is very beneficial for children across the lifespan, but can only be effective if someone is willing to embody and to guide them in practicing the techniques. Sift through the following references at the end of this article and study additional material in your free time. Consult with a doctor or other healthcare professional about how to learn mindfulness and how to apply it in your home.


References

Davis, D., M. & Hayes, J.A. (2012). What are the benefits of Mindfulness. American Psychology Association, 43(7), p. 64. https://www.apa.org/monitor/2012/07-08/ce-corner.aspx. Viewed on Jan. 2, 2019.

Gelles, D. (n.d.). Mindfulness for Children. New York Times. https://www.nytimes.com/guides/well/mindfulness-for-children. Viewed on Jan. 2, 2019.

Mindful Staff (2014). What is Mindfulness? Mindful. https://www.mindful.org/what-is-mindfulness/. Viewed on Dec. 31, 2018.

Niemiec, R.M. (2017). 3 Definitions of Mindfulness that might Surprise You: Getting at the Heart of What Mindfulness Is. Psychology Today. https://www.psychologytoday.com/us/blog/what-matters-most/201711/3-definitions-mindfulness-might-surprise-you. Viewed on Dec. 31, 2018.

Wiggles for 3 to 5 year olds: Summer Ideas for Motor Development

Summer is on its way, which means for many parents across the United States more time with kids. Yearly preschool and other fall and winter programs are over, so now you are on your own in your quest to keep your children occupied. You probably have building up an arsenal of summer activities during these hibernation months, and you probably think that you have those long, 3 months handled. Then, the first two days of summer pass and you have used up every single idea and you are now left high and dry with children who are driving you crazy.

Time to switch the gears. From an occupational therapy standpoint, there are endless amounts of summer activities that you could apply in order to get your children moving. OTs are all about the goals, and there is much truth in being able to utilize your time wisely with your children if you have goals in mind. Children from the ages of 3 to 5 years old are very busy growing and learning. Parents can facilitate that growth by implementing activities during the summer schedule.

In order to keep things simple, let’s only focus on a child’s motor development. This means developing skilled movement patterns in order to participate in daily tasks that are the most meaningful or necessary for a particular age group. Motor development is broken down into fine motor (using fine movements of the hands) and gross motor (using large muscle groups to perform bigger movements) development. According to the CDC (2019), typical growing children between the ages of 3 to 5 should be able to do the following:

3 years:

  • Climbs well
  • Runs easily
  • Pedals a tricycle (3-wheel bike)
  • Walks up and down stairs, one foot on each step

4 years:

  • Hops and stands on one foot up to 2 seconds
  • Catches a bounced ball most of the time
  • Pours, cuts with supervision, and mashes own food

5 years:

  • Stands on one foot for 10 seconds or longer
  • Hops; may be able to skip
  • Can do a somersault
  • Uses a fork and spoon and sometimes a table knife
  • Can use the toilet on her own
  • Swings and climbs

Of course, the CDC is not the only foundation that provides developmental milestones information so parents should do their research and review all sorts of developmental charts. If your child appears behind or delayed in some motor performance skills, this is not always a sign of alarm. However, parents should make themselves aware about their own children’s development so that in the event there is a concern then help can be provided early on. This is an essential growing period that prepares children for more complex tasks outside of the home including school and community programs.

Rather than going down the bullet point list and making your child follow a rigid activity agenda, consider using some of the following tips to foster your child’s motor growth:

  • Set up play dates: It is hard when you’re a parent of very young children, and getting out of the house every day can be a terrible hassle. However, scheduling play dates can be very beneficial for your child’s development. Purposefully have your child hang out with other children who are at similar or even higher motor development levels. It is astounding how much children learn from each other by simply watching each other move around in their environment.
  • Go to the playground: If you do not have that swing set or jungle gym in your backyard, go to your local playground. It’s free and full of obstacles that can appropriately challenge your child to move (hopping, jumping, ducking, climbing, crawling, etc.). If you are capable, join them and play on the equipment with your child. Make a habit out of “playground hopping” so that your child can utilize new and different obstacles each week.
  • Take your children on picnics: Schedule a time during a nice afternoon where you can take your children on a picnic. Load your basket with fun foods with a variety of textures. Let your child help with setting up the picnic area including passing out plates and plastic ware, laying out the blanket, pouring the drinks, etc. It doesn’t have to be perfect and yes, your child will probably spill things. However, it gives your child exposure and opportunity to practice meal prep and self-feeding demands.
  • Send your children outside no matter what the weather looks like: With the exception of severe weather and hail, let your child go outside no matter what type of precipitation is coming out of the sky. Have them dress appropriately by donning and doffing weather-appropriate clothing. This gives children lots of practice in self-dressing tasks, manipulating buttons and zippers, lining up Velcro, tying shoes, etc.

References

Learn the Signs. Act Early. Important Milestones (2019). Center for Disease Control and Prevention. https://www.cdc.gov/ncbddd/actearly/milestones/milestones-5yr.html. Viewed on March 27, 2019.

The Importance of Learning to Gauge Problem Size

Teaching problem solving in speech language pathology can encompass many skills including learning to identify when there is a problem, and helping providing solutions to problems. Being able to do both of these enables a person to be safer and more independent within various environments (home, community and school). One aspect of problem solving skills that I like to focus on when working on problem solving is learning to gauge the size of problems. While this might not seem as imperative as being able to identify and solve when problems are happening, this skill addresses two important areas: safety and reaction/pragmatics.

When teaching this skill, I like to provide criteria for each problem size. In simplest terms, a small problem is easy to solve, only effects ourself or one other person, and can be solved quickly. Examples of small problems could include the Ipad is not charged, don’t like the food choices of a meal, unable to do a desired activity, etc. A medium problem may effect a small group of people, and the problem is of longer duration. More resources or time may be needed to solve this problem. From a pragmatic perspective, a medium problem may involve hurt feelings. Examples of a medium problem could be a dropped birthday cake, you don’t get picked for a team, or your friends aren’t talking to you. A large problem effects a large number of people and/or may take a lot of resources or time to solve. Any problem where danger may be a possibility is viewed as a large problem. Examples of a large problem could include you cut your finger and don’t know if it needs stitches, you get separated from your parents on vacation, or a stranger is trying to talk to you .  (You can also address the problem size of catastrophic problems (house fire, natural disaster, etc). However, all of these would have a parent or trusted adult involved automatically.

So, why is being able to determine the size of a problem such an important skill? I find there are two benefits to working on this skill. One, being able to correctly gauge the size of a problem as small, medium, or big helps provide criteria for if help from a parent or trusted adult is needed. Knowing when help from an adult is needed improves overall personal safety, whereas knowing when a problem can be safely handled on one’s own improves independence and confidence.

Secondly, if we are taught to gauge the size of a problem appropriately, then we can work on the skill of matching our reaction to the problem size. If someone has a big response to a small problem, this has pragmatic implications. For example, if a child is told they have to share a toy and has a meltdown, they are having a big reaction to a small problem. By learning this is in fact a small problem, we can then help the child learn to have an appropriate sized reaction (play something else while you wait, know they can have a turn later, it is good to share with our friends). Likewise, the reverse can also happen. If a large problem is happening, for example, flunking classes, but the child is having a small reaction (indifference) we can lead them to understand this is a large problem and therefore a larger reaction is necessary (study more, get grades up, be able to graduate).

Gauging problem size correctly is a good skill for all age groups, child to adult. While an often overlooked scope of problem solving, learning to correctly gauge problem size enables those learning this skill to improve their overall safety and independence, and can lead to an improvement of social skills by improving appropriateness of reactions to given problems that can happen in everyday routines and situations.

How to teach gauging problem size:

Decide your criteria for each problem size (I like using this packet when teaching this skill in therapy sessions) and teach the differences between them.

Explain and provide examples of each type of problem size. (The teaching of the skill must come before the question/answering of a skill).

Start with visual examples (flashcards that depict everyday problems, freeze frames of problems depicted in media, etc.) Show the example and ask what size problem it is and why. I like to match my examples to those that could realistically happen within my child’s (or my client’s) daily environments.

Once there is good understanding with visual examples, move to verbally presented ones. (“Your wanted to wear your favorite shirt today, but it is dirty. Is that a small, medium, or big problem?”). Discuss why it is a small problem–Only effects one person, easy to solve (wear a different shirt, you can wear it again as soon as it is laundered).

This goal is easily linked to common problem solving goals by expanding the task. For example, we can ask  to identify the problem in a photo, then determine the size of that problem. Once problem size has been determined, we can then prompt for solutions to the given problem.

Katie Sullivan, M.S., SLP-CCC

has been a pediatric Speech Language Pathologist for 23 years, and is a Therapy Supervisor with Theracare.  She is the mother to five children, ages 8-18,  including twin teenage sons with special needs. You can follow her at the My Sweet Homeschool blogfacebook, twitter, and instagram.

 

 

 

 

Pediatric Home Health

Early Onset Schizophrenia and its Impact on Child Development and Function

When we think about the term schizophrenia, we reasonably picture an adult exhibiting bizarre or unexplainable behaviors. However, there is a very rare condition called early onset schizophrenia in which children under the age of 18 experience a break down in mental health. What is early onset schizophrenia? According to the Mayo Clinic (2019), this type of schizophrenia can present with the typical symptoms of hallucinations and delusions in teenagers:

  • Hallucinations: Hearing or seeing things that do not exist (i.e. hearing voices, seeing people who others can’t see).
  • Delusions: Holding false beliefs (i.e. believing that you are famous when you are not, believing you have superpowers, etc.).

Other symptoms of typical schizophrenia include disorganized thinking or disorganized speech (i.e. word salad or reciprocating inappropriate or odd conversation) as well as negative symptoms with is a reduced capacity to function normally (i.e. lack of hygiene, social withdrawal, disinterest in activities, lack of emotion, monotone speaking, etc.). These symptoms can present in teenagers, but may not yet come to light in children with early onset schizophrenia under the age of 13.

In extremely rare cases, children between the ages of 7 and 13 years can be diagnosed with early onset schizophrenia but the symptomology presents a little differently. The following may or may not be symptoms of schizophrenia in early childhood, according to the Mayo Clinic (2019):

  • Language delays
  • Late or unusual crawling
  • Late walking

Other abnormal motor behaviors — for example, rocking or arm flapping https://www.mayoclinic.org/diseases-conditions/childhood-schizophrenia/symptoms-causes/syc-20354483. The American Academy of Child and Adolescent Psychiatry (2013) states that the following symptoms are often found in children with early onset schizophrenia as the approach the teen years:

Schizophrenia is still being heavily researched regarding its etiology. Researchers believe that there are both genetic and environmental explanations for why schizophrenia is triggered in some individuals. As far as function is concerned, schizophrenia left untreated can have a detrimental impact on a person’s ability to carry out day-to-day living tasks. Imagine how hard it would be on a child who is just starting to get used to the requirements of life.

Pediatric occupational therapy has a place in the world of mental health, including any affected individual across the age span. When it comes to early onset schizophrenia for a very young child, an OT’s work may include the following:

  • Consultation and Evaluation: The OT will want to complete a detailed evaluation of the child, whether that is in the home or in a clinical setting. Assessments will include testing the child’s developmental milestones, tracking strengths and weakness, and how delays are impacting a child’s ability to participate in activities typical of their age.

  • Interdisciplinary communication and collaboration: Schizophrenia is a very complex disorder, no matter how old the individual. Thus, it would be wise of the OT to collaborate with relevant clinicians who may also be working with the child. This will include pediatricians, mental health counselors, and/or psychiatrists. The OT will need to review the child’s medication schedule, if there is in fact one that has been recommended by a doctor already. The medications schedule will need to be coordinated with the OT intervention in order to help the child participate in the most optimal way possible. Intervention planning: After the evaluation period, the OT will then plan out interventions and goals with the parents and the child. Goals are related to developmental milestones as well as to what area the child or parent’s find the most important. Examples include hygiene, dressing, motor activities (crawling, walking), social participation, academics, play, self-feeding, dressing, sleeping, and community activities just to name a few.

  • Caregiver/parent education: Of course, all interventions need to be followed up with education for the parents and caregivers of the child. This includes providing handouts and information that proves helpful for parents and caregivers to carry out interventions in the absence of the OT.