• Keep it light: a backpack should weigh no more than 10% of your child’s total body weight.
• Choose a bag with two well-padded straps – and insist that your child wear them both.
• Place the heaviest items closest to your child’s body.
• Avoid lunchboxes that dangle from the bottom of the backpack, opting instead to place it inside the main compartment of the bag – or have your child carry it separately.
• Cinch up the straps so the bottom of your child’s bag rests in the curve of his or her lower back.
• Pick a bag that’s sized for your child.  Preschoolers may look awfully cute in giant bags designed for elementary-aged kids, but oversized backpacks aren't doing their little bodies any favors.

Labels: A Community in Motion, backpack, Backpack-related health problems, child development, Hartland, Lebanon, OT, pediatric, school, Upper Valley, Vermont

        A few months back, I stayed at a ski condo with some family members.  It had a fairly typical set-up for such rentals, with bunk rooms designed to cram in as many people as possible. Each top bunk was accessible via a ladder, something like this:

Photo credit: http://www.flipkey.com/mammoth-lakes-condo-rentals/p307733/

        There were three rungs – one in the middle, one a normal distance above it, and one a normal distance below.  But a standard bunk bed ladder has four or five rungs and thus there was quite a distance from the floor to the bottom rung and from the top rung to the mattress.  Another notable feature is that these bunks, unlike the one pictured above, lacked railings.
Now imagine trying to climb that ladder and coming back down again.  Difficult for a young child with short legs, right?  But surely a twenty-something adult who has slept on numerous top bunks, some without ladders at all, in her lifetime can navigate this simple task without a problem?  Not so, it turns out.

        My sister claimed one of the bunks in mention.  She climbed up to check out her sleeping arrangements, hoisting herself from the top ladder rung onto the mattress, noting a lack of leverage due to the distance and lack of handholds.  But after a slight struggle she was up.  Nothing too taxing.  Coming down, it turns out, was another matter.
She turned around, felt for the first rung, and took another step down.  Before she knew it, she was out of rungs.  She was standing there, her upper body still lying across the bed as she gripped wherever she could reach, one leg dangling down unable to locate another foothold.  She flailed a bit, tried to reposition to see how far she still needed to descend… and got stuck.  The rest of us, of course, laughed copiously at her expense.  Stuck on a bunk bed ladder with her bottom sticking out in the air?  How absurd.  Her husband had to pick her up and place her back on the ground.

        Well, I apparently don’t watch and learn from others’ predicaments.  I thought I’d try this for myself, show my sister how easy a task it really was.  Oops.  I ran into exactly the same thing (rescued by my brother-in-law and all).  Who designed that thing anyway?
The reason I’m telling you this story is that how my sister and I felt stranded on that ladder, unable to navigate our way down to the ground, is how I imagine my students who struggle with praxis feel when confronted with a novel task.  Developmental dyspraxia occurs when a child is unable to create motor plans for new actions.  His muscles and joints work fine, but his brain can’t figure out how to move them in the correct order.  He may intellectually know exactly what needs to be done to participate in an activity, yet the neurons won’t fire to tell his limbs how to move.  Children with dyspraxia do eventually learn new motor tasks with increased support and opportunities to practice.  I likewise could have conquered that ladder if I had scaled it a few more times.  In the meantime, it was frustrating, embarrassing, and a bit scary.

        This is how it can feel every time a child with poor praxis (motor planning) skills faces a new task.  This could be playing soccer, tying shoelaces, cutting with a knife and fork, climbing on playground equipment, stepping over an obstacle, catching a ball, holding a pencil, completing jumping jacks, anything.  He’s helpless in controlling his own body.  This child appears clumsy, uncoordinated, even lazy or obstinate in his refusal to try new things.
Luckily, treatment is available.  In occupational therapy, we break down complex activities into their component steps, use forward and backward chaining techniques so children can be successful at part of a task before doing the whole thing, design sensory-rich obstacle courses and games, and teach new skills through play.  Speech and language pathologists likewise work with children whose motor planning difficulties interfere with forming words. These kids can and do learn to move their bodies.  Given appropriate support, they are able to participate in recess, physical education, rec sports leagues, and play of all sorts alongside their peers.

Interested in increasing your understanding of what it’s like to live with this condition?  Try snowboarding, water skiing, or roller-blading for the first time.  Attempt a gymnastics or martial arts move you've never done before.  Try to keep up with an unfamiliar line dance. Or find that ski condo in Vermont and dare to venture up onto the top bunk.  It’s harder than you think.

Labels: A Community in Motion, Coaching, community, Lebanon, sensory integration, tactile sensitivity

It was spring of my junior year in high school, and I had the dubious pleasure of taking the SAT IIs; something I had all but forgotten existed until I recalled this story.  Not yet having a driver’s license, I waited outside the school when I was done, pacing back and forth across the concrete until my mom arrived.  At some point, it would seem I stepped in a sticky wad of fresh chewing gum.  I climbed into the passenger’s seat unaware and assumed my typical (and I should note, not terribly safe in the car – don’t do this at home!) posture with my feet tucked up under me.
I suppose it comes as no great surprise to mothers everywhere that I wasn't the one to clean up the resulting gooey mess on the minivan’s upholstery.  In the process of scrubbing some unknown person’s used gum, Mum applied perhaps a bit too much elbow grease.  The result was mallet finger, a tendon injury that prevents the last joint of the affected finger from fully straightening.

http://en.wikipedia.org/wiki/File:Mallet_finger.jpg

       My mom went to see her primary care physician, who told her there was nothing to be done and her finger would never be straight again.  Unsatisfied, she convinced him to write a referral to occupational therapy.  Her OT, specializing in hand therapy, provided exercises to strengthen and repair the damaged tendon.  With a combination of clinic visits and home exercises, my mother restored full range of motion to her finger.  Now she not only has ten equally straight fingers, full function in both hands, and a story to tell about those darn careless kids, but she also had the opportunity to go back to her doctor and say “I told you so.”  Sounds like an OT success story to me!

Labels: A Community in Motion, A Community in Motion Occupational Therapy ADHD Coach New Hampshire Vermont, Lebanon, Motion, New Hampshire

Recently, I started a program at the ADD Coach Academy, http://www.addca.com/. ADDCA is an institution for the education of ADHD and training of coaches for Attention Deficit/Hyperactivity Disorder. I began the program with a goal of becoming an ADHD coach. There are few resources for those struggling with the day to day impact of ADHD in their lives, childen and adults alike. There is equally as little true understanding and use of solid education surrounding ADHD, even in supportive services that are available. It's a diagnosis that can sometimes seem invisible. It varies in degree and can often present differently from one person to another. For folks who don't know, while medication for ADHD can help, it only helps about 70% of the total ADHD population. While it can open a doorway, medication doesn't help with many of the underlying behaviors and beliefs those with ADHD develop. Even with medication, the day to day patterns that are not serving a person can remain unaddressed. Some benefits of coaching can include:

• Reduction of procrastination
• Support for decision-making and prioritizing
• Expanding perception of option
• Create ADD-appreciative accountability
• Set up supportive environment for success
  
• Management of impulsivity and distractibility
• Improvement in time and self-management
• Learning to set boundaries
• Improving social and communication skills
• Removing blame and shame
• Improving self-confidence
• Reducing overwhelm
• Controlling worry
• Learning about your ADD
• Appreciating your strengths and unique gifts
• Discovering personalized approaches

For more information about the program I am taking you can visit: www.addca.com

You can also go to: http://www.add.org/

Until next time, ~t

Labels: ADHD, advocate, Attention Deficit Hyperactivity Disorder, child development, community, Lebanon, New Hampshire, occupational therapy, pediatric, school, sensory integration, Upper Valley, Vermont

My daughter just left for school.

For the third time this year, we are recovering from head lice. One would think I must have been doing something wrong. I wasn’t treating correctly. I wasn’t combing enough. I wasn’t washing enough. I suppose if the occurrences hadn’t been spread out longer than the gestation period, I might suspect I had missed something. My mother had a home daycare for nearly ten years. I’ve seen my fair share of head lice. My daughter having it for the third time is not likely attributed to our negligence.

It is infuriating that since I originally went to the school nurse and principal to bring this to their attention, not so much as a generalized note has been sent home with kids. After two months, I got a note yesterday, in a building miles away from my daughter’s school, my son’s daycare has their first reported case. At least they told everyone.

What have we come to? A school doesn’t feel they can or need to send home a note. Why? Mornings like this I get so mad that the fleeting and perhaps insane thought goes through my head: “ I know! I’ll march into the school and demand they do something to let other parents know. If they don’t do it, I’ll sue them for conspiracy to unnecessarily torture my daughter.”

O.K. I will never do that. But when your daughter screams for an hour every day, like she is dying and you’re the only one doing anything about it, it gets to you. She screamed at me this morning, "Mom! Why are you killing me?"

I’m writing about this because my daughter is diagnosed with Asperger’s Syndrome. With this, we have the misfortune of sensory integration issues, specifically tactile sensitivities. Early on, we were very lucky to be closely linked with a sensory integration clinic. Sarah received SI treatment regularly and we worked through the bulk of it.

What we still struggle with is the sensitivity in her head. Along with the defensiveness, she has a lot of hair. It isn’t just that it’s a lot. It’s the kind of hair that is 90% straight and 10% spring curls. If you don’t know what I mean, let me just say that it’s the kind of hair that makes tiny impossible knots just by looking at it. It has a mind of it’s own.

To my daughter’s horror, I had to break down and cut her hair a couple of years ago. It just became too much to deal with. She couldn’t comb it or rather refused to and I wasn’t getting any volunteers to comb the rude, swearing little girl’s hair. As her mother, I felt traumatized. Every time I combed her hair, it was like another day of torture; it was like another day of driving a wedge between us. I felt like our hearts were breaking and for what?

Having her hair cut devastated Sarah. Yes, devastated is the word. While we all know what it’s like to have an undesired haircut, to kids with ASD, it can seem like the end of the world. Sarah views all parts of her body as something she can’t live without. On another day, perhaps I’ll tell the story of what it was like training her to do number two.

After the hair cut, we pledged to do better. We bought better conditioner, better brushes, combed the night before, piggy-tailed, you name it. And now, two years later, her hair is getting long again. It makes her feel happy. How do I keep up with this lice problem? How do I tell her I might have to cut her hair off again?

Can you imagine what this all must be like for her? She thinks I am hurting her on purpose. She thinks her mother is cruel. I am not guessing. She tells me these things. If you know a child like mine, than you know she believes it. Sarah has an extremely difficult time reconciling the difference between the fact that I have to do it with the alternative of not doing it and what the consequences are. She feels excruciating pain caused by someone she is supposed to feel safe with. This sucks.

I sat at the table this morning feeling quite helpless. Even as I write this, I know that some people will read it and perhaps think I am over reacting. I also know some of you will read this and know exactly what I mean. I guess my goal is to share this story and hope for four things:

1. That someone who is struggling with any of these issues, and doesn’t know why, will seek help.

2. That someone who is struggling with any of these issues and relates, will want to also share their story. It feels good to not be alone.

3. That someone who reads this might want to make some suggestions to me or anyone else dealing with this kind of thing.

4. That it will help me move on with my day.

Until next time, Terry

Labels: advocate, child development, community, Farm, Hartland, head lice, Lebanon, New Hampshire, occupational therapy, pediatric, school, sensory integration, tactile sensitivity, Upper Valley, Vermont