Calm and Alert: How Activities Can Affect Your Attention

Swimming, digging in dirt, chewing gum, playing with playdough, jumping, and coloring – what do they have in common?  All of these activities can affect behavior and emotions.  The big question is which activities work for you?  Which ones work for your child?  The same activity may have a different result from one person to another.  For some people digging in dirt or sand is calming, for others the feel of sand in between their fingers would be totally irritating!

In past posts, I have written about how we can use activities to help us move from one state of behavior to another.  For example, we may go for a run to help us organize our thoughts or even decrease feelings of anxiety.  Similarly, children may intuitively choose the swings at recess or the climbing structure to release pent-up emotions.  After recess they may be able to concentrate better.  Hooray for recess!  And if they have a hard time calming down when they come back from recess, the teacher may have them do some deep breathing before transitioning into seat work.  It may look like this:

“Take a deep breath.  Hold.  Let it out slowly.  Again.  Now give yourself a hug.”

In the world of sensory processing, there is a host of strategies categorized as heavy work activities. The list is endless and varies from deep breathing to jumping on a mini-tramp.  There are considerations for particular environments and for personal choices.  Some activities are more appropriate for larger spaces (pushing a loaded cart) and some for smaller spaces (squeezing a fidget).  Some are appropriate for home (bike riding) and some for school (carrying books to the library).  The goal is to choose an appropriate effective activity or mix of activities. 

One of my favorite suggestions for a calming activity is coloring with the use of colored pencils or crayons because they give you good feedback and require more pressure (heavy work J).  I was recently talked to a bookstore owner who told me about the explosion of coloring books for adults, especially mandalas.  There are many with the express intent of soothing the adult soul with books such as Color Me Calm and the Zen Doodle Coloring Book.  Maybe this is something to put into your schedule before or after a challenging bedtime routine! J

Choosing activities and seeing how they work with your child is a challenge! Contact me if you would like help talking through activities which may be helpful for you or your child to help with transitions and daily routines.  I would love to help you develop a plan. 

Here are some resources and related articles:

OTMama blog has 40 heavy work activities listed which you can use and expand upon! 

NPR interview on adult coloring includes the benefits of coloring followed by an interview with a Scottish author of adult coloring books (love that accent!).  The comments at the end of the article are a great promotion for coloring

Dover Publications has some great low cost coloring books for all age levels.

NBC news article on fidgeting and movement which incorporates ideas on heavy work.

Not This Again! When Daily Routines are a Struggle**

Everyone has daily routines – like your routines for getting up, dressing, eating meals, transitioning to and from the car, and going to bed.  When I say “routine,” it doesn’t mean that you have a fixed way of doing things, but rather that you have a “typical for your family” way of doing things.  It may be, for example, that you struggle every day to get your children to bed and that bedtime is a chaotic time for your family.  Like it or leave it, that’s your routine. You may be the lucky family who gently guides your child through the toileting and toothbrushing, tucks them in bed after a book or two, and listens as they sing themselves to sleep.  Or not.

If you are challenged by helping your child to get to sleep you are not alone.  One indication is the host of books on the subject:  just try googling “children and sleep.”  And then there’s Amazon’s “top selling book which promises to put your child to sleep.”  What desperate sleep deprived parent wouldn’t run out and get that?!!  Yes, my daughter ordered it.  I am curious, too, and intend to find out what the magic is within those covers.  It could be a great addition to the bedtime routine, but I doubt that it can “stand alone.” *

What this plethora of books tells me is that there is no single, definitive answer – not for sleep routines or any other routines.  And when your child has sensory differences, you may have to make even more intentional efforts to calmly get through these transitions and routines. 

So what goes into creating a successful bedtime routine?  This routine needs to have some components of flexibility, but overall, the goal is to give your child clear expectations and a consistent order to the process. It needs to be individualized, and, in order for you to be consistent, it may help to write out your bedtime routine.  This written plan, or story, will also help if different people put your child to bed.  It may reduce anxiety and gaming behaviors.

Here is a case study:  I recently started working on a bedtime routine for a delightful, bright little three- year-old girl (my granddaughter).  She went through a pleasant phase as a two-year-old where the routine developed and was fairly smooth for bedtime. Then she reverted to challenging early behaviors stretching out the bedtime process sometimes to two hours.  When I assessed her sensory needs, I realized she seems to crave a good amount of jumping, running, swinging and climbing.  These are things she needs in order to be calm.  She also seems to do best at the end of the day if she has had a good nap and timely dinner.  When devising a plan or “bedtime story” for her, I took into account her great verbal skills, her need to move, her skill at manipulating (!), and which sensory strategies she generally responded to positively. 

I drafted a bedtime story called “Every Night I Go to Bed.”  I drew simple pictures to illustrate eating, jumping, bathtime, towel snuggles, donning undies and nighties, talking about the day, reading two books, singing two songs, back rubs and listening to music as the lights are turned off.  We read the book during the day.  We read it several times at night.  How did it go?  Pretty well at first, but then not so successful.  I mean, some nights were dreadful.  Did we tear up the book?  No!  This was a good starting point and now it was time to look at what was working and what we needed to change.

This leads to an important part of creating a routine:  modification.  I talked with her parents and we decided she needed more movement during the day, a written-out daily schedule to bank on her verbal skills and help with any anxieties about what was happening the next day. Further, we needed to reassure her and be consistent with the plan where it worked.  We continued to repeat the story during the day and it is gradually working into more consistently pleasant bedtimes!

In summary, here are some tips for developing and writing out a routine:

·         Keep what works, modify what doesn’t, and get rid of the ideas that you dread – then write those changes into the story.

·         Use visual supports integrating pictures and words.

·         Keep it simple for each item whether you use a list style or book form. (in book form write no more than one or two activities per page, such as “Then I go potty and brush my teeth.”)

·         Incorporate sensory components:  touch, movement, music, pre-bed snack, calming lights.

·         You may find it helpful to add a time to the activity: “Mommy rubs my back for 5 minutes” or “I play in the bath for 10 minutes.” Also, you may find that use of a timer reduces resistance.

No matter what daily routine you are hoping to improve, consider your child’s unique needs and strengths along with their developmental level. Consider your own strengths and needs, too!  If you continue to struggle, seek input from your friends, family members or even a professional for some fresh perspective, ideas and compassion!

*I read this book and it nearly put me to sleep, but only because it was tedious to read.  It was quickly tossed as it was not a good style for me or for my daughter.

**This article was previously published in ParentMap online.

HANDWRITING: a target skill for late summer (or anytime)

For many, summer vacation is about the break from “seat work” – but this break also provides us with s great opportunities for development! Recently, I heard that Shari Lewis of Lamb Chop fame developed her wide variety of skills by focusing on learning one skill during each summer vacation.  I know some wise parents who follow a similar approach with their children’s summer vacations.  We had one neighborhood boy who had numerous challenges.  One summer, his parents decided he should learn how to ride a bike.  He spent his summer riding happily around the neighborhood.  A great life skill! 

Many children attend sports camps in the summer. But maybe your child needs a more relaxed approach to building their basic gross-motor skills - like spending time riding a two-wheeler, bouncing a ball on the driveway, kicking a ball around the yard, or just building confidence on the playground without competing with 150 kids for the equipment. 

Summer can also a great time to work on handwriting skills (okay, I hear that little groan) – including catching up on improving the formulation of letters as well as the fluidity or pace of writing.  When your child has great things to write and say but their peers, teachers, and others find reading their writing challenging, they may get frustrated and just “give up.”  A great deal of writing is expected in school, with the pace and amount of writing increasing rapidly beginning already in first grade.  Why not use the time that summer allows to work on building confidence and foundational handwriting skills in a fun, no-stress environment? Even though most of this summer has slipped past, anytime is the right time to work on handwriting skills!

Here are some ideas for young writers:

1-      Play!  Many fine-motor activities are good warm-ups for writing activities.  Ideas include:  playdough play, writing and drawing with sidewalk chalk, sticker play, stamping, tiny wind-up toys, small building blocks, Legos.

2-      Form letters using materials with different sensory properties.  Ideas include:  playdough “snakes,” Wikki Sticks, sticks from the yard, pencil or stick tracing on a slab of clay, finger tracing in sand or salt in a tray. (Provide a model as needed.)

3-      Write letters and numbers.  When you get to this step, it can still be fun!  A couple ideas include: playing tic-tac-toe using letters or numbers; writing the letter in the air first; tracing letters with eyes closed; using a variety of media to write with (paint, vibrating pens, markers, sparkly crayons) and to write on (dark paper with white crayons, strips of paper, colored 3x5’s or papers decorated with stickers). All of these pave the way for motor memory and automaticity of letter formation.  For an app to help with motor and visual memory, try Letter School. 

4-      Put everything together in a “writing suitcase” or another special box.

Here are some ideas for your older writers:

1-      Try some fine-motor activities as a warm-up.  Ideas include:  Legos, clay play, drawing step-by-step, painting.

2-      Writing practice – not drills!  Ideas include: playing games such as Mad Libs; making lists for shopping or places they would like to visit; writing postcards or letters to relatives or friends (I know – old-fashioned!).

3-      Writing.  Older students should do a writing sample to ensure you are focusing on the letters or numbers that are a challenge.  When reviewing the writing, don’t assume that they know what “messy” is – instead have your children learn to self-critique by looking at formation, spacing, and letter placement one at a time!  The goal is not to have perfect handwriting, but to produce legible handwriting.  Practicing letters is not helpful if the child is repeating mistakes!  This is a time to build skills and confidence on the basics so they can then spend energy on content.

4-      Keyboarding.  If you have a child who is finishing 3rd grade and struggles with handwriting legibility, find a good keyboarding program now (such as Mavis Beacon).  Instead of searching their keyboard for letters when they are trying to produce writing in school, they can concentrate on their creative content! (If they are younger than 3rd grade, there are some more fun-based programs like Sponge Bob, but focus should be on handwriting.)

For a skill like handwriting, designate 20 minutes a day for maybe 3 or 4 days a week.  Include in that time the fine-motor preparation activities for the “writing.”  Use a powerful reward if necessary, but do everything you can to make it fun!  And if your child has a lot of writing homework, make sure you give time for "brain breaks" and "eye breaks" -- stand, stretch, breath!

I occasionally brush up on my handwriting and find it calming.  I am now using a cursive workbook for which uses the Italic Handwriting style.  There are so many ways to go!  If you have questions, please contact me.  We could even do a one-on-one or small group session.

Here are some websites with useful ideas especially for using a variety of lined paper and making your own worksheets:  Writing wizard, Donna Young. For complete handwriting programs here are two I recommend:  Getty-Dubay Italic Handwriting Handwriting success and Barchowsky Fluent Handwriting.  These are both beautiful and give consideration to warm-ups, print and ease into cursive without teaching a whole new way of writing.

Need more convincing of the importance of handwriting?  Check out this article in the New York Times or these findings from an Educational Summit regarding handwriting research.

Relating to Your Sensory Self

So far, my posts have been focused on your child’s challenging behaviors and sensory processing differences.  Before we continue, I want to emphasize that we all have differences!   However, sometimes these differences are more extreme and become a challenge to us.  I always tell parents that the sensory processing differences that they observe in their child are only a problem if those differences interfere with family or school life. In terms of sensory needs, is your child comfortable in his or her daily environment?  Are sensory patterns affecting social interactions or ability to focus in school or follow a daily routine? 

Before you consider your child’s patterns, reflect on your own sensory processing patterns. Winnie Dunn wrote an insightful book called Living Sensationally:  Understanding Your Senses.  She helps adults view their own behaviors through the lens of sensory responses in daily living. The responses are then grouped into four basic patterns:  avoiders, sensors, bystanders and seekers.  Her questionnaire helps you to determine your own patterns as well as the degree to which they influence your social interactions, activity choices, clothing and so forth. 

I took the questionnaire myself and the results show that my behaviors appear to be moderately influenced by avoider and sensor patterns, some mild bystander characteristics, and virtually no influence by seeker patterns of responses.  It confirms, from a sensory point of view, that I am a mixed bag:  I avoid perfume but like spices, love haircuts and going barefoot, but I do not touch others when I am talking to them – in fact, I respect a substantial personal bubble.

My primary take-away from this book is that no one pattern is better than another; however, how you experience and respond to sensory input can impact your activity choices and how you relate to other people.  While this is particularly true in marital and roommate relationships, just consider how much this can influence your relationship with your child!

If you are a “seeker” parent and have a “sensor” child, you may clash in your idea of what is fun!   A seeker may love the big crowded playground and all of its activities, but the avoider child might prefer his or her own backyard with a friend or two.  A seeker child might like the front row of a parade, while the bystander parent might like to watch from a few rows back. The avoider parent would have someone else take their child to the parade.  A sensor child might only be comfortable in cotton clothing with tags cut out, while a seeker parent might love bright lively fabrics - and it doesn’t matter what it feels like. 

Pay attention to how you perceive sensory input and respond to it. This may prove to be vital in your relationship with your child.  No matter what the results, it is important to honor the fact that your child may be experiencing the input in a totally different way. 

I can help you decipher the sensory patterns in your family.  Being aware of your own sensory processing patterns is a key first step!  Contact me to start the conversation.

The Sensory Sensitive Child

“Is the fire alarm going to go off?  The lights are too bright!  It’s too noisy in here – it hurts my ears! My tummy hurts.  I want to leave!”

Do you have a sensitive child?  This is not an uncommon phenomenon and yet these children can feel alienated and misunderstood.  When I have had children referred for sensitivities, it’s usually because it is interfering with their concentration and even with social skills.

Noah came to me and could not get off the topic of the possibility of the fire alarm going off.  His mother said he also had a hard time entering public bathrooms because of the anticipated noise of the hand driers.  My nephew has extreme sensitivity to pain to the point where a hang nail can make him miss a piano lesson.  The other afternoon I was attending a child-friendly concert—or should I say friendly for most, as one child was brought out plugging his ears, screaming about the noise and his parent looked equally stressed saying, “just play outside then!”

It can be so frustrating for the adult, but even more anxiety producing for the child! When I try to explain to parents and teachers how real this is to a child, I ask them to imagine standing in front of a car and the person inside is poised to hit the horn.  You know it’s just a horn, but you would feel better if you were the one who was going to honk it.  Or, imagine that you are experiencing a nasty headache and you are stuck in traffic in a construction zone.  The point is, a child feels like there is no escape.  Or maybe they do escape and they bolt from the house or classroom or away from you in a crowd.  Or they just melt.

As discussed in past posts, it is good to think of your own sensitivities and try to think about how your child is experiencing the environment.  It is helpful to think of yourself on the same side as the child and honor their sensitivities.  Just take their word for it that it truly “hurts.”

If you were stuck in traffic, hearing someone say, “Get over it, there is nothing I can do!” would simply add to the frustration.  But it might help you to hear something like:  “Oh, getting stuck in traffic is the worst!  Can you find some good music to listen to? I heard the funniest story at work today.”

Similarly, a child might like to hear:  “Oh, I am so sorry that noise is bothering you and hurting your ears.  It does not bother me, but I know it bothers you.  What about putting your hands over your ears or using these ear plugs or these noise-blocking headphones?”  If they are not at the peak of anxiety, it may help to divert them with a story or song. I had one little guy who just needed to have the ear plugs in his pocket.  At first he used them, but eventially he would just finger them for reassurance.

Sometimes if you anticipate a “sensory event” it helps to talk it through, talk about ways to handle it and go through the time table for when it will be over.  Help them practice tolerating the noise.  Even have them imitate the noise.  In the case of pain, try to give the child some deep calming back rubs or find another calming event for them such as music on headphones.

*If you would like to go on an outing with your child who has sensitivities, there are venues which accommodate those needs.  Libraries offer smaller group times with less stimulation.  Also Seattle's Child Magazine has pulled together a list of possibilities you may want to check out.

**If your child is overwhelmed and you are overwhelmed, seek a professional to help you work through these very real challenges.  It can be an occupational therapist, or for babies you can contact the people at the FussyBabyNetwork:  www.cooperhouse.org/fussybaby. (Seattle area)

May 5, 2015

The Bull in the China Shop

“Oh my word, why do you keep knocking things over?  You tore your paper again?  Here’s a new one, but it’s the last one.  Will you please close the door more quietly?  Indoor voice please!!  Your zipper is broken?  You have to be more gentle!”

Do you know this child?  The child who seems rough on everything?  Sometimes seems to do things on purpose, but often is just like a bull in a china shop leaving a path of destruction?  The cause for this behavior varies, but sometimes the child just has a need for bigger input into his body.  This is the child who will gravitate toward the puddle and jump into it, run up and down the aisle in the market, chew on their ice, insist on climbing into their car seat (no help please!), dump all of their toys out, and break the crayons accidentally on purpose when coloring.  They seek more resistance, more intense feedback.

What’s interesting about this child is that when I start questioning the teacher – and especially the parent – and start giving them ideas for meeting this child’s deep sensory needs, they will often say, “Oh, he loves to do that!”  In other words, when they think about it, this child chooses what he needs.  So we’re all good, right? Unfortunately, some of the ideas the child comes up with are not so appropriate or acceptable.

So how do we intervene after we have observed this pattern of behavior?  One way is to guide them to acceptable and effective strategies for meeting this evident sensory need. Some of these are referred to as “heavy work.”  They include activities such as:  having your child help you carry groceries, open heavy doors, wipe off tables, and – for older children – push the vacuum cleaner.  Yes, your child can do chores!  Sweet.

Other ideas you may want to consider include:  sucking water from a water bottle, riding a bike, climbing at the playground, jumping, fun yoga, drawing with chalk on a sidewalk, coloring with crayons, crunchy or chewy snacks, playdough play, building with heavy wooden blocks.  Swimming, sand play, and swinging are also favorites for many children.

There are several points to remember:

• Sprinkle these activities throughout their day. Consider putting them into your routine right before a time they have challenges such as mealtime when they have to sit for a bit…or before bedtime when they need to calm down.
• Try catching them before their behavior starts spinning out of control. My son-in-law started a “calm song” activity with his two-year-old daughter.  What a great practice for her to learn!  It helps her to regain that calm necessary for engaged play.
• Choose activities which will work for you and your child. Observe the effect of each activity and toss out the ones that don’t work.
• Some activities can work both ways, e.g.,running can be calming for some people and can stimulate others.

So, what about that bull in the china shop?  He needs support if he is to enter and stay in the china shop, but altering the environment might be better. 

April 24, 2015

Articulating Sensory Preferences

“I can’t wait until recess and tether ball…oh, I wonder who that visitor is here for… I wish I could go with them…oh, man, my pencil point broke off again – I was using it to balance while I tipped my chair back…kind of fun to roll the point back and forth on my desk…it’s making my fingers gray…I should wash it off…huh, there’s that hangnail…wonder if I can pull it off – oops, bleeding. These shoes are bugging me…I wish I didn’t have to wear shoes at school.  Yesterday we had a fire alarm…wonder if we will have one today.  I’m hungry. Oh, yeah, time for recess.  What? I can’t go out because I didn’t do my work?  Argh!  What?  I didn’t push him; I was just turning him around. Sorry.”

I’ve known many children who have similar thoughts and feelings throughout every day in school.  They are often not able to articulate what is bugging them.  Even if they noticed what would help, for example a change in seats, chewing gum, or shoe removal, it is against the rules…or disruptive to others.  They don’t have a bandaid to tape up that pesky hangnail.  They have a need to move and it’s constantly squelched.  They miss directions and later they act out.  Or perhaps they hold it together at school and act out at home.

The issue may not be purely sensory in basis – it could be that they did not have a good meal before school or maybe not enough good sleep.  They may “forget the rules” or have peers who “set them off.”  So many variables!  However, sensory issues need to be addressed both when doing the “detective” work of looking at causes of behavior and when considering strategies to help the child manage their behavior.

Imagine a comparable scenario for an adult.

“I hate being late to conferences.  Now I have to sit in the middle of the row and it’s crowded.  My neighbor is talking to her friend and I am having a hard time hearing the lecturer.  The Power Point doesn’t seem to match what she is saying – or I am on the wrong page.  Eesh, I am so chilly, wonder if they will turn the heat up.  I wish I had eaten more breakfast and I forgot my water bottle in the car.  I think I will leave early.”

Could this be you?  It could be me!  As an adult, though, we have options, right?  We could politely let the neighbor know that we are having a hard time hearing.  We could get up, move and find a warmer spot with more room.  We could get a snack from our bag and eat it (quietlyJ) anytime we choose, look at our phones, find some coffee or tea, use the bathroom without raising our hand – you get the idea, right?  We have more awareness of what is bugging us and what appropriate measures we can take to stay focused.  We can even anticipate going home and kicking off our shoes.  If we are not aware and do not use some strategies, we may start grumbling and sighing – in other words, our behaviors may deteriorate!

Being able to articulate our needs and having choices in how to mediate those needs makes a world of difference in helping us to be comfortable in our environment.  Observing your own sensory patterns and how you fulfill your needs will in turn help you in observing your own child and their preferences.  This is an important step in choosing effective strategies for helping your child to be comfortable in their environment.

April 6, 2015

Sensory Processing and Behavior

When I am contacted to help with challenging behaviors, I am often asked:  is it behavior or is it sensory based?  In other words, when a child has a challenging behavior, could it be that there is a sensory component?  My answer is “probably.”

Luke exhibited a lot of “bull in a china shop” behaviors:  he was always bumping into his peers, knocking things over, slamming doors too hard and breaking his pencils.  He was often in people’s faces and could not grasp the concept of an “indoor voice.”  He often was the child who had recess taken from him (his favorite thing) and he was the child who needed it the most.

We all process sensory information.  We react to our body’s movement, smells, touch,  tastes, what we see and sounds around us.  We make choices based on our preferences:  shower or bath, exercise or sit in a comfy chair, fast food fries or home roasted potatoes, all cotton clothes with a loose fit or snug fitting athletic clothes.  Time of day, stress or our health can alter these preferences so that we may react to loud music irritably at one time and with passive acceptance another.  So although we all have patterns, our preferences may vary or we can compensate.  For example, if you are at a meeting and the voice of the presenter is irritating to your ears, you may step out a minute and get a drink or just doodle on your paper.

Children, however, are more likely to react in a visible way and their way of dealing with something noxious to them may result in what we see as challenging behaviors.  Don’t like the noise?  Put your hands over your ears (good compensation!) and scream (not so good).  For Luke, he craves pressure into his joints so he loves opening heavy doors and carrying the groceries (great activities) but he also pushes his friends (not a good choice).

When looking at challenging behaviors in children, it is generally valuable to look at their sensory processing profile.  There are standardized tools used to gather information about sensory related behaviors.  The purpose is to help the adult to discern what part sensory responses might play in the cause or exacerbation of the behavior.  Not only does this help in understanding their behavior, but also helps in devising ways to intervene.  You may find out that the child can’t stand seams in her clothing so they only feel comfortable when they wear clothes and socks inside out.  Further, when you shop with them you may pay more attention to the insides of the clothing.  Paying attention to these details can affect behavior as well as relationship dynamics.

Next time we will look at some more specific sensory patterns and preferences – for you and for your child.

March 5, 2015