Occupational Therapy
18
Aug
2012
Diaphragmatic breathing for children with anxiety
“I'm feeling like a star, you can't stop my shine” – lyrics in Ridin' Solo.
A teacher told me she used that lyric in her classroom as a quotation. I LOOOOVE IT. Going to do that.
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Mind blown: BerenSTAIN bears, not BerenSTEIN bears…..Whatttt….. I would have sworn my first born child and sixty million dollars that it was STEIN. Alas. My childhood, my spelling efficacy…good thing I didn't bet…
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I spent this Friday evening with my friend who I met through work, as she is the district's autism behavioral specialist. We hung out casually at her house and we spent a ridiculous amount of time looking at the sympathetic and parasympathetic nervous systems (I had to refresh my memory a little) and how it relates to autism/anxiety and flight or flight school mode, etc. Then I talked to her about deep breathing/diaphragmatic breathing and we researched how to teach that best to children.
Here's what I have seen happen. Aide, to rapidly escalating anxious child: “Calm down, take some deep breaths”. Child: ::rapidly takes quick shallow breaths with chest rising while standing there, essentially beginning to hyperventilate which is not in any way helpful::
Deep breaths: great idea, great plan. However, most children – and many adults – don't understand what that really means and how to properly execute it. Diaphragmatic breathing typically takes some practice, and is best learned while lying down. Most children with anxiety for whatever reason, are constantly in fight or flight mode with their sympathetic nervous system in activation, meaning ready for that lion (or piece of homework, or another child's light touch, or a transition) to come at them at any moment. This is exhausting and consumes so much energy and is not a good state to be in while in the school environment (except perhaps a little bit before a test or something). We want to help these children learn to rest/relax a little, not see school as a lion. To activate their own parasympathetic nervous system.
Deep breathing for several minutes, slowly, can help activate that more relaxing system, but it requires actual understanding of how to use the diaphragm appropriately instead of the shallower chest breathing most of us do. I researched Youtube videos and websites and either I'm a really bad google searcher, or there really wasn't any high-quality websites clearly showing the relation between anxiety and the nervous system in an understandable manner, and the few Youtubes we looked at were either too quiet to hear properly, or didn't have enough live video, etc. So my coworker and I want to see about doing a better version. I find it VERY hard to believe it's not already out there though, as we'd rather not re-invent the wheel. So I feel confident that perhaps some of you have a link to a good site and/or Youtube video that will help us describe the nervous system and the sympathetic/parasympathetic aspects as well as the benefits of diaphragmatic breathing, in a way we can use with elementary school aged kids? I liked the idea of a light stuffed animal on their stomach that they can watch rise. If I make a YouTube video or a hand-out, I'll share it here…Or if someone sends me one they have used I would love that person forever.
It's almost midnight. I better go to bed. I am just rambling my braincells away so I can clear it for bed! Good night 🙂
Category: Occupational Therapy | Comments: 1
17
Aug
2012
Insiduous changes…
So today I ran into a front-desk lady at one of my schools who has told me about her grandson at the end of last school year, and we had chatted about him. I don't remember how his name came up, but she was talking about how he didn't like to do all these things and she was pushing him to do them and couldn't understand why he fussed so much. I asked her some questions and he sounded like a TOTAL sensory kid, in the sense that he over-reacted to a lot of different sensory stimuli. Anyway, we talked about some tactics she could use to gently get him into trying more sensory experiences, and also recommended he did lots of swimming, etc.
Today, I stopped by and asked how her grandson was doing. She told me about how he had gone from not being able to put his face in the water to being able to SWIM and loving it, and how excited and happy she was for him, a tear coming to her eye. She mentioned somebody said it wasn't a big deal but that SHE knew it was such an accomplishment for a kid like that.
I smiled happily. She didn't realize it, but late last year SHE was the one saying that he should be able to do these things, and now she is defending him and realizing that certain things truly ARE harder for him to handle. I feel certain I had a part in having her change her mindset, although I don't think she would realize it. I'm totally okay with that. I'm thrilled for her and her grandson.
I like – no – LOVE – when I can help someone change their mindset in a way that allows for more compassion for a struggling child. I feel like in a little way, I changed that child's world, for the better 🙂
Category: Occupational Therapy | Comments: 1
16
Aug
2012
Starting the school year off right…
Sorry guys. I apologize in advance. I feel like rambling. So yes, I could break this up into like ten posts. But I won’t. You have to roll with it. No pictures either.
Tomorrow (Thurs) is my first day back to work. We have two prep days/meetings and then the kids come back Monday. I am trying to stay calm, but the first few weeks are definitely stressful trying to figure out scheduling. I like to work with the teachers and ensure the child is getting a time that doesn’t make him miss important items, but I also have to schedule so many kids with so many teachers at so many schools that scheduling isn’t exactly easy.
Tomorrow I plan to go through my work emails and ensure I’m caught up on things we talked about at the end of last year, organize my files, write up a Hello Parents Letter and a Mini Contract, Print out all Goals, etc. So much to do, and I swore I’d work on it all summer, but I lied to myself, I guess…Just like we all have our great intentions. Whoops. :O
Another thing I want to write up is a little something the kids can be “tested” on which is what OT is (briefly), why that child has it, and who I am, and their goals. All in very simplistic language, and I know some of my kids know all that but some don’t and I want to be consistent. My “what OT is” is simply knowing that the term occupational therapy exists and is separate from speech or PT, and that we try to help the child be successful at school, etc etc.
Blogging wise, I have accumulated a massive amount of things I want to at least briefly blog about, and it’s going into this one bag/box, but it gets so overwhelming. I know I should just use OT on myself and break things down into little steps, etc, but it’s kind of like how maids can have dirty houses 😉
I’ve been walking a lot with co-workers and friends, and I love them all. One of my co-workers, Amy, is especially deep and we have similar philosophies in many ways. She is a teacher. We discussed how she works hard to empower her students so that they don’t say “She taught me how to read” but rather “I know how to read”. Sometimes I get caught up in getting credit, or just wanting them to learn, that I forget how important empowerment is. We want the child to have a sense of self-efficacy, of being able to be independent and know how to do things and apply that knowledge, taking pride of the fact “I CAN” rather than “She taught me…” In fact, I think I want to go get the “I think I can, I think I can” tank engine book! That might be a slogan that goes on my wall… “I think I can!”
We also talked about knowledge itself and how it’s just a foundation, a baseline. Then you build up on that knowledge, and take it much further. The knowledge is JUST the start, not the finish. Again, so true. We talked about Bloom’s hierarchy and the pyramid and working to higher levels once the knowledge is situated. Again, not something I had really specifically thought about before, but true. In this case, I could break it down to something as simple as tying shoes. We start with two different colored laces within one shoe with a specific pattern. Once we have that, we can move on to contextualizing generally, being able to use the same colored laces, maybe making the pattern faster, being able to tie swim trunks and bows and other things besides just shoes, being able to show others how to do it, being able to take responsibility and power for knowing how to do it, maybe using knowledge of tying shoes in other formats or problem solving skills, etc etc. That was a kind of lame example, but you get the point, I hope.
Finally, I love that she told me a story about how one of her old students Facebooked her from many years ago, and she wrote to him “I believe in you.” He wrote back “I believe in me, too”. This was a common thing she had done with her kids, always telling them she believed in them, and them responding “I believe in me too”. I love that. She has this very special way of encouraging her kids, believing in their mistakes being learning opportunities, and teaching them self-respect and self-efficacy.
I think in *some* ways I do these things, but I need to work more on it with a more conscious view of what we’re working on. A child is never going to learn to write beautifully if he thinks he can’t, doesn’t believe in himself, etc etc. I do often talk to my kids about their frustration or anxiety budget as I’ve mentioned before, before we try frustrating tasks – tying shoes happens to be one of the worst. We decide how much frustration we can tolerate that day and go from there. Come on, we’ve all been there, days where we can tolerate a lot or not so much, depending on what’s already happened that day, what side of the bed we woke up on, etc. As adults we give ourselves a lot of leeway, we need to remember that SOMETIMES kids need it too.
There are days and times when I know I gave a child too much leeway, but other days when I see a child who desperately needs some leeway, not getting it. I need to work on putting firmer boundaries in place, while still giving the child some leeway, it’s hard to combine the two I think! But so necessary! I’m trying to decide if I want a SET discipline in check that’s the same for all kids, or maybe one for each school depending on what their special ed teachers use, or what. Last year, near the end of the year, I got bad about using candy as a reward. It works SO WELL, but I know it’s not a great idea. But most of my kids aren’t thrilled with just a sticker or a stamp. Hmmm. Still pondering that one.
Sorry this was so long. I know I am supposed to be blogging about set topics and in much smaller doses than this, so if you read this far, thanks. Just
getting stuff off my chest, I know much of it is repeated throughout the blog but clearly it’s the stuff I’m still heavily pondering. I still need to put aside a set time to blog. I was thinking about maybe designing certain days of the week blog days, certain days of the week writing days (not for blog), for a 30 minute session.
getting stuff off my chest, I know much of it is repeated throughout the blog but clearly it’s the stuff I’m still heavily pondering. I still need to put aside a set time to blog. I was thinking about maybe designing certain days of the week blog days, certain days of the week writing days (not for blog), for a 30 minute session.
Majorest goal of all, besides improving my grammar, haha: NOT stressing so much about starting the school year and the transition from lazy days to running around. It’s all going to happen whether I stress out or not, so why not just be chill?
Category: Occupational Therapy | Comments: 1
14
Aug
2012
This is the company I work for, and I recommend them. :)
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Category: Occupational Therapy | Comments: none
14
Aug
2012
Roulink…
Start back to work Thurs. Lots to do! Sorry haven’t been blogging much lately. To be fair, the blogs of almost everybody suffer a decline in the summer!! Guess people like to read at work or when it’s cold and dark outside, hmm…
So much to say and share, then I get overwhelmed so share nothing. Ugh. so black and white. must work on my 50 shades of grey, yes? Lol….and my grammar. But it’s after midnight, so I get a semi-waiver. Just gonna show you guys the five tabs I currently have open to look at soon.
The first three links are all OT related….About a 3D printer, pull-boxes, and playing card holders for kids. The last two are random. I’m not going into more detail because I’m tired and going to bed and because this is like ROULETTE only ROULINK! 🙂 In the sense you don’t REALLY know where you’re going. But don’t worry, all these sites are legit and nothing not safe for work.
Category: Occupational Therapy | Comments: none
14
Aug
2012
Perfume ads: Olfactory Sensory Tool???
We’ve all met people who are allergic to perfume or don’t tolerate it well. This post isn’t for them. But for those who do tolerate smells, including chemical smells such as perfumes, beauty catalogs are often filled with perfume scent ads. I was absentmindedly going through my ULTA catalog that came in the mail, pulling out the perfume ads randomly, when I realized they could potentially be a sensory tool. So I placed them in a bag in case it ever comes in handy, as rule number one of being an OT is that you must be a hoarder….::ducks::
I might use it with some of my OT children *IF* I am sure they are not allergic or overly sensitive to those types of smells, as a form of “arousal”. The G-rated kind of arousal that allows them to simulate their senses through various modalities and pathways.
I know of some OTs who work patients who are comatose or have significant brain injuries, trying to slowly re-stimulate their senses and help bring about consciousness, and I wonder if any of them are able to use such scents, or if they are too harsh for those noses.
I also wonder if they could be used with people with dementia, to help trigger old memories. Have any of you ever smelled something that transported you into a memory? Perhaps an old perfume scent would be a trigger for them.
In terms of senses, many of us overlook the olfactory sense, but it can be quite powerful. There is something to be said for aromatherapies, for scent-based memories, and for awakening all our senses. On the other side, for people lacking various senses (such as the deaf/blind), or people with sensitivities to smells (such as pregnant women, people on chemotherapy), smell can be overwhelming. I know my roommate, who is deaf and almost blind due to Usher’s syndrome, has a very strong sense of smell and can definitely smell things we can’t. And when I volunteered at a pediatric cancer hospital, we were asked to not wear fragrances of any type, as the children on chemo were quite sensitive.
Scents/smells/olfactory sense is a tool that can be used in occupational therapy, but carefully. Being aware of allergies, sensitivities, and tolerance levels is very important so that you cause no harm. But don’t forget about the olfactory sense entirely! Used in conjunction with other tools, it can make a treatment session more powerful.
Category: Occupational Therapy | Comments: none
10
Aug
2012
I should have been a criminal…
I just got the application to renew my OT licensure so that I can continue practicing. Obviously very important. This will actually be my first renewal. I originally got a Tennessee license, but didn’t end up practicing in Tennessee – I ended up in Georgia. So I got a Georgia licensure. Then after a year I moved to California. So now I’ve stayed in CA long enough for a renewal, my first! Even though I graduated in May 2009. I was reminiscing on the fingerprint process. Now most licensures use LiveScan, where you go to special places that have digital scanners for your fingerprints.
Apparently, my fingerprints suck. It’s a very stressful experience getting my fingers printed, because the computer rejects them over and over again, and what should take 5 minutes takes about an hour of fussing and trying various tricks. So frustrating! I really should have been a criminal, considering how poorly my fingerprints process!! 🙂 Alas, I choose to err on the right side of crime, helping instead of harming. But if fingerprints were in charge of destiny, I would most certainly have ended up a criminal rather than an occupational therapist!!
PS: For those of you applying for licensure…yes, it’s a pain. Start as early as you can as everything will take longer than you think!
Category: Occupational Therapy | Comments: none
8
Aug
2012
Dogs help children read…
I was just reading an article in my Tennessee alumnus magazine about a program that helps children learn to practice reading comfortably by reading to dogs. That’s my one sentence summary. I love the idea. For those of us working with young children, we can certainly encourage having parents encourage their children to practice their reading with a family pet or someone else’s pet! 🙂
Category: Occupational Therapy | Comments: none
8
Aug
2012
Bamboo skewers are an OT's best friend
I like to use bamboo skewers, although I didn’t like how big they normally are, ie for kebobs. I stick them in styrofoam (you know, the left-over white stuff that comes with electronics), and then have the child put little ring things around them…I found these shorter skewers at Publix and am excited! I may actually use all three sizes (my biggest size not pictured here) and have them do all three heights…
Category: Occupational Therapy | Comments: none
8
Aug
2012
Whoopsie doodles….when OT enters your own house
So my mom broke her ankle this weekend, had surgery today, about to go wake her up to give her pain medicine, but it's been full-OT mode here since Saturday in regards to toileting, bathing, walking with a walker versus crutches, transfers, weight-bearing, etc etc etc. Good thing I'm an OT or this would be a lot more daunting. Today as I was in the bathroom with her after helping her from wheelchair to toilet and then standing in corner with back to her for privacy, I had all sorts of flashbacks of working in rehab, lol.
I have so many things I want to write about in regards to it – including how annoying it was that the parking lot for the ortho surgeons was a pain in the ass in terms of accessibility. Ugh. But we did like our surgeon and the center. 🙂 And I think I have a bunch of other posts saved as drafts I can post. And I am finally home to write some of the posts I couldn't write while away! And I will be doing a MAGIC WEIGHTED BLANKET giveaway in the next few weeks, so stay tuned!!! 🙂
Karen
Category: Occupational Therapy | Comments: none