The Power of Coregulation and Connection

Have you ever had a hard day and felt better after venting and connecting with a friend or family
member? You were coregulating and it shouldn’t come as a surprise that your kids need that too!

Coregulation is a process by which adults and children regulate their emotions and behaviors
together. While adults are able to manage their emotions and “use their words”, children are still
learning this skill! When a child becomes overstimulated or overwhelmed by emotions, they
can’t access the logical part of their brain like an adult can, meaning they lose the ability to use
words or learned coping strategies, resulting in a meltdown. In a meltdown, children are not
always “hearing” what is being said to them; they respond more to body language and facial
expressions versus words or prompting. A meltdown isn’t the time to control or dictate a child’s
behavior, but instead is a time to create a supportive environment where the child feels safe and
understood. By focusing on connecting with the child, we can help them manage their emotional
and physiological state.

Why is Coregulation Crucial in Occupational Therapy?

  • Building Trust and Security: Coregulation provides a consistent and responsive relationship that builds trust. When a child feels secure and understood, they are more likely to be able to participate fully in therapy sessions.
  • Enhancing Emotional Regulation: Through coregulation, children learn to recognize and manage their own emotions. It is important for the trusted adult to model appropriate responses and coping strategies to help the child develop their own tools for managing stress, frustration, or even excitement.
  • Facilitating Engagement and Learning: When children are regulated, they are better able to focus, follow directions, and participate in daily activities. Coregulation helps to create an optimal state of arousal where children can be both calm and alert, making learning and skill acquisition more effective.

How Can I Use Coregulation At Home?

  • Modeling Calm Behavior: By remaining calm and present, you can provide a model for children to emulate.
  • Using Sensory Tools: Incorporating sensory activities like weighted blankets, calming music, or bubbles can help regulate a child’s sensory system.
  • Responding to your child’s cues: Pay close attention to your child’s cues and adjust activities to support their needs. For example, if you can tell your child is already frustrated, it’s probably not the best time to ask them to learn or practice a new skill!
  • Have empathy: Remember that your child doesn’t WANT to have a meltdown. It is their attempt to connect and get help the only way they know how to in the moment. They are still learning and are doing the best they can!

By Michelle Beckwith, OTR/L

Handwriting Readiness

Handwriting readiness is a crucial part of a child’s development, involving fine motor and visual motor skills, which are essential for writing and dressing skills, like buttoning and zipping, that support their overall participation in school and activities of daily living. 

Fine Motor Skills 

Fine motor skills involve the small muscle movements in the hands and fingers that allow children to hold and manipulate writing tools effectively.

Children’s grasp of writing tools will change as they grow. By 4-5 years old, most children should be using a more mature grip. Here’s a timeline:

  • 1-2 years: Fisted grip (holding with their whole hand).
  • 2-3 years: Digital pronate grasp (holding with fingers pointing down, thumb up).
  • 3-4 years: Static tripod grasp (holding with three fingers, but using the whole hand to move the pencil).
  • 4-5 years: Dynamic tripod grasp (using three fingers with wrist and fingers moving independently for control).

Visual Motor Skills

Visual motor skills are essential for using scissors and making pre-writing lines, as they involve coordinating what the eyes see, with how the hands move. 

Children typically begin using scissors around 2-3 years old, starting with simple snipping. Here’s a timeline:

  • 2-3 years: Snipping paper and cutting along straight lines.
  • 3-4 years: Cutting out simple shapes like circles and squares.
  • 4-5 years: Cutting more complex shapes

Practicing pre-writing lines is crucial before learning handwriting because it helps children develop the fine motor skills and visual motor coordination needed to form letters and write neatly. Here’s a timeline:

  • 2-3 years: Scribbling and imitating horizontal lines, vertical lines, and a circle
  • 3-4 years: Copying simple lines, a circle, and imitating a cross
  • 4-5 years: Copying a square, cross, triangle, diagonal lines, and an ‘X’

Fun At-Home Activities to Boost Your Child’s Visual and Fine Motor Skills

  • Practice drawing pre-writing lines, shapes, and letters in sensory bins filled with rice, shaving cream, or sand
  • Use playdough or wikki stix to create different shapes, lines, and letters
  • Use broken crayons when coloring/drawing to help initiate a proper grasp 
  • Use large or small beads to string on a shoelace, pipe cleaner, or string
  • Rip paper to make crafts at home and practice opening and closing markers and glue sticks

By Allie Calcagno, OTR/L

Summer Themed Activities for Speech and OT 

Summer is finally here! We are excited to share some summer-themed activities you can enjoy with your child. These activities offer therapeutic benefits, helping your child work toward their goals while still enjoying the summer season. 

Ice Cube Animal Rescue 

To do this activity, put little plastic animals in an ice cube tray, fill it with water, and freeze it. Gather some tools found in your home to break the ice and rescue the animals. For example, use a small hammer to break open the ice, tongs/tweezers to pull the animals out, or an eye dropper with warm water to melt the ice. Use the tools to break and melt the ice more quickly. Once all of the ice melts, you have rescued the animals! 

To target language goals, talk about the animals using descriptive language. Describe the animal’s appearance, where they live, and the sounds they make. Use language like, “Oh no, we need to rescue the animals,” “The animals are stuck,”  “It feels very cold,” “This animal is really fast,” “That animal has cool stripes,” etc. 

To target occupational therapy goals, use a variety of tools, as mentioned above, to work on hand strengthening, force modulation, and grasping patterns, which will contribute to your child’s overall fine motor development.

Use your imagination with this activity! If you do not have little animals, you can freeze other mini objects or toys, little craft pom-poms, etc.

Fun with Chalk 

Use sidewalk chalk to draw pictures to target both speech and language goals! Draw pictures and practice speech sounds your child works on in speech therapy. For example, if your child is working on “s,” draw a sun, a bus, an octopus, ice cream, etc. Play pictionary! Take turns drawing pictures and guessing the drawing. Use language to describe colors, patterns, etc. Drawing with chalk is great for developing fine motor and visual motor skills as well! 

Make a sensory path! Use sidewalk chalk to create a series of guided movements to challenge your child’s gross motor skills while providing regulating sensory input. These movements could include anything that involves running, jumping, skipping, spinning, or balancing. 

For example, start with a two-foot bunny hop, then walk along a curved line, trying to maintain balance. From there, do an animal walk, such as a bear walk or frog jumps, followed by a hopscotch sequence. Then, balance on one foot for 10 seconds and end with a race to the finish line! Get more inspiration on Pinterest or Instagram!

For an added challenge, have your child create their own sensory path to work on executive functioning skills such as planning and organization. See how creative they can get!

Scavenger hunt

Get outside and look for items in nature that are a specific color, texture and/or size! For example, look for something pink, yellow, bumpy, smooth, crunchy, etc. This simple activity can target skills such as describing, following directions, and increasing vocabulary. It is also great for tactile sensory processing, for example, exploring and discriminating between textures. Scavenger hunts can also help your child develop visual perceptual skills, such as finding differences between items and scanning through a busy background to locate an item. 

By Nathalie-Rose Malecot, MS CCC-SLP and Jamie Carlson, OTR/L

Poop is a funny word:  Resources for Toileting

Toileting, or as more commonly known as potty training, can be a challenging endeavor for children. Toileting is a complex task which requires many skills such as executive functioning skills including sequencing, sensory processing skills such as interoception, motor skills such as reaching and grasping, balance, dressing skills and so much more. However, occupational therapists are here to help with this challenge. Throughout this post, there will be a multitude of different books to read with your child to help improve their ability to toilet! 

The first few books cover the science behind using the bathroom, exciting stuff, right? Well, using books to break down a basic task can help a child understand the process a little bit more and why it is important for our bodies. 

“From Chewing to Pooing: Food’s Journey Through Your Body to the Potty” by Lauren Gehringer & Dr. Natalie Gehringer

The first book is called, “From Chewing to Pooing: Food’s Journey Through Your Body to the Potty” by Lauren Gehringer & Dr. Natalie Gehringer. This book talks about digestion in a fun way for children to understand. A child may feel fear surrounding using the bathroom, so learning more about the task can ease toileting anxiety. 

“See Inside Your Body” by Colin Daynes and Katie King

The second book titled, “See Inside Your Body” by Colin Daynes and Katie King is a book to help children understand the organs involved with digestion. The more children can understand the process of digestion, the less pressure there may be surrounding using the bathroom. It also contains a lot of fun flaps to lift up and down to learn a little bit more about the body. Through learning more about the body, children can better understand interoception. Interoception is the sensory information people receive from their organs that lets them know if they are hungry, thirsty, sick, or need to use the bathroom. 

“My Body Sends A Signal: Helping Kids Recognize Emotions and Express Feelings” by Natalia Maguire

The next book helps children learn more about interoception. The book titled, “My Body Sends A Signal: Helping Kids Recognize Emotions and Express Feelings” by Natalia Maguire teaches about the body sending us different messages and what these messages might mean. While this book focuses a lot on bodily cues related to emotions, it is still a valuable book for children to explore to learn more about how their body can send different signals such as their belly hurting or feeling like there are ‘ants in their pants’. 

“It Hurts When I Poop: A Story for Children who are Afraid to Use the Potty” by Howard J. Bennett, M.D.

The last two resources or children’s book shared in this blog post focus more on constipation, which is the build up of hard stool inside the colon that is difficult to pass. Constipation is a common problem that affects a lot of children. Some children may find using the toilet aversive because of constipation. So here are a few books below to help a child defeat the potty time blues.

The first book is titled, “It Hurts When I Poop: A Story for Children who are Afraid to Use the Potty” by Howard J. Bennett, M.D. In this book it follows a main character who experiences constipation in an easy to understand format for kids. It also includes a “poop program” for parents to help their child through this process. 

“I Don’t Want to Go To the Toilet” by B. Annyne Rothenberg, Ph.D.

The last book included in this post is titled “I Don’t Want to Go To the Toilet” by B. Annyne Rothenberg, Ph.D. which is a great guide for parents to use throughout the process of potty training, especially if there is a youngster who is having a hard time with this skill. 

For more specific information regarding your child’s toileting success, reach out to your child’s occupational therapist. We are here to help, even if it stinks!

By Kat Danella, OTD, OTR/L

Childhood Occupations and How OT Supports Them

April is Occupational Therapy Month!

April is occupational therapy month! It is a month to celebrate occupational therapists and their work to make a difference in the lives of their clients. In pediatrics, occupational therapists support kids in the various occupations that they engage in. 

In occupational therapy, occupations are anything clients value and spend their time doing to make their lives more meaningful. In pediatrics, these occupations generally fall under the following categories: 

Activities of Daily Living (ADLs)

ADLs are basic self-care activities that include feeding, bathing, getting dressed, toileting, and more. The expectations regarding these activities change as a child grows. Still, through play and fun activities during our sessions, pediatric OTs work on supporting a child’s independence in age-appropriate activities. 

Instrumental Activities of Daily Living (IADLs)

IADLs support independent living skills in the community. These activities include meal preparation, chores, and transportation, to name a few. Supporting the skills needed to complete these activities is essential for a pediatric OT. 

Rest and Sleep

Rest and sleep are essential occupations that support children and their development. If they aren’t getting appropriate sleep, they can struggle to maintain a proper level of arousal to support engagement with their other occupations. Occupational therapists can help families set up a sleep routine and meet sensory needs for appropriate sleep, among other things. 

Education

Education consists of being able to engage in a variety of learning activities. OTs support skill-building and environmental adaptations to allow children to access their education to the fullest extent possible. 

Play

Play is the primary occupation for young children. They learn through play and build a majority of their skills through play. Occupational therapists help children engage in meaningful play and support their self-regulation skills through play. As pediatric OTs, play is the primary way we treat and engage with children. 

Social Participation

Social participation is another primary way children interact with their environment. It is how they interact with their peers and those around them. OTs support a child’s regulation and skills to engage in appropriate social participation. 

Occupations are not just work; they play a significant role in everyday life for everyone, including children. During April, if you encounter an occupational therapist, thank them for helping their clients engage in meaningful occupations and activities. 

References: 

American Occupational Therapy Association. (2002a). Occupational therapy practice framework: Domain and process. American Journal of Occupational Therapy, 56, 609–639. https://doi.org/10.5014/ajot.56.6.609

By Erin Christensen, OTD, OTR/L

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