Holiday Travel Tips for Kids with Special Needs

The holidays are right around the corner and for many families this means that a road trip or an airplane ride is inevitable. Some things one must understand and take into consideration when traveling with a child that has sensory processing challenges is that consistency and structure is very calming and organizing, and change causes anxiety and is very disorganizing to the nervous system. Not only is change an obstacle, but hypersensitivity to noises and/or touch as well as sensory seeking behaviors such as constant movement or craving deep pressure. This makes traveling by car or airplane especially challenging.   

Car and Airplane Travel Tips:

• Pack or purchase at the airport calming snacks that provide organizing oral input: crunchy and chewy snacks, (pretzels, carrot sticks, apples, bagels, beef jerky, fruit roll ups, gum) water bottles that have a straw or sport spout that requires sucking, use straws to eat pudding, yogurt, apple sauce or smoothies. Don’t forget personal chewies or vibrating oral tools (pack more than one)
• Pack a variety of fidget toys (stress ball, Koosh ball, Magna Doodle, Legos, spinner, Rubix cube, Thera band tied to adjacent car structure or arm rest in an airplane, etc.)
• Pack sensory tools (I pad and charger, head phones, ear plugs, weighted lap sock/pad or blanket, soothing music and I pod, compression vest, DVD player, small blanket and pillow to create a sensory retreat)
• Car Travel: Pack fresh food with allot of protein and avoid fast food and preservatives as much as possible and let your child hold and manipulate the cold pack as needed to decrease anxiety or stress
• Car Seating: If your child is sensitive to sound or touch then have your child sit toward the back of the car behind siblings if possible. This positioning is much quieter and provides for more personal space. Have a parent or someone who can provide as needed sensory input sit next to the child if possible. Position the child in the middle when possible so the child can see out the front window.
• Decrease car sickness by covering adjacent windows with a window screen
• Airplane Seating: If your child is sensitive to touch then have your child sit next to the window away from the isle and request to sit in the front to limit stress and the amount of people bothered in the event of screaming or a meltdown. If you didn’t pack one, ask the attendant for a blanket and pillow so that you can create a small sensory retreat in the event of a meltdown
• Car travel movement breaks: Take frequent sensory or movement breaks every hour if possible (stopping at parks when possible) and encourage the kids to run, jump, and really move. Don’t wait for a meltdown to stop for a break. This has the potential to start a pattern of meltdown = break vs. staying calm = break
• Airplane movement breaks: While in the airport or during a layover, encourage the kids to run, jump, and really move. When it is safe to do so on the plane, remove the child’s seatbelt so that they can reposition their body, sit cross legged, stand to stretch, and even pace the isle as needed.
• Toileting on an airplane: Avoid flushing the toilet on an airplane with your child present. The volume and sound of the flushing toilet on an airplane may trigger a meltdown. Walk your child back to their seat and then return to flush or ask the attendant to assist you in flushing once you are far enough away from the restroom.

Ways to Incorporate Proprioceptive Input at Home

Proprioceptive input is typically very calming and organizing to the nervous system. A child who has lots of energy or a “fast” running engine will typically be able to calm and re-focus with proprioceptive input. Proprioceptive input can also be alerting for a child who has low energy or a “slow” running engine. Experiment with your child with the activities below to see what proprioceptive activities are calming and which ones are alerting.

Activities that provide proprioceptive input:

• Hand Hugs
• Wheelbarrow Walks
• Wall Pushes
• Chair Push Ups
• Hand Presses
• Hand Clapping Games
• Animal Walks (bear crawl, crab walks, frog hops)
• Pillow Squish (stack couch or bed pillows and squish under them)
• Pillow Fights
• Burrito Roll (child rolls up in a blanket or towel with head exposed)
• Steamroller (roll a large ball or foam roller on the child’s back, arms and legs while child lays on their tummy)
• Squish Box (a box that is just big enough for your child to squeeze into with pillows)
• Stomping, Jumping, Marching, Skipping, Hopping
• Chewing Gum or Chewy foods
• Using a Straw to Drink/Eat (milkshakes, smoothies, yogurt, pudding, applesauce)
• Chewelry
• Vibrating toy or oral tools
• Hop Scotch
• Tug of War
• Safe Rough Play/Wrestling
• Heavy Ball (toss to target, play catch, pass to your partner)
• Trampoline
• Hippity Hop
• Hand Stands (against the wall)
• Climbing Activities
• Swimming
• Gymnastics
• Karate
• Bike Ride
• Carrying Heavy Objects (groceries, laundry, lunch bucket at school)
• Push/Pull Activities (shopping cart, wagon, stroller, lawn mower, friends on a sheet or blanket)
• Open Doors for people
• Hammering Activities
• Sweeping, Vacuuming, Mopping
• Wash Tables, Windows, Car, Toys
• Digging Dirt or Raking Leaves
• Rearrange Furniture (move chairs etc. to sweep or clean)
• Compression garments or tight clothing
• Body Sock
• Theraband Activities
• Heavy blanket
• Weighted Lap Pad or Lap Sock
• Fabric Tunnel
• Weighted Backpack

Eat To Succeed

As a mom, I know I am frequently needing new ideas for what food to put in front of my child and easily get stuck in a rut.  I also catch myself feeding my child when I get hungry and forget that their little bodies are metabolizing and growing at a much more rapid rate than I.  Below are some simple meal reminders, kid schedule ideas, and food ideas.  As a therapist and a mom, I hope it helps you too.

To help your child perform at his/her optimal level nutritious food is key. Our bodies need proper fuel to be able to grow our bones and muscles, build our neuro pathways, and help our brains function.

Kids need a mix of Protein (eggs, beans, meats, nuts, soy), Veggies (peas, carrots, celery, zucchini, broccoli, spinach), Fruits (berries, apples, grapes, oranges, bananas, pears), Dairy (cheese, milk, yogurt), and Grains (oatmeal, whole grains, quinoa, rice).

Some children can be sensitive to sugars and additives, possibly increasing behaviors.

You can try a variety of ways to eat fruits and vegetables.  Such as offering baked versions, freeze dried versions, canned versions, or fresh options.  Trying them as smoothies, solids, incorporated into baked goods or crunchy treats can provide a variety of texture and possibly a new favorite.  Exposure through sight, touch, play, and fun is helpful in expanding palates.

Ask your Occupational Therapist (OT) or Feeding Therapist  (FT) for suggestions on ways to introduce new foods, hide needed foods, or explore and expand your child’s palate! ☺

*Always work with or check with your doctor if you your child has allergies or special dietary or medical nutrition needs*

*Refer to Feeding Littles School Lunch Cheat Sheet for more ideas

Sample elementary school meal (portion sizes will vary depending on child’s needs and activity level this is just an example):

Breakfast: ½- 1 cup Oatmeal with fruit (berries/apple/banana) and glass of milk

Snack: 3 apple slices with cheese or peanut butter

Lunch: ¼ -½ cup peas, ½ cup strawberries, ¼- ½ quesadilla (w/ or w/o avocado), Greek yogurt

Snack: tortilla chips and beans or salsa

Dinner: ½ of a hamburger with ½ cup broccoli or green beans and a popsicle

Snack (if hungry): banana with peanut butter (or Nutella) and chocolate chips.

Sample meal ideas for a typical picky eater (hamburger, pizza, chicken nugget eater):

*allow regular opportunities for exposure (through sight, touch, play, or taste) to new foods

Breakfast: Dry cereal with freeze dried strawberries and a glass of milk

Snack: Veggie straws and apple slices

Lunch: 1 slice of pizza, 1/2 cup berries, greek yogurt, freeze dried peas or baked/crunchy broccoli

Snack: Tortilla, peanut butter, and honey roll up

Dinner: Pasta with peas, sauce (ricotta cheese mixed/hidden in) or chicken nuggets, and grapes

Snack:  Cookie or frozen banana dipped in yogurt or chocolate

Allison Heitzinger MS., OTR/L

Sonoran Sun Pediatric Therapy

Occupational Therapist

Picking/choosing your battles

As a follow up and conclusion to the two previous blog posts, this blog post is Part 3 of 3 in a short mini-series of Strategies to help with behaviors.

While the strategies presented in the 2 prior blog posts can be used in multiple situations and scenarios to help decrease unwanted behavior. We realize that the circumstances don’t always allow for this. Sometimes you as a parent or guardian are having a bad day, or are tired and while you want to be firm with boundaries, sometimes you can’t. It is understood that even with the best intentions, we all have bad days. While we may want to follow through with something we may be more inclined to give in to a child to prevent a scene or to decrease our own frustration.

In these situations, we need to do our best to stay consistent, but also, we need to pick our battles. Maybe we know that when we take our child shopping on the weekend, it is very crowded. Therefore, we are more likely to give in if a child asks for candy to prevent them from having a meltdown and making a scene. Or maybe we personally have had a tough day, so we have a lower tolerance for dealing with behavior. In this situation, we may give in to our child to prevent ourselves from having our own meltdown. That’s ok if it happens occasionally; we can’t expect ourselves to get it right all the time. Pick your battles, and more importantly – don’t feel bad when you have to do this.

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/