Is My Child Ready For Potty Training?

Posted on October 3, 2023October 4, 2023

Is My Child Ready For Potty Training?

Many parents ask the question, “Is my child ready for potty training?” Making the transition out of diapers is an important developmental milestone but it can also be a topic that causes frustration and anxiety for both children and their caregivers. Questions about when to start and how to promote a child’s success with potty training can feel overwhelming. If you are a caregiver that can relate to any of those feelings, this blog post is for you!

When Should I Start Potty Training?

This is a question that many caregivers ask themselves. A variety of factors must be considered before initiating the toilet training process. A child must be physically, emotionally, cognitively, and physiologically ready prior to starting the process. Here are some tips to identify whether your child may be ready:

Emotional readiness – Can your child tolerate sitting on the toilet or potty training seat? Are they excited about wearing “big kid” underwear?

Cognitive readiness: Can your child follow 1-2 step directions? Can they communicate their need to use the restroom?

Physiological readiness: Are they able to stay dry up to two hours at a time or wake up from a nap with a clean pull-up?

Physical readiness: Is your child able to sit on a toilet or potty training seat without assistance? Can they get on and off the toilet with little to no assistance? Can they assist with managing their clothing during toileting tasks?

If you have said yes to the majority of the above questions, then your child may be ready to begin potty training!

At what age can I expect my child to start potty training?

The following list includes general guidelines to help establish a baseline of where a child might be on their journey towards potty training. However, each child has a different timeline in which they are emotionally, physically, cognitively, and physiologically ready for potty training. It is vital that you never push a child towards progressing through the developmental sequence. If you see meltdowns or signs of regression, it may be best to take a break and try again at a later time.

Developmental Sequence for Toileting:

1 year – Children indicate that they are wet/soiled through non-verbal signs of distress

2 years – Child begins to tolerate sitting on the toilet

30 months – Child communicates that they need to use the bathroom and will likely require assistance with managing their clothing and wiping

3 years – Children will initiate using the toilet independently. They may attempt to wipe but continue to require assistance for thoroughness.

4-4.5 years – Children may have a few accidents. They are able to manage their clothing independently.

5 years – Child is able to complete a full toilet routine independently, including washing and drying their hands.

5-7 years – Children are consistently able to stay dry throughout the night.

Tips to Help Progress Through the Potty Training Process

Make potty training FUN!

Whether it is the sound of the toilet flushing or the new environment, some children may have a fear of sitting on the toilet. If a child is anxious, they may be hesitant to sit on the toilet or may not even tolerate sitting on it. One method to help ease this transition is to allow the child to play with their favorite toys while sitting fully clothed on the toilet. Another method to make potty training fun is to invite the child into the process. You can do this by allowing the child to pick out their underwear and ask them to choose their potty seat. This helps address their newfound need for autonomy and allows them to take pride in the potty training process.

Consistency is key.

Establishing a consistent routine will help minimize a child’s accidents and increase their likelihood of using the toilet successfully. A general guideline is to prompt the child to sit on the toilet as soon as they wake up, after naps, and in two hour intervals throughout the day. Encourage your child to sit on the toilet for a few minutes at a time. It can be helpful to read a story to them while on the toilet or provide them with a preferred toy to make this time fun and engaging.

Know the signs.

If a child is squatting, holding their genital area, or fidgeting, they may need to use the bathroom. Prompt the child to sit on the toilet when these signs occur. This can help the child become familiar with these signals to increase their ability to identify these signs as well.

Celebrate the small victories.

It is important that parents and caregivers build up a child’s confidence and self-efficacy during the potty training process. Caregivers can do this by providing their child with positive praise and celebrating the small victories! Some examples of this include praising their child for sitting on the toilet, communicating that they need to use the bathroom, successfully using the toilet, and completing all other steps in the toileting sequence (ex. Pulling up their pants, flushing the toilet, washing their hands). Sticker charts can also help motivate children to use the bathroom by providing them with a tangible reward to work towards!

Know there will be accidents.

In combination with Point 4 above, it is important to know that accidents will happen and how to respond when they do. Never punish a child for soiling their clothing. Instead, always be prepared with an extra set of underwear or clothing, especially when going out in the community.

You can find more tips on the potty training process here!

How can Carolina Therapy Connection Help?

If your kiddo struggles with self-regulation, completing their daily activities, or meeting developmental milestones, call our clinic at (252) 341-9944! Your child may benefit from an occupational therapy screening or formal evaluation!

Blog By: Emily Britt, OT

Does My Child Have Dyslexia?

Posted on September 12, 2023October 4, 2023

What is Dyslexia?

Dyslexia targets about 15-20% of our population! Most of us may not even know we are dyslexic. We could continue our lives undiagnosed and seek little to no help with this problem. Many people with Dyslexia that have been evaluated struggle with academics, self-esteem, and most importantly, they struggle with reading/writing within their own home and in the school environment. Many adults with this diagnosis have difficulties with finding or obtaining employment and causes them to lose self-confidence. Dyslexia is a type of learning disability, specifically reading, but not to be compared with low intelligence. There are many types of disabilities that involve learning, but dyslexia meaning is more in-depth of someone having issues with learning to read, although they are most likely educated enough to learn when want to learn.

What are the symptoms of dyslexia before and at school age?

When it comes to signs of Dyslexia, it can be difficult to visually see a child’s symptoms before they reach a certain age or start going to school. There’s a high chance that the child’s educator will notice an issue before the caregiver.

Here are some signs of Dyslexia:

The child will have difficulties with letter reversals; (b and d) and/or word reversals (was and saw).
Your child could be a late talker.
Problems processing and understanding what is heard
The child may have difficulties with reading aloud and learning new words and an age-appropriate pace; the child may avoid activities that involve reading
The child may mispronounce words; or form words incorrectly, such as reversing sounds in words or confusing words that sound alike.
The child may have trouble with rhyming words and remembering nursery rhymes
Difficulties with math word problems.
Difficulties with understanding jokes, punchlines, sarcasm, and inferences.
Your child may have difficulties with following a written outline of directions or telling directions.
Difficulties with spelling, learning to read, and recalling names or words.

What Causes Dyslexia?

Dyslexia is not a disease. It is a neurological condition caused by the way the brain is wired up enabling reading and writing causing the individual to result in utilizing coping strategies to adapt to normal environments. Studies show that an individual born with this condition are neither more nor less intelligent than the general population. Research has shown that dyslexia is one of the most common inherited neurological disorders an individual is born with. Even though it affects how the brain processes reading and language, most children have average or above-average intelligence; therefore, work extremely hard to achieve and overcome their reading problems.

What should you do if you suspect or if your child has Dyslexia?

Have a conversation with your healthcare provider and discuss your child’s reading level if you or his/her teacher notice a below-level reading status for your child’s age or if you notice other signs of dyslexia. Fortunately, with the proper assistance, most kids who are dyslexic can learn to read and develop strategies that allow them to stay in the regular classroom. If you suspect you or your child may be dyslexic, early detection and evaluation to determine specific needs and appropriate treatment can improve success. In many cases, treatment can help children become competent readers. It’s important to set an example and support your child with goals that are attainable. Show your child that reading can be enjoyable.

Set Goals for yourself and the child:

As a parent, you should play a key role in helping your child succeed.
You can assist your child by reading aloud to them while they are young, then transition to reading together when they’re old enough.
You can also listen to recorded books with your child.
Collaborate with your child’s educator.
Engaged in creating a schedule for reading time.

How can Occupational Therapy help?

Pediatric occupational therapists and certified occupational therapy assistants can encourage children to participate in meaningful tasks within the school and home environments. Therapists can assist in managing dyslexia and assist in increasing children’s confidence and participation in reading and writing tasks. Occupational therapy for kiddos really focuses on building confidence and implementing client-centered care for the child and their families. OT’s can provide strategies for home and school such as:

Implementing multi-sensory approaches – using other senses to approach learning such as seeing, listening, doing, and speaking).
Visual prompts: Providing visual prompts for both instructions and organization.
Visually sequencing tasks (or components within a task) using visual cues.
Use of colored lines and templates to assist with line placement and letter sizing.
Visual strategies to assist with reading and spelling such as colored coding paper size according to letter size.
Using modeling techniques rather than only giving a simple verbal instruction
Letter formation practice

Written By: Carlos Guilford

Teaching Kids Independence With Life Skills

Posted on July 6, 2023October 4, 2023

Chores or Life Skills?

Kiddos may ask themselves this question: Why do I have to do these chores? Here at CTC, we call chores “Life Skills” because that is simply what they are. Although not always the most preferred thing for your child to do, washing dishes, washing clothes, making the bed, vacuuming, sweeping, mopping, grocery shopping, cooking, and many more are essential life skills that are necessary when becoming an independent adult. Not only are they necessary, they are also very helpful for the development of time management skills, executive functioning, sensory regulation, and even emotional regulation.

You may be wondering how you can gauge what skills are appropriate for your child. Below is a short list of age appropriate chores to get you started based on your child’s age:

Life Skills for 2-3 years old

Picking up toys
Wiping up a mess (wiping off the counter after eating or messy play)
Putting laundry in the hamper after taking off dirty clothes

Life Skills for 4-5 years old

Making the bed (even if it is assisting you with the task!)
Starting simple meal preparation (putting thing into bowls, stirring, etc.)
Helping wash/rinse dishes

Life Skills for 6-8 years old

Feeding pets
Vacuuming, sweeping, mopping
Folding laundry/putting away own clothes

Life Skills for 9-12 years old

Prepare simple meals (heating up a hot pocket, TV dinner or oven pizza)
Taking out garbage
Cleaning areas of the home other than own bedroom (bathroom, living room, outdoor areas)
Helping make a shopping list and helping to find items in the grocery store

13-18 years – Include all listed above with increased to total independence!

So your child may be age appropriate for the tasks at hand, but what if you wonder whether they are developmentally, emotionally, physically or cognitively appropriate for the task at this age? Recently CTC held a Life Skills camp with 4 days of fun while completing tasks that increase independence within the home environment. The kiddos in this group worked on grocery shopping, meal preparation, cleaning up after themselves, household life skills, taking care of pets and plants, team work and communication. During the camp, each child was asked to review their skills and determine the toughest part of doing “chores”. The #1 answer was time management and feelings of overwhelm when presented with multiple tasks to complete. We all worked to develop either written or visual (picture) schedules for each kiddo to take home to aid in these concerns, making getting these life skills done easier and less frustrating!

Talk to your child’s occupational therapist to see if these could be options to help your child regulate their emotions, plan their time with greater efficiency and learn new skills after mastering current ones! If your kiddo struggles to complete their daily activities, call our clinic at (252) 341-9944! Your child may benefit from an occupational therapy screening or formal evaluation!

Here is 2 recipes of foods that were made during the camp:

Rice Kripsy Treats – The Original Rice Krispies Treats™ Recipe | Rice Krispies®
Soup (written by a kiddo in the camp)

Ingredients

3-4 boneless chicken thighs
1 medium onion
3 carrots, sliced
2 chicken stock boxes
1 small rice pack (boil in a bag)
1 can black beans

Add a pinch of…

Pink Himalayan Salt
Chili powder
Seasoned Salt
Black pepper
Red pepper flakes

MIX TOGETHER IN A SMALL BOWL

Steps:

Make the rice according to directions on the rice bag
As the rice is cooking, cut chicken into 1 inch cubes
Sprinkle seasoning onto chicken
Cut carrots and onion into preferred size and cook until preferred texture
Cook the chicken until done in saucepan
Once all ingredients are finished, combine with stock in a pot and boil for 2-5 minutes
Simmer for 10-15 minutes

Written By: Shelby Godwin, COTA/L, AC

Why Does My Child Put Everything In Their Mouth?

Posted on May 24, 2023October 4, 2023

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

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.

At Home Spring Activities

Posted on April 19, 2022October 4, 2023

Spring Fun in Full Bloom!

Spring has officially sprung here at Carolina Therapy Connection! We are taking full advantage of all of the creative opportunities to foster a supportive learning environment. The onset of a new season also brings opportunities for fun, hands-on ways to incorporate goals into daily play routines!

The Role of Play

Play is the predominant way that our children learn; it helps them develop and grow into functional roles necessary for daily living. Play helps them access the world around them and is one of the PRIMARY occupations in which they engage.

Through play, we help our children to explore and thrive in a way that is interactive and full of purpose! Here are some of our absolute favorite ways to employ play in a meaningful way. Check them out and share your joy!

Fine Motor Coordination Spring Themed Activities

Lacing rainbow
Button Flowers
Nature Scavenger Hunt (Handwriting and Grip Development)
Seed Sorting
Chalk! Make this activity as structured or as creative as you would like. Upgrade the challenge by having them help to “wash it off” using a water gun or spray bottle for greater strengthening of the hand muscles, development of age appropriate grasping patterns, and overall coordination.

Gross Motor Spring Themed Activities

Outdoor Yoga
Outside Obstacle Course
Planting Flowers or Building Your Own Garden
Spring animal walks! Do the bunny hop, waddle like a chick, or wheelbarrow walk for our older kids.
Heavy work!

Spring Themed Sensory Play

We can’t get enough sensory play around the clinic! Sensory play and exploration is vital for developing brains, and has such an important role in overall health and development. Any activity that engages your child’s senses is considered sensory play, but did you know that each new experience builds upon the last? Through sensory play, our children learn to plan movements, develop organizing concepts such as color, shape, texture, foster problem solving, and many more!

So, go ahead. Squish, scoop, jump, smash, smear, and dig into these ideas for your next play activity!

Create a Spring themed Sensory bin using a variety of materials. Just think! The possibilities are endless. Our favorites right now are: sand, faux grass, dirt, colorful rice, jello (yes, we said jello!)
Make slime, putty, or dough!
Cook yummy spring themed treats together!
FREE Printable Nature Walk: Find and Explore Natural Elements. Your child can become a nature investigator and explore items found in your own backyard such as rocks, pinecones, different leaves, and tree bark! Ask questions to guide their thinking and their exploration such as: “What do you notice about that? Does that feel smooth or rough? What does that look like to you?”

Feel free to share your creative and fun spring festivities with other families on our social media!

Additional resources to help keep the Spring fun going!

OT Toolbox: Spring Gross Motor Activities

Pink Oatmeal: Spring Themed Gross Motor Ideas

Kindergarten Connection: Spring Themed Fine Motor Activities

Written by: Katie Joyner, MS, OTR/L

Does My Child’s Pencil Grasp Matter?

Posted on March 1, 2022October 4, 2023

Does the way children hold their pencil really matter?

If you have a pencil handy, pick it up and notice how you hold it. Which fingers does the pencil rest between how are you supporting it? How much pressure do you use when you write? Does it really make a difference in your handwriting? The answer is YES, it does matter! How you hold your pencil really does make a difference—and it will also impact your writing. Your pencil grasp is directly related to handwriting speed and legibility, as having a mature grasp is more efficient and less tiring on your hands (Schwellnus, et al., 2012). Having a mature grasp also directly correlates with fine motor skills and your ability to manipulate other things (i.e. tying your shoes, picking up small objects, flossing, zipping up your jacket, using a fork or spoon).

Handwriting is essential for academic success and a foundation for efficient writing lies in how the child holds their pencil and the order in which letters are formed. It is important to address these concerns as early as possible. After the age of 8, changing grasp and formation patterns is difficult, but not impossible.

What are the stages of pencil grasp development?

There are several stages of pencil grasp development needed to develop a functional grasp that can be used to write efficiently and legibly. Each stage is important and helps to develop different muscles in the hand. Children typically develop control over the larger muscles of the trunk and arms before developing the smaller muscles of the hands. This is why grasp changes over time. Not all children will use all of these grasps during their fine motor development. Some children will use more than one grasp at an age as their skills develop and change. However, they should develop a functional mature grasp similar to the tripod grasp listed below.

Palmer grasp/Fisted grasp: typically develops between 12-18 months.

Digital pronate grasp: typically develops at 2-3 years.

5 finger grasp: typically develops between 3-4 years

Four finger/quadrapod grasp: typically develops at 3.5-4 years

Tripod grasp: typically develops at 5-6 years

What is letter formation?

Handwriting is a complex process that involves many skills and body functions to work in a precise manner. Letter formation refers to the order in which each line segment is produced to make a single letter. Children should learn to form letters from top to bottom and from left to right. The order in which letters are formed either aids or interferes with efficient, legible writing.

Why is proper letter formation important?

Children who have poor letter formation usually do not enjoy handwriting and/or the process takes longer than they would like.
Proper letter formation increases handwriting legibility, speed and accuracy.
Without the proper order of formation, letters are being ‘drawn’ more than formed and handwriting suffers.
Teaching proper letter formation can help to limit letter reversals such as b and d.
Practicing proper letter formation teaches higher cognitive skills ( i.e. working memory, sequencing, self-monitoring).

It’s important to note that every child’s handwriting style and process of learning is different and THAT IS OKAY! Our occupational therapists use a child-centered approach to help your kiddo become confident in their abilities while making handwriting FUN! If you are concerned about how your child forms letters or holds their pencil, an occupational therapist should evaluate your child. The therapist will determine if there are any skill or strength deficits and formulate a plan that is individualized for your child’s unique needs.

Written by: Amanda Easter, MS, OTR/L, CAS

References

Schwellnus, H., Carnahan, H., Kushki, A., Polatajko, H., Missiuna, C., & Chau, T. (2012). Effect of pencil grasp on the speed and legibility of handwriting in children. American Journal of Occupational Therapy, 66: 718–726.

Should My Child Be Using a Visual Schedule?

Posted on January 3, 2022October 4, 2023

What is a visual schedule?

As adults, many of us live by our planners. We gain satisfaction from marking off our to-do lists and being organized with our daily activities. Children are better able to learn, grow and adapt to changes using this same strategy! Although there are many types of visual schedules, they all typically contain images, symbols, photos and/or words to better communicate a task or activity. Depending on your child’s age and specific needs, their visual schedule may contain activities by the minute, hour, day or week. For example, if your child requires more structure, they may use a visual schedule that uses “first, next, then” language to communicate activities for the next few minutes. If your child requires less structure with their daily activities, their visual schedule may list tasks by hour for an entire day. Check out these examples below!

What are the benefits of a visual schedule?

Visual schedules are a powerful tool that can help kids perform complex tasks, organize their day, or follow a routine. Here are a list of benefits that result from using visual schedules:

Visual schedules provide structure and predictability. Has your child ever become upset because they didn’t want to complete a task or weren’t expecting an upcoming activity? Visual schedules provide a consistent reminder of what activity is next and can show a reward that follows a non-preferred activity. For example, if your child doesn’t like bath time, they can use their visual schedule to understand they will get to watch their favorite TV show following their bath.
Visual schedules encourage independence. Once your child becomes comfortable with using their schedule, they can help create it and plan for each day. It will also allow them to select preferred activities or rewards between non-preferred activities. When a child helps create their own schedule, the sense of independence promotes completing activities without being asked to do so.
Visual schedules reduce negative behaviors and meltdowns. When kids know in advance what’s happening, it can help them feel more in control and at ease. If there is a change in their routine, they can plan and prepare themselves for that change.
Visual schedules work with your child’s visual strengths. Although visual schedules can use words, pictures and symbols often times create ease for reading a visual schedule. You can also use pictures that are specific to your child’s household or routine. For example, you can use a picture of their favorite book using your phone camera instead of a generic or cartoon book.
Visual schedules teach a variety of skills during childhood development. Visual supports open the doors of communication, increasing your child’s ability to interact with his or her surroundings. Creating and utilizing visual schedules promote visual motor skills, fine motor skills, organization, positive self-esteem, decision making, and a wide variety of executive functioning skills.
Visual schedules can be used for more than just sequencing activities. You can use visual prompts similar to visual schedules to break down one task into steps. For example, if your child has difficulty with sequencing the steps of toileting, they can use a chart similar to the one below provided by A Day In Our Shoes.

Tips For Implementing a Visual Schedule With Your Child

Before using the visual schedule, ensure that your child understands the purpose of it and how to use it.
The schedule needs to be manageable. Start with a small schedule that only contains a few tasks and uses language such as “first, then” or “first, next, then.”
Mix preferred activities with non-preferred ones. This helps to motivate children to persevere through non-preferred activities.
Personalize the schedule with their favorite characters or colors. Use pictures of your child’s specific toys or items in the household. If your child is able, let them help create it!
Cue your child to use the schedule or ask them to check it when they begin an activity. Repetition is key!
If your child gets satisfaction from marking off completed activities, place a check box beside each task.
Use these instructions for tips on creating your own visual schedule at home.
This awesome resource from A Day In Our Shoes has plenty of FREE visual schedules you can print from the comfort of your home.

How can Carolina Therapy Connection help?

At Carolina Therapy Connection, we offer pediatric occupational therapy to addresses concerns with things such as self-care skills, including feeding, bathing, and dressing; fine motor skills, including writing, tying shoes, and picking up small objects; neuromotor development; and sensory integration. Our occupational therapists can work with your child and family to ensure they are using the right type of visual schedule for their routine and help them create the perfect one just for them! Our experienced therapists can help your child use a visual schedule in the clinic, as well as carryover of using them in the home or school. As our team of specialists work to help your child reach their goals, you will begin to see remarkable changes in their skills and abilities. More importantly, you will see the happiness, confidence and sense of independence this brings to your child, and the peace of mind this brings to your family.

If you have any questions regarding visual schedules or your child’s development, call Carolina Therapy Connection at 252-341-9944 to speak with one of our occupational therapists! We currently offer occupational therapy, physical therapy and speech therapy in Greenville, Goldsboro and New Bern, NC.

Let’s Get Real About Screen Time

Posted on August 2, 2021October 4, 2023

Screen Time and Childhood Development

Screens and technology use are becoming more and more common for children. According to the CDC, children ages 8-10 spend an average of 6 hours per day in front of a screen. This increased time spent starring into a screen can have significant effects on a child’s health and development. Young children learn about the world by exploring their environment and watching and modeling others’ behaviors. They learn to foster their imagination and creativity by interacting with toys and others. Increased screen use can have significant effects on this aspect of their development. A new study from Cincinnati Children’s Hospital Medical Center published in JAMA Pediatrics showed concerning evidence that brain structure may be altered in kids with more screen use. Researchers looked at brain MRIs in 47 preschoolers and found that screen time over the American Academy of Pediatric’s recommendations was associated with differences in brain structure in areas related to language and literacy development. Below is a chart with suggested screen time use by age by the American Academy of Pediatrics.

Screen Time and Behavior

While screens can be beneficial teaching tools, great for reward and even better for making those long car rides more bearable, their growing presence means parenting around them has become increasingly challenging. The exciting nature of screen time can trigger the release of dopamine, a feel-good neurotransmitter that makes us associate screens with pleasure and therefore something we want to spend more time with. These dopamine releases make it physically and mentally challenging for kids to put down technology. As a parent, think back to your childhood and how often you were watching a screen. It may have been for about an hour after dinner right? Let’s also think about what you were watching. It was most likely an hour long show that you had to wait until the following week to find out what happened next! Kids today are watching short-lived Youtube videos, 1-3 minute Tik-Toks, scrolling through social media, or binge watching a show with 10 episodes readily available. Research shows that these short clips of fast-paced programming have an immediate, measurable, negative impact on sustained attention and self-regulation. When screens displace activities like outdoor time, play, independent work and social interactions it can result in a kid missing out on valuable caregiver interactions that model and teach emotional regulation. Without those skills, a child might be quicker to anger, become frustrated or shut down.

Negative effects of increased technology use:

Decreased attention span and/or social interaction skills due to lack of peer interaction and engagement
Deficits in language and communication skills due to lack of reciprocal dialogue and social interaction
Difficulty sleeping: The blue light that screens omit, inhibits melatonin; our body’s sleep hormone
Risk factor for obesity: Engaging in a sedentary activity for extended periods of time increases this risk

Ways to Decrease Screen Time

Tips/ strategies to set boundaries and decrease screen time:

Keep certain times screen-free (i.e. during mealtimes, bed-time, and family time)
Set restrictions on the content/ apps that can be accessed
Co-watch with your child so that the content is educational and appropriate. The parent can also help the child understand what they are watching
Download games, apps, and YouTube content that are only educational
Parents can model healthy screen usage by decreasing the amount of time spent on their screens in front of their child
Set a family curfew for screen-usage (i.e. after 6:00pm, no more screens)

Ways to take movement breaks:

Nowadays increased screen time is more common because of virtual learning and adults working from home. Here are some ways to take a break from the screen and get your body up and moving.

5 senses walk pointing out 5 things that you can see, 4 things that you can hear, 3 things that you can touch, 2 things that you can smell, and 1 thing that you can taste
Wheelbarrow walks across the room
Animal walks: Bear walks or crab walks
Jumping jacks
Crashing or jumping onto couch, mattress, or cushions

Screen-free activities for families:

Make a fort out of pillows, blankets, chairs, furniture, etc.
Get outside! There are so many fun activities that can take place outside; go for a walk, ride bikes, sidewalk chalk, water play with a hose or sprinkler, hide and seek
Karaoke or dance party
Create a scavenger hunt around the house
Have a game night

Screen-Free Toys under $22 that promote imaginative play and exploration:

Tummy Time Tips

Posted on March 15, 2021October 4, 2023

What is Tummy Time and why is it important?

Tummy Time is one of baby’s first exercises—and the most important! It is any period of the day where the child is placed on his or her stomach to play. It is a crucial exercise for baby’s motor, visual, and sensory development. Practicing tummy time helps babies develop the muscles necessary to lift their heads and, eventually, to sit up, crawl and walk. Tummy time is not an activity for sleep! Your baby should always be awake and supervised when lying on their tummy.

Tummy time is important because it:

Helps prevent flat spots on the back of your baby’s head
Makes your baby’s head, neck and shoulder muscles stronger so they can start to sit up, crawl, and walk
Improves your baby’s motor skills (using muscles to move and complete an action)
Alleviates gas and gastrointestinal pain
Helps master head control
Exposes your baby to different sensory environments
Engages and promotes bonding between you and your baby

When should Tummy Time start and how long does it last?

The American Academy of Pediatrics recommends parents start tummy time early. In fact, babies born at full term with no health issues can start tummy time as soon as their first day home from the hospital. As a new born, your baby can benefit from 2-3 tummy time sessions every day, lasting around 3-5 minutes each. As they get older and become more able to tolerate tummy time, your baby should gradually practice more each day. When your baby is 3-4 months old, aim to achieve at least an hour total per day. You should continue doing this with them until they are at least 7-9 months old when they begin crawling. At this age, they will be getting the developmental benefits of tummy time while moving, and it is not as essential to have them do it, however, it is still beneficial to have your baby lying on their stomach during play.

Why doesn’t my baby like Tummy Time?

Some babies may not like the tummy time position at first, particularly when they have not yet developed the muscles to lift their head and neck. Eventually, your baby should enjoy lying on their tummy and begin to enjoy play in this position.

Tips for making tummy time more enjoyable:

Place yourself or a toy in reach for him or her to play with.
Lie on your bellies together, side-by-side or face-to-face, on a comfy surface.
Put your baby tummy-down on your chest while you do your sit-ups. Add some funny faces and silly noises with each rep.
Change locations, giving your baby a different view to look at each session.
Entertain your baby with colorful toys that make noises and have lights while lying on their tummy.
Use a pillow or folded towel under your baby’s arms to slightly elevate them when lying on their tummy.

Tummy Time Abilities

At 2 weeks your baby:

Using tummy-to-tummy with you, tummy down carrying positions, and lap soothing positions
Working towards lying on the floor on their tummy
May become irritated when placed on their tummy, especially on the floor

After 1 month, your baby:

Should attempt turn their head while lying on their stomach
Attempting to lift head up, even if they are unsuccessful

At 2 months, your baby:

Spending at least 1-2 minutes lying on their stomach without becoming upset
Doing most exercises on the floor
Tilting their head to one side (Note: ensure they are tilting their head to both sides and watch for early signs of Torticollis)

At 3 months, your baby:

Is beginning to put some weight in their arms, with elbows behind their shoulders
Gaining more head control for longer periods of time
Spending a total of 1 hour total each day lying on their stomach
Visually tracks toys and objects in front of them

At 4 months, your baby:

Lifting their head to a 90 degree angle and keeping it centered
Pushing up on their arms to bring chest off the floor
Lifting head and moving neck simultaneously to visually track you and toys in front of them

At 5 months, your baby:

Beginning to push up on hands with straight elbows
Starting to reach for toys placed nearby and moving/scooting forward

At 6+ months, your baby:

Initiates lying on tummy on their own during play
Reaching and grabbing toys
Pivoting in a circle while on their stomach
Rolling from their tummy to their back and vice versa
Prefers being on their stomach to allow for easier play, movement, and exploring

How can Carolina Therapy Connection help?

We often have parents ask us about tummy time, so our amazing physical therapist, Emily Tower, is here to help! Watch this video to learn more about how you can engage your child in tummy time.

If you have any questions about tummy time or your child’s development, contact Carolina Therapy Connection!

Our email is info@carolinatherapyconnection
Our phone number is 252-341-9944
We will be happy to do a FREE screening!

Sensory Sensitivities: What Can I Do?

Posted on February 15, 2021October 4, 2023

What is Sensory Processing Disorder?

Sensory processing disorder occurs when a child (or adult) experiences more than one significant sensory sensitivity that interferes with everyday life. One’s body must first register the arrival of new sensory stimuli in order to process and respond to it. Some kids have poor registration, meaning they have difficulty recognizing and attending to new sensory stimuli; other kids might have high registration, meaning they feel constantly bombarded by stimuli, even those that are insignificant to a typical person in their environment. Your child might also display sensory seeking or sensory avoidant behaviors in response to their differences in processing. It is important to remember that symptoms and behaviors may be inconsistent, with varying triggers, intensity, and frequency.

Sensory Avoidant Children

The many types of sensory stimuli typically elicit a calming or arousing response. When faced with an extremely arousing, alarming type of stimuli, our body’s fight or flight system can be activated. This leads to behaviors including, but not limited to, running away, yelling or crying, physical aggression, or self-injurious behaviors. Kids who experience sensitivities to certain types of stimuli typically exhibit avoidance behaviors towards the sources of this stimuli. It is possible to desensitize children’s experiences with certain sensory stimuli; however, this process should be designed and monitored by a licensed Occupational Therapist.

Sensory avoidant behaviors might include:

Difficulty with washing or brushing hair
Difficulty with tolerating hair cuts
Difficulty with brushing teeth
Difficulty with trimming nails
Upset by unexpected touch
Difficulty adjusting or tolerating being in a loud, crowded environment
Prefers solo play
Prefers stationary activities – avoids running, climbing, jumping, etc.
Gagging or other extreme response to certain food smells or textures

What is 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.

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!
Touch, or tactile sensation, comes from receptors in our skin found all over the body. Tactile sensation includes sensations of pain, temperature, pressure, and textures.
Taste
Smell
Sight
Hearing

Understanding Sensory Overload & What You Can Do

Maintain a positive mindset:

Move at your child’s pace. Never force a sensory experience on them. This will lead to broken trust – Remember that your child is experiencing these stimuli as an attack to their state of wellbeing and you are there to support and encourage them.
Start slow – simply tolerating being near aversive sensory stimuli is something to celebrate!
Give your child aspects of the situation to control by using conditional choices
- “Would you like to brush your teeth first or take a bath first?”
- “Would you like to try the peas or the carrots today?”
- “Would you like to use the green or the blue finger paint?”
Desensitizing your child and creating new habits takes time! Progress can seem slow, but don’t get discouraged.

Activity ideas:

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 – This is crucial when trying to expand your child’s diet. 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

Check out this video of our AMAZING Occupational Therapist, Kelly, helping a child overcome a sensory fear.

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!