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Category: Feeding

Why Is Food Play Important For Picky Eaters?

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What Is Food Play? 

As a child, most of our parents would tell us not to play with our food…well, sometimes playing with food is a great benefit for children. 

Food play is an important sensory play activity for children with sensory defensiveness and those that are picky eaters. This type of play can be fun and a non stressful way for children to explore different foods using all of their senses. Children gain skills through play-based learning. Food play is a great opportunity for children to explore and learn about foods and over time become comfortable with interacting with the foods. Not only does food play increase exposure to different foods, it improves fine motor skills for self-feeding, imaginative play, family interaction, and increases vocabulary to help describe foods.

Food Play Activities: 

  • Pretending to make a meal for you, their dolls or friends.
  • Having a tea party with dolls or parents.
  • Playing restaurant
  • Using a paint brush and paint with puree food
  • Using tongs to play with cooked noodles
  • Cutting foods with knife or a cookie cutter
  • Simon Says with food (placing food on different parts of the body, make it dance, make a noise, take a bite, etc.)
  • Making a sensory box out of cereal or dried noodles
  • Drawing with shaving cream, apple sauce, or pudding with their finger
  • Driving cars and digging through rice, beans, or dried noodles
  • Cutting foods into small pieces to feed to toy animals

Great Tips for Setting Up Food Play Activities: 

During food play, go with the pace of the child. Do not force your child to do food play. It should be a positive and low-pressure activity. Present foods with different colors, shapes, sizes, and textures. You can present foods during food play that you would like your child to eventually eat. It is important that food play should not be engaged in the child’s regular mealtime environment. Conduct it outside, on the floor with a blanket, activity table, etc. During food play, it is okay if the child denies eating the food that is being presented. Remember the goal is to expose the child to these foods not consumption. You can model eating the foods but try not to pressure your child into eating.

How Can Carolina Therapy Connection Help?

In addition to utilizing the tips above at home, we know that sometimes children need an extra push to expand their food repertoire. At Carolina Therapy Connection, our occupational and speech therapists provide feeding therapy that uses a collaborative approach to work closely with you and your child to determine the source of a child’s feeding difficulties, and develop specific intervention plans to make the entire eating process easier and more enjoyable. Often times, feeding therapy happens on a weekly basis and may consist of working on difficulty with trying new foods, chewing, swallowing, sensory issues, irritability at meal time and so much more. Our goals are to broaden your child’s scope of foods, teach them the benefits of healthy eating, and develop oral motor skills needed for optimal growth and nutrition.

Our Occupational Therapists take a sensory-based feeding approach to therapy.  They focus on: oral motor skills, sensory sensitivities, progressing through food textures, and using adaptive equipment and tools to develop self-feeding skills. They also use a process called food chaining, which is a child-friendly treatment approach that helps introduce new foods while building on the child’s past successful eating experiences. In this process, the child is presented with new foods that may be similar in taste, temperature, or texture to foods the child already likes and accepts. Our occupational therapists are certified in the SOS Feeding Approach, a nationally and internationally recognized approach for assessing and treating children with feeding difficulties.

Our feeding therapists have 15-20 years of experience with children of all ages and a variety of feeding disorders. They have certifications in SOS and AEIOU approaches and significant training from around the country on feeding approaches, treatment strategies, and focused plans. We also having consistent collaboration with other professionals in the community to guarantee the best care. Call our clinic at 252-341-9944 for a free phone screening with one of our feeding therapists and schedule an evaluation today!

Why Does My Child Put Everything In Their Mouth?

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What is Oral Sensory Seeking?

Oral Sensory Seeking is the constant desire or need for a child to place objects in or touch their mouth. Children who have an oral fixation usually feel the need to constantly chew or suck on something. Depending on the age of the child, this may or may not be appropriate. As a parent, this can be difficult to navigate, especially due to the risk of choking on small objects. We know it is impossible to have eyes on your child every minute and scary to feel like you need to keep everything picked up off the floor and out of reach at all times. The oral stage of development that happens from birth to 21 months involves an infant’s pleasure center being focused on the mouth and lips, which are used for sucking and feeding. This is the age when the infant puts everything in the mouth—from hands, fingers, wrists, toys, pacifiers, clothing, blankets … just about anything within hands reach. One of the first prominent objects the baby’s mouth becomes accustomed to is a mother’s breast, for milk. In this blog, we will explore some of the reasons why your child may continue seeking additional oral sensory needs when it is no longer age-appropriate and activities to help them with this behavior.

What are Oral Sensory Seeking Behaviors?

When a child chews, mouths, sucks, or bites non-edible objects and/or edible objects frequently, we will call this an oral sensory seeking behavior. It can also involve harmful behaviors like biting. Some children who are seeking out oral and tactile (touch) sensory input will bite parts of their body, such as the arms, legs, feet and hands. Although oral seeking behavior can help children regulate their bodies and emotions at times, it can also prevent children’s learning if the child is constantly looking for objects to put in their mouth, or cause harm when they bite or suck on themselves. If children are distracted by finding objects or fixated on this behavior, it can affect their ability to focus at school or on an activity at hand.

Here is a list of common oral sensory seeking behaviors:

  • Excessive or frequent licking and/or chewing of random objects or toys
  • Excessive or frequent chewing of soft items or clothing (shirt sleeves, bed sheets, blankets, stuffed animals)
  • Biting toys or people, especially when unprovoked or when overly excited
  • Chewing the inside of the cheeks or biting/sucking on lip
  • Biting nails
  • Grinding teeth
  • Stuffing mouth with food or holding food in mouth for a long period of time
  • Drooling or spitting purposefully

How Can I Help My Child With Oral Sensory Behaviors?

Although there are a variety of ways to provide oral sensory input to children in a safe way and to replace oral sensory behaviors.. no child is the same when it comes to the solution. Our occupational therapists at Carolina Therapy Connection recommend that you experiment with these activities as part of your child’s sensory diet and notice what tends to calm, alert, and/or regulate them.

Create a FREE sensory diet with this template from “Your Kids Table” HERE!

Oral Sensory Seeking – Chewing Activities

  • Chewing crunchy foods, chewy foods, gum etc.
  • Use a chewy jewelry or other sensory chew toys

  • Vibrating chew toys (for kiddos who need that extra sensory input!)

Various Activities for Sensory Input

  • Blowing bubbles or blowing up balloons
  • Suck on sour candies, lollipops, ice cubes, etc.
  • Clicking tongue
  • Drink various textures through a straw (apple cause, milkshakes, yogurt, pudding, etc.)
  • Whistles, party blowers, kazoos, harmonicas, pinwheels etc.
  • Make a bubble mountains with dish soap and water

Bubbles Oral Motor Activities

How can Carolina Therapy Connection help?

Occupational therapy addresses any barriers that affect someone’s physical, mental and emotional wellbeing, which includes sensory integration difficulties. Sensory integration refers to how your body recognizes, processes, and responds to information received by our sensory systems on an individual and combined level.This includes our traditional 5 senses, sight, touch, taste, smell, and hearing; however, we also have proprioceptive and vestibular sensory systems. Often times, oral sensory processing or seeking difficulties are paired with other sensory system difficulties. Occupational therapists use sensory integration therapy by exposing a child to sensory stimulation in a structured and organized way. The goal of sensory integration therapy is to adapt the child’s brain and nervous system to process sensory information more efficiently.

At Carolina Therapy Connection, we offer Sensory Integration Therapy and play-based treatment intervention that is specifically designed to stimulate and challenge all of the senses. Sensory Integration involves specific sensory activities (swinging, bouncing, brushing, providing oral sensory input and more) that are intended to help your child regulate his or her response to incoming sensory input. The outcome of these activities may be better focus and attention, improved behavior, and even lowered anxiety. Our therapists may work on  lowering a patient’s negative reactions to touch, help them become better aware of their body in space, and work on their ability to manage their bodies more appropriately (run and jump when it’s time to run and jump, sit and focus when it’s time to sit and focus, etc.).

Our occupational therapists will complete an initial evaluation to become familiar with your child’s strengths, weaknesses and daily routine. Following the evaluation, they will create an individualized treatment plan and goals to address any concerns with development. We take pride in making therapy enjoyable and fun for your child, so that they can be motivated to live their life to their greatest potential. If you are interested in a FREE occupational therapy screening in the Greenville, Goldsboro, or New Bern, NC areas, call us at (252) 341-9944.

Why does my child put everything in their mouth? Carolina Therapy Connection

Mealtime Tips For Your Picky Eater

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Why Is Mealtime So Important For Children?

The 3 most important things for humans to survive is: food, water and oxygen. For some parents, the concern for their kiddos health and well-being becomes heightened when they notice their kiddo isn’t eating as much food or as many types of foods as they may have at one time. Some kiddos who are referred to Occupational Therapy are considered “Picky Eaters” and others may be referred to as a “Problem Feeder”. We all know a picky eater. This is a person/kiddo who has at least 30 foods in their repertoire. Whereas a “Problem Feeder” is a person/kiddo who has less than 20 foods in their repertoire. There are many reasons this could happen such as trauma, sensory related challenges, anxiety, behavioral challenges, and more. As Occupational Therapists, we are trained to assist these kiddos by addressing these challenges which can increase their tolerance for trying new foods! Keep reading to learn more picky eater tips we have below!

So why is MEALTIME so important to assist with this?

One of the first things we will ask as OTRs or COTAs is “What does mealtime look like at home?” Some parents may say, 

“We all sit down as a family every night for dinner but we are busy or gone for breakfast and lunch”, “We are so busy that we are lucky to eat all at the same time”, or “(The child) eats all day but won’t eat the food I cook at dinner”. Of course these are just examples, but can you relate to any of them? It’s a possibility! 

Asking about mealtimes is very important to your therapist because this gives us an idea of how your child eats during the day. Kiddos need fuel to keep their bodies going. However, WHAT they are taking in and HOW/WHEN they are taking it in will make a huge difference in behavior, attention, ability to process/retain information and regulate emotions/emotional responses. To give you an idea of why the “what”, “how” and “when” are so important, I’ll follow up on the questions above.

1. “We all sit down as a family every night for dinner but we are busy or gone for breakfast and lunch”

This could be a beneficial time to incorporate feeding techniques and build interest in the foods around the table. Interest always comes before action. A child must first be interested in the food before they will interact with it. This is one reason that mealtime is so important for kiddos. It can be an opportunity to build interest in various smells, sights, and textures of foods provided by parents in a supportive and positive manner.

2. “We are so busy that we are lucky to eat all at the same time”

How can you work your schedule to have a least one meal together every other day? We understand that this busy world requires busy people to keep it going. However, when you are overwhelmed and exhausted your child may pick up on that. Children are very intuitive. Incorporating as many mealtimes as possible may assist with parent/child interaction and decreasing anxiety and overwhelming emotions in adults which can in turn make eating less stressful for a “picky eater”.

3. “(The child) eats all day but won’t eat the food I cook at dinner”

Grazing is when a kiddo eating little snacks all throughout the day. Have you ever seen a child leave a snack on the table, go play for 30 minutes, then return to finish the snack? If your child is doing this all day, it may explain why they are not eating at mealtimes. Typically, the brain lets us know when we need to refuel because the digestive system sends signals saying, “I’m empty in here!”. When grazing, a child’s brain will begin to have a hard time distinguishing when the child is hungry due to constantly having food in the digestive system. This can effect metabolism and the ability to regulate hunger. When given mealtimes, the body has time to regulate, digest and filter out what it needs for fuel. Additionally, if given processed snacks that are high in sugar or carbohydrates throughout the day, the body will begin to crave them. This can create a difficult loop to break when introducing thing like vegetables, meats and some fruits. Positive interactions at mealtimes can assist with parent/child interactions, lowering anxiety and stress levels, giving the child’s body time to process what it needs for fuel and providing learning opportunities for the sensory system. This can be a major changing factor in how your child engages with food! 

Additional Mealtime Picky Eater Tips

Picky Eater Tips #1: Don’t force foods on children

As parents, we want our children to eat a variety of foods, including vegetables, fruits and other healthy snacks to help them grow to be strong and healthy. Studies show that forcing a child to sit and eat until they have cleared their entire plate is not the best method for achieving this goal. Instead, parents should promote foods that may have not been a hit the first time around. You can model this yourself by trying a food you haven’t liked in the past, and explain that you’re giving it another chance because your tastes may have changed. We want to show kids that we are adaptable. Remember: It can take as many as 10 or more times tasting a food before a toddler’s taste buds accept it. 

Picky Eater Tips #2: Get Creative With Food Bingo

You can also put together a list of new foods for the family to try and make a game out of it—what will we try tonight? You can make it interactive and fun by doing something creative like Food Bingo. There are many free printable online similar to the image shown below. You can even make your own! Hang it on the fridge and have your child place a sticker or check off the new foods they have tried. You can even add in a reward for them getting “bingo” – a trip to their favorite place, a new toy, a play date, or something else they really enjoy!

Food Bingo

Picky Eater Tips #3: Don’t Make a Second Meal

When you serve a meal to your family and your kiddo refuses to eat it, we recommend having simple and consistent back up options, such as yogurt, a cheese, nut & fruit snack pack, apple sauce, cereal etc. It’s important for children to know that if they can not eat the meal you have prepared, they will receive the standard option – rather than the usual chicken nuggets baked quickly in the oven. We should also teach kids that a meal isn’t ruined if it comes in contact with something they don’t like. Finding an unwanted pickle on your cheeseburger will not contaminate it. Children should be encouraged to push food they don’t like off to the side, or onto another plate, or offer to share it with someone else.

Picky Eater Tips #4: Involve Your Kiddo in the Meal Prep Process

Some cooking tasks are perfect for toddlers and small children (with supervision, of course): sifting, stirring, counting ingredients, picking fresh herbs from a garden or windowsill, and “painting” on cooking oil with a pastry brush. Allowing our children to interact with the foods they are going to eat will help to promote and encourage them to try it!

Picky Eater Tips #5: Food Chaining

Once your kiddo tries a new food and that food is accepted, use what one our Occupational Therapist’s favorite pickle eater tips call “food chaining” to introduce others with similar color, flavor and texture to help expand variety in what your child will eat. Children with sensory concerns have difficulty with leaping from the types of food they are willing/able to eat. Food chaining builds a bridge to get to those foods you really want your child to eat one step at a time through links to food they’re already eating. Examples include:

  • If your child likes pumpkin pie, for example, try mashed sweet potatoes and then mashed carrots.
  • If your child loves pretzels, try veggie straws next, and then move on to baby carrots or carrot sticks. Carrots are hard, crunchy, and stick shaped, but are cold and have a different taste.
  • If your child loves French Fries, then give a try to Zucchini fries.
  • Move from cookies to Fig Newtons, to jam toast, to jam sandwich, to bread with sliced strawberries, and lastly to fresh strawberries
  • If chicken nuggets are the fan favorite, try to first change the brand of nuggets, then move to homemade chicken nuggets, then to homemade tenders, and lastly to a baked chicken breast.
  • Maybe your kiddo love goldfish crackers. Next give Cheeze Itz a try, and then move on to saltine crackers, and lastly to saltines with cheese slices.

How Can Carolina Therapy Connection Help?

In addition to utilizing the tips above at home, we know that sometimes children need an extra push to expand their food repertoire. At Carolina Therapy Connection, our occupational and speech therapists provide feeding therapy that uses a collaborative approach to work closely with you and your child to determine the source of a child’s feeding difficulties, and develop specific intervention plans to make the entire eating process easier and more enjoyable. Often times, feeding therapy happens on a weekly basis and may consist of working on difficulty with trying new foods, chewing, swallowing, sensory issues, irritability at meal time and so much more. Our goals are to broaden your child’s scope of foods, teach them the benefits of healthy eating, and develop oral motor skills needed for optimal growth and nutrition.

Our Occupational Therapists take a sensory-based feeding approach to therapy.  They focus on: oral motor skills, sensory sensitivities, progressing through food textures, and using adaptive equipment and tools to develop self-feeding skills. They also use a process called food chaining, which is a child-friendly treatment approach that helps introduce new foods while building on the child’s past successful eating experiences. In this process, the child is presented with new foods that may be similar in taste, temperature, or texture to foods the child already likes and accepts. Our occupational therapists are certified in the SOS Feeding Approach, a nationally and internationally recognized approach for assessing and treating children with feeding difficulties.

Our feeding therapists have 15-20 years of experience with children of all ages and a variety of feeding disorders. They have certifications in SOS and AEIOU approaches and significant training from around the country on feeding approaches, treatment strategies, and focused plans. We also having consistent collaboration with other professionals in the community to guarantee the best care. Call our clinic at 252-341-9944 for a free phone screening with one of our feeding therapists and schedule an evaluation today!

Blog Written By: Shelby Godwin, COTA/L, AC & Morgan Foster, MS, OTR/L

 

All About Occupational Therapy

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What is Occupational Therapy? 

The main goal of OT is to increase quality of life so that the client can continue to participate in their personal interests as well as take care of their own needs. Through therapeutic use of self, a strong relationship of trust is built between client and therapist that will help the client to grow in skills leading to increased independence. Occupational therapists improve, rehabilitate, or maintain individuals’ performance to complete everyday occupations (IADLs & ADLs).

What is the role of an Occupational Therapist?

As an occupational therapy assistant, working in the pediatric setting, it is my responsibility to implement activities and tasks that will improve my clients ability to perform at an age-appropriate level. In this setting, you will commonly see OTs working on improving age-appropriate grasp and legibility with handwriting, sensory processing, oral motor skills for feeding, core strengthening for postural control, hand strengthening to increase fine motor skills, visual motor/perceptual skills for copying shapes and or letters.

What are IADLs?

IADL’s stands for Instrumental Activities of Daily Living that involve your home and community. Below is a list of different IADLs an individual may complete regularly.

  • Care of others
  • Care of pets
  • Communication management
  • Driving and community mobility
  • Financial management
  • Health management and maintenance
  • Housekeeping
  • Food preparation
  • Religious and spiritual activities
  • Shopping

What are ADLs?

ADL’s stands for Activities of Daily Living and are basic self-are tasks an individual engages in daily.

  • Bathing
  • Grooming
  • Toileting
  • Dressing
  • Feeding
  • Transfers
  • Abulation

How Can OT Benefit Children? 

Occupational therapy can benefit children of all ages with a variety of needs and diagnoses including:

At CTC, our occupational therapist provides screenings, assessments, consultations, and treatment for those concerned about: 

  • Cognitive skills
  • Gross & fine motor skills
  • Self-care tasks
  • Self-feeding tasks
  • Sensory processing
  • Visual processing & perception
  • Social skills

How can Carolina Therapy Connection help?

Our occupational therapists will complete an initial evaluation to become familiar with your child’s strengths, weaknesses and daily routine. Following the evaluation, they will create an individualized treatment plan and goals to address any concerns with development. We take pride in making therapy enjoyable and fun for your child, so that they can be motivated to live their life to their greatest potential.

We use evidence-based treatment approaches including:

If you have questions regarding your child’s development or want to learn more about occupational therapy, call our clinic today at 252-341-9944 or visit our referrals page HERE. We provide services in Greenville, Goldsboro and New Bern, North Carolina. One of our licensed and board certified therapists will be happy to provide you with a FREE developmental screening today! We can’t wait to begin this journey with your family!

Blog Written By: Lacey Smith, COTA/L 

Transitioning from Bottle to Cup

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When should my child transition from their bottle to a regular cup?

It’s time to transition off the bottle! The American Academy of Pediatrics recommends transitioning from a bottle to a cup when your baby is about 15 months old. You might think it is time for those adorable sippy cups! BUT, current research is clear, and many therapists are recommending skipping the sippy cup altogether and moving straight to an open cup or a straw cup.

Many parents decide to use a sippy cup because they think that’s what they are supposed to do. Sippy cups were not designed as a tool for proper oral motor and feeding development, but instead were created to keep the carpets clean! The occasional use of a sippy cup is nothing to worry about, as it can be great for those long car rides and times where cleanliness matters. It is important to note that if your child has a medical reason to use a sippy cup, follow your pediatricians recommendations (i.e. some children require a valved sippy cup for safety). Despite the convenience of a sippy cup, parents should be aware that it is easy to become dependent on anything that makes life less messy, so when it’s possible to bring out the regular cup or straw, do it!

Why should I skip the sippy cup?

At only 12 months of age, your baby is developing a more mature adult-like swallow pattern! As opposed to the anterior-posterior suckle pattern infants use with a bottle, at only a year old, the tongue begins to stay in place or even move backward and rise while pressing on the alveolar ridge (the hard, ridged spot just behind the front teeth). The tongue will rise, push, and propel the food backwards! When your little one drinks from a bottle or a sippy cup, the spout prevents their tongue tip from elevating, often forcing the tongue down or requiring them to stick their tongue out in order to drink. If the tongue doesn’t rise to the alveolar ridge at rest and when swallowing, the brain creates a habit to keep the tongue on the floor of the mouth. This can contribute to oral motor weakness, and an impaired oral phase of the swallow.

According to the American Speech-Language and Hearing Association, when the tongue sits low in the mouth it often forces the mouth to rest in an open position, which leads to mouth-breathing instead of your little one breathing through their nose. Long-term use of a bottle or sippy cup may also lead to dental concerns. The immature pattern of an anterior tongue thrust during the swallow increases the risk of pushing their teeth forward and creating a dental malocclusion. The tongue, lips, cheeks, and jaw all play important roles in both articulation of speech sounds and eating, and little ones with weaker oral motor skills may be at increased risk for a speech sound delay.

What are the benefits of using a regular cup or straw?

  • Open cups and straw cups help build normal movements in oral musculature.
  • Using a straw helps your child develop lip, cheek and tongue strength.
  • Open cups provide practice using the mature pattern of swallowing that will allow your child to safely drink and eat.
  • Straw drinking supports a child’s early articulation of speech sounds.
  • Regular cups and straws encourage proper breathing patterns and prevent mouth breathing.

What’s the best way to make the transition from the bottle to a cup?

When beginning to make the transition from a bottle to a straw cup or regular cup, it’s important to start small! This process can take time and it’s important to know it won’t happen overnight.

  • Start by introducing an open cup at mealtimes. You can hold the cup for your child to sip from the side of the rim to get them comfortable.
  • A great straw sipping cup is the Talk tools Honey Bear Straw Cup, which allows your child to squeeze the bottle so they can get comfortable with using a straw to start out with.
  • Offer both straw cups and open cups to allow for comfort with various drinking cups.
  • Use a weighted straw cup, which is spill-proof and allows a child to drink from any angle!

How can Carolina Therapy Connection help?

Your child may need speech therapy if they have difficulty with speech/articulation (pronouncing sounds or words) or using words to communicate. Because the muscles and structures used for speech (such as lips, tongue, teeth, palate and throat) are also used in drinking and eating, a speech and language pathologist may also help with feeding, drinking and swallowing difficulties, also known as dysphagia.

While using a sippy cup does not necessarily mean your child will need speech therapy, it’s considered best to encourage oral motor development by using open cups or straw cups at home! Ditch those sippy cups, and check out the spill-proof options for open cups and straw cups they make these days! Spill-proof….now that’s a concept we can ALL get behind!

As always, if you have any questions about your child development, call our clinic at 252-341-9944 to speak with one of our speech-language pathologists!

 

Written by: Ashley R. Holloway, MS, CCC-SLP

Ashley Holloway SLP Greenville NC Carolina Therapy Connection

 

Transitioning from a bottle to a cup Carolina Therapy Connection Greenville, Goldsboro, New Bern North Carolina

Helping Children Develop Self-Care Skills

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What are types of self-care skills?

As children learn and grow, they have a drive to be independent and do things on their own. One area that an occupational therapist address in childhood development are their activities of daily living (ADLs), also known as self-care skills. Self-care skills are skills that are required to manage a person’s basic needs including:

  • Brushing teeth
  • Dressing (upper/lower body dressing, zippers, belts, shoe tying)
  • Bathing
  • Grooming (brushing/styling hair, nail cutting)
  • Self-feeding
  • Toileting

What are the building blocks necessary for self-care skills?

  • Executive functioning skills (i.e. attention, sequencing, initiation of task)
  • Fine motor skills (hand & finger strength, object manipulation)
  • Receptive & expressive language (comprehension and alternative forms of communication to communicate wants, needs, thoughts and ideas)
  • Sensory processing (tolerating sensory stimulation in the environment, such as grooming or dressing tasks for tactile processing)
  • Coordination & motor planning (moving body through space in a functional way)

What age should my child be able to engage in self-care tasks?

It is important to understand that all children develop at their own pace and that is okay! Remember — there is no penalty for being cautious about your growing child, and if there is a problem acting early can make all the difference. Self care skills are the every day practice of the foundations skills for academic performance and not just life skills. According to the CDC and American Academy of Pediatrics, below are a few of the developmental milestones pertaining to self-care skills in early childhood development.

6-12 months

  • Drinking from a cup
  • Holding a bottle or cup independently
  • Using tongue to move food around mouth
  • Feeding self small crackers or other small pieces of food

1-2 years

  • Settling themselves to sleep at night or during the day
  • Attempting to brush teeth
  • Removing own socks
  • Cooperating with dressing by extending an arm or leg

2-3 years

  • Using toilet with assistance and having daytime control
  • Attempting to manipulate large buttons
  • Distinguishing between urination and bowel movements, and names them correctly
  • Using a napkin to wipe face and hands
  • Feeding self simple meals using a fork or spoon
  • Taking socks and shoes off

3-4 years

  • Unbuttoning and buttoning large buttons
  • Feeding self without difficulty
  • Tolerating different clothing textures, seams, tags etc
  • Toileting independently
  • Brushing teeth independently or with supervision only
  • Dressing and undressing self (only requiring assistance with laces, buttons, and other fasteners in awkward places)

4-5 years

  • Choosing weather appropriate clothes
  • Dressing self independently
  • Attempting to bathe and groom with supervision only

5-6 years

  • Dressing independently
  • Able to manage morning and night time routine with supervision only
  • Settling independently for sleep
  • Able to manipulate more difficult fasteners and tie shoes

6-7 years

  • Showering or taking a bath independently
  • Independently toileting during the day and at night
  • Preparing simple meals (i.e. cereal)
  • Independent grooming (combing hair, brushing teeth, flossing)

7-8 years

  • Showering independently
  • Taking on more responsibilities (i.e. chores)
  • Preparing simple meals and helping with more complex meals (i.e. making a sandwich, using the microwave, spreading condiments, pouring from a larger container into a cup)
  • Interest in taking on more complex grooming tasks – nail cutting, tolerating hair cuts, styling hair

How can an occupational therapist help address self-care difficulties?

Create a routine: Developing a consistent routine with a child can help them know what is expected of them and when to complete their self-care tasks throughout the day. Creating a routine may require a visual schedule or reward chart, something that an occupational therapist can help your child and family plan, develop, and implement in the home!

Improve fine motor skills: Almost all self-care skills require adequate fine motor skills, such as brushing teeth, using utensils, buttons, zippers, tying shoes, and more! An occupational therapist can help improve your child’s fine motor skills to increase independence of their self-care tasks.

Sensory integration: some children may have difficulty tolerating grooming or dressing tasks which can indicate a challenge with tactile processing. They may also have difficulty with tolerating hair cuts, nail cutting, or teeth brushing. Seeing an OT to address these sensory processing concerns can help your child to improve their ability to register and tolerate tactile input to improve their ability to complete these self-care tasks using a variety of treatment strategies.

Adaptation & modification of tools and the environment: An occupational therapist can recommend different types of adaptive equipment (i.e. button hook, weighted utensils, shoe horn, etc.) to help increase independence in self-care skills. They may also get creative by providing tips for adapting the environment to promote independence in the home.

Executive functioning skills & attention to task:  If your child has difficulty with their higher level cognitive skills then self-care may be difficult. Seeing an OT could be helpful by implementing and utilizing a variety of treatment strategies for increasing attention, initiation of tasks, sequencing steps of an activity and more!

Caregiver/parent training: An occupational therapist may be able to provide tips and strategies to parents in the home for carryover of self-care skills into daily routine.

How can Carolina Therapy Connection help?

Through demonstrated excellence in clinical, school, and home-based practice, Carolina Therapy Connection’s occupational therapists provide screening, assessment, consultation, and treatment to children having difficulty with a wide variety of needs, including difficulty with self-care skills. We believe it is critical to make therapy as fun and motivating as possible by celebrating the small victories as well as major achievements. We have a strong focus on helping your child develop the skills appropriate to their age and current stage of development. We also use a holistic approach and evidence-based practices to help your child develop and grow to their greatest potential. If your child is having difficulty with any of the skills discussed above, call our clinic today at 252-341-9944 for a FREE occupational therapy screening! We currently provide occupational therapy services in Greenville, Goldsboro and New Bern, NC!

References

Holland, B. (2017, February 14). Top 10 ways occupational therapy can help children with self-care. Chicago Occupational Therapy. Retrieved November 2, 2021, from https://chicagooccupationaltherapy.com/articles/top-10-ways-occupational-therapy-can-help-children-with-self-care/.

Admin, K. S. W. (2016, November 27). Self care skills. Kid Sense Child Development. Retrieved November 2, 2021, from https://childdevelopment.com.au/areas-of-concern/self-care/self-care-skills/.

Centers for Disease Control and Prevention. (2021, January 22). CDC’s Developmental Milestones. Centers for Disease Control and Prevention. Retrieved November 2, 2021, from https://www.cdc.gov/ncbddd/actearly/milestones/index.html.

 

Carolina Therapy Connection Occupational Therapy Greenville, Goldsboro, New Bern North Carolina Help with Self-care skills

Making “Sense” of Our Experiences

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The Pyramid of Learning

Pyramid Of Learning

The Pyramid of Learning was developed by Occupational Therapist Kathleen Taylor and Special Educator Maryann Trott. The Pyramid of Learning is an easy-to-understand illustration that depicts a general idea of a child’s foundational skills, and what other skills build upon those. Think about it: You can’t place stones on the top until the foundation stones are in place… every block relies on the ones underneath to be strong and stable. This pyramid explains why the sensory systems are so incredibly important to support academic learning. In other words, kids NEED routine sensory input for their bodies and their brain! Our central nervous system processes and organizes the sensory information we put into it each day. Adequate sensorimotor development for things like motor planning, postural security and body awareness are built on adequate modulation and processing of sensory information that we take in every day! Sensory input can be anything such as, smells, tastes, sounds, movements, pressure, and textures.

When a child is referred to occupational therapy, it is usually for things like attention to task, handwriting difficulties, picky eating, self-care tasks, tolerating routine changes, or school readiness skills. These functional difficulties are in the “Cognition and Intellect” categories at the top of the learning pyramid. The role of an occupational therapist is to determine underlying causes of these issues and utilize specific interventions to address them. Often times, it is hard for parents to fully understand why their child is not performing at the level at which they would like them to be. Some parents may see their child become frustrated when they are trying their best to be compliant, listen and learn, but their sensory processing abilities are hindering them. These frustrations root from the child working throughout the day just to do the simple things, the things that should be automatic and unconscious for them. This may include things like listening to the teacher, keeping their balance on the stairs, standing close to their friends in line, trying a new snack, or engaging in messy play. It all begins at the bottom of the pyramid!

Understanding Our Sensory Systems

  • Proprioception is our ability to sense the location, positioning, and movements of our body and its limbs. It allows us to navigate a crowded area without bumping into people and furniture in our path.
  • Vestibular sensation is housed in our inner ears and uses gravity to sense spatial orientation and movement. This system is responsible for maintaining balance during movement. If you or child is a victim of motion sickness, you have the vestibular system to blame!
  • Tactile sensation comes from receptors in our skin found all over the body. Tactile sensation includes sensations of pain, temperature, pressure, and textures.
  • Gustatory includes specific tastes (spicy, sweet, minty, bitter) and specific textures (crunchy, chewy, mushy). Taste also involves knowing the difference between food items and non-food items.
  • Olfactory or smells involve the ability to distinguish, detect, tolerate and object certain scents.
  • Visual includes noticing and tolerating visual patterns, colors, shapes, bright and dimmed lights and moving objects.
  • Auditory involves the ability to distinguish and tolerate loud sounds (fire alarms, sirens or loud music) and soft sounds (finger snapping, repetitive tapping, hearing others breathing).

How Sensory Processing Difficulties Affect Behavior

As a parent, it can be difficult when our children are having difficulty with negative behaviors. Let’s say that you receive a call from your child’s school reporting that they often seem distracted and don’t pay attention in class, bump into kids in the lunch line, can’t hold a pencil correctly, become upset when asked to switch from one activity to another, or melt down during circle time. Although these seem like behaviors that are caused by the child seeking attention or not getting their way, sometimes it can root from difficulty with sensory input. It is important for parents to work with an occupational therapist in determining the root of the problem. Sensory integration therapy or a sensory diet may be the key to diminishing these behaviors. Sometimes, just some simple routine changes can allow the child to regulate themselves. Regardless, it is important to have an occupational therapist on your team to help make those adjustments.

Sensory Integration

Sensory integration refers to how your body recognizes, processes, and responds to information received by our sensory systems on an individual and combined level. This includes our traditional 5 senses, sight, touch, taste, smell, and hearing; however, we also have proprioceptive and vestibular sensory systems. Occupational therapists use sensory integration therapy by exposing a child to sensory stimulation in a structured and organized way. The goal of sensory integration therapy is to adapt the child’s brain and nervous system to process sensory information more efficiently. The OT may use a sensory gym to engage the child in these repetitive and stimulating activities.

Sensory Integration Strategies 

  • Messy play – mud, dirt, water, food play, finger paints, shaving cream, bath bubbles, etc.
  • Noise cancelling headphones or ear plugs
  • Window shades or adjustable lights
  • Include your child in meal preparation process – encourage them to help whether with their hands or using cooking utensils to interact with the many food textures and smells
  • Food play – Encourage your child to interact with new foods in the most basic manner; the SOS Feeding Approach, used commonly by Occupational Therapists, encourages the following progression with new foods: See –> Touch –> Kiss –> Lick –> Taste –> Chew & Swallow. It is important to allow your child to move at their own pace and allow them to clean off hands or spit out food at any point along the continuum.
  • Sensory toys – check out Ark Therapeutic, a leading manufacturer of innovative therapy tools and special needs products! They have great sensory toys, chews and fidgets that can help your child deal with sensory overload.
  • Finger painting – also try bathtub paint to reduce mess and give child control over cleaning off their hands
  • Listening to music
  • Having a clear visual schedule posted with plenty of preparation for transitions.
  • Providing sensory breaks such as walking in circles, jumping on a mini-trampoline and sucking on sour candy.
  • For the child who needs to move a bit, you might try an inflated seated cushion or a pillow from home so they can both squirm and stay in their seat.

How can Carolina Therapy Connection help?

At Carolina Therapy Connection, we offer Sensory Integration Therapy and play-based treatment intervention that is specifically designed to stimulate and challenge all of the senses. Sensory Integration involves specific sensory activities (swinging, bouncing, brushing, and more) that are intended to help your child regulate his or her response to incoming sensory input. The outcome of these activities may be better focus and attention, improved behavior, and even lowered anxiety. Our therapists may work on  lowering a patient’s negative reactions to touch, help them become better aware of their body in space, and work on their ability to manage their bodies more appropriately (run and jump when it’s time to run and jump, sit and focus when it’s time to sit and focus, etc.). Various techniques include swinging, deep pressure therapy, which may include squeezing, rolling, etc., jumping on a trampoline, or gross motor play such as wall climbing, balance beam, etc.

Carolina Therapy Connection now has the largest and most state-of-the-art sensory gym in all of Eastern North Carolina!  Check out our 360° view of our sensory gym HERE. Our sensory gym is fully equipped with a zip-line, monkey bars, slides, scooter board ramps, ball pit, trampolines, rock climbing wall, and an expansive set of swings to offer a wide-variety of sensory experiences for each child.

If you have any questions or would like to schedule a screening for your child, call our clinic at (252) 341-9944 to learn more about what you can do and how we can help!

 

References:

Pyramid of Learning by Taylor and Trott (1991)

Amy Hathaway, OTR/L DEVELOP, LEARN, GROW

Kids First Children’s Services 

Sensory Blog