Catching Some Z’s

Sleep is extremely important for one’s mood, growth, and overall wellbeing, but sometimes counting sheep just isn’t enough to fall asleep. Falling asleep can be particularly challenging for children with sensory processing differences, developmental delays, or Autism. Working with your family, occupational therapists can develop an individualized plan to help your little one fall asleep and catch some Z’s.

Why Isn’t My Kid Falling Asleep?

Sleep can be challenging for multiple reasons including:

  • Sensory Sensitivities and Overstimulation: Your child may have heightened or under-responsive sensory processing, which means they can be overly sensitive to certain sights, sounds, textures, or even smells. These sensory sensitivities can make it difficult for them to relax and fall asleep. 
  • Difficulty Regulating Emotions: The transition from daytime and play to nighttime and bed can be challenging for those learning calming strategies for when transitioning can be challenging. Changes to routines from earlier in the day or known changes in future routines can also impact a child’s stress and ability to navigate through challenging emotions before they can calm to fall asleep
  • Medical Issues: Gastrointestinal problems or other sleep-related disorders such as sleep apnea could also be negatively impacting your child’s ability to fall asleep and stay asleep (Consult with your child’s pediatrician to rule out any medical issues that may be affecting sleep.)

How Occupational Therapy Can Help

  • Developing a Bedtime Routine: Having a routine helps kids wind down for the night. They know what to expect and don’t have to use additional brainpower to go from one step to the next.
  • Creating a Sensory-Friendly Sleep Environment: Occupational therapists can coach you to make your child’s sleep environment the best for them. That may mean using a sound machine, looking at the fabrics of both the child’s clothes and the sheets, and incorporating calming sensory supports prior to bedtime.

Final Thoughts

If your child is experiencing difficulty falling asleep, reaching out to an occupational therapist may be a valuable step towards finding a solution that works best for your family. With the right support, restful nights and more manageable days can be within reach.

By Lauren Fong, OTR/L

Tips For How to Use Books to Target Speech and Language Goals

Life with children can be so busy, sometimes it feels like there’s not enough time in the day to work on speech and language goals. I have a great solution – BOOKS! Books are everywhere! I bet you’ve seen books in the dentist’s office lobby, your child’s pediatrician’s office, schools, and maybe even all over your child’s room! As a speech pathologist, I’m constantly grabbing and using books in my speech therapy sessions. Whether it’s associated with the time of year, a holiday, or just to use a book that is loaded with actions, books are an incredible resource to support your child’s speech and language development. Now, taking a book and putting it into practice whether that’s working on speech sounds, questions, perspective taking, etc. can feel daunting. Let’s make it simple, practical, and of course, FUN! Here is a list of my top 3, go to books, how to work on a variety of goals, and keep your child engaged throughout the process.

Go Away Big, Green Monster

1. Language:

  • Words have POWER in this book! What your child says goes, if they say “go away!” POOF, it’s gone! How cool is that cause/effect relationship!
  • Early language, Core word: “go,” this can be a sign, vocalization, word, etc
  • Identify: work on identifying body parts on the monster
  • Descriptions: big, green, purple, squiggly, etc.

2. Speech sounds: /g/, “go,” “big,” and “green”

3. AAC Device:

  • TouchChat WordPower 60 page set has this book programmed into the device!
  • Go to Read>Early books>Go Away Big, Green Monster

Where is Spot?

1. Language:

  • Yes/No questions, “is this Spot?”
  • Actions: knock knock, “open” sign
  • Answering “where” questions
  • Labeling animals, furniture, etc
  • Using prepositions
  • Animal noises associated with each animal
  • Gestalts:

– Let’s open it

– It’s not Spot

– What’s inside?

– It’s a X (label animals)

– What’s next?

2. Speech sounds:

  • /s/ blends (spot)
  • Multisyllabic words: honey, monkey, alligator, hippo, puppy, mommy, etc

3. AAC Device:

  • Model language on the animals page after opening each door

Little Blue Truck


1. Language:

  • Imitation and use of animal and environmental noises! “Beep!” “Croak,” “Neigh,” “Cluck,” etc
  • Identifying and/or labeling of animals
  • Variety of questions such as “Where are they going?” “Where are the animals?”
  • “What happened to the truck?”

2. Speech sounds:

  • Final consonants: beep, dump, honk, toad
  • /l/ (little, blue)
  • /k/ (truck, stuck, duck, honk, cluck, cow)

3. Rhyming

  • Great book for phonological awareness!

Next time your child brings you a book (or five), to read before bedtime, try to use a tip that best
resonates with you and your child’s needs! Happy reading!

By Brie Russell, M.S., CCC-SLP

My child was just diagnosed with autism spectrum disorder… Now what?

Step 1: Take a deep breath!

Learning that your child has been diagnosed with Autism Spectrum Disorder, or ASD,
can understandably flood parents and caregivers with a range of overwhelming emotions.
It’s easy to feel trapped or condemned by a label. When the “what ifs” start to invade,
remember that this new information does not change who your child is or who you
already know them to be. It is simply an identification of a root cause for various
symptoms and the first step to helping your child reach their full potential.

Step 2: Free your child (and yourself) from expectations

Following a diagnosis of ASD, it is common for parents and caregivers to experience a
period of mourning for “normality” and feelings of uneasiness when thinking about the
future. However, the new diagnosis is not a predictor of the future, let alone a sentence to
a life of failure or unhappiness. Taking one day at a time and celebrating any progress,
no matter how small, is key in cultivating both acceptance and a sense of hope.

Step 3: Advocate for your child

With a new diagnosis comes a plethora of recommendations from medical and school
professionals. Always remember, though these recommendations are backed by research
and have been proven to help, you have the final say in your child’s treatment. Though
30 hours of therapy per week might be recommended, you may feel that is too much. Go
with your instinct! Your child’s team of professionals will work with you to ensure the
best possible treatment to match your child’s individual needs.

Step 4: Find community

No one has to face the journey alone! Consider joining a virtual or in-person support
group for parents and caregivers of children with Autism, or an online forum. Sometimes
well-meaning family and friends can misunderstand and unintentionally cause more pain,
so it can be important to connect with people who do understand. Autism Society San Diego offers both support groups for parents/caregivers and fun events for the entire family. Military families can take advantage of the Exceptional Family Member Program
(EFMP) for a range of family support. When in doubt, meetup.com is a great place to
start!

Step 5: Take care of yourself!

Self-care is often placed on the backburner when caring for a child who has an ASD
diagnosis. However, burn-out is not only emotionally draining for you, but is also
unhelpful for your child. It’s important to seek Respite Care services if you don’t have a
friend or family member to babysit while you take time for yourself to recharge. In
addition, pick your battles with your child. Rome wasn’t built in a day, so anticipating
immediate results and/or perfection can contribute to high stress levels.

Checklist, in no particular order:

  • Developmental evaluation (medical) through your doctor or San Diego Regional Center. It is important to get a medical diagnosis, not just an educational label
    through the school district. This is not the same as a formal diagnosis.
  • Speech therapy (medical/outpatient)
  • Occupational therapy (medical/outpatient)
  • Behavioral therapy (e.g., ABA) (in home or in facility)
  • Apply for school services at age 2 and 10 months to begin at age 3. This will determine eligibility for services through the school district such as, speech
    therapy, occupational therapy, and behavioral therapy. Your child can receive these therapies in both the medical and school setting, as medical and educational
    services are autonomous from one another.

Written by: Kat Winger, MS CCC-SLP

What is Pediatric Occupational Therapy and how would I know if my child would benefit?

Occupation refers to functional tasks or activities that bring meaning to your life. And our children’s main activity is PLAY. Did you know that kids play to learn and that play requires motor, sensory processing, cognitive, and social skills? All these skills work together for learning. However, when the necessary skills for play are observably difficult, it can make grasping new competencies challenging for kids.

Occupational therapy addresses all the skills needed for play. It works on strength, coordination, and control to support their movement. OT also helps with sensory processing difficulties by identifying the way your toddler receives or responds to sensory input and teaching fun ways for you to support your child. And finally, Occupational Therapy promotes executive function skills building on motor, attention, and regulation foundations for learning.

Though play can look different and vary from child to child, there are general toddler development skill ranges necessary for learning to happen. When these are not progressing or missing, they can inhibit engaging in and learning through play.

The development of sensory processing and motor skills begins immediately at birth. The brain is where all the magic happens. Newborns take in sensations, but their body is unable to organize them—their reflexes are neurological responses to stimulation, including the senses of light, sound, touch, or pressure input such as stroking and vestibular sensory input with sudden movement.

The sensory processing and motor skill development looks random and clumsy at first with the baby’s initial kicking of their legs or trying to find their mouth with their hand. As they continue to be exposed to the sensation and repeat the movement, it becomes more purposeful.

Babies are holding, pulling, pushing, and dropping toys as they learn about cause and effect. More and more skills work together to explore and learn through play.

For your toddler, the years from 1 to 3 are very busy. They are essential years of curiosity, trial and error, and learning about what they can do. At age one, toddlers are very active. Give them a container, and everything comes out; maybe a few things go back inside. Set something on the table, and they pull up to see if they can get it. They make sounds and babble and may tug on your heart with Ma Ma or Da Da words!

Toddlers are in a transition of building more independence. During the terrible twos, a stage that everyone stresses about, they continue to learn about their environment, manipulate things, and communicate their experiences. Their development takes all the work that the baby’s brain and body did and uses it in play to build confidence, control movement, and explore new sensations. Toddlers experience big emotions. They must learn about these feelings and how their body responds to them. How we react and support them is important.

They also learn to transition from one activity to another, even when they don’t want to.
For example, two-year-olds usually can stack a few blocks, string a few large beads on a shoelace, feed themselves with a spoon, drink from an open cup or a straw, remove/pull on clothing, brush teeth, help wash their body at bath time, jump, run, and walk up and down a few steps. They can also throw a small ball toward a target, help clean up, and put toys away. Though the terrible twos try on parents and toddlers, they don’t last long. And both parents and kids learn a great deal!

As we strive to develop more patience during these times, our toddlers are growing far more in their quest for independence. Two-year-olds should be able to attend and learn a new play activity for 4-6 minutes. Some research even suggests that this age group should be able to focus on a task for 10 minutes.

Though many toddlers can sit and play for extended periods of time with preferred toys or activities they have initiated themselves, a better learning opportunity is to give them a new task to work on to develop manipulation skills like using a tool to scoop, fill a container, feed themselves with a spoon or fork, stack or build with blocks, lace beads on a string, or roll a ball back and forth.

Notice how your child works through activities. When development is not smooth, there will be clues in how your child moves, plays, speaks, or acts. See if you observe any of these challenges:

  • unable to manipulate toys in play, they continue to dump, empty containers, or throw them around the room
  • difficulty using tools to scoop, squeeze, hammer, draw
  • unable to demonstrate repetitive play activities. May run around, only roll the car back and forth
  • moves between many play activities quickly, not engaging in any of them
  • requiring or demanding your attention and unable to initiate or engage in play by themselves for short periods
  • difficulty imitating actions in movement, imitating mouth or tongue movements, silly faces, or being unable to throw a ball at a target. Difficulty moving from sitting to moving under structures, crawling through a tunnel
  • unable or very clumsy with jumping, climbing, moving between different level surfaces, climbing ladder to slide
  • unable to take turns in play activities such as rolling ball back to you, stacking blocks
  • seems fixated on the television, tablet, or phone and unable to engage with other toys in play
  • difficulty putting things together such as connecting blocks, lacing, and beads
  • unable to tolerate play on a swing, on a slide
  • unable to play near or with other children
  • unable to tolerate tactile messy play or engagement with media like play-doh, finger paint, or shaving cream
  • difficulty removing pull on clothing from dress-up activities

Play is one of the most significant areas that can provide clues about your toddler’s development. As we’ve outlined, there is so much growth happening during this time. If you see your child struggling in any of the areas we mentioned, occupational therapy can help develop and strengthen the skills needed for learning.

Occupational therapists are experienced experts and can help identify the areas inhibiting your child’s primary occupation and introduce fun activities for successful skill development.

Children are tiny individual humans with varied interests and gifts. We embrace and work together with parents to help children reach their greatest potential.

Come in and check us out in April for Occupational Therapy month!

Author: Pamela Vasiloff, OT

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