Occupational Therapy at AKT

Occupational Therapy at AKT begins with the belief that each child that we serve is unique and deserves unique services. This belief is set across all that we do and all that we strive to be. Services begin with a thorough evaluation of each child. The assessment tools are choosen to ensure that the proper areas of concern are being evaluated as well as any possible additional performance areas that may be affecting the child. This can include residual reflexes, fine motor coordination, dexterity, visual motor coordination, sensory processing, ADL skills, visual perception, social skills, cognition, and bilateral coordination. Following the completion of testing, therapists will spend time with the caregiver present to collect information regarding history and present abilities. They will spend time reviewing test results and impressions with the caregiver while providing them with their recommendations for treatment.

Once the evaluation is complete, services can be scheduled. Treatment sessions will look different for each session. This can include the treatment approaches as well as the therapist providing them. AKT strongly believes that children benefit from seeing a variety of therapists. There are several reasons for this. The first is that every therapist has a different set of specialties. By having each therapist provide treatment to a child we can ensure that each expert is assessing the child thru their specialists eyes. Another great reason for utilizing different therapists is to ensure that there is carryover for new skills and not just performed for one therapist alone.

Throughout the course of treatment, therapists will communicate and educate the following with our AKT families: 1. Progress towards goals 2. Work/exercises/activities to be performed at home 3. Discharge planning from services once goals have been mastered Although discharge time can be sad for both our kiddos, therapists, and families, it is such an exciting time to celebrate all the hard work that our kiddos have put in to achieve their maximum potential. It is such a magical time to celebrate! We hate see our kiddos leave us but we love when they visit just to say hi!

What is Self Regulation?

What is Self-Regulation? Self-regulation refers to a child’s ability to manage their emotions, behavior, and attention in various situations. As a pediatric occupational therapist, I often witness the crucial role self-regulation plays in a child’s occupational performance, encompassing daily activities like play, learning, and social interactions. Self-regulation encompasses the ability to manage one’s emotions, thoughts, and behaviors in different situations. It involves the capacity to stay focused, control impulses, and adapt to changing circumstances. In the context of a child’s development, self-regulation extends to various domains, including emotional, cognitive, and behavioral regulation. Impact on Function Impaired self-regulation can significantly impact a child’s ability to engage in age-appropriate tasks. For instance, a child with challenges in regulating their emotions may cause a struggle to focus during classroom activities or face difficulties in forming meaningful peer relationships. Occupational performance relies heavily on a child’s capacity to navigate their internal state, adapt to environmental demands, and maintain a balance between arousal levels. In therapy, we utilize various strategies to support the development of a child’s self-regulation skills. These may include sensory integration activities, mindfulness exercises, co-regulation strategies, and structured routines to help children better understand and manage their emotions. Recognizing the importance of self-regulation is fundamental in fostering a child’s overall well-being and enhancing their participation in daily life. By Aja Perry, MS, OTR/L

What is Visual Motor and Why is it Important?

 

In occupational therapy, we work on many skills vital to a kid’s everyday life, one of those include visual motor skills. Visual motor skills are defined as being able to translate a visual image, or a visual plan, into a motor action - or in other words, taking what we see and turning it into movement in order to complete a task. They are the controlled coordination of the visual system (eyes, head, and neck) and the movement system (muscles, joints, and body parts). Visual motor skills include visual processing, visual perception, and hand-eye coordination, which are all needed for success in school, sports, crafts, games, dressing, or overall day to day life skills that Occupational Therapy addresses here at AKT. 

  Visual Processing is the movement of the eyes and ability to collect information. 

• Examples of visual processing activities you could try at home include: 

• Holding a picture up in front of your child with either shapes, words or a picture and having them draw/write what they see 

• Replicate a picture by building with legos

• Imitate a block design shown 

• Use play-dough to form shapes or letter shown 

• Creating patterns or finishing a pattern 

Visual perception is our ability to make sense of what we see. Visual perceptual skills are essential for everything from navigating our world to reading, writing, and manipulating items. Visual perception is made up of a complex combination of various skills including visual memory, visual closure, form constancy, visual spatial relations, visual discrimination, visual attention, visual sequential memory, and visual figure ground.

• Examples of visual perceptual activities to try at home include:

• I Spy Games

• Where’s Waldo

• Word searches

• Memory games

• Puzzles

Hand-eye coordination is the way a person’s hands and eyesight work together effectively and efficiently which allows us to manipulate and manage objects and items. These motor skills allow us to collect visual information and use it in a motor action. Eye-hand coordination requires fine motor dexterity, strength, shoulder stability, core stability, etc.

• Examples of eye-hand coordination include:

• Catching a ball

• Manipulating pegs into a pegboard (i.e. Lite Bright)

• Lacing a lacing card

• Cutting activities 

Visual motor skills are an important part of childhood development and are needed to complete almost any activity. Without visual motor skills, a child couldn't catch a ball, complete a puzzle, or put on their shoes. It can also affect a child’s handwriting and school performance as well. Here at AKT, we work to improve these skills in occupational therapy to help kiddos succeed in their daily activities, at school, in sports and while they work on their hobbies! 

Elizabeth Bowden OTD, OTR/L

Transitions Made Easier

                       

One of the most frequently occurring topics I have been approached by parents with is how they can help their child with overall transitions. As a therapist, I have encountered many instances where a child has a difficult time transitioning not only in the clinic but in a classroom, home, and social setting with their peers. 

The most important factors to remember are time and consistency. With time, the child will adapt and become flexible to the changes and transitions occurring. A key word that is frequently talked about here at AKT is FLEXIBILITY. This is a term we use often in occupational, speech, and physical therapy. 

Throughout our life span we learn to become flexible and adaptable with time. This starts at a young age when the introduction to new challenges and new experiences are presented. Growth and development encompass flexibility. With time, transitions become easier and we learn to adapt to the changes we are faced with. However, as much as flexibility is important, consistency is important too in the sense of continuing to expose children to various scenarios in which they experience change leading to transitions and flexibility. This will help in the ease of transitions decreasing any behavioral outbursts that may occur whether it is fear from separating from the parent or overall difficulty transitioning to various environments or tasks.

There are a few ways in which we can help children with their overall ability to transition. As mentioned above, exposure is a key component to learning how to effectively transition throughout various environments. The more a child is exposed to various environments, the more adaptable they become. One great way to help with transitions is a visual schedule. This provides the child with guided times and expectations of transitions in various directed activities. This is a great resource to incorporate at home as well to help with transitioning between day to day tasks. For example; a morning to afternoon schedule focusing on the task for the day such as getting dressed, school, time for homework. This provides clear expectations for the child as well as a visual reference for them to refer back to. Another way to help your child with transitions is to provide a timer. For example; if a task is concluding and your child has a difficult time ending the task, a timer is a great way to provide those visual and auditory clues that the task has concluded and it is time to move on. This may be used for activities and self care tasks as well as the utilization of a visual schedule.

Occupational, physical, and speech therapy have incorporated strategies to assist all of our patients and their families with transitions to maximize the outcomes across all environments. If you have any further questions in regards to helping your child with transitions, please feel free to reach out to the AKT team! 

Melissa R. Pueschel

COTA/L

Toe-Walking in Children

By Morgan Hamlett, DPT

 

Toe walking is common in children and can be caused by a variety of reasons. Toe walking can be due to loss of range of motion in their calf muscles, neurologic disorders, or sensory issues. So when is toe walking a problem?

 

The biggest misconception is that a child will “grow out” of toe walking. However, this is not always the case. In fact prolonged toe walking can lead to an increase in muscle tightness as the child grows, which prevents them from being able to stand with flat feet and increases the risk of orthopedic issues such as joint pain and increased risk of injuries. This muscle tightness can also affect a child’s balance and ability to perform gross motor activities such as standing on one leg, jumping, hopping, or navigating stairs.

Therefore, it is important for a child to be treated for this as early as possible while following a physical therapy plan of care. Treatment often includes a variety of approaches such as:

Stretches - There are 2 common stretches performed including static stretching and dynamic stretching.

·         Static stretching is where the stretch is held for an extended period of time with the most important being stretching into ‘dorsiflexion’ or bringing your toes up towards your nose. This is more commonly known as a calf stretch and is performed with both the knee straight and the knee bent to stretch both calf muscles.

·         Dynamic stretching is where the stretch is held repeatedly for a short amount of time often times during other movements or activities. This can be done while performing animal walks such as bear walks or walking up inclines.

Strengthening - Another important aspect of treating toe walking is strengthening the muscles which pick up your toes when you walk. This can be done during activities such as heel walking or repeatedly picking up toes while sitting or standing.

Exercises providing sensory input.

·         Exercises such as tapping heels on a step or propelling self using heels on scooterboard can provide sensory input to the heels required for flat-footed walking

Soft tissue massage - In cases where the muscles are tight massage can also be used to improve muscle lengthening in combination with stretches.

Bracing - Bracing can also be a key component of treating toe walking as being in a brace allows for a low load consistent stretch over a long period of time and prevents the child from going up on their toes.

 

Overall, toe walking is a common condition treated with a combination of physical therapy and a home program consisting of all these components. By introducing these activities in a fun way, your kiddo will be on the path to walking confidently!

Physical Activity Effects on Sleep in Children with Autism Spectrum Disorder

A large portion of children with ASD have trouble sleeping' whether that means falling asleep, staying asleep, or getting good quality sleep. So what are your non-pharmacological options to help your little one get the sleep they need to function on a day to day basis? Exercise!

 

Research actually shows that a moderate amount of exercise every day can positively impact sleep duration and quality compared to no exercise at all! Examples of specific exercises that have shown this effect are basketball, swimming, jogging, and structured group exercise classes. However, implementation of any structured physical activity can positively impact your kiddo’s sleep.

 

So what exercise is best for you child? Well the best exercise for your child to participate in is something they truly enjoy and are able to maintain on a daily basis. Using your child’s interests will make it possible to implement physical activity on a regular basis and maximize benefits on sleep. Additionally, build this activity into your daily routine to ensure carry over and continued interest.

 

On the other hand, it is important to read your child and ensure not to overwork them because it also found that too much vigorous exercise can have the opposite effect on sleep. Therefore, ensuring that your child is having fun, taking breaks, and drinking plenty of water.

 

Ultimately, regular structured physical activity can have a positive effect on sleep in children with Autism which helps with improved regulation and energy to perform daily activities.

By Morgan Hamlett, DPT

Why is Physical Activity Important for my Child with Autism Spectrum Disorder and How Can Physical Therapy Help?

 

Children with Autism Spectrum Disorder (ASD) can exhibit motor impairments that include deficits in visual-motor and bilateral coordination, low tone, motor apraxia, toe-walking, and gross motor delays. Children with ASD also have a higher incidence of obesity due to the movement difficulties that they face. 

 

Physical activity poses a challenge for those on the spectrum due to impaired motor functioning and increased difficulty engaging in a team environment. The CDC recommends 60 minutes or more of moderate to vigorous physical activity for children aged 6-17 including daily aerobic and activities that strengthen muscles 3 days each week, however, encouraging a child for 60 minutes may prove challenging. 

 

Physical therapists have the ability to improve motor delay impairments and decrease developmental and daily functional obstacles that exist. Physical therapists help treat motor delay problems by improving strength and gross motor skills, stretching tight and underdeveloped musculature,  and increasing stability in weakened musculature. This can help children gain confidence in day-to-day activities and participation in sports. 

 

Performing physical activity has shown to result in a reduction in stereotypical behaviors such as finger waving, arm slapping, body rocking, toy chewing, hand biting, and head banging with external reinforcement and self-monitoring. Physical activity before classroom time has also shown to have a significant correlation to staying on-task and decreasing disruptive behaviors in the classroom. In addition, there has shown to be a positive correlation between the amount of physical activity and social interaction and sensory skills of those affected by Autism.

 

Autism Speaks offers strategies to encourage regular physical activity!  https://www.autismspeaks.org/expert-opinion/autism-exercise-benefits 

 

Be on the lookout for Amazing Kidz Therapy exercise groups in the near future led by our physical therapist :) 

By: Karly Zengel, PT, DPT