Occupational therapy…”hmm, yeah, I have heard of it”..”but, umm...what is it that you do again?”
“You help people get jobs right?”...
“Wait...you’re a pediatric occupational therapist?​
​ "Well….why would children need jobs?”

If I had a nickel for every time I have heard a similar conversation I would be RICH! SO...what is occupational therapy and what do we do when it comes to a population of children? First off, we don’t help your child get a job, however, we can help provide skills that one needs for a job in the future. Instead, we enjoy being called the specialists that are going to teach your child how to use their brain and hands together while sitting upright in a chair. Let’s begin with what our brain and hands are doing. Think about how much you do with your hands throughout a day. We button up our shirt, we feed ourselves with a spoon, we grab our seat belt to lock in place, we hold a cup to drink our large coffee out, we write to-do lists with a pen, we pick up the small M & Ms as a midday snack, we tie our tennis shoes to walk our dog...okay, you see where I am going with this. Everything we do with our hands begins with a plan in our head and is then executed with movements of our body, this is called motor planning. This motor planning allows us to accomplish everything we do in a day...which explains the brain part. But now our hands, too?? I promise I will make it simple. Our arms and hands make all of these activities possible through how we move, grasp, and manipulate items in our everyday life. Period. So as occupational therapists, we help to coordinate what our brain and hands are doing and provide the tools needed for your child to be able to control their upper body movements and manipulate objects to complete necessary activities across their environments. “Okay...but upright in a chair?” “What?!” Well, that takes us to the “foreign language” part of occupational therapy... What do I mean by saying upright in a chair? We do focus a lot on what our arms and hands are doing, but we can’t even begin to observe that if we aren’t sitting upright in a chair, or sitting pleasantly on the ground, or having enough balance to stand up tall, right? This is where the sensory approach comes in. I know when we think about sensory we think about our five main senses we learned in elementary school: touch, taste, smell, sight, hear...but did you know there are actually 8 sensory systems in our bodies? The last three that we don’t learn about are vestibular (knowing where our body is in space), proprioceptive (movement of our muscles and joints in relation with the rest of our body), and interoception (what our internal organs are feeling) systems. All of these systems work together in order for us to sit in a chair, stay in a chair, and attend in a chair. “Okay...so what? We have 8 sensory systems...what does that have to do with occupational therapy?” Well, I will tell you. Occupational therapists are magical masters in finding how your child processes sensory input coming in from all directions, then we provide fun activities that helps the child process that input better (without them even knowing it, WHAT?!), and then the child learns how to attend to their teacher or you, control their emotions, sleep better, or EVEN SIT UPRIGHT IN A CHAIR without falling or causing disruptions. We all have sensory needs and we all process these systems differently. A lot of the time, for adults, we learn how to regulate without help...such as tapping a pencil or a foot in a meeting, chewing gum, doing a midday stretch, etc. We have just naturally learned what is going to help us stay awake or attend to someone or something. “So...how do I know if my child may need occupational therapy?” Great Question! Some things to look for: ● Trouble holding items (such as spoon/fork, writing utensil, etc) ● Maintaining a grasp on such items ● Uninterested or avoid activities with small manipulatives (beads, cutting, writing) ● Does not use both hands/sides of body ● Trouble finding objects in a background ● Handwriting difficulties ● Picky eating ● Avoids messy play ● Avoids movement (climbing, swinging, etc) ● Seeks movement constantly ● Seeks tight hugs, consistently pushing/falling into you ● Requires specific clothing and clothing materials ● Seems to require their name to be called a few times before noticing ● Enjoys chewing/biting objects ● Avoids loud/ busy places ● Loses balance easily I know...you’re thinking “maybe some of these things happen but I am just not sure if it is normal or if it means anything more than just being a kid.” Well, GREAT NEWS. Here, at Reaching New Heights, we offer FREE, yes…..I said FREE, screenings to assess if your child might need more help from the brain and hand specialists, the magical sensory masters. Feel free to contact me with any questions/concerns or comments at bmoran@reachingnewhts.com
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​It’s a crazy, fun, hectic, and overall special time of year as the holidays are quickly approaching. For you this might mean tons of family time, parties, big dinners, decorations, shopping, holiday music, lights, shows, etc. These all seem like exciting activities, but if you have a child with ASD it may be overwhelming for them and stress inducing for you. Children with ASD can be overstimulated by a variety of things during the holidays such as the loud music, crowds of people, bright lights, strong scents, social situations and gatherings, just to name a few.  My best advice is to be prepared for these challenges!  Here are a few proactive strategies you can use for yourself, family, strangers, and a child with ASD.

1. Social Stories- Write a holiday story with your child as the main character that will prepare them for all that is to come with the holidays.  Tailor it to fit you and your child’s needs by teaching them what they can do if faced with a certain situation. For example, if you know your child’s trigger is being around large crowds of people, write about how you will be going to crowded stores and attending large dinners with your extended family. Include photos of all your family members, as well as pictures of stores to help them as much as possible. [SS1] Offer them replacement behaviors of what they can do if they do feel overwhelmed. Social stories can be made simply by using a word document, or if you are tech savvy, try making one through an app on your phone.  If you are unfamiliar with social stories, I recommend following The Autism Helper, http://theautismhelper.com/behavior-social-stories/.
2. Bring Your Tool Belt- Let’s be honest, Christmas time can be sensory overload for a lot of people, not just children with autism.  If you know your child’s triggers will be tested, bring your “tool belt” filled with all the materials you can use to provide support for your child.  Stack your purse, car, and/or bag with reinforcements, visual supports (such as your social story), fidget toys, headphones, sunglasses, music, blankets, etc. to use before a trigger may occur.  The key is to be proactive, not reactive, so you can alleviate a behavior before it even starts! 
3. Educate-A lot of people do not understand autism and what the symptoms may be.  Since you may be seeing a lot of distant family and friends who are not familiar with your child’s needs and diagnosis, try and educate them beforehand so they won’t have any “expectations” of your child’s behavior. Send an email out, call (if you have the time) or write up a quick bullet point list of things they can do to help alleviate your child’s holiday experience or better yet, help them with their behavioral goals.  For example, if your child doesn’t like to be touched, include this in your list so family members don’t go in for a big hug or expect to be kissed upon arrival.  Offer different ways to greet them, such as a wave, high five, fist bump, thumbs up, or even just eye contact or a simple hello.  Or you can also take advantage of these situations by practicing your child’s behavioral goals. If your child needs help with appropriate social greetings and comments, probe these situations by having your family ask them social questions and observe your child’s responses.  There are so many social goals you can practice during the holidays!

 
These are just a few ideas you can use to make your holidays run smoother. I look forward to sharing more ABA techniques with your families once the ABA Department opens up in February 2019.  Until then, Happy Holidays!

AUTHOR
Betsy Soshnik is a Board Certified Behavioral Analyst at Reaching New Heights. Betsy is passionate about helping children and families overcome obstacles and improve the qualtity of their lives. She has 7 years experience providing ABA services to clients ages 2-19 years old. Betsy enjoys spending time with her husband, son George and daughter Audrey. ​

Halloween is one of our most beloved holiday traditions, but it can be challenging for some children.  Children diagnosed with Autism or Sensory issues or even language delays or speech disorders can find various aspects of Halloween to be more of a “trick” than a “treat”.
Planning ahead can help alleviate many of these challenges. Here are some simple tips for reducing stress!
1. PREPARE YOUR CHILD.  Show your child pictures or videos of Halloween.  Talk about what happens or read a social story or even role play the act of trick-or-treating. Anxiety is often caused by not knowing what to expect.
2. CHOOSE THE RIGHT COSTUME. Some children with sensory issues have difficulty adjusting to different textures or weight of fabric. Masks should be avoided and it’s best of every day clothing can be adapted to be a costume.  Use sweats and a hoodie to make an animal costume or super hero. (I was a pink sweat suit bunny in preschool!) Let your child wear the costume before Halloween and be prepared that they may refuse on the big day. And that’s alright!
3. MAKE A PLAN. Choose to go early before it gets dark or too crowded.  Choose to only go to houses near your own in case your child needs to exit quickly. Avoid houses with scary decorations or people dressed up to scare the kids.  
4. THE BUDDY SYSTEM. Stay with your child, but it helps if you can pair them with a neuro-typical peer if possible. This peer can serve as a role model and may help reduce anxiety.
5. DIET RESTRICTIONS.  If your child has a restricted diet, you can bring your own treats to hand to the homeowner at the moment or ahead of time. Also, discuss with your child ahead of time what and how much candy they will be allowed to eat that night.

In some cases, it can help if the child carries or wears a card explaining why they don’t say “trick or treat” or “thank you”.  Feel free to use mine or make your own.

HAPPY HALLOWEEN!!!!!!!!!