Archive for September, 2013

Is It Picky Eating? Or Something More?

Are you concerned about your child’s eating habits?  Avoidance of new foods is a typical part of child development, most often seen in 2-3 year olds, but for some children, this pattern continues further into childhood. How do you know if your child is a just a picky eater or if there is a need to seek out assistance in this area?   Here are some brief guidelines to help differentiate between picky eaters and problem feeders:

Picky Eaters:

  • Are reluctant to try new foods, but can typically tolerate them being nearby, touching them or looking at them.
  • Have at least 30 accepted foods.
  • Will typically accept the food again after a break from eating it for a period of time
  • Will eat at least some food from most food groups or texture groups.
  • May frequently eat a different meal than the rest of the family, but typically sit with the family at mealtime.
  • May slowly “warm up” to a new food after 10 or more presentations.
  • May eventually agree to try a new food if they are hungry enough.

Problem Feeders:

  • Become excessively distressed when a new food is presented – may gag, vomit or cry after looking at a new food.
  • Have a significantly limited food repertoire – typically less than 20 foods.
  • Will not accept a food again once a food is lost from the diet, even after a break.
  • Avoid whole categories of food groups or texture groups.
  • Are frequently unable to join the family for mealtime.
  • Continue to have strong negative reactions to foods even after 10 or more presentations.
  • Will ignore hunger cues from their body and refuse to eat a non-desired food, even if this results in malnutrition or dehydration.

If you are concerned about your child’s diet, talk to your pediatrician about nutritional concerns and to rule out physical or medical reasons for feeding difficulties, such as swallowing difficulty, food allergies/sensitivities or reflux. Your occupational therapist can also help by examining your child’s food preferences for patterns in texture, flavor or other factors, and help make suggestions about how to introduce new foods into your child’s diet.

The Four Food Groups

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Apps We Love: Lil’ Kitten Shopping Cart

App Name: Lil’ Kitten Shopping Cart

Why We Love It:

This adorable app involves a kitten that goes to the grocery store with a list and a budget.  Play begins as the kitten’s mother gives him a list and a specific amount of money. If the kitten can get all of the items with savings left over, he can go to the toy store and pick out a reward. The game addresses many areas, including cognitive processes such as reading the list, recognizing price differences, placing food into categories, and the concept of keeping under a budget. Also addressed are visual perceptual skills, visual memory skills and fine motor skills. The shopping list can be hidden as the cat walks down the aisles, encouraging the child to remember what food item he is looking for. The list is not categorized, which requires the child to carefully scan the entire list for all of the vegetables, meats, etc. Each food item is available at 2-3 price points and there is a sale section as well. The app does all of the math calculations but the challenge could be increased by giving your child a pencil and paper to keep a running total, then compare it to the cashier’s total at the end of the shopping trip. Although there is lively background music, it can be turned off. We have found that children of a wide age range love this app. Younger children benefit from the reading and scanning practice, while older children learn money management, budgeting, and the benefit of using an organized plan in a store.

Why Kids Love It:lil kitten shopping

Children love being able to complete “grown up” tasks. This app allows them to be responsible for money and pick out a toy for the cat. The animations are clear and colorful and the children enjoy the scavenger hunt to find each food item.   Having your child help categorize and locate food items during a real trip to the grocery store is a great way to carry this over into a functional skill.

Available: iTunes FREE

What is Bilateral Coordination?

Bilateral coordination is the underlying skill that allows us to use the two sides of our bodies in complimentary ways in order to complete a task. Skills that require efficient bilateral coordination include manipulating paper while cutting with scissors, tying shoe laces, stabilizing the bottom of a zipper while pulling the zipper closed, cutting food with a fork and knife or holding a piece of bread while spreading peanut butter.cutting with scissors

If your child is having trouble with tasks that rely on bilateral coordination, try to encourage some of these play activities:

  • Playing card games: dealing the cards, stabilizing a group of cards while removing one card from the hand.
  • Stringing beads over pipe cleaners, shoelaces or stretchy string to make a craft project.
  • Building with manipulatives, such as Legos, Wedgit blocks or other toys.
  • Paper folding activities: paper airplanes or origami creations, here is a link to some simple origami patterns.
  • Using modeling clay or Play Doh: molding, kneading and shaping the materials, using scissors or a fork and butter knife to cut through the clay.
  • Stabilizing a paper on a vertical surface while coloring or painting.
  • Kitchen helper activities: stabilizing a bowl while stirring, spreading butter, frosting or other soft food items, holding a cup while washing or drying it.

Keep in mind that simply practicing bilateral coordination tasks will not lead to a mastery of shoe tying overnight. Children need the chance to practice, practice, practice and develop the underlying skills required to take on more complex activities.

Sleep

sleepingHow much sleep does my child need? Here are some general guidelines for the amount of sleep children should be getting.

3-6 Years Old: 10 – 12 hours per day

7-12 Years Old: 10 – 11 hours per day

12-18 Years Old: 8 – 9 hours per day

What are some signs my child is not getting enough sleep?

  • Difficulty waking in the morning.
  • Awakening in an irritable mood
  • Decreased attentiveness and alertness during the day.
  • Frequently falling asleep during the day outside of normal napping hours, or frequently falling asleep during the day after naps are no longer part of the daily routine.
  • Taking more than 30 minutes to fall asleep at night.

How can I help my child improve their sleep patterns?

  • Studies have shown that children (and adults) who watch TV, play video games or use other electronics before bed took a longer time to fall asleep than those who avoided screen time.  It’s always easier said than done, but try to avoid screen time 1-2 hours before bedtime.
  • Dim the lights.  Turn off some of the lights or use table lamps in the 30 minutes before bed.
  • Create a bedtime routine that can be completed in 30 minutes or less.  Give your child some control over the routine, such as choosing a book to read or what PJs to wear.
  • Provide calming and organizing sensory input.  Taking a bath, getting a lotion massage, or providing deep pressure via “pillow squishes” can help a child with a high arousal level transition to sleep.  To safely do pillow squishes, have your child lay on a solid but comfortable surface on their belly.  With a couch cushion, large body pillow or several smaller pillows, provide firm pressure to their back, arms and legs for the duration your child desires.  Always be sure his face is not covered and his breathing is not impeded.
  • Some children benefit from a supplement called Melatonin.  If your child is still having sleep difficulties after trying bedtime routines and sensory strategies, you may wish to discuss potential use of Melatonin with your pediatrician.

Making a Homework Zone

homework zone

School has started and the homework is coming at full force. Here are some things to consider when making homework area for your child.

  • Look at the potential distractions present near the homework zone. Is your child easily distracted by auditory input? An area away from the TV or a noisy window may help. What are the visual distractions? Sit in your child’s seat and see what she will see.
  • Keep the homework zone stocked with supplies. Try to keep pencils, erasers, scissors, rulers or any other items typically needed for your child’s homework assignments handy in this area.
  • Lighting is very important. Use a desk lamp at eye level rather than overhead lighting to reduce glare.
  • Consider seating options. If your child has a hard time keeping an upright posture, he may benefit from a chair with arms and a solid surface to place his feet on. Other children may enjoy sitting on a small yoga ball. Ideally for all children, the table surface should be 2” below the height of bent elbows.
  •  For children who tend to wiggle and fidget, provide opportunity for controlled movement that does not interfere with the completion of homework. Tie a length of theraband across the legs of the chair for her feet to push on. Affix a material with texture your child likes on the underside of the desk – try the fuzzy or bumpy side of Velcro, a small piece of corduroy or something squishable, like an icepack at room temperature or a water-filled teething toy. This will provide your child with a textured fidget toy, without the chance of it becoming lost or getting in the way.

Save Those Broken Crayons!

Save those broken crayons! If you look through the crayon boxes at our clinic, you will find a fine collection of broken crayons. Is it because the children accidentally break them while coloring? Nope! We break them on purpose.

When a child holds a standard length crayon, there is more opportunity for dysfunctional grasp patterns. However, when they hold a short stub of a crayon, they are more likely to maintain a functional tripod or quadrupod grasp pattern.

The same theory goes for pencils as well. We use short golf pencils, Handwriting Without Tears pencils or half-used pencils for most of our children at the clinic in order to help promote efficient grasp patterns.

 

broken crayons

Apps We Love: Super Stretch Yoga

App Name: Super Stretch Yoga

Why We Love It:SuperStretch yoga

This is a great introduction to 12 simple yoga poses. Super Stretch is a yoga superhero who guides the children through each movement. Each pose is described in kid-friendly, positive language, then a video is shown of real children — not actors with perfect form — as they attempt the poses. The sequence moves from alerting movements with head inversion, to organizing movement with flexion and static positions.

Why Kids Love It:

Super Stretch is narrated by a young boy with an energetic voice. The cartoons representing each pose, such as an elephant dipping his trunk in water, are easy to carryover into the movement. The fact that the app developers used children who look and act like peers learning the movements is empowering for children who struggle with balance and coordination.

Available: iTunes FREE, Also available in Spanish