Occupational Therapy - What's in the Bin?

How about we start off 2015 with an old (really old) Occupational Therapy post? I promise to return with a full update and account of the girls Christmas.  

 

As Hazel grows and masters old skills, we change the activities we do in Occupational Therapy. Here are some of the toys that are in our OT bin right now.

Hazel really does well when sitting to do these activities are part of her regular routine. We try about 3-4 days a week minimum. Sometimes we sit for 5 minutes, some times for 20. Sometimes we do all the activities, sometimes we do one. I really try to make it a fun experience for both of us. That being said, sometimes I take her out of the chair immediately after I put her in. You gotta know when to fold em'.

Hope this helps!!! Any DS parents out there that wish to share their ideas, I would love to hear them!!! Post a comment or email me!!!!

Gift Guide for Therapy Toys

Seeing that it's Christmas time, I thought I would put together a gift guide. I can't believe it's well into December already!!! We, fortunately, are done our holiday shopping. I'm feeling very thankful to have this month to spend just enjoying our family and friends. May your cup runneth over this holiday season. And I probably mean with eggnog and rum, but love and peace works too.  

For those of you who still have some last minute shopping to do, I thought I would try to help. Hope these toys will work for someone on your list. Here are some of the toys that we have been using during therapy time with Hazel. These are mostly Occupational Therapy toys.

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Buying toys I always look for 3 qualities.

1. Developmental skills

2. Longevity

3. Fun

Keep this list in mind when buying for the kiddos on your list this year. These toys are not only great for children with Down syndrome but any child. These are skills all children will need to practice and toys that they will enjoy!!!

Lacing Beads

We started with the wooden spools and the big beads in the first set. Then we moved to the string lacing set. I did take some electrical tape and reinforce one end of the string to make it easier and more firm for Hazel to grasp.

Play doh

So many things you can do with this inexpensive toy. Also, make your own and it's even cheaper. We hide little objects or animals in the Play doh and Hazel digs them out.

Puzzles

Large peg puzzles are a great way to start and move onto the smaller pegs. We also use the puzzles that the doors open (hide and seek barn) and the latches board.

Lift Flap Books

ANY BOOK with lift flaps will do. Helps children to learn to isolate their finger to manipulate objects.

Duplo Lego Sets/Mega Blocks

Love these for pulling apart, building, and pretending.

Blocks

These are the best!!! Can be used for building, stacking, spelling. These will be around for a while.

Colouring/Crafts

We try to get Hazel to do this often. Practice with grasping the markers, working on her grip.

Sensory Play

We have not yet attempted this sensory activity yet. Hoping to get this from Santa!!! It was recommended by our Occupational Therapist as a great sensory play toy.

Pretend Play

Baby dolls, kitchen set, cupcake making set, the list can go on. Use whatever toys your child is interested in. We use a lot of Little People toys.

Slots

We use so SO many different toys for this skill. I feel like it takes a multitude of toys to master this skill. Each toy offering a different way to turn your wrist and put the item in the slot. We use buttons in a peanut butter jar, coins in a small plastic container, the fisher price pig, and on and on.

Hand Strengthening - OT & Down Syndrome

Down Syndrome Awareness Month continues. I thought I would share an OT post. Hope it's helpful. We do Occupational Therapy (OT) with our daughter Hazel. Click here and here to find out more about what OT is and what we do here in our home. It's important to note that I AM NOT AN OCCUPATIONAL THERAPIST. I am just a mom who works closely with one and listens to everything she has to say like it's the bible. I strongly encourage you to speak to your child's OT before trying any of these activities to make sure they are a good fit for your child.

 

Sometimes children with Down Syndrome experience low muscle tone. One area this can affect is their hands, making it difficult for them to manipulate objects.

I always hesitate to add an age to these posts because every child develops individually. We have been doing this one for a while and will continue to do so as she grows. As she gets stronger, I will find more challenging objects for her to pull apart.

2 OT activities we do that target Hand/Finger Strengthening.

1. Pull Apart Toys

Here are a couple of things we use. We also use MEGA blocks, bristol blocks, snap beads and pretty much anything that links together. Some are easy to pull apart and some a little more challenging.

2. Play doh

I hide objects in the play doh and she digs through to find it. She also likes the feeling of it so she squeezes it and manipulates it with her hands.

There ya go!!! Too easy.

Occupational Therapy - What's in the bin?

  When Hazel and I do OT (Occupational Therapy) I like to have her sit in her high chair so that she gets used to more of a structured activity time. We are kind of always doing OT when we play just by doing puzzles, snap beads, pull apart activities, eating, dressing, reading etc. But I find that it's easier to introduce new skills and activities when her and I can both focus on one thing at a time. Once she has mastered the skill I take the toy and put it in "gen-pop" (general population with the rest of the toys).

Also, I try to give her as many different ways of doing the same thing that her therapist and I can think of (most of these ideas are her therapists. I just try to find things around the house that reinforce the concepts). For instance, building blocks. She has several different shapes, sizes and colours that she can practice with. Specifically, mega-blocks, bristol blocks, counting blocks, ABC blocks etc.

Here is what is in our OT bin at the moment:

We work on all these activities together. We try everyday but more realistically its probably 3 to 4 times a week.

We use the containers to put the toy into that we are done with. It's important to offer her a place for them so that she doesn't throw them everywhere. OT can be very messy....Yikes!!!

The little people toys are for teaching animal sounds or to use while we read books with the corresponding animal. Girlfriend likes props!

Play-doh for hand strengthening and putting pegs into. Sometimes we sing songs and make it into different shapes. For example, "Patty Cake". We roll it, pat it, and so on.

The textured surface for colouring just makes it more interesting because of the sounds when she colours.

As always I encourage you to share "what's in your bin?" I love to hear your ideas, thoughts, comments, questions. Please leave a comment!!!

Down Syndrome - Our Top 10 Therapy Toys/Tools

I have always been interested to hear what types of therapy activities parents are doing with their kids with Down syndrome. There is such a vast array of options out there and I love to learn and experiment with Hazel. I like to have ideas to discuss with her PT (physiotherapist), OT (occupational therapist) and SLP (speech and language pathologist). One thing I have learned raising a child with special needs is that it truly does take a village. This post was inspired by my love for learning new activities to try and help my girl reach her full potential. I'm hoping this gives you some ideas to bring to your next therapy session to find out if these activities might work for your children.

Please feel free to share your ideas and activities in the comments of this post. I would love to hear from you.

 

1. Big Ol' Piece of Foam (PT & OT)

A piece of very firm foam that's about 2 feet x 2.5 feet. We used this for almost everything (kneeling, sitting, weight baring on arms, reaching, playing and standing). I know this could be tricky to get but ask around I am sure you will find it somewhere.

2. Mirror (PT & Speech)

We used this to encourage Hazel to sit, balance, reach, and TALK TALK TALK. She loves looking at herself and hearing her voice.

3. Baby Signing Time (Speech)

These DVDs are great for introducing common signs to your toddler. I find that as long as I use them in her day-to-day routines she learns them in context. They are an excellent tool to teach me the signs so I can use them to communicate with her.

4. Flap Books (OT & Speech)

5. Large Peg Puzzles (OT)

6. Pegs (OT)

7. Blocks (OT)

Stacking anything is the idea. It doesn't have to be blocks but this is what we use. We also use nesting cups, books etc.

8. Piggy Bank (OT)

Anything that has a slot and something to put into the slot is a winner here.

9. Push Toy (PT)

We used this toy for the longest time. We started with reaching, then kneeling, then standing, then walking. It really is a great investment.

10. Exercise Gym (PT)

We used this for standing and shifting weight on each leg. Then we used it to get her to cruise around the outside when she was bigger. Also, we used it for pulling to stand. We used this toy for a long time so I think it's definitely worth the investment.

So these are 10 of our favourite tools to use in therapy. To read more about what else we do check out my older posts here.

Also, don't forget to take a second to share your ideas or activities that you do with your children in the comments of this post. Also, feel free to ask any questions you may have!

Wishing you all success in your current and future therapy ventures!

6 Occupational Therapy Activities - Down Syndrome

 

As I have mentioned in the past we do 3 different types of therapy with Hazel on a regular basis:

1. Occupational therapy (OT)

2. Speech therapy

3. Physical therapy (PT)

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This post will focus on OT. To learn more about OT click here and here. Also, there is a great book I mentioned in my last PT post called, "Fine Motor Skills in Children with Down Syndrome." Between the help we get from our OT and this book, I feel I have a really well-rounded idea as to the skills Hazel needs to work on.

As I mentioned in the PT post, Hazel is very focused on gross motor development at this stage. She is walking, dancing, balancing and in her opinion, all that leaves little time for her to sit still and build a puzzle. We all have our challenges.

OT has become an extremely trying experience on a daily, although lately it seems to be looking up.

She is into throwing her pegs, eating her puzzle pieces and walking away with everything. Some days I feel like a complete failure, others I feel success. Such is parenting I guess???

My goal whenever we do OT activities is to try and make Hazel think we are playing and that it’s a good idea.

I begin by creating a play circle. I take out a few toys that reinforce the concept or skill we are working on and scatter them around the room. I like to give her the option of which one she would like to play with by letting her explore and move to the toy that interests her. However, I think now I might have to put her in a booster chair on the floor because she is far to excited about the fact that she has control to get up and walk away from me now.

Usually, our OT sessions vary in length and take place several times a day or whenever we are sitting and playing together.

Here are some of the activities we do:

(oh yes...before I forget to mention, I must say that we do NOT do all these activities everyday. Only supermom could manage that...I mean, I'm close but I just can't find a cape I like)

 

1. Board Books

We are trying to encourage Hazel to turn the pages of a book. Also, working on manipulating flap or pop-up books. She has been working on getting only the one page to turn at a time as well as lifting flaps or sliding tabs.

I have tried:

• Putting tape tabs on each page for easy grip
• Hand-over-hand (less is more)
• Books that have “peek-a-boo” tabs and lift flaps (working on both object permanence and page manipulation)

2. Puzzles

Big knob puzzles are a winner in this house. Hazel loves them so we play with them often. Lots of modeling - taking pieces out and putting them back in. Again, I do hand-over-hand with her. She tries so hard to get them to go in the right spots. Circle is her favourite. She has been really working hard on this and making great strides. I'm super proud!

3. Pegs

Putting small pegs in a pegboard or even this Melissa & Doug peg toy. It’s pretty straightforward. No re-inventing the wheel on this one.

Pegs are not well received by Hazel. The absolute lost thing on earth she wants to do with them is put them in the hole. Throw - YES. Eat - Of course! Bang together and pull apart - ABSOLUTELY! But NO - never put them in the hole. Difficult to even get her to try.

Need a new plan. Any suggestions???

The pegboard our OT uses has a little bit bigger holes, which are outlined with a black sharpie marker. It makes it a little bit easier to see the target. She suggested we could use a piece of Styrofoam with handmade outlined holes in it. We haven’t tried it yet.

4. Toys with Slots, Pull Apart Pieces & Stacking Blocks

Piggy bank, monkey barrel, Alpha-pops, snap beads, Velcro veggies. We use any blocks we have and try to go from stacking big ones to smaller ones.

5. Self-feeding

We use the suction cup bowl and spoon that came with it (although I heard they have spoons that curve toward their mouth that I might try too). I try to give her something she really enjoys like ice cream, yogurt, oatmeal etc. It’s very messy but she’s getting better all the time. I also give her Popsicles a lot. She definitely knows her way around a Popsicle (and an ice cream cone). We do try the fork as well but I do A LOT of hand-over-hand with her to help her get the food on it. She’s good about bringing it to her mouth if it’s loaded.

6. Isolating the index finger

We have several toys that she needs to push the buttons on to get them to sing her favourite songs and this is great motivation for her. I put the toys out and she finds the buttons and off she goes. There’s usually a lot of dancing, clapping and smiling with this activity, so naturally it's one of my favourites.

Also, I give her blueberries and Cheerio’s to eat.

Small Disclaimer: I just want to remind everyone again that these activities were given to Hazel, for Hazel, by her OT. If you would like to try any of these at home with your babes, please ask someone in your local community for support and advice on what will work best for your children.

PT & OT for Children with Down Syndrome

Since Hazel started crawling our main focus for physio has been to encourage her to crawl as much as possible. We have not been working at all on bringing her to the next step which is walking (although she has her own ideas about standing independently and cruising). I am a huge fan of keeping her crawling for so many reasons.  

1. She's easier to chase after while crawling

2. She is getting so much more coordinated by strengthening all her muscles by using them often and equally.

3. She is acquiring a keen body awareness for all her muscles. Even down to the pincer grasp. It is coming along nicely since she is constantly aware of her fingers because of the constant weight baring through her arms while crawling.

4. She is easier to chase while crawling (Oops...already said that)

Small Disclaimer: I just want to remind everyone again that these activities were given to Hazel, for Hazel, by her OT and PT. If you would like to try any of these at home with your babes, please ask someone in your local community for support and advice on what will work best for your children.

Another Small Disclaimer: My intention for these posts is to provide ideas and information about OT, PT and Speech for anybody who feels compelled to learn or is interested in what it looks like in our home. It is NEVER to compare Hazel to other children. My favourite thing about kids is that they are all different and do things when they are ready and in their own time.

Also, we have stopped doing some of these activities and still continue to do others. Since she has started standing and cruising on her own we have added some new activities that I will include in the next PT/OT post.

The activities this time around speak for themselves...

 

1.  High Kneel on Couch

2. Pull to Stand & Cruising

We use anything that is the right height for her to pull up on. Actually she is good at scanning a room and trying her darnedest to pull herself on everything in it. (Who says "darnedest"?)

3. Bench Sitting

We have the toys within reach on either side of her so she has to turn and reach/lean down to grab the toy and bring it up to center.

4. Crawling...crawling...crawling

 

1. Self feeding with a spoon and fork

She does great with this as long as I load it for her. She is pretty proud of her self, actually!!!

2. IN & OUT

We practice with anything and everything. PRAISE!!!! Girlfriend can put things IN & OUT!!!

Here is a pic of the toy that really drove the concept home for her. She is obsessed!!!

3. Lots of listening to music while we play

Listening to music facilitates movement and also allows me an opportunity to add actions and signs that she is starting to learn slowly.

4. Working on early feeding signs

We are working on "more", "eat", and "drink." She has mastered "all done" and knows when to use it. The other are more difficult because she won't let me use her hands to show her how to do it. She just gets mad and pulls them away. (Same with loading her own spoon, won't let me guide her hand)

5. Pincer grasp

Like I said crawling has helped her a great deal with this. I just try to give her small pieces of food and try to encourage her to use her fingers to grab it. We are laid back about it but it is coming along. We are going to start using 1 inch cubes and smaller toys for her to try and manipulate them with her fingers.

Have a good week everyone!!!

PT & OT 9-12months (for Hazel)

First, I MUST share this video. It's the John McGivney Awareness Video, the facility where Hazel's therapists work. LOVE!!!  

Click here if having trouble viewing 

Amazing, right?

Ok...moving on...

This post is a medley of old and new(ish) Physical Therapy (PT) and Occupational Therapy (OT). I am working on a new post of activities from 12 months and up.

YIKES!!! Time fly's...Hazel grows and then we start new activities.

Hazel started to do these activities when she was 9 months. She is still working on some and has mastered others. As with all of my PT and OT posts, these activities have been approved by Hazel's therapists for Hazel, please check with a therapist in your local community before trying any of these activities with your children.

Occupational Therapy

1. In & Out

Hazel is working on putting objects in a bowl and taking them out. We use any big bowl available. I think maybe a metal one would be better so that when she drops something in, it makes a louder noise. Sometimes when I am feeling brave, we use a huge metal pot (side note: holy it's loud!!!) Any little toys work to drop in, links, cubes, pegs, balls. Hazel often has a hard time hearing anything drop in because she is constantly talking and babbling while playing. What is that saying - "you can't talk and listen simultaneously" - wait...did I just make that up? Oh, either way, you know....

She takes toys out of her bin, not so much put them back in. That's my job. I think she just wants to make sure my position as maid is secure. She's so kind and thoughtful.

2. Drinking/Eating

We are always working on eating and drinking. Hazel practices drinking out of a cup and a sippy-cup everyday. We try to encourage self-feeding by giving her pieces that she can pick up herself and put into her mouth. Her pincer grasp is not finessed enough for her to pick up really little objects like Cheerios, but she does well with penne noodles, crackers, bread and bananas (to name a few). Poor girl still has no teeth, so taking bites is difficult. When she gets the pieces into her mouth, she can't bite a piece off. Frustrating!

3. Rings

Put them on. Take them off. Put them on. Take them off. Put them on...

So that's that one.

Oops...that's cheating! You can't just dump them all, Hazel!!!

Oh yes...bang them together is another game she likes to play.

Physical Therapy

(these activities are not all we do, just some)

1. Weight Bearing on Arms

This one is a precursor to crawling. Here is one of the positions that works for getting her ready to push herself up in a 4 point. It is also encouraging her to weight bare on her arms. We try to get her to go from one side to the other. I find it easier if you hold a toy out for her to see, however, it feels like I need another hand to support her and hold the toy. You have to find what works for you.

When I move the toy in front of her, she follows along with it and sits looking forward and then I drag it to the other side and she leans to reach it. It's a tricky one!!! This was also great for getting her comfortable with putting herself in the sitting position. She would push herself back into a sit.

She would often shift her weight and would be in a 4 point stance for a couple of seconds, which was great to get her used to the crawling position.

2. High Kneel

This was my favourite PT activity (now she does it all the time on her own while she's playing)

It is easy and efficient for mommies and very effective in teaching backing in to a sit. It is also perfect for strengthening her arms by encouraging her to weight bare on them for a extended periods (by this I mean about a minute...maybe more if she was really into the toy that day). When backing into a sit she just pushes off the toy with her arms, leans to the side and goes down.

I would often switch up the tools we used to get her into a high kneel. Here she is leaning on a pillow or nursing pillow that is on top of the foam piece we have. Works perfect. Sometimes I would put her mirror in front of her so that she would stay there and talk to herself for a while.

At some point, she started going into this position and rocking. Crawl prep...

3. Crawling

Turns out this is the best PT there is. So, we just encourage her in which ever way motivates her that day to crawl around the house. Under the advisement of her therapist, we are not working on walking with Hazel. She is gaining so much strength in her arms, legs and core by crawling that we are just content to keep her doing that.

Speech Therapy

1. READ! READ! READ!

Lots and lots of reading. The same books over and over. We make sounds of animals, we point to the text. We start again...

Girlfriend is obsessed with books. She will sit forever with me and read. I LOVE IT!!!

Sometimes, she can't decide, speech or OT??? Decisions...

  

We have since added a bunch of new activities to our daily routine. I will share in a later post. Hope this helps to give some ideas!

Happy Days...

Occupational & Physical Therapy for Babies

For Down Syndrome Awareness month, I thought I would put together a post of all the PT and OT Hazel has done from birth to 6 months (she is doing more than this now, I will post later). I tried to be thorough and remember back to when we started. Hope it helps!!! This is our experience and if you would like to try any of these activities, please ask a professional in your community.

 

We are so fortunate to live in a community that has excellent resources for children with special needs, like Hazel. There are so many countries in the world that are not equipped with the financial means or the expert knowledge that Canada has to support children with different abilities (K...I am stepping off the soap box now, but I am only putting it aside, this topic will be addressed another day). I hope that this post helps those who feel they live in a community that doesn't have the best support for their children.

The John McGivney Children's Center (JMCC) provides us with all the services that Hazel needs, such as occupational therapy (OT), speech therapy and physical therapy (PT). I've sung this tune before and I will continue to sing the praises of the therapists that come to visit and play with Hazel. They are always encouraging, positive and extremely knowledgeable in their respective fields.

(Note: Hazel is awarded in-home services as a result of her cardiac issue (VSD). She is considered medically fragile and therefore needs to be in a clean sterile environment. When she is bigger and stronger she will receive all of these services at JMCC.)

Now that Hazel is done her surgery and getting older we can do some really fun muscle awareness and strengthening activities with her. We always follow her lead and never push her to do anything unless she wants to. For us, and all her therapists, it is first about Hazel being happy and content, one of the reasons I love them so much. Hazel has demonstrated a will to grow and meet her milestones all on her own with little help from us. We are only providing her with the foundation and from this she will build her empire.

Disclaimer:

I want to make a note that I am not suggesting that anyone do any of the activities that Hazel does without proper instruction from a therapist. Every child is different, works at their own pace and has needs that are their own. I am outlining the basics for those of you who are interested and can gain some understanding of what we do to support Hazel. Also, seeing what we do may spark discourse with your therapist to see whether these activities would benefit your child.

I wasn't as diligent at documenting her OT and PT at the beginning, perhaps because there really is not much we did early on. Starting from when she was about 3 to 4 months old we would put her laying on her side up against the back of the couch. We would often hold a toy out in front of her to encourage her to bring her hands to her mid-line. We gave her as much tummy time as she would allow. I would also carry her around the house in my arms while she faced out, which also encouraged strengthening the neck muscles. Rolling over started when she was about 4 months old.

Hazel in her side lying position...

Hazel working on balance and sitting up...

Sometimes I put her nursing pillow in front to support her and give her a top to play with her toys...

Now that she is 7 months and has mastered the art of rolling everywhere and anywhere, we are moving on to sitting up and being able to shift her weight from one side to the other, which will help to facilitate going from laying to sitting. Hazel has been doing very well and can sit balanced for a while, both using her hands out in front and with no hands at all.

Here is the position we have her getting used to. This will help her to transition her weight from one side to the other. So she will be able to turn to either side to play with her toys. Also, this will help her to learn to lean on and strengthen both arms. There are pictures attached of Hazel with her OT...LOVE LOVE LOVE her!!!!

Having her legs tucked under her like this will start getting her comfortable on her knees for crawling. Her arms are on top of her OT's thigh. We are making sure her knees and feet stay together so that her joints are not getting over extended. The OT is just putting gentle pressure on her leg to keep it tucked under and in the right position.

This one is just sitting with her feet firmly on the ground, which will get her used to putting pressure on her feet. The OT is holding her hand and applying light pressure to the tops of her knees or tops of her feet to create muscle awareness for her legs and feet.

This is Hazel's play arch. This is another way to help her to shift her weight and get used to balancing her weight on either side. It also encourages her to grab and play with her toys, aiding her along with her gross and fine motor skills. Her OT is there to guide her and let her move where she would like. She is allowing her enough freedom to go to whatever toy she wants, she just keeps her hands on her to support her.

FINALLY, the medicine ball has a purpose in our home!!! By putting Hazel on the ball and gently bouncing her on it in the position shown, it creates muscle awareness all over her body.

Her OT is applying firm pressure to keep her from slipping off (obviously) and so that she feels comfortable. She doesn't want her to over-extend any of her muscles by trying to look up and back at her.

She can let her stand on her legs, as shown here, to get her used to using the muscles there.