Strategies to help with behaviors in the community

(As a follow up to the last blog post, this blog post is Part 2 of 3 in a short mini-series of Strategies to help with behaviors.)

There is some overlap on strategies in the home and community we can use to help with behaviors. So, some of the strategies listed in this blog post are similar to some of the strategies in the previous blog post. Regardless, they are helpful in multiple situations, and once you learn them they can help you to decrease unwanted behaviors.

• Have clear expectations for your child on what behaviors are allowed and not allowed, and discuss these expectations with your child. Example:
  • When Mommy or Daddy tells you to hold their hand in the parking lot, you are expected to listen and hold their hand for safety.
  • When Mommy or Daddy tells you that you cannot get any candy in the grocery store, you are expected to listen and you will not get any candy.
  • When Mommy or Daddy tells you it’s time to sit down in the car, you are expected to listen and sit in your seat.
• Stay firm with boundaries, this is essential! If we don’t stay firm with the boundaries, it teaches children that the boundaries are not firm, and they can get what they want (candy, a toy, etc.) by screaming, crying, having a meltdown, etc. This will cause more unwanted behaviors in the future.
• If multiple family members will be partaking in this outing, everyone has to be on the same team and handle behaviors the same way.
  • For example, if the consequence for not holding Mommy or Daddy’s hand in the parking lot means that the child does not get to read their favorite book with their parent/guardian when they get home. If someone lets the child read their favorite book with their parent/guardian when they have been told no to this. It will confuse the child, and teach them that all they have to do is ask Mom, or Dad, or Grandma, or Grandpa and they will get what they want. It will teach them that the boundaries are not firm causing more behaviors in the future, and causing everyone’s hard work to go unnoticed.
• If you are concerned about your child having a meltdown in a public place, consider going during a less crowded time (not on the weekends, preferably on weekdays in the morning, early afternoon)
• Use a visual timer (kitchen timer, etc.) if needed to help with transitions. A child’s sense of time is still developing, so while a verbal cue (“we will be leaving in 2 minutes”) is good. It helps to give them a visual as they are still learning the concept of time. So we can say “look this timer has 2 minutes on it, and when those 2 minutes are up, it will be time to leave, look at the numbers count down and get smaller”
• Consider using a visual schedule if there are multiple things going on during the day. This will allow children to see when things will happen and how many things need to happen before they return home or get a preferred activity; playing at the park, playing with friends, etc.
• Reward success (and good listening) with verbal praise and encouragement
  • While we need to be firm with our boundaries and follow through with consequences. It is equally important that we give our children verbal praise and encouragement when they listen to us and make good decisions. This way we are encouraging them to continue to listen and continue to make positive choices.

While these tips work in a variety of situations, it is understood that each family has to find the best routine for their own individual family. An Occupational Therapist can help you incorporate these strategies in the community to help decrease negative and unwanted behaviors in the community environment.

Strategies to help with behaviors in the home

(This blog post is Part 1 of 3 in a short mini-series of Strategies to help with behaviors)

Inappropriate and attention seeking behaviors are never fun, but they are part of growing up, and part of how a child learns about their world around them. Children use rules and boundaries to learn cause and effect, and what is and what is not appropriate and acceptable. Boundaries also help a child feel safe as they teach children that there are limits and expectations set on their behavior and there are consequences for not following those limits and expectations. There are simple things we can do in the home environment to help with behaviors:

• Have clear expectations for your child on what behaviors are allowed and not allowed, and discuss these expectations with your child. Example:
  • When Mommy or Daddy tells you “no” you are expected to listen and stop what you are doing.
  • When it’s time to have dinner, you are expected to sit at the table with the rest of the family.
  • When it is time to get ready for bed, you are expected to stop what you are doing and take a bath, brush teeth, get into bed, etc.
  • When Mommy or Daddy tell you to work on your school work, you are expected to complete school work before anything else, (playing, reading, etc.)
• Stay firm with boundaries – this is essential! If we don’t stay firm with the boundaries, it teaches children that the boundaries are not firm, and that they can get out of situations or out of doing things they don’t want to by screaming, crying, having a meltdown, etc. This will cause more unwanted behaviors in the future.
• Along with the prior tip, everyone at home has to be on the same team and handle behaviors the same way. For example, if the consequence of not listening to their parents when they say no, means the child does not get to play with their favorite toy. Everyone at home has to be on the same team, and not let the child play with their favorite toy.
  • If someone lets a child play with their favorite toy when others have told them “no” it will confuse the child, and teach them that all they have to do is ask Mom, or Dad, or Grandma, or Grandpa and they will get what they want. It will teach them that the boundaries are not firm causing more behaviors in the future, and causing everyone’s hard work to go unnoticed.
• Use a visual timer (kitchen timer, etc.) if needed to help with transitions. A child’s sense of time is still developing, so while a verbal cue (“we will be leaving in 2 minutes”) is good. It helps to give the child a visual as they are still learning the concept of time. So, we can say “look this timer has 2 minutes on it, and when those 2 minutes are up, it will be time to leave, look at the numbers count down and get smaller”
• Reward success (and good listening) with verbal praise and encouragement.
  • While we need to be firm with our boundaries and follow through with consequences. It is equally important that we give our children verbal praise and encouragement when they listen to us and make good decisions. This way we are encouraging them to continue to listen and continue to make positive choices.

While these tips work in a variety of situations, it is understood that each family has to find the best routine and options for their own individual family. An Occupational Therapist can help you incorporate these strategies in the home to help decrease negative and unwanted behaviors in the home environment.

What to do when your child gets a Diagnosis

When your child receives a diagnosis of Autism, Delayed Milestones, Sensory Processing Disorder, Attention Deficit Disorder, Attention Deficit Hyper Activity Disorder, Down Syndrome, or any other diagnosis. It is very easy to feel overwhelmed and not know what to do next. It is very easy to feel a mixture of emotions from confusion to frustration to sadness (and everywhere in between). While our initial reaction may be to go to Google and ask family/friends about what they know about the diagnosis. We need to be careful with this; while there are many great resources online, there is also an equal amount of misguided, misleading, and downright wrong information. We need to be careful to whose information and advice we listen to, and make sure that it is credible.

When your child receives a diagnosis, it is a good time to reach out to a therapist, and schedule a screening or evaluation. This way you can make a plan of what steps to take next to help your child. It is very important to remember with a Diagnosis is and what it is not. A diagnosis is simply information – it is not a predictor of whether or not your child will be happy and successful in life, and it is not a reflection of the child’s upbringing and parenting. A child with a diagnosis is like any other child; they want to play, laugh, smile, love, and be loved; a diagnosis does not take this away from them. Each child is special and unique regardless of a diagnosis, and each child continues to need Love and support from their family so they can continue to grow and learn about the world around them – a diagnosis does not change this.

Does Sonoran Sun Pediatric Therapy accept an Empowerment Scholarship Account (ESA) to pay for therapy services?

Yes! Occupational and Speech therapies are covered under an ESA as approved therapies for students with a documented disability, MET Evaluation Report, or Individual Educational Plan (IEP) from a public or private school.

What is an Empowerment Scholarship Account?

In Arizona, an Empowerment Scholarship Account (ESA) allows parents to “seek a range of alternative educational services, such as private school or home-based education, to tailor an individualized educational plan that is best for their child.”

“To participate in the program”, applicants abide by an annually signed contract that includes the following:

• Student cannot be enrolled in a public school (including charters and public online schools)
• Student cannot be enrolled in a summer public school program (including charters and public online schools)
• Student cannot receive any School Tuition Organization (STO) scholarship or any tax credit scholarship concurrently within the same year
• Applicant submits quarterly expense reports, with uploaded receipts, by a given deadline
• Applicant adheres to the approved expenditures
• Applicant spends a portion of their annual funds every quarter”

Among other eligible spending that is covered under an ESA, funds can be used to pay for educational therapies or services for students with documented disabilities. Covered therapies under an ESA include occupational therapy, speech therapy, physical therapy, vision therapy, art therapy, and recreational therapy. Additionally, “assisted technology, defined as ‘assistive, adaptive, and rehabilitative devices which promote greater independence by enabling students to perform tasks they were formally not able to accomplish or had difficulty accomplishing’ can be rented if prescribed by therapy”.

An ESA may not be used:

-to pay for fees for late, cancelled, or missed appointments

-for any therapy where payment involves any form of medical insurance

Visit http://www.azed.gov/esa/frequently-asked-questions/ for more information

How does an Empowerment Scholarship Account work?

Funds are dispersed on an ESA Prepaid Bank Card, which can be used like a debit card when it is time to pay for your therapy services. Please read the most updated ESA Applicant Handbook for further details (http://www.azed.gov/esa/parent-handbook/).

Need more information?

If you have any questions about an Empowerment Scholarship Account, please do not hesitate to contact us or the Empowerment Scholarship Account (ESA) program:

-ESA website: http://www.azed.gov/esa/

-ESA phone: 602-364-1969

-ESA e-mail: esa@azed.gov

By Kristina Burnham, MS, CCC-SLP

Speech-Language Pathology Supervisor

The Importance of Outdoor Play

Playing and experiencing the outdoors helps brain development in children. Research shows that playing outdoors reduces anxiety/stress and helps children develop self-regulation skills, problem solving skills, language skills, fine motor skills, gross motor skills, social skills, and provides a multi-sensory experience to help children develop sensory processing skills.

Outdoor Play Activity Ideas for Infants

• Have tummy time outside and introduce their hands and feet to grass, leaves, dirt, sand, and water.
• Swing and let the child experience different sounds, sights and the gentle breeze on their face.
• Take the child for a walk in the stroller around the neighborhood or park and let them experience outdoor noises, different weather patterns (warm/cool, sun/rain, wind), and different scents.

Outdoor Play Activity Ideas for Children

• Build a fort outside with climb through tunnels using cardboard boxes.
• Create a garden or make a sensory bin garden
• Sidewalk chalk to create beautiful masterpieces or hop-scotch
• Wash the car, bikes, or toys
• Gather old kitchen containers and create an outdoor kitchen and make mud pies
• Nature walk and gather pretty things for a table centerpiece or outdoor sensory jar
• Collect pinecones for making peanut butter bird feeders
• Go on a “listening” walk and identify all the wonderful outdoor sounds
• Play parachute games using an old sheet
• Play with empty containers in a sandbox or water table
• Push and pull activities (wagon, play lawn mower, rake leaves, sweep, push dolls or sibling in a stroller)
• Go for a wagon or bike ride
• Kick or throw a ball around
• Ribbon dance
• Fly a kite
• Eat outside
• Blow Bubbles
• Jump rope

Adapted Outdoor Play Ideas for Children with Special Needs

• Plan and pack for success. Along with your everyday outing items (medication, wet wipes, change of clothes etc.) it may be beneficial to pack a timer, a visual schedule, weighted lap sock, lap pad or weighted blanket, a sheet or blanket to sit on to decrease tactile hypersensitivity or to provide a visual boundary
• Start by playing in the backyard or grandparents or friends backyard
• Play in quieter areas secluded parks with trees that muffle out the sound of traffic
• Provide a visual boundary of where to play with cones, ropes, chalk lines, or blanket
• Set up an obstacle course
• Bring along motivators (favorite toy cars, trains, Legos etc.) and incorporate them into the outdoor activity (hidden toy car scavenger hunt, make a sidewalk chalk train track)
• If technology is their motivator, provide them with binoculars or teach them to use cameras or recorders to explore the outdoors
• Move the sensory bins outside

Fun Fall Outdoor Sensory Bin Ideas

Garden Sensory Bin

• Organic potting soil
• Play gardening tools
• Small watering can
• Silk sunflowers
• Small clay pots
• Seeds (Pumpkin, Sunflower, Dried Beans, Peas)
• Rocks
• Toy bugs and critters

Fall Theme Sensory Bin

• Dried Corn Kernels
• Dried Beans
• Rice
• Fall items / Gathered outdoor items
• Don’t forget various scoops, tongs, muffin tins, bowls and funnels

Fall Colored and Scented Rice Bins

• How to Dye Rice: Pour plain white rice into Ziploc bags. Add liquid watercolor paint or food coloring and scent if desired to rice. Seal bags and mix. Once color has sufficiently coated the rice, pour the colored rice onto a paper plate, wax paper, or cookie sheet to dry.

Pinecone Peanut Butter Bird Feeder

1. Attach string or pipe cleaner to top of pinecone
2. Cover pinecone in peanut butter
3. Roll peanut butter pinecone in birdseed
4. Hang finished pinecone bird feeder in a tree

Apple Scented Soda Dough

http://frogsandsnailsandpuppydogtail.com/how-to-make-apple-scented-soda-dough/

Erupting Sidewalk Chalk

http://www.learnplayimagine.com/2013/09

Fall Window Painting

https://kidscraftroom.com/fall-art-window-painting-for-kids/

Fall Sensory Jars

http://www.kidsplaybox.com/fall-activities-fall-sensory-jars/

Carved pumpkins, costumes, flashing lights, decorations, noises, lots of people, and knocking on stranger’s doors.   This evening for a typical child can be confusing, scary, and unsettling; for a child with special needs it can be downright terrifying, uncomfortable or meltdown inducing.

Every child is unique and we need to be aware of what senses their body can tolerate, what they are hypersensitive to, and what they are able to do.

Here are some simple tricks to help with everything from costumes, to social interactions, to planning, to the day of options to help your little one and your family have an enjoyable and stay safe. But don’t forget to speak with your friendly Occupational Therapist (OT) for more personalized suggestions or helps to desensitize or prepare you and your child!

• Costume choices: Think about what things can cause undue distress for your child (is it sounds, textures, fit, colors, mobility, etc) and work to avoid those. Then, do your best to cater to their strengths.  Does your child prefer to wear as little clothes as possible? Can you find a costume that would appropriately allow for this?  Does your child enjoy soft pajama like textures?  Did you know many stores (Target, Walmart, and many more) sell pajama costumes?  Don’t be afraid to try something new or use it as a time to introduce something new, just plan to have a back-up costume.  Don’t forget you can often times use their own clothes to make a costume.

Also, think of how you can incorporate tools that help your child (head phones, compression garments, sunglasses, etc) into their costume! J

• Costume “Practice”: Allow your child time to try on the costume at home.  Let them get used to wearing it, moving in it, and seeing themselves in it.  If your child requires devices or medical equipment make sure that they are able to utilize and access it with their costume.
• Trick or Treating: Knocking on random doors and interacting with new people is often times confusing and scary. These practices often contradict common rules or routines that the child has been taught.  Help them to understand what this Halloween is.  You can use social stories, books, movies, or other examples to help.  Make sure that you always keep your child safe, attended to, and within sight to ensure safety.  Practice this interaction with your child in full so they: know how to knock/ring a door bell (and what sound to expect), what to say (or if they have a communication device you can teach them or program it to say “trick or treat” for them), how to carry their bag, what they might expect (other people, random sounds, moving objects), and how to appropriately accept or take the candy/item.
• Route and Transportation: Plan your route ahead of time and if you can, walk the route with your child prior in the day time so they can see their surroundings.  Also consider your child’s abilities and limits. Walking for some children can be quickly fatiguing so bringing a stroller or a wagon can be helpful, this also provides a place of comfort as well as some physical and visual containment to help decreased the input.  A stroller or wagon is often a helpful option for children who run, dart or stray.
• Alternatives: Trick or treating is not for every child or every family. There are lots of fun alternatives if you still want to enjoy the holiday; hosting or attending a fall/Halloween party with a group of close friends or family, handing out candy at your house, going to a festival, or trunk or treating.
• Set them up for success: Use the day to help cater to your child’s strengths and preferences.  If they seek tactile input, let them get in on carving the pumpkin or touching the “creepy” things.  If they avoid messy play offer them paints/markers/stickers to decorate with.  Help prep your child’s body, providing them with beneficial and helpful sensory information (or lack of) that helps regulate your child (deep pressure, quiet environments leading up, time alone, vestibular input, etc).
• Food Allergies or Sensitivities: Know that the “Teal Pumpkin Project” is out there, if you see a teal pumpkin on a porch the house will offer non-food options as “treats” for your child.

https://community.kidswithfoodallergies.org/blog/keepitteal-a-safer-and-more-inclusive-halloween-for-kids-on-special-diets-and-food-allergies

Last but not least, a few pure safety ideas:  Often times when children are more overwhelmed and overstimulated they are more forgetful as well as more likely to “dart” or run.  ID bands, bright or visible costumes, custom temporary tattoos (many places sell these now) or “DIY tattoo IDs” on the child can be helpful (you can write with pen on your child’s hand/arm and coat with clear nail polish or liquid Band-Aid to provide a single day use identification number/name/note).

Is your child in speech therapy for articulation? Does your child love books? One of the many early language sounds that kids come to speech therapy for is /g/. This sound is made in the back of the mouth and often times can be a tad bit tricky for some kids. With that said, practice makes perfect!  As you read to your child they will hear the sound over and over in these books. This is what us speech therapist like to call auditory bombardment. Listed are 3 fantastic/classic books that you can read to your child that I know they will absolutely love and target the /g/ sound.

Go Dogs Go! By Dr. Seuss

Goodnight Moon. By Margaret Wise Brown

Silly Little Goose. By Nancy Tafuri