Occupational Therapy at Home
I had another great Facebook Live chat again today. Today it was Jaime Bassman, MS OTR/L from nearby Lower Merion. We spent an hour discussing various OT and IEP things. Jaime is a 0-3 OT, so she offered up a zillion tips on how to do this at home, easily!
She also gave me some tips which I am including below. So first it’s the video, then her tips, then the transcription of the chat for the hearing impaired.
OT INFORMATION, IDEAS, AND RESOURCES FOR DISTANCE LEARNING
First we did talk about 0-3 services and the pandemic, since 0-3 has been a bit less talked about than school-age services.
0-3 Service Provision during Pandemic:
*Every state has telehealth rules and regulations for its occupational therapy licensing board (or, in the case of Pennsylvania, no regulations existed in the first place!)
*Therapists are free under emergency order of HHS to use telehealth platforms that aren’t strictly HIPAA compliant during COVID, school may ask you to sign FERPA waiver
*Huge number of school based OT’s are subcontractors – by now the district should have worked things out with the contracting agency – agreed upon guidelines for service delivery and payment
*There ARE some aspects of an evaluation that can be completed remotely- records review, skilled observation, interview and questionnaires
*There’s been discussion between OTs about which assessments can be performed remotely and still be considered standardized (ex. Beery VMI, if forms are dropped off to the parents )
*Reach out to OT for a phone chat about individualized goals, decide together what to prioritize given circumstances, communicate via email on needed materials for each session
*Create a “new normal” routine that works for your family’s unique situation, and for ALLmembers of your family.
* Consistency of bedtimes and wake times, daily outdoor activity and specific time frames for school completion will keep your child in a predictable rhythm that will be necessary for them to remain focused and self regulated.
*Visual schedules :all of us need our own form of visual schedule, even adults (think IPhone daily calendar).
*Daily visual schedule/ to do list of work to follow along .
*Weekly list broken down into chunks- help child visualize and understand the big picture first (what is due on Friday) then break down into manageable daily pieces. Work with child in advance to plan out when to complete each piece during the coming week. This planning process in and of itself is a way to help improve executive functioning.
Setting Up the Environment/Workspace:
*If child is setting in a chair at a desk, make sure feet are directly touching the ground or surface (not dangling), desk at elbow height (not too high or low), chair not too deep, consider a Move N Sit cushion or theraband especially if that has helped in past, fidget toy access or weighted backpack on lap if helpful.
*Some children may do best NOT sitting in a chair at a desk. Do they need to sit on a beanbag chair, lie on belly, rock in a rocking chair or some other option? What about sitting in a box with pillows or a laundry basket (for the little ones)?
*Warm ups/breaks: heavy work options, stretching, jumping, hand squeezes, wall pushes etc.
*Do they need less/more input ? Including auditory- some kids focus better with music or background noise. Make sure they are facing away from distractions. Now is time to help child figure out what they need, and become more independent with managing sensory needs.
*For OT sessions and otherwise, make sure child has tabletop access to the following:
Lined/college ruled paper, construction paper, pencil, scissors
Consider OT shoebox idea: Keep items in a shoebox that would be useful for putting out for OT sessions and other fine motor practice breaks. Example of great items to keep in shoebox…
- Wikki Stix
- Tweezers, tongs, strawberry hullers or tea sifters
- Playdoh or putty
- Cardboard with small cutout window
Examples of other household items to use during sessions:
- Pillows and cushions
- Laundry basket
- Toilet paper rolls/towel rolls
- Hula hoop
- Jump rope
- Unmatched socks
- Any board games
Building in life skills:
- *Using snack foods to make ‘crafts’
- *Carrying and putting away groceries
- *Helping plan ‘menu’ of weekly meals
- *Bringing down laundry hamper, doing laundry, putting away laundry
- *Working on getting dressed
- *Dressing up in nice clothes and taking family pictures
- *Sweeping with broom and dustpan
- *Wiping down table, setting table
- *Making the bed including changing sheet
Handwriting at Home- Make it Functional:
- *Creating cards or signs to thank healthcare workers
- *Writing out the family grocery list
- *Writing out daily to do list
- *Writing and mailing out letters to a friend
Which issue needs the most work– Letter formation? Sizing? Spacing? Orientation to line? Focus remediation around that specific issue- ask OT for specific ideas.
OT Resources Jaime provided
I have not edited this, and it mentions 3 speakers and there were only 2 of us.
Speaker 1: Or an E L in your name for some reason. I don’t know why you’re not alone. Okay. I don’t feel like it should be two syllables. I feel like you need another syllable in there. okay. Let me just check on the page and see if we are appearing for people. If you are tuning in right now, can you give us a like or say hi or something so that we know that you
Speaker 2: are here.
Speaker 1: Okay. It is showing on the page. I hope that people can hear us. Oh yeah, we have about 10 Watchers so far. Good. Okay. We are in day 55 of quarantine. If you want to stop in and say hi. Tell us where you’re from. Jamie and I are both from Pennsylvania but we’re not going to talk about too much legal or regulatory, special ed stuff. Today we’re going to talk more about, the curriculum isn’t the word I want to use. OT practices, activities and practices.
Speaker 2: Mmm.
Speaker 1: Oh good. Okay. Let’s go ahead and get started cause we have been running over on some of these. So as long as I have Jamie here now, don’t want to waste her time, get her as much time as she wants to chat with all of you and for you to ask her questions. Jamie’s a friend of mine right now, it feels like she’s so far away, but she’s really only about 20 miles away from me. But of course neither of us have really been out of our homes and a long time. I just went there for the first time on Saturday because I had to go up to Downingtown and pick up some Peaky stuff for my people were still crazy there. I’m like, really The Wegmans customer can not take a break for the pandemic. They still have to act
Speaker 3: and it’s one of the best places, which is the sad part. Like I go there cause it’s better than some of the other supermarkets, but you’re still like,
Speaker 1: we’re limiting how many people go in. I’ve actually been using ShopRite delivery and I’ve been using them for years, so it was no big deal to switch over. Oh, somebody said Aloha. That means it’s 6:00 AM there six, 8:00 AM 8:00 AM there, I think it’s a six hour difference or no, 8:00 PM no, 8:00 AM
Speaker 3: no, I can’t do my math either. Yeah. Let’s say Aloha back cause I don’t do tests. alright. Jamie, why don’t you introduce yourself and tell us what you do. Okay. so my name is Jamie Bassman and I am an occupational therapist. I was realizing, just yesterday I had gotten my, graduate school like alumni, you know, thing in the mail, you know, they, they put out every quarter or whatever and I was like, Oh my God, I was there 20 years ago. So I’ve been in OCI for like almost 20 years. and or I work in infant toddler early intervention, so in the birth to three system in Pennsylvania. but I have also worked for many years in the preschool and school based settings, including, an approved private school, for kids with emotional behavior disorders. I’ve worked in, you know, autism classrooms using verbal behavior approaches and kind of done a little bit of everything. But this month is really been my first, I guess it’s been the last six weeks has been my first experience ever with teletherapy myself. So there’s just a big learning curve for everyone.
Speaker 1: Yeah, there is. Well, thank you for being with us. a couple of reasons why I wanted to have you on first of course. Cause I like you and know you and I know that you have, I know that you have knowledge to share with the audience but also we hadn’t really spoken with anyone yet about zero to three. So maybe we can touch on that for a little bit. And for the moms and dads who are tuning in right now, if you’re thinking that you’re going to leave here today and that Jamie’s going to have this like whole giant list of things for you to do, do not worry. We’re not doing that. we wanted to focus today on using your home and natural environment to practice the skills which the zero to three folks are excellent at. because Jamie and I are both in the same boat in that we have kids who are also distance learning who we have to work with, on a daily basis.
Speaker 1: And we understand that you don’t want another list of activities to do, that you’d rather just try to fit it into your natural day. And that’s one of the things I miss is that that constant, reminding when the zero to three folks were in my house all the time when Kevin was a baby, that you’re just constantly reminded of that. And if there’s any bright spot to, you know, not having school and kids being home, it’s that I do get to see his therapists now, you know, weekly which, you know, I usually only see them, you know, a couple of times a year. So, okay. So let’s just touch on it briefly. Again, Jamie and I are both from Pennsylvania, so your state may be a little bit different, but do you want to just touch on, for the parent in Pennsylvania who maybe hasn’t heard from their providers yet, what is zero to three doing as far as distance learning or as far as the pandemic if they have an ISP and all that fun stuff.
Speaker 3: Sure. so actually these year to three system in Pennsylvania was literally one of the first to get up and running with teletherapy because of the way that the system is set up, you know, the money comes down, you know, federal to state to County. And so it’s really about that, you know, depart from it in the state of Pennsylvania starting to make those guidelines and also realizing, and this was actually something I wasn’t even aware of as an occupational therapist ever. As it turns out, the state of Pennsylvania has no rules or regulations already in place for telephone. So I was like, Oh wow, we’re good to go. which was useful to know, not as, not necessarily the case in other States and not necessarily the case in other practice areas for occupational therapy. But for us, that was the case. So I work in three different counties and it was like each County, it was like kind of like one by one by one, you know, they’re like, okay, we’re closing down, we’re going to get this teletherapy thing started.
Speaker 3: Just wait for your guidelines. one thing that was really helpful was to find out that from the department of health and human services, and this is so this is like a national thing that they waived the requirement that, teletherapy services be provided through a HIPAA compliant, provide like software, right So basically that meant I didn’t need to spend $200 a month on healthcare for zoom and that instead, what I could do was offer up to the family basically because of the biggest emergency order, we want to make sure that everyone has access to teletherapy. So, whether it’s via zoom, whether it’s via face time, which is what a lot of my families have chosen to do. you know, I’ve now done sessions with like WhatsApp and I get to learn about all these things, but whatever it is, and if a family doesn’t have access to video, then doing phone calls are also a possibility.
Speaker 3: I will say it’s been a little slow going in terms of referrals because a lot of families are still not aware that this is an option and not aware that virtual evaluations are also happening. So that’s an important thing to make sure that people know that if you do have a child and you have concerns about them, they’re not in the early intervention system that you can call, get an intake. And what happens is you will get evaluated but it will be virtual and that will, but that will not stop you from getting services. Yeah, that’s a really important thing to know.
Speaker 1: That is. okay. So if a parent, okay, I know that I’ve read cause, the questions that I’m answering this frequently for whatever reason seem to be about speech, I would say OT is definitely second. so I’ve read everything that, I’ve read it pretty much everything that Asher has put out, regarding their for speech pathologists, speech therapists, and what they should do for tele services. what is your governing body, and that’s not the right word. What is your, what is, it would be the
Speaker 3: be the equivalent of Ashoka for the national yeah, the national organization.
Speaker 1: Okay. And I’m only mentioning that because, I’ve had some parents come back and say, well, my school said that they can’t provide it because, and I’m like, well that’s not really, you know, you may want to read what Ashley has said because Ashley has said that their speech pathologist can do this, you know, provided you follow their rules. So you might want to look at AOT if, again, if you’re getting pushback from your school on that.
Speaker 3: Oh, right. I mean there, there shouldn’t be any that isn’t really related to what the state has laid out. It’s really about not even what AOTA is, what AOT is saying is, it all depends on what your state guidelines are for the provision of teletherapy. And so, you know, if you live in Montana and this is like literally what’s, what’s linked up on the AOTA website, you know, you’re going to want to know if your therapist, a licensed provider what they can or can’t do. But they have definitely been as hot of webinars for therapists on best practices. at this stage, there should not, if you’re talking about early intervention preschool or school-based, if they’re, if people are not somehow being, like moving forward with the therapy services at this point I would have to wonder what, what’s going on because it wouldn’t be based on anything that the national organization is putting in. Probably not based on the license or either. It’s wildly more logistical. A lot of occupational therapists are contractors and so the school district has to work that out with the contracting agency. you know, how does payment work you know, what, how are services being delivered but there shouldn’t be an issue with,
Speaker 1: okay, that’s good. And it’s like, you know, this has been changing on a daily basis. So, I think some it is just taking them longer to catch up and what they’re saying now may have been true two weeks ago. It just, you know, is not true. You know, you know, when it first started, everyone was like, zoom, you can’t go on zoom because it’s not HIPAA compliant. And then it’s like, no, no, it’s slow down everybody, you know, and, and kind of regroup and get and get the information. That’s a great point though about, them being contractors, which I think probably a lot of parents don’t know or don’t understand is that they are not school district employees. and many times the school district, they may contract with a person specifically, but more likely an agency as a whole. So it’s not so easy as to say, okay ahead and do this. They
Speaker 3: do have to work out details first. Right. Okay.
Speaker 1: So, okay. all right. So, let’s see, what else do we want to get into I’m just looking at our list. so, all right, let’s get, get into then the OT stuff. for those of us who have kids with OT needs, I don’t know if you want to get into fine motor first or sensory. what I liked a lot when you first started was the piece about, you know, when you go into a home, when you can, that you don’t take a bag with you.
Speaker 3: and yeah,
Speaker 1: but you don’t carry a whole bunch of stuff in with you. So, you know, we can go over some things that parents can do with things that you probably already have in your house too, to work in skills that, you know, that, that your, that your kids need to work on.
Speaker 3: So I think the first thing I would say to people is when you’re looking at your child’s OT goals, I’m trying to really focus on, given the circumstances, given your family’s current life circumstances, given the priorities and what’s going to make the most sense in the near future. Decide really what are you going to prioritize right now Cause it might not be everything, it might not be all of the goals. and try to find something where you feel like, you know, this is something my child can work on given the circumstances and it’s going to go well for us. You can also, I would encourage people to talk to the OT. I was saying to you, we said before about how I think that a lot of parents, because you know, we’re, we’re busy and you know, it feels like it’s kind of like a constant, like back and forth with the district.
Speaker 3: Jono is a proactively take advantage of asking the therapist or checking in with them or partnering with them proactively the way that maybe they did during those infant tablet early intervention years when the therapist was coming into the home. And it was really that that relationship was there. But especially right now, you know, if you feel like you’re at a loss, you know, kind of asking that therapist, okay, so what is it about my child’s handwriting that maybe we need to focus on more Is it an issue with size or is it an issue with spacing or, you know, and then maybe is there one thing you know, that I can kind of do at home that might help them with that, that spacing thing. And then that frees you up to integrate some more ideas that, you know, kind of go outside of the therapy session and into the home once you kind of know a little more about what you’re targeting.
Speaker 3: the other thing I would say is, to think about, you know, your daily routines. this is where early intervention really focuses. It’s really about the natural environment and integrating therapy, quote unquote, into naturally occurring routines. And I think you also want it to be something that’s meaningful for the child. if it’s something that the child is, you know, it feels like it’s a constant struggle right now. it could be because it doesn’t feel like there’s a lot of inherent meaning in it for the child right now. and I’m going to use handwriting as an example just because for a lot of kids right now, working on handwriting as a school based goal must feel a little weird when they’re doing all of their schoolwork on it. So, you know, thinking about, you know, again meaning and what’s going to be the thing that they’re going to really prioritize and it’s going to be okay if some of those other goals are not your main focus, but your therapist is a resource can help you. So reach out.
Speaker 1: Yeah. And I think that’s, that’s really consistent with, the behaviors I’ve spoken with. And every, person or professional that we’ve had on has said you have to prioritize. And, I know that parents, some parents are still working outside the home right now because you’re essential workers. and many of you are working inside the home and you’re expected to, you know, work side by side in some, some capacity, in guiding your child, but also, you know, you performing your job so that your family can eat. so you just have to do the, you know, just keep in mind that just do the best you can and give yourself a break. And again, the behavioral subset of everybody said it, that you have to prioritize and that all kids are gonna regress. It’s just, it’s just, you know, kind of I think accepting that, that, okay, my child is going to regress, but what can I, you know, what’s really important to me to maintain and I know the one BCBA I spoke with said that not even trying to learn anything right now, just trying to maintain the skillsets that they have.
Speaker 3: I think the other interesting thing about this setup, and I know this, you know, as, as a parent, you know, I have two kids who themselves have IEP is, that this also provides a little bit of a window into how your child self regulates as they try to focus on their schoolwork or complete their schoolwork. And that can be helpful I think in terms of their ability to come up with their own strategies. my daughter was interesting, you know, she is 12 and she had said that, you know, for her listening to music, you know, has always been an alerting thing. You know, cause we all, you know, no matter how old we are or what our, you know, whether we have, you know, a diagnosis or not, every human being has their own kind of sensory experiences, their own sensory quirks, their own issues, their own way of learning best.
Speaker 3: And that’s the same thing for our kids. and the question is just can they communicate what their sensory needs are And so the funny thing about it is that all of a sudden in the home, you’re not necessarily tethered to, okay, you need to sit in a desk and a chair all day if that is not what works best for you. With both of my kids, the goal was not about sitting at the desk. the goal was how are you going to maintain your focus so that you can complete your work. And I think when you look at it through that lens, it allows you to say, all right, you know, what if, what my kid needs is to, you know, sit on a beanbag chair or to, you know, jump up and down, you know, in between lessons and zoom calls or you know, they need those extra fidget toys, you know, fill in the blank. But it’s a good opportunity and a learning opportunity for your child and you to have a conversation about their sensory needs and for them to start seeing, you know, that they can be empowered to, you know, kind of be their own.
Speaker 1: Yeah. I think, yeah, I think my, my son is enjoying the freedom, but he is now starting to understand that there’s a certain amount of responsibility that comes with that. It’s a balance and it’s not every day. And if you, yeah, and if you want the privacy of your own room to do this with a laptop, then
Speaker 3: you know, if you don’t want to sit at the kitchen table, then you’re going to have to actually do your work. and that’s the key part of the equation. Yeah. Yeah. That was the key part of the equation. I think the other opportunity that this has opened is, and I hear this from a lot of parents and you might be seeing it too, is wow, you know, now we actually have some more time and space for the life skills to become more of a focus, you know, you know, whereas before it was like, you know, I just don’t have the time or the inclination to work with my child becoming more independent. Right. With like around the house. Cause time, you know, time is a problem. Right. But I think what I want parents to understand is how much you can work on motor planning and processing and all of those sort of OT things through some of those every day activities and have your child obviously help you and help themselves around the house. So how did they,
Speaker 1: okay, before we get to the specifics of that, which we will in a second. Casey has said that’s been our biggest struggle is working to working in trying to work with your kiddo and yeah, I hear you. I mean, I, right now it’s, it’s may. so if there is an, I know if there was an IEP season, you know, April and may would definitely be it. And now is the time of year when I would literally be attending at least two IEP meetings a day. that’s not happening. obviously. so I, for better for worse, because I’m self employed, I’m, my business isn’t doing so great, but that’s freed up some time for me. For those of you who haven’t had that time freed up because you’re working with, you know, you’re working for, for someone, for an employer who has expectations.
Speaker 1: I would say then go with, you know, the, the school or the therapist. And I have had to do that because I do have some work commitments and I’ve just had to say, you know, Hey, on Mondays I just can’t do this. And, and, and that’s it to the school. and I think, you know, I think for as much conflict as we have a schools, I think right now many are being very understanding, when, and the feedback that they’re getting from parents as far as, Hey, I just can’t do this. So, all right, so if you want to ask Jamie question, go ahead and type it in and we will try to get to it. But other than that, let’s move. So let’s move on to some specifics as far as working with your kids at home. So what are some ways that I could get more practice in
Speaker 1: Maybe, cause you know what, I am so guilty of, I’m getting better because of the pandemic and we were not on the tight schedule that we’re usually on, but I’m a doer. It’s like, just let me do it. Just let me do it. And I do a lot of care for my son, because he does lack a lot of skills, but also because it takes him a very long time and I’m like, okay good, let’s go. The bus is going to be here, hurry, hurry, hurry. so we’ve been getting better at that. But what are some other things parents can do to, you know, get this stuff done just in the normal course of the day
Speaker 3: Right. So I think first of all, every family has a different routine. Right And so, you know, as an early intervention therapist, a very used to be it, you know, kind of going in and like, tell me about your daily routine. Like what does it look like Kind of like, what do you do in the morning What are, you know, what does your afternoon look like You know, and it really is, everyone has kind of like the basics, you know, but it’s different for everyone. So I think what I would ask people to do is like literally, I know it sounds like a silly idea, but like literally like kind of write down what you know, what, what the rhythms of your day look like now and think about, you know, in terms of those different things that your doing, think about which of those kind of like chore type things you might be more willing to spend the extra five minutes on.
Speaker 3: Slowly kind of guiding and coaching your child through it, using more indirect language and indirect prompting, which is going to actually allow them the time to really think and process and also think about which activities and chores are not going to work that way. So, I think the other factor is to think about which activities are your child is going, you’re, you’re going to be able to, in OT language we think about grading the activity so that they can be successful, like slightly challenged, yet successful at it. so like for example, you know, it could be that, you know, using a vacuum cleaner is not going to be the activity because maybe a, for your child that’s just going to be a little too challenging. They’re not going to kind of understand or know what to do with it and be maybe the sound, you know, from a sensory standpoint, it’s not going to work out.
Speaker 3: But it could be that you could work with them on learning how to use a broom and maybe you’re using the dust pan and when you’re doing that, you’re actually doing an activity together. And you know, it’s not the most exciting activity in the world obviously, but it’s like they have to learn to coordinate their body and their movements to work with another person. And there’s a lot of motor planning, you know, so, you know, again, I think, think about the days or the time of day where it might work and then the times of days where you’re, it’s just not gonna work for you and go, go from there. the other thing, it’s like I always tell parents when it comes to like for example, practicing dressing, you know, sometimes it’s better to practice dressing when you’re putting on your pajamas because there you’re just going to have a lot more time for most families to kind of like slow it down. It’s that nighttime or teen you’re already in that sort of sense of togetherness versus working on something in the morning when it’s sick.
Speaker 3: so again, it’s a very individual individualized thing. you know, I know I’m putting my kids to work, you know, with a lot of work. So like heavy work. That’s a thing that a lot of parents, you know, heard about, you know, maybe when their kids were, you know, really young and you had people like me coming in to then, you know, at some point in time people just kind of stopped with the heavy work activities. Like we’re past that heavy work is one of the safest, easiest things that you can do. And if you even think about yourself, like how do most people calm themselves Even like, cause grownups, you know, people like to do things like kickboxing or yoga, like those are all essentially organizing heavy work activities. So, you know, if you’re doing your leg daily, you know, your daily, your weekly trips to the grocery store or whatever, maybe there’s one of those bags that you can save for your kids to be the one.
Speaker 3: So like kind of help, you know, take the, take the groceries in or you know, in the case of my son, he helps, you know, put the groceries away and, you know, he has to really kind of think through, okay, you know, where is this going to fit or where does this go, you know, with everything else, you know, and you know, he asked to kind of like look to me for some guidance for that, but also try to like kind of problem solve and, you know, problem solving as important. So, you know, there’s a lot of visual perception, right Like, just in that, I think the other thing is like, even thinking about cooking for example, you know, and again, when I bring up these things, I, you know, I, I’m not thinking about people who are, you know, essential workers on the front lines or you know, trying to balance out their work jobs right now and are just trying to survive.
Speaker 3: you know, if cooking is not something that you feel like you have the time for with your kid, that’s okay. That’s totally fine. You know, it’s more, you know, thinking about if that is an option for you or not. And then thinking about what opportunities there are, you know, in working with your child or you know, fine motor planning, solving, even executive functioning. Like, here’s a picture of what this is supposed to look like. And now we gotta think about, you know, okay, so this is what it’s supposed to look like. How do we get there What are the ingredients And then bring in the handwriting piece. Maybe you need to write stuff down.
Speaker 1: I liked, I’d like your idea on, on your list. And which by the way, I will, I will send it out. I liked the list with laundry and matching up socks and my wheels are already turning. because I have this perpetual basket of clean laundry in my living room that needs to be folded. and you know, I sit down at seven or eight o’clock at night and I’m like, I’m too tired again to do it. and it never gets done. But I think,
Speaker 3: well, you know, w I don’t know why I think that I’m the only one who can do it. because
Speaker 1: yeah, they can help with that. And you know, almost tricking them cause the TV’s on or you know, that they think they’re just watching TV. and they don’t realize that they’re also helping me fold laundry
Speaker 3: or, or sorting darks and whites. That’s another thing, you know, so maybe you know, for one child, maybe the folding is not going to be it. Maybe that’s going to be too complicated. Maybe they’re sorting out the pants from the shirts, you know, maybe they’re sorting out the darks from the whites. Maybe it’s about the socks. Right. But like you have to think about, okay, what’s something here that’s going to work
Speaker 1: for my child Yeah. yeah. And I’ve been, because we’re all home for every meal every day. I don’t use paper towels or napkins. I only use cloth things. but I’m perpetually washing these rags, but cause I don’t use, you know, I don’t use paper towels, but they’re, so I don’t care how they’re folded cause they’re just drags. So that would be something that would be so easy for him to fold in hat and not so easy for him. But you know, I don’t care if he folds it in half or in quarters. but it’s, you know, my husband doesn’t have to wear it to work the next day or whenever we go back. So if it’s wrinkled, it won’t matter. So I’m ex, I’m excited to try those. Yeah. I like to also your idea about the handwriting. I think every kid has their thing that they don’t want to do. And for mine it’s, it’s reading and writing can be hard, right. It’s hard for him. And he just, he, he doesn’t like doing it. but I like the thanking the health care workers. Of course we have mother’s day coming up so they could send a card or you know, hand it’s gonna have to be handmade card cause I’m not going to store, for grandparents, grandmothers. that, that’s I think a great idea. And what was some of the other,
Speaker 3: so it’s also talking about the idea of like writing a letter to a friend or maybe writing a letter to the teacher. I think people at this point are a little more comfortable with the male thing. So it’s like, don’t send it out. Just, you know, something functional. It’s, it’s functional, it’s meaningful. And when you’re doing it to one of, I mean there’s a, there’s a few different tricks, you know, if, if you’re trying to work on the, you know, the actual handwriting piece, one of the things that I suggest to everyone is to get Wiki sticks. you know what those are Lisa waxy things. Yeah. Like a little collar right there. Right. Or you know, if you need those like kind of raised up, you know, something that’s like raised up to work on like orientation of one so you can put them down on the paper and then it kind of helps you to like orient, you know, to the line. They’re also great for just anything. Like if you know you’re trying to like form letters, you know, and you can make like an a or a B out of them. You can also put them on the paper and they stick. So like say you’re working on coloring, right And then you put it down and you call her and it’s like a whole like raised line thing but it doesn’t like stay there. Then you just pick it up when you’re done. All right. We have a question from Kim.
Speaker 1: See her son received OT for four years. but in sixth grade, no longer school could not do anymore for him. He still has some visual spatial issues and physical coordination issue that re-emerges in subtle ways how he holds a cooking spoon. He could not use a manual can opener last week. He has difficulty cutting lately when he’s, lately he’s been running into the wall when turning the corner. I try not to instruct him or nag him unless absolutely necessary. will he eventually gain these skills on his own or should I set up situations to work on these
Speaker 3: So I think that, like I said before, if it’s logistically feasible for you to try to set up some situations to work on the skills, and to do so in a way that it feels like he can be successful. So like it could be like the manual can opener things for example, like it could be that that’s just going to be too difficult for him. But if you think about it, if say you do most of the can opening and the cans almost open and then he has to help you just squeeze that last part of it. Right So it’s like that idea of backwards shading that you just do the last part first. So that might make him feel more successful than trying to do it from the beginning and having zero success and then just giving up. If you do it with that little end part, then like there’s that success.
Speaker 3: They’re like, Oh we, we open it, you know. And he can also see that like, you know, he could watch you do kind of like the rest of it. so it’s that whole idea of how to set up a situation, but do you Sue so that he’s got that little bit of a challenge. He’s got some support and guidance from you, but there’s also that possibility of success there. And again, when in doubt try to always go with having them do that little end, that little last piece of the activity to help them be successful. and I think with like running into the wall when turning the corner, I just kind of want to know like, I guess kinda like, you know, where do you think he’s going so to speak. Like, has this been like kind of a general kind of problem or is it like, I don’t know if it’s a situation where you can kind of talk to him about it and be like, you know, I noticed that you, when you’re, when you’re like turning the corner, you tend to like run and you know, kind of bump into things.
Speaker 3: What’s up, you know, and him, you know, think about, Oh gosh, yeah, I guess I was in a rush. That might or may not be the case, you know, I don’t know your child, but you know, if it is, then you’re kind of putting it out there for the child to think about like, wow, why is it that whenever I do that, is it that I’m not looking, am I not using my peripheral vision Like what is it, you know Yeah. and I think you have to know your child and
Speaker 1: hi, I’m trying to think of how it was explained to me with my son has like the ability to first of all do the inherent learning, which is when you’re learning from social cues and things around you that kind of like a natural progression or does your child need to be direct taught everything
Speaker 3: Mmm.
Speaker 1: So that’s something you’re going to have to, you know, again, only you know your child, but I know when it comes to my son and feeding himself,
Speaker 3: it
Speaker 1: does not bother him to have food on his shirt. Like that does not bother him at all. It does not bother him to have food on his face, nor will he ever pick up on the social cues as far as it’s not really socially acceptable to have food on your face or food on your shirt. So he is going like, he has to be direct taught that. That’s not something that he’s going to learn just from kind of doing it. I don’t, I, I’m trying to think of how she explained it to me. I don’t know if,
Speaker 3: no,
Speaker 1: I’m, I’m, I was trying to relate it to her, like when she said, is he going to get it back or is he going to have to be direct taught
Speaker 3: some. Right. I mean, and, and it’s just one of the things that, you know, and that, and this can just be one of the, the heavier burdens. Sometimes it feels like that when you have a child with a disability that it just feels like there’s so many things where that’s the case where they don’t intuitively learn and so they do need that extra repetition or they do need, you know, things to just be, and I think it’s, it can be hard. It’d be hard for us to be hard for the child, but I do think, you know, can can wear people down. and at the same time, you know, I think to a certain extent, you know, yeah. I think there, there are things that, but there are also ways to like for example, like with your son, like one of the things I would almost want to know is like if you were to take a picture of him with the food all over his face and then take a picture of him, like with the food, not on his face and then show it to him and then have like a mirror while he’s eating, would he start
Speaker 3: Correct. Right. So there, there are ways, yeah.
Speaker 1: And for what it’s worth, my typical child, I’ve been trying to teach him to cook over this pandemic shutdown and I got out our can opener and he asked me what it was. So I’m
Speaker 3: sensing
Speaker 1: right. And in fact I took me, cause you know, we just do it, you know, I had 40 more years of experience than he has. and it, it really, they can be hard to turn even.
Speaker 3: Yeah, that’s, yeah. Yeah. So that’s something that I wouldn’t call that the ODS. I was wanting to call them all, do the just rights challenge. So what I look for a challenge that’s manageable and not a challenge that’s like insurmountable.
Speaker 1: Yeah. okay. Tracy says, Oh it’s a sensory question. Any info on helping zoom meetings, her son refuses zoom video. Is it related to a sensory issues And most teachers are of course requiring them.
Speaker 3: so okay. Zoom meetings. So I’m not sure how many people on here have seen some of the pieces that have come out recently and like some magazines about like some different articles about zoom meetings and how exhausting they are for everyone. Right Like this is definitely one of those situations where I want you to like just kind of put on your, like we as humans all have sensory needs thing and like think about the things about zoom meetings that make them challenging for you as a grownup even. And then when you multiply that by how many meetings you are attending, and it’s hard because some schools are a lot more flexible than others. So like my kids only have two, usually two, maybe three of these a day. But it is definitely not like, it depends. It depends. Like it might be one of them might be like core and they’re, and they’re optional and they can keep their video off.
Speaker 3: So I think there’s a whole bunch of factors. you know, one of them I think is definitely that from a visual perceptual standpoint, it can be hard to, you know, like are you, you know, focusing on the person versus uterus focus, focusing on the teacher, trying to maybe eliminate a situation where you have to look at all the boxes. which I think could be hard, right Like for a lot of people. So part of it is like with zoom, if there’s a way to even just focus on the person who’s talking, which should be like one of the options. Some kids that’s just like an easier thing, especially on a zoom call with the teacher where it’s like mostly just kind of focusing on the teacher. a lot of people, especially kids, they get distracted by seeing their own video on the call.
Speaker 3: So that’s another factor I would say like just seeing if they can either, I was zoomed there. There should be a way to do that where you can only just, you know, you, you don’t see your own video, the other person might see it or they know that. but they can also, you could also ask about, you know, does my child have to be on camera or not you know, and if they don’t need to be on a camera, that also can like, just ease a little bit of pressure on them. But the main issue is how many zoom meetings are we talking about How many in a row Like, you know, cause I think some schools it’s like way too much, where it really is all day long and it should not be all day long.
Speaker 1: No. and I think if it’s not unreasonable to ask for accommodations if your child was distracted easily in a regular classroom, I don’t know why you wouldn’t think that they wouldn’t be distracted with 20 faces. Now, you know, sometimes I think in the classroom, if there’s stuff going on behind you, you might be able to turn that off. But now it’s
Speaker 3: all right in your line of vision. So hard. And like I said, it’s hard for adults. Now we have to think about how hard it is for kids.
Speaker 1: Oh. And I know with my fifth grader, like they’re bringing their dogs in and you know, the teacher had to shut that down. And it’s like a whole thing. Like of course you can’t concentrate like so-and-so is trying to show you a dog. And yeah. So I mean, I think it was asked for whatever accommodations you might need. And I think Jamie has given you some great ideas, as far as knowing, you know, what, what the issue is. If it’s focus, if it’s attention, if it’s,
Speaker 3: mm,
Speaker 1: the longevity and how many a day and things like that.
Speaker 3: And if your child is capable of telling you what it is that’s bothering them, please ask them. It’s always important to try to get your child’s eye view as I call it, because that is always going to be, if it’s possible, the best way to do problem solving, having to be a big fan of Dr. Ross green. And I do like to like kind of apply that to a lot of things. but yes, and motor breaks are huge. another thing that, I, when you see the form afterwards, at least they’ll give you like, you know, some of my strategies that I, wrote up, talked about just environmental setup. If you do have your child at a desk with a chair and a table, I said, chair at a desk, I’m getting tired. so very important to make sure your child B are on the ground and not dangling.
Speaker 3: any time your feet are dangling, it’s going to make it more difficult for you to focus. And generally speaking, like you can’t assume that all shares and you know, fit people. especially, you know, just random chairs that you may have at home. So just something important to think about, is your table or your desk at like basically elbow height or is it higher, is it lower, is that comfortable How far away is the computer Is the chair comfortable or is it a little too deep So all of those factors are also really important. And in addition to like also what, you know, which way is your child facing Are they facing things that are distracting for them or not So, you know, thinking about the environment, you know, is another, you know, just really important thing, you know, with like what does that environmental setup look like. So if you’re having any struggles with your, with your child over, you know, learning, just trying to kind of get a sense of what you know, what it might be.
Speaker 1: Yeah. Okay. let’s move on to handwriting. Erica. And is it Kayleen or Coleen or Colin they’re kind of related around. Son’s been working with OT and his writing, but he struggles with letters that dig down such as G, J, Y P and Q, also spacing. So she was looking for that. And then someone else, she, so you can wrap it all in. her son writes too lightly. How can she get him to write better cause he writes too lightly. Hmm.
Speaker 3: Okay. So let’s see. So in terms of, I actually have like my little Andy dandy locker mirror, I that there’s a screen. So if you don’t already have like handwriting without tears or one of those things at home, this is just something you can do. Like you can go to like your local, you know, pharmacy or whatever store and just get one of these and just some dry erase markers. I felt like a little little smiley up here. you know, when it comes to this stuff, don’t feel like you have to practice it on lined paper. You know, like definitely I’d be more inclined to go with something like this, which is going to be a lot more fun. And then, you know, really I can’t really do this. Okay. So like, you know, if you’ve got like, let’s see, and I know it’s backwards.
Speaker 3: It’s kind of even having to do that one part first and then maybe like switching to, okay, you know, now I’m going to do my line down with like a different color and then I’m going to pull in like a different color for the last part. So what you’re doing is you’re just sort of like breaking it down, if that makes sense. so that’s just my like kind of three second ICS for working on those like kind of loop things is to just take the paper out of the equation completely and try to use color coding as a way to break it down to who doesn’t like writing on bearers. Right.
Speaker 3: okay. The other question was Oh he writes lightly. Oh, lightly. Okay. So, depending on what he is using, I would look at does he tend to write more lightly with like a certain pencil or pen or crayon marker I would even have them like kind of try out each of them in turn and see, see if he can tell you. Wow. Like, does that look lighter or was it like, you know, cause a lot of kids it’s like purpose of the thing. They just don’t have the sense of how much pressure they’re using. a lot of the cheese will have kids who write lately sometimes practice with or like who, they don’t know how to use the right amount of pressure. They’ll practice with some of the mechanical pencils to get a sense of like, just how much do I have to do until it, you know, kind of breaks. I think also just giving them some more resistive activities to do so that they just get a little more sense of like their body and like how much force they need to use. The other thing you can do is, I think taking the, like, again, like the sitting down at a table thing out of the equation, maybe putting some paper up on like the refrigerator and having them right up against the vertical surface. That gives you a lot more feedback.
Speaker 1: Yeah. And, I mean, I know none of us can really go out to stores right now or it’s not something you want to do for, you know, something like that. But look around your house and see what you have from, you know, I’m surprised at the things that my kids get, like for Christmas. So that kind of throw off to the side and I think, Oh, whatever. Like somebody got Kevin, bathroom or bath tub crayons and I thought, well, he’s too old for that. But actually, bathtub crayons is just exactly what you just said. And that in the shower he can write, you know, he can practice writing and it’s on a vertical surface and I don’t want to clean it up. You know, it’s,
Speaker 3: it’s different fun, you know, like, yeah, yeah, there’s a lot, there are a lot of items around your house and I did have kind of like a list of, of them, that are going to be useful to just even like if you see go just go around your house and if you see something random and you think, wow, you know, maybe that would be helpful for like this OT stuff. Kind of get it together in like maybe one location, try to put it in a bag or like with smaller stuff but in a shoe box and then have that stuff nearby when your child has an OT session. so that the other, the other key thing is that, you know, as we’re all trying to adjust to this, like brave and scary new world, occupational therapists are also trying to deal with this teletherapy time.
Speaker 3: And one of the struggles I am here kind of out there, I know land is, you know, it’s hard when they don’t always know what materials people have in the home or if like kind of, you know, just making sure that you don’t, when your child has a session that they have like the materials that they can kind of use. Cause if that isn’t the case, then the OTs end up kind of doing more computer related stuff because they don’t have the opportunity to work with your child there. And then I’m like, ham skills, you know, like on hand strengthening or on dexterity. but if you, and especially if you can coordinate with the OT so that you have, you know, you say, Oh gosh, you know, I found these like, you know, tweezers or you know, like, clothes pins or whatever, you know, around the house and I’m gonna put them in this box so that when you do your session with my kid, they’ll, they’ll have it. Then the OTs will be like, cool, okay. So now what I’m planning, I can think to myself, I know that they’re going to have those close friends. So like,
Speaker 1: right, right. let’s see, someone else mentioned taking motor breaks of course. And I think, you know, as Jamie has said, talk with your child’s teacher and talk with their therapist. no, I just did an interview as a teacher back before the pandemic and she said, you know, no teacher gives assignments or homework assignments with the intent of stealing your family time and making you cry and making your child cry. You know, that’s not the purpose behind any of this. So, you know, they’re not having these zoom classes and doing these zoom sessions with the intent of making your child miserable and stressing you out and all that. So don’t be afraid to reach out to them and, you know, Hey, we want this to be successful. You know, what, what are some, what are some ideas, when you mentioned about the dangling feet, my son has a home Rifton chair, which of course not everybody can just run right.
Speaker 1: Run out right now and get a Rifton chair. but while we were waiting for it to come in, some have some shoes come in like a bigger box than like a shoe box. Like you know how like some of your Nike’s or your hiking boots come in like a thicker box. you might want to try that if they are going to sit in and say a typical chair to, you know, cause they’re little, they’re feet floor. yeah, no, there’s definitely different like boxes or surfaces that, I’m trying to think of what else we use to keep him. cause she told us that works with the, he doesn’t have the core strength either too. It takes a lot of code, something that we kind of take for granted. We don’t realize how much core strength it’s takes to sit there with your feet dangling. And if you don’t have it, it’s very distracting. Yeah.
Speaker 3: it’s another thing to just think about, you know, as much as possible having to eliminate for your child, them having to hold up their body against gravity because that is just another way of tiring their body out. so, you know, again, is there, you know, if they’re sitting on their bed, do they get to like, lean up against the wall Like do they have some sort of surface for support you know, because between that and the fact that our eyes are just getting exhausted by the zoom calls, it’s kind of no wonder that, you know, like, Oh my God, you know, I can’t focus on my teacher’s voice or I can’t focus on what they’re saying because my body is doing this to hold myself up and I’m trying to not, you know, my eyes are blurring and all, you know, all that stuff.
Speaker 1: Right. and I know that schools in particular tend to get a little uncomfortable when you talk about recording anything, but zooms or whatever modality your school is using to have these classes are really set up. Like, it’s so easy to record whatever it is. whether it be a class or you know, a therapy session, you may want to approach them about that and let them know that you’re interested in recording it because it twofold. one is that if your child fatigues 20 minutes into the 30 minute session, you can keep it going, but also for the kids who have to relearn and be retaught and review, review, review, you have the recording of that class and they can watch it, you know, they can watch it as many times as they need to.
Speaker 3: Yeah. At my own district, it’s funny you say this because literally like an hour ago, I got an email from my own district that said that they didn’t wants to talk to parents about doing the recordings of these for exactly those reasons. Yeah.
Speaker 1: And I get it. I mean, you’re talking about you’re putting cameras into the homes of every single kid in the district and now you’re talking about somebody wants to record them. So I, I get it. You know, like why people are uneasy about it, but it’s an accommodation that’s, I mean, it’s so simple that looked like, let’s figure out a way to make it work. Because again, for the kids who need to rewatch it, I mean, what easier way it’s just like kind of like built in tutoring, just listen to it again and again or watch it again and again.
Speaker 3: And by the same token, what I would say to parents is because this is such a normal and natural part of birth to three early intervention and yet it doesn’t really happen in any other modality anymore. so I always have family sending me videos like all the time. So if there’s something that they’re doing with their piles or something, you know, great that they want to show me or some moment, you know, and that’s part of our progress monitoring is I get, I get those videos and so, you know, taking a video or if there’s something that you would like to be able to show the other therapist about like look, you know, look what we did. You know, or like we were working or even like, you know what I was working on this can opener thing with him and it didn’t work.
Speaker 3: You know, like I wanted to show you and trying to like actually show them the therapist can then actually even just watch and give feedback or be like, that was, that was great. And it also helps them to have some more tangible feedback about something that’s working right by the child. Right. And by the same token, if it’s, you know, I don’t want to dwell on the negative, but if it’s something that’s not working, that is, you know, say in your child’s baselines or in your child’s present levels that says, you know, that your child can do this and you’ve repeatedly asked them to do it and they’re unable to do it, take a video of whether, you know, whether it’s reading a passage or you know, writing their name or whatever, you know, whatever that task or skill is. you know, and you have the video and say, you know, what am I doing wrong here because I’ve asked him to do this and you know, his, your data says he can do it.
Speaker 3: I can’t, I’m not seeing it. We’re taking it. They’re taking picture or video of the environment shoe. Like, so if you’re not sure about the table and chair thing, for example, if it’s working for them, take a picture and send it to the therapist and they should be able to. Yeah. I mean, I found, I mean, my son’s team has over the past decade plus been great. but they just come, I mean, you guys just come up with these ideas off the top of your heads, like nothing. Like I honestly, I mean it’s definitely a while. Yeah. Yeah. Pretty cool. cause I actually went up to pick up some PT equipment from my son’s PT on Saturday at Devereaux. And, like I just like mentioned like a couple of things and she’s like, Oh, well if you do this and take the sofa cushions off the sofa and then do this and then do this.
Speaker 3: And it’s like she had the whole thing set up and I was like, okay, like, you know what I mean Like it just, it didn’t even tax her brain at all. She already like, I could just like literally see the wheels turning and she had solutions for me and she’s like, well, what kind of, what kind of couch Do you have the coat Does the cushions come off and are they square or are they, you know, and she had a, she had it all set up for us inside of your school based occupational therapist and physical therapist is someone who has the same mindset as the people who saw your kids for early professional when they were really little. Right. And you just have to be willing to think about how to tap into that. Right. All right. Before we sign off or take any last questions, let’s
Speaker 1: see if there’s anything we missed.
Speaker 3: let’s see. Kim posted the article. Thank you. And yes, and actually that article literally quotes like a high school, high school classmate of mine. Yeah. Oh good. Yeah, that’s a really good article.
Speaker 1: okay. I will send out Jamie’s list that she sent me and I just looked and it’s
Speaker 1: don’t be alone, right I won’t tell you how many pages it is now. It was three pages but it’s, it’s bullet points. It’s easy reading. It’s stuff that you guys can implement at home. I’m actually pretty excited about it. I was feeling pretty flat this week cause I was like, Ugh, you know, it’s week is this week eight, are we ending week eight or starting week eight, whatever it is. I don’t know. but yeah, I was feeling pretty flat and now I’m like, Oh that’s right. Zero to three. We used to do this and we used to do that. So, I’m kind of excited about implementing some of these things again. So are any, any last words you want to say
Speaker 3: or just any final, final thoughts Not last for being easy on yourself. Don’t do anything unless it’s going to work for you, the child, I don’t know in your house. And just really, again, just focus your priorities and check in with your child’s therapist and see how they can use their expertise on your child to help you, the expert on your child. Great.
Speaker 1: Okay, well thanks so much everyone for tuning in. As usual. It’s my plan within 24 to 48 hours, I kind of gather all the resources that we talked about and I put it in a blog post with the video and a transcript and send it all out so that you all can revisit what you need to revisit. So thanks for tuning in.
Speaker 3: Thank you everyone. Thank you so much, Lisa, for having me. Pleasure.