Archive for August, 2013

Helpful Hints for Haircuts


Many children find it difficult to tolerate haircuts. From the auditory input (clippers, hairdryers), to visual input (large mirrors and styling tools), to tactile input (light touch of scissors, water dripping or trimmed pieces of hair) to the smells of a salon, this environment is primed for over-stimulation. Here are some tips to help with the next time your child gets a haircut.

  • Try to schedule appointments when the salon is the least busy.
  • Bring an extra large tee shirt or soft flannel shirt from home to use instead of the stylist’s cape.
  • Always plan on going straight home after a haircut so your child can wash off any stray hair clippings.
  • Barber shops are often less overwhelming from a sensory standpoint, as opposed to a salon.
  • Give your child a scalp massage prior to a haircut to help desensitize the scalp.
  • Make a picture schedule of what to expect. Talk about the steps in positive terms (“Sometimes clippers are loud, but we’ll be OK.”).
  • Ask the stylist if they would be willing to give your child breaks. Count back from 10 (sloooowly), then give a  break (read a short book or let your child play for a few minutes on a handheld game). Use a timer if needed. Repeat until finished.

Tips for Middle School

The transition from elementary school to middle school can be a challenge. Here are some quick tips to consider before the school year starts.

  • Combination locks are often difficult for children with motor planning difficulties.

o       Some children benefit from using a padlock with a key rather than a traditional combinationword-lock lock.  Others may prefer to use a lock with a code, such as this.

speed dial combination locko      Another option is the “Speed Dial” lock that uses a slider that moves up, down, left and right and can be set with the combination of your choice. (Please note this style of lock is larger than traditional combination locks and we have found that it does not fit on all lockers.)

o       If your child’s school locker has a combination lock built in, your child could ask permission to place a discrete sticker on the right side of the lock to help him recall which direction to spin the lock first.

  • Begin a color-coding system with your child.  This system can last him through the middle school, high school and college years.  Have your child pick a color for each subject (e.g. math is the red folder).  Label the outside of the folder “Math” and label the pocket on the inside “To Do” and “Finished”.  If your child can get in the habit of always placing homework and completed assignments in the proper colored folder, there will be fewer misplaced papers and less stress for all involved.
  • Purchase or print out calendar pages for your child to keep by their homework area in order to track long-term projects.  As soon as assignment dates are given, teach your child to put them on the calendar.  Use colored stickers or markers to reinforce the color-coding system for each subject.

Back to School Tips

school busSummer has flown by and once again it is time to head back to school. Here are some ideas to help with this transition.

  • Get back to school-year bedtimes and wake-up times at least a week before school starts.  Although this may not be popular with older children, it will be worth it during the first weeks of school.
  • If your child is bothered by the feeling of new clothing, do not push them to wear a brand new outfit on the first day of school.  Wearing comfortable clothing will reduce the sensory demands on your child when in a new classroom with unfamiliar sensory stimuli.
  • Use a calendar to set up after school routines.  Having a visual aid as well as the comfort of knowing what to expect is helpful to many children.
  • If your child has fine motor or motor planning difficulties, food and beverage packages may be a challenge at snack and lunch time.  Give your child a chance to master these packages at home before going back to school.  You can even serve snacks and lunch in your child’s lunch box to practice the motor sequences from start to finish.

Animals on Parade

We often use “animal walks” in the clinic. These silly walks provide the children with proprioceptive input, which tends to be calming and organizing in nature. Using animal walks during transitions can give a child a sense of control (i.e. “It’s time to leave, are you going to walk like a bear or a hop like a bunny?”). Here are some of the walks we use, but feel free to make up your own:leap frog

  • Bear walk – have your child put his hands and feet on ground with his bottom in the air and walk.
  • Crab walk – have you child sit on the floor and place his hands behind him, then lift his bottom off the floor and walk forward or backward.
  • Mule kicking – have your child lean down and put his hands on the floor, then try to kick his legs up in the air behind him.
  • Bunny hopping – have your child hop with his two feet together
  • Elephant walk – have your child bend over at his hips and put both arms together, walking while swinging his arms back and forth like a trunk.
  • Frog hops – have your child squat down on the floor and place both hands on the floor, then push off and jump with hands and legs.
  • Inchworm – have your child place his hands and feet on ground with his bottom in the air and move his arms forward keeping his feet still, then move his feet forward while keeping his arms still.

Helpful Hints for Potty Training

How do I know if my child is ready for potty training?

  • He shows an interest in the process of potty training.
  • He is able to recognize the feeling of having a dry or wet diaper.
  • He is staying dry for longer periods of time during the day.
  • He is developing the motor skills to pull pants down and up.
  • He is able to follow simple directions.


What are some ways to help my child with potty training?

  • Make sure your child’s feet are flat on the floor or a step stool.  Having a solid base of support is often necessary to relax the muscles involved in voiding.  Some children may benefit from the additional support of arm rests if trunk control is an area of difficulty.
  • If your child has a history of gravitational insecurity or seems anxious about sitting on the toilet, start by having him sit on the toilet with the lid down, fully clothed.  Slowly move toward having him sit on the toilet with their clothing or diaper on, then finally transition to sitting with a bare bottom.  Another modification is to allow your child to sit astride the toilet, facing the tank and holding onto the raised toilet lid for stability.
  • Children who are over responsive to auditory input may react negatively to the bathroom in general because of the tendency of sounds to amplify and echo off tile and other hard surfaces.  Speak in a quiet voice when in the bathroom.  Try hanging extra towels in the room to help absorb sound.  If your child is bothered by the sound of the toilet flushing, let him use the toilet, wash his hands and leave the bathroom before you flush.  When in a public restroom, place a sticky note or hold a piece of paper towel over the automatic flush sensor to avoid an unexpected flush.
  • Children who are under responsive to proprioceptive input may be constantly “on the go”, seeking intense movement and crashing experiences or seem unaware of their own bodies, bumping into people and objects, unintentionally breaking toys or seem to be more clumsy than peers.  These children may not notice the subtle signs that they need to use the bathroom until it is too late.  Watch for those wiggles, squirms or holding onto the genital area that are telltale signs your child needs to use the bathroom.  Point them out to your child and help him transition to the bathroom.
  • Some children find it very difficult to transition from a desired activity to the bathroom.  Use terms such as taking a “break” or a “pause” from an activity rather than telling your child he needs to “stop” what he is doing to use the bathroom.  Giving 5-minute and 1-minute warnings prior to a bathroom break may be helpful.  Visual timers can be useful for transitions as well.  Be sure to praise your child for transitioning to the bathroom and make it a point to discuss the fact that the desired activity they left is still available to return to after he is finished.
  • Use a rewards system.  Some families use sticker charts, others use edible treats.  Pick something that will be a strong motivator for your child.  Start by giving the chosen reward for each successful attempt at using the potty, then move to extending the reward for staying dry for a morning or afternoon period and finally to staying dry all day.
  • Give boys something to aim at when urinating such as Cheerios or Fruit Loops.  Award points for “hitting the targets”.
  • Keep in mind that it is not uncommon for children to wet the bed up to 6 or 7 years old.  It may be necessary to use nighttime pull-ups or training pants for quite a while after daytime training is complete.

Heading to Kindergarten

The Autism Society has created a tip sheet for parents of children on the autism spectrum who are transitioning from preschool to kindergarten. You can read it HERE.

Multisensory Handwriting Practice

Research has shown that a multisensory approach to learning is beneficial for a wide variety of children, particularly with teaching handwriting and reading skills. Many children who struggle with the formation of letters will show reluctance to complete class work or homework and may write the shortest answer possible rather than demonstrating their full grasp of the concept.

In the clinic, we see children who glaze over at the thought of practicing letter formation and other handwriting skills but are willing to participate in novel multisensory activities such as those listed below.

  • Write or print out letters that take up an 8×11 piece of paper. Place a sticker or other indicator for where to start the letter.  Have your child drive a car or walk a stuffed animal along the letter’s path.A with push pins
  • Use the same printed letters from the first activity and place them on a cork board.  Have your child press push pins (with close supervision) into the start and end points for the strokes, then stretch elastics over the pins to create lines for the letter.
  • Assemble a rainbow salt tray.  In short, glue colored construction paper into the lid of a shoe box and pour a thin layer of salt on top.  Your child can form letters with her finger or use a paint brush or other tool to write.  For complete step-by-step instructions, visit
  • Shaving cream is a tried and true OT modality. Squirt a small amount of shaving cream on a cookie sheet, or right onto the tabletop if you don’t mind the mess. As with the salt tray, your child can use her finger or a tool to write and draw in the shaving cream.
  • Pour finger paint on a plastic plate or small tray. The paint won’t adhere to the surface and provides the opportunity to practice letters repeatedly and correct errors easily.
  • If you have a child who is over-responsive to tactile input, and therefore would run for the hills if you asked him to touch shaving cream or finger paint, try squirting hair gel in a sturdy zipper bag. Double bagging is probably the best approach.  You can add glitter or food coloring for extra visual appeal. Here is a great example:
  • Roll play-doh or other modeling clay into “snakes” and form them into the letters.  Encourage your child to build the letter in the correct stroke order, for example, to make a “T”, start by forming the vertical line and then place the horizontal line on top.
  • Wiki Sticks are a fun tool for learning letter formations.  They are a combination of yarn and food grade, non-toxic wax that can be bent into any shape you wish.  They will stick on a piece of paper, a sliding glass door, a smooth easel or the tabletop.  Start by having your child bend the Wiki Sticks to “trace” on top of a printed letter.  Then have him copy the letter by looking at an example and work up to forming the letter on his own.
  • To work on letter identification, play a mystery letter game by tracing on your child’s back with your finger.  For extra motivation, give your child 100 points for every correct guess.  Please note:  this would likely not be an appropriate activity for children who are over-responsive to light touch and tactile input.
  • Many kids have difficulty sitting long enough to practice letters and reading and need movement to stay regulated.  So you can print out letters or sight words and tape them firmly to the floor, or write with sidewalk chalk on the driveway.  Call out a letter or sight word and have your child jump on the correct answer.  Make this a little harder by giving instructions such as “Jump on the letter that makes the sound ‘sss’”, or “What does ‘lion’ start with?”.
  • For a spin on the jumping activity listed above, try the same activity but give your child a (clean) fly swatter to smack the words or letters.Wiggle Pen
  • Children who naturally have a low arousal level and children who seek intensity may benefit from using a wiggle pen. Their legibility may decrease with this pen, but it is great for repetitive assignments such as writing out spelling words.  These same children may enjoy using scented markers as well.