Oftentimes parents ask me, “Why would my child need OT in a clinic setting, if they receive OT as part of their IEP?”. This is such a great question! Occupational therapy is such a wide-reaching profession, that it sometimes seems like all settings are the same. In actuality, there is a big difference in the scope of practice depending on the setting. Let’s break down the difference below!
Sessions typically occur in a specialized clinic setting with swings, slides, climbing equipment, and games. Parents are invited into the sessions to learn ways to work on skills outside of the session. The frequency and duration of sessions are based on recommendations from the therapist at the start of intervention, but can be adjusted to a child’s schedule as needed. Therapists can also perform occasional classroom observations to support the child if needed. Typical frequency/duration is 30-60 minutes per week of direct services (i.e. one therapist working with one child for that length of time).
Skills Addressed:
Dressing: putting on and taking off clothes, tolerating clothing textures, fastening buttons and zippers, tying shoelaces
Hygiene Routines: Toileting, teeth brushing, showering and bathing, hand washing, flossing, hair washing, etc.
Feeding: using a spoon, using a fork, using a knife, tolerating food textures, trying new foods
Play Skills: Cooperative playing with others, frustration tolerance, following group instructions, playing in a variety of settings (i.e. sand, grass, play structures, etc.)
Fine Motor Skills: Handwriting, pre-writing shapes, scissor skills, coloring, opening food packages, pencil grasp, etc.
Sensory Processing: Being able to handle all aspects of a child’s daily routine (all the tasks- and more- listed above) without becoming overwhelmed or upset. Being able to sit and attend to daily tasks without needing to get up and move, and being able to tolerate change in routines.
What a Session Looks Like?
At Valued Voices, our sessions are designed to meet the needs of the child and their family. Parents are invited to participate in the sessions, but if this is not possible, a detailed report is provided after each session. The activities are all child-friendly, encourage movement, and are adaptable to your child. They take place in both the clinic gym, and the fine motor room, and can include obstacle courses, fort building, swings, board games, crafts, and more!
Funding:
Typically outpatient services are funded by medical insurance or private pay.
School-based occupational therapy:
Place:
Sessions can occur in your child’s classroom or in an occupational therapy office. Sessions can also take place in a group format or individual format (one therapist to one child). Therapists are a part of the IEP or 504 team, and are mandated to fulfill the service requirements outlined in the IEP/504 plan. The frequency and duration of services remains the same until the next meeting with the team. The duration/frequency typically ranges from consultation (i.e. the therapist meets only with your child’s academic team and no direct service is provided), to 15-60 minutes per week. This can vary, though, depending on the child’s needs.
Skills Addressed:
Fine Motor Skills: Handwriting, pre-writing shapes, scissor skills, coloring, opening food packages, pencil grasp, etc.
Access to the academic curriculum: This basically means making sure your child can participate in the school day to a functional degree. This may include adapted seating, accommodations for breaks and regulation strategies, or extra time for test taking. School based occupational therapists can suggest tailored accommodations to make the school day functional for your child.
What a Session Looks Like?
The therapist arrives at your child’s classroom and will conduct the session during the school day. The sessions focus mainly on the goals included in the IEP/504 plan. Activities include specific games, movement activities, writing tasks, typing, and crafts geared towards boosting skills in a fun way.
Funding:
School based occupational therapy services are financed through the state, and are free for students in public schools if they qualify.
Ultimately, both school based and clinic based occupational therapists are dedicated to adapting your child’s environment to their skills, while fostering growth and independence. Oftentimes, children receive both types of services to make progress in both the school setting and the home/community settings. If your child is in need of support, it’s important to determine where they are having trouble (i.e. school only, or school, home, community) and where the challenges arise (i.e. daily routines, during the school day, outings with family, etc.) to best determine which type of occupational therapy to pursue. If clinic based occupational therapy seems to meet the needs of your child, reach out to us for a complimentary consultation!
Sholeh Shahinfar is the Founder of Valued Voices, a licensed Speech Language Pathologist, Child Communication Specialist and Certified Oral Motor Therapist. She is passionate about uplifting children’s voices in the world and inspiring self-expression. In her free time, Sholeh embraces a vegan lifestyle, loves going to the ocean, exploring nature with her pup Kobe, practicing yoga, traveling, and spending time with her loved ones.
KAELYN GREEN
Kaelyn Green is a licensed occupational therapist at Valued Voices. She is certified by the University of Southern California in Sensory Integration and is an advocate for addressing underlying sensory functioning in order to improve occupational performance. She is passionate about meeting children and families where they are at and seeks to tailor interventions to the unique needs of her clients. When she is not working, you will find Kaelyn taking care of her two goldendoodles, working in her garden, or taking trips to the Central Coast.
What are the stages of gestalt language development?
If you are curious to learn more about the six stages of gestalt language development, please click the button below.
Understanding language processing in children is a complex and multi-faceted experience that starts developing in early childhood. It involves not just the understanding of words and grammar but also the perception of sound, vision, and social cues. One aspect of language processing that is gaining attention among researchers, educators, and therapists is Gestalt Language Processing (GLP), also referred to as the Natural Language Acquisition (NLA) framework. GLP refers to how children perceive and organize language based on patterns and relationships, rather than isolated words or phrases. Gestalt language processing has emerged as a crucial component of language development in autistic children, yet it remains lesser-known among the general public.
This blog post aims to familiarize parents and educators of autistic children with the intricacies of gestalt language processing. We will explore the definition of gestalt language processing, the unique opportunities it presents, effective strategies that can be employed to support children, and inspiring case studies that highlight the potential for growth and development as we support and empower our gestalt language processors!
Gestalt theory or Gestalt psychology, first introduced in the early 20th century, refers to the concept of holistic perception, which means that our mind tends to perceive objects or patterns as a whole, rather than as a collection of individual parts. In language processing, Gestalt theory suggests that children perceive the meaning of a sentence or a phrase based on its structure, coherence, and context, rather than just the sum of its words. For instance, if a child hears the sentence “The cat chased the mouse,” they may understand the meaning of the whole sentence, rather than just the individual words. Gestalt language processing is, therefore, a natural way of understanding language, as it matches the way our brain processes information.
Gestalt Language Processing in Autism
Most autistic children are likely gestalt language processors, however, both neurotypical and neurodivergent children can develop language in this way. There are six stages of gestalt language development, and although some may require support across all stages, some children may not. Just like analytic language processors, gestalt language processors can also be delayed in their language development.
Researchers have found that gestalt language processing is crucial for multiple aspects of early language development in autistic children. Firstly, it helps children to infer the meaning of new words based on the context they are used in. For example, if a child hears the sentence “She brushed her teeth with a brush,” they may guess that a “brush” could mean a toothbrush, rather than a hairbrush because it makes more sense in the context. Secondly, gestalt language processing helps children to identify the subject and object of a sentence correctly and understand how they relate to each other. This skill is especially important for comprehension and expression of complex sentences. Finally, Gestalt language processing supports children’s ability to form mental models of events or stories, which enhances a child’s narrative skills and creativity.
Research suggests that gestalt and configural processing may be areas of strength for some autistic children, providing a unique window into their cognitive and learning potential, if harnessed effectively. Understanding and addressing gestalt language processing is therefore key to empowering autistic children.
Ways to Identify a Gestalt Language Processor
Long scripts:
Repeating long scripts that they may have heard from TV shows, videos, movies, books, songs, communicative partners, etc… after a delay. It’s a chunk of language that is said in the same way each time. These can be said in or out of context.
Example: “If you give a mouse a cookie!” Child may say this every time they want a snack or they are hungry. This comes from their favorite book, “If You Give a Mouse a Cookie”.
RICH INTONATION:
Gestalt language processors have been called “intonation babies”. Often, GLP’s are attracted to high intonation and emotion of utterances. Sometimes, when a child uses rich intonation, it may be difficult to understand what they are trying to say, but that is where our detective work comes in! Often, the intonation gives a clue into the source of their utterance. For example, it might sound like a line from their favorite song, book or movie.
Example: “Clean up, clean up, everybody, everywhere.” Child says this with the same intonation pattern and emotion that their teacher/parent uses every time a transition is coming. The child is often using this gestalt to communicate that they want to do something different.
UNINTELLIGIBLE & LONG STRINGS OF LANGUAGE:
This is frequently mislabeled as “jargon” because you are unable to understand what the child is saying. However, if we tap into that inner detective, you can hear that these long strings of unintelligible language are gestalts coming from a source (ex: TV shows, movies, videos, song, books, etc.). These longer utterances are often unintelligible because the child has a harder time hearing the word as a unit, so it sounds like it is all blended together into one string, to someone who is unfamiliar to their gestalts and gestalt language processing.
Example: “…busgoroundnround.” The child is saying “…Bus go round and round” (from their favorite song, “Wheels on the Bus”), although it may be difficult to understand this string of language.
SINGLE WORDS:
Child is able to label or name items and may respond with single words to prompts and/or questions, but these single words are “stuck.” These children are often the most difficult to recognize as gestalt language processors. When the child is stuck using single words gestalts, they have difficulty combining single words with other words in order to expand their utterance length.
Example: “ball” Child says this every time they see a ball or any round object (ex: an orange is also called “ball”). This single word now has a much larger meaning and now is used to label every round object. It is difficult for the child to build upon this single word (ex: “white ball”, “big ball”, etc.)
What are the stages of gestalt language development?
If you are curious to learn more about the six stages of gestalt language development, please click the button below.
There are several ways parents, educators, and therapists can support gestalt language processing in young children. Firstly, it is essential to expose children to rich linguistic input that contains diverse sentence structures, vocabulary, and contextual cues. Reading books, telling stories, and using multisensory teaching methods are effective ways to achieve this. Secondly, providing opportunities for children to engage in interactive and cooperative language-rich activities such as child-led play, role-play, dialogues, and games can enhance their social language skills and gestalt perception. Thirdly, giving feedback and modeling language that highlights relationships and patterns, such as using conjunctions, prepositions, and connectors, can strengthen children’s gestalt language processing.
Supporting gestalt language processing in autistic children requires a multi-faceted approach, involving parents, educators, and speech therapists. Here are some strategies and interventions that have shown promise:
Speech & Language Therapy and Language Interventions
Speech & language therapy can be particularly effective in targeting gestalt language processing difficulties. Making sure your speech language pathologist (SLP) is trained in Gestalt language processing is very important when supporting your child.
Parent and Professional Tips
Child-Led & Directed: Allow the child to lead. Go with the flow of their direction and engage in the things they are interested in. Play with what the child wants to play with and model language naturally during play.
Real-life Contexts: Model language skills in the context of everyday activities that the child enjoys and can relate to.
Model Appropriate Language Use: Model and teach language in various social contexts. Make sure this feels natural. If it doesn’t, hold off and try again another time. Modeling language during play should always feel natural.
Don’t Eliminate Gestalts. The child’s gestalts (scripts) are a way of communication. Gestalt language processing is natural language development, which makes the child’s gestalts meaningful. Acknowledging the child’s gestalts empowers them that their communication is meaningful and valid. Building rapport and trust as communicative partners is so important when supporting children’s development.
Acknowledge Scripts & Validate them as Communication. Whether you know the meaning yet or not, you can and should always be validating the child. You can repeat the script back, smile, nod your head, etc.. to let the child know their communication was heard and is valid.
Become a Detective: Do the work and try to figure out what the child’s gestalt (script) means. Even if you think you know what it means, model what you think your child is trying to say. Keep trying until you get it right, and trust me you will, because you will get that “a-ha” magical moment from your child, where they will show you that you got it! Most gestalts aren’t going to be literal, so ask your questions to dig deeper into the meaning of what the child really means. Some important questions to consider: What sources is the child exposed to frequently? Which source is this gestalt coming from? Is the script used at certain times of day or around certain situations? What is my child’s body language like? (there are so many more questions that arise when we dig deeper)
Do NOT Ask Questions: Asking questions frequently can become frustrating for the child, and for you too! Most GLP’s begin answering questions when they begin self-generating language, which is around stages 3 and on. So instead, try commenting, narrating and pausing. When we do this, we are giving our child a mitigable model that they can use in the future!
Create a Supportive & Knowledge Team: If you are a parent, find a team who understands, acknowledges and accepts your child’s language development in order to better support you and your child. SLPs will be able to identify if your child is a gestalt language processor, as well as help identify the stages they may be in and ways to support your child through the stages as they move to self-generated language.
Case Studies and Success Stories
Real-life examples and success stories can provide hope and inspiration for families and educators of children with autism. By sharing these narratives, we aim to showcase the impact that understanding and addressing gestalt language processing can have on a child’s overall development.
Below is a story about one of our shining stars that has blossomed using their unique strengths and their learning style to empower their voice:
“Since starting with Valued Voices, I have seen truly remarkable growth in her ability to communicate meaningfully. When we first started, she mostly communicated in memorized phrases from her favorite movies, tv shows, and books. She could not answer simple questions. Now, she communicates wants and needs clearly, answers questions, and is starting to hold conversations. Identifying her as a gestalt language processor has also helped me to better understand the way her brain works and as a result, enables me to communicate with her more effectively. Working with your team has truly been life changing for my daughter and our little family. You all understand her and have helped me to understand her as well.”
The Transformative Power of Consistent Support
By understanding how children perceive and organize language based on patterns and relationships, parents, educators, and therapists can enhance their language skills, social communication, and overall learning. Consistent and structured support at home and at school can make an extraordinary difference.
At Valued Voices, we believe the biggest success comes when we focus on a child’s strength and work as a team to empower their voice and their independence. We not only provide services, one-on-one in our center, but we provide group classes, sessions in the community and sessions in your kiddo’s school to support you and your family in all environments. We also understand that as parents, you are your child’s greatest teacher and need attention, so we offer support groups for parents and parent coaching classes.
By providing diverse and engaging linguistic input, interactive opportunities, and feedback that emphasizes context and acknowledges unique strengths, children can develop their language in a natural and meaningful way.
Bringing it all Together
Gestalt language processing is a fascinating and important aspect of early language development that deserves more attention and support. By delving into the realm of gestalt language processing in autistic children, and appreciating the beauty and complexity of language, we have uncovered a critical aspect of their language development that warrants attention and understanding. As parents and educators, it is essential to recognize and appreciate the strengths and challenges that gestalt language processing presents. Embracing these differences and guiding our little ones, can unlock a child’s deepest potential and empower them to raise their voice.
We hope this blog post has shed light on the topic of gestalt language processing as a natural way of developing language in children, and provided valuable insights for those supporting these exceptional humans. Encouraging an open dialogue and the exchange of experiences within this community can further advance our collective knowledge and approach to language processing, especially in autistic children. The journey of language development is as unique as the children themselves, and by fostering an environment of understanding, patience, and tailored support, we set the stage for growth and success.
Sholeh Shahinfar is the Founder of Valued Voices, a licensed Speech Language Pathologist, Child Communication Specialist and Certified Oral Motor Therapist. She is passionate about uplifting children’s voices in the world and inspiring self-expression. In her free time, Sholeh embraces a vegan lifestyle, loves going to the ocean, exploring nature with her pup Kobe, practicing yoga, traveling, and spending time with her loved ones.
GENNA HENDERSON
Genna has been with Valued Voices since 2019, she joined the family after graduating with her bachelor’s degree in sociology and a minor in communication sciences and disorders from Pacific University in Oregon. Genna has always been passionate about helping give opportunities to others and believes all children have a joyous light inside them that deserves to be shown to the world. She knows that giving people the chance to express themselves allows them to reach new heights internally and in their communities.
Handwriting is one of the most common areas parents ask me about in my practice. It is such a necessary occupation for classroom tasks, general fine motor development, and visual perception/motor tasks. Pencil grasp development is central to legibly completing handwriting tasks and there are so many factors impacting pencil grip development and fine motor control that it can be tricky to determine when grasp patterns are ineffective and when/how to intervene.
What is a Pencil Grasp and Why is it Important?
Simply put, a pencil grasp is the way in which one holds onto a writing utensil. While I could go on and explain the technicalities of finger placement in relation to the writing tool, and how the hyperextension of different joints impacts the success of the grasp, it really is not relevant in this context. In general, an effective grasp pattern is one that does not cause fatigue quickly when writing or drawing, and that does not impact the legibility or accuracy of the work. Pencil grasp can have a large impact on the legibility of handwriting, which is a relatively large occupation for kids. Therefore, remediation of dysfunctional grasp patterns is important to academic success.
Pencil Grasp Development and Dysfunctional Pencil Grasps
As a child grows, they gain more control over coloring and writing tools, which lead to development of a mature grasp. Typically a child’s pencil grip moves from fisted (or using the entire hand to retain grasp of the tool) to digital pronate (or holding on to the top of the pencil and pointing the index finger down towards the writing tip) to a four finger or quadrupod grasp. A quadrupod grasp is where the thumb and index finger are in opposition around the pencil tip, the middle finger supports the index, and the pencil rests on the ring finger. A three finger or dynamic tripod grasp is where the thumb and index fingers are controlling the pencil movement, with the back of the pencil rest on the middle finger. Basically, it’s expected that the child holds the pencil with an “adult grasp” around age 5. There is a lot of variation in pencil grasps, and really pencil grips are dysfunctional when the child is using an immature grasp pattern or when they are using too much force or pressure when completing work.
Factors Impacting a Child’s Pencil Grip
Surprisingly, many different body systems need to work appropriately and efficiently to support a functional pencil grasp. The common areas impacting pencil grip are detailed below, however it’s by no means comprehensive. Occupational therapists work to determine if the pencil grip is dysfunctional, if intervention is warranted, and what specific areas are impacting functional grip development. Occupational therapists in both the school system and in outpatient clinics can work on fine motor skills and help your child develop an appropriate grasp.
Core Strength and Postural Control:
As an OT, they teach you “proximal stability leads to distal mobility”. In other words, you need to have strength and control in your core, shoulder and arm muscles to allow for your finger and wrist muscles to do their jobs. If you think about it, you won’t be able to write or draw anything well if you can’t sit upright in your desk, or are having to use whole arm movements to complete that drawing. If you don’t believe me, I highly encourage you to try signing your name or completing a more precise drawing activity while keeping your wrist and elbow stable, and only moving your shoulder and arm. It’s tricky, I promise. Core strength and functional strength in your shoulder and arm muscles allow for development of tool use and fine motor coordination. When remediating pencil grip, this is usually where I start.
Proprioceptive and Tactile Processing:
Proprioceptive processing and tactile processing are exceedingly important to efficient pencil grasp development. Proprioception is our body’s way of determining body awareness and body position. The receptors are located in all of our muscles and joints and are activated by stretching and contracting our muscles or applying force or resistance to our joints. This system helps other types of input integrate in the central nervous system due to the anatomical orientation of the nervous system tract. It is responsible for safety awareness, gradation of force and pressure, tool use, gross motor and fine motor coordination, and self-regulation. The tactile system is our body’s way of receiving, decoding, and reacting to touch. This system can process light touch, deep pressure (tight hugs, weighted blankets) vibration, and temperature. The main receptors are in our skin, with the highest concentration of receptors located around our mouths and fingers. Now you may be thinking that these don’t sound relevant to handwriting and hand muscles, but trust me on this. Hand muscles require the same communication from our nervous system as all other body systems do. When proprioception or tactile processing is not efficient or is unreliable, maintaining an effective grasp pattern is challenging to say the least. It can be hard to “feel” the writing tool in your hand, resulting in needing more surface contact in order to feel in control of that writing utensil. This may look like a closed web space (or the area between the thumb and index fingers is small) rather than the ideal open web space. Therefore, you may often see a fisted grasp or a variation of a four finger grasp when children who present with sensory processing differences are writing. It is not always a matter of strength, it’s maybe a matter of subcortical processing and sensory integration.
Fine Motor Strength:
Oftentimes children have limited strength, low muscle tone or limited dexterity in the small muscles of the hands, impacting their ability to maintain an appropriate grasp on a coloring tool. This is typical of children who can write one or two sentences with a dynamic tripod grip, then fatigue and switch to a less functional grasp pattern. Generally speaking, a closed fist grasp or digital pronate grasp require less strength and coordination than a tripod grasp does.
When is Pencil Grip a Problem?
Everyone uses a different type of grasp. Whether you use a thumb wrap, three fingers, four fingers, or some combination of grasp types. Pencil grasp development is important but its also important to recognize that different does not always mean wrong. Occupational therapy may be warranted when the grasp development is impacting function. If your child’s hand is getting tired quickly, or if their grasp is impacting the legibility of their handwriting, then remediation may be needed.
Tips for Adjusting Pencil Grasp at Home
While there are many different strategies for adjusting pencil grasp, here are a few of my favorites:
Pencil Grips
There are just about a million different pencil grips you can find which say they are the best for promoting a dynamic tripod grasp. I wish I could point you to a surefire brand or type that works for all kids regardless, but unfortunately that isn’t the case. Your child will likely need to try out quite a few different grips to determine which one fits their little fingers the best. Whether it’s a triangle grip, a “puppy dog” grip, or a crossover grip, see which is most comfortable for your child’s little hands and which is promoting appropriate thumb, index finger, and third finger placement.
Hiding “Treasure”
This may be one of my absolute favorite tricks. When a child is holding a crayon or pencil with a less than functional grasp, I ask them to “hide” pom poms or other small objects against their palm with their fourth finger and pinky. This will force the fingers to move into a. tripod grasp as only the thumb, index fingers and middle fingers are available to hold the pencil. Try keeping this small object in the hand for as long as tolerated, and work up to longer periods. If your child has smaller hands, use smaller objects. Remember, your child’s hands are working hard to maintain the grasp, and they may fatigue. It is okay to take breaks while the muscles build strength and develop.
Fine Motor Games
Just like other muscles in our bodies, our fine motor muscles need to develop with different stretches, exercises, and activities. In occupational therapy we often play different “warm up” games before moving to handwriting activities. This helps to wake up those muscles before we ask them to hold a pencil correctly. Your child can work on these muscles by using resistive putty to find treasures like beads or gems, placing coins into a piggy bank using their thumb and index finger to pick up the pieces, playing Mancala or opening and closing a tennis ball monster to feed him pom poms. Any activity that requires coordination of fingers and hands is likely helping develop those pencil-grasp muscles.
In summary…
Just like the rest of our body, our children develop hand strength and coordination over time. Exercising is key to developing an appropriate pencil grip. If you have concerns about the way your child is holding their pencil or crayon, it is always best to consult a trained occupational therapist. Whether or not occupational therapy is needed, the therapist can help develop specific activities your child can use to improve their pencil grip.
Kaelyn Green is a licensed occupational therapist at Valued Voices. She is certified by the University of Southern California in Sensory Integration and is an advocate for addressing underlying sensory functioning in order to improve occupational performance. She is passionate about meeting children and families where they are at and seeks to tailor interventions to the unique needs of her clients. When she is not working, you will find Kaelyn taking care of her two goldendoodles, working in her garden, or taking trips to the Central Coast.
As an occupational therapist, the number one question I get from parents, caregivers, and even other professionals is “What is occupational therapy?”. The name really doesn’t provide a lot of information on what OT intervention looks like, or how it benefits a pediatric population. Occupational therapists are trained healthcare professionals who help individuals who experience traumatic injuries, illness, or developmental delays increase independence and confidence in order to participate in everyday tasks. Occupational therapists have a master’s degree or a doctoral degree and can have additional certifications in sensory integration. While OT’s can work with adults too, pediatric occupational therapists work to develop fine motor skills, gross motor skills, school skills, and other types of skill sets in order to support participation.
What is a Childhood Occupation?
Occupational therapy addresses anything and all things you need to do during your everyday life. Consider how your morning went. You probably woke up, got dressed, brushed your teeth and hair, made breakfast, packed a lunch, etc, etc, etc. These activities are all considered occupations because they occupy your time during the day. In order to complete these tasks efficiently, you need accuratefine motor skills, gross motor skills, visual perceptual skills, sensory processing skills, balance, bilateral coordination, executive functioning, and more. Occupational therapists work on developing skills in order to improve independence with day to day tasks. For children, occupational therapists develop treatment plans which focus on improving sensory integration, developing gross motor skills, bilateral coordination, executive functioning, problem solving, and fine motor skills needed to meet developmental milestones, achieve independence with everyday activities, and improve their ability to play and develop peer relationships.
What are Fine and Gross Motor Skills?
Gross motor skills include any motor action that uses large muscles of our body. If you are. using your arms, legs, core, or any combination of those major muscle groups, you are likely completing a gross motor task. Examples of these skills include, skipping, jumping jacks, riding a bike.
Fine motor skills usually involve only the small muscles of the hands. Fine motor skills can include but are not limited to handwriting, scissor skills, using a spoon, fork, or knife, coloring, buttoning, fastening a zipper, shoe tying, stringing beads, etc.
What are Sensory Processing Disorders?
Sensory processing is the general term for how our body takes in information from the environment (sensory input) through our receptor organs (like our noses, eyes, mouth, skin, etc.), decodes that information, and then uses it to inform our motor reactions. We all process sensory information differently, and there is not a “correct” way to respond to different environmental input. That being said, when sensory processing issues impact function, well being, or independence with daily living, intervention may be warranted. Sensory processing disorders are the general description for difficulty tolerating, responding to, or registering certain types of sensory input from the environment, impacting day to day activities.
Emotional Regulation and Occupational Therapy
Oftentimes, when sensory processing or motor coordination are challenging, children can have difficulty regulating their emotions, tolerating frustration, filtering extraneous sensory input, and feeling confident and secure in their bodies. This can negatively impact social skills, school performance, and can cause strain for families. Seemingly minor disagreements or interactions can result in large emotional reactions, aggression, and big feelings. Occupational therapy works to help individuals develop a toolbox of coping strategies, communicate their feelings, and take steps to reduce the frequency of tantrums and frustration to promote positive interactions with daily activities.
Does my child need occupational therapy?
If your child is struggling to participate in everyday routines and activities (like brushing teeth, brushing hair, getting dressed, self-feeding, organizing materials, fastening zippers, fastening buttons, tying shoelaces, etc.) or is having difficulties focusing, completing multi-step tasks, or completing school activities, they may benefit from intervention.
Overall…
Occupational therapists work on developing skills in order to improve independence with day to day tasks. Childhood occupational therapy works to support those day to day skills for children ages 0-23. These areas usually involve dressing, self-care, self-feeding, fine motor, and gross motor skills. If you have concerns about your child’s development, behavioral problems, or suspect sensory processing problems, consult with your pediatrician or a pediatric occupational therapist to determine if services are needed. You know your child best, and if you have concerns, it is always best to reach out!
Kaelyn Green is a licensed occupational therapist at Valued Voices. She is certified by the University of Southern California in Sensory Integration and is an advocate for addressing underlying sensory functioning in order to improve occupational performance. She is passionate about meeting children and families where they are at and seeks to tailor interventions to the unique needs of her clients. When she is not working, you will find Kaelyn taking care of her two goldendoodles, working in her garden, or taking trips to the Central Coast.
With the holidays upon us, there are so many wonderful ways we can celebrate and show each other love. If one of your ways to show love is by giving gifts then this guide is for you!
I am breaking the gift guide into age groups and providing you with some of my favorite toys that target:
speech and language development
play skills
fine motor skills
social skills
problem solving skills
hand eye coordination
gross motor skills
cognitive development
sensory input
social interaction
AND SO MUCH MORE!
Click on the links to take you to the exact item in the guide! BONUS: almost all gifts are under $30!
Mini sensory books are a great way to begin introducing your little ones to the wonderful world of literacy! These books not only provide great visual stimulation, but great tactile stimulation too! Your child will learn through touch and exploring their senses! Make sure to model vocabulary like nouns, animals, and body parts. BONUS TIP: when you are reading with your child, use animated facial expressions to make it fun! Learn more about reading with your kiddo here.
Great cause and effect toy and fun for so many kiddos! Model how to use it for your little one and model new vocabulary like colors, actions, and prepositions. This is also a great way to target joint attention, eye contact, and fine motor skills.
At this age, kids love to pick things up and bang things together. As they get a bit older, they will love to begin stacking and making tall towers! This simple toy is a fun way to target fine motor skills, as well as identifying new vocabulary.
Similar to our stacking blocks, stacking rings are another one of those simple toys that children love! Model descriptive words like colors and different word types like action words and prepositions. This is another great way to boost your child’s vocabulary while engaging in play with a classic toy!
This toy is a great motivator to promote speech sound development, language learning, and joint attention It is also great practice for spinning and reaching. Because of all the fun colors, playing with this toy provides great visual input without being overly simulating.
This is one of my favorite go to toys for cause and effect that your child will love! It is one of the best toys to keep your child engaged, promote language development and work on motor skills. Your little one is also learning prepositions (like “up,” “down,” “in,” and “out”) and learning vocabulary like animals, animal sounds and colors!
Knob puzzles and puzzles of any kind are such a wonderful way for children to practice hand eye coordination, visual motor skills, and problem solving skills. Puzzles are also a great way to work on speech and language skills, like identifying colors, shapes, animals and following directions, and even targeting some of your child’s first intentional sounds!
This sensory tissue box is filled with multicolored handkerchiefs that you can push in and pull out of the box, a great way to begin following directions and working on location words. This interactive play toy also makes for a great speech and language learning activity! Your little one can learn cause and effect, work on fine motor skills and explore their senses with textures and visual stimuli!
Another wonderful cause and effect toy for your little one! This is also a great way to target joint attention, eye contact, and fine motor skills. Model how to use it for your little one and model new vocabulary like colors, actions, and prepositions and early developing speech sounds!
Books are a great way to bring literacy into learning and play! Model vocabulary like nouns, animals, and body parts. BONUS TIP: when you are reading with your child, get at eye level and use animated facial expressions to make it fun! Learn more about reading with your kiddo here.
One of my new speech and language favorites (thank you to our fabulous OT team for this new toy introduction)! Coming in so many different colors, Squigz is great for targeting language goals, like expanding vocabulary, combining words together, identifying and labeling colors, using prepositions (on, off) and learning action words like “pull” or “push.” For our older kiddos, you can work on following directions and turn taking too! Squigz are a great travel toy and your little one can push/pull them on to many different surfaces!
Toy cars are another great activity I love to use to help develop language skills and to target speech sounds. This Wooden Car Ramp can be used to expand vocabulary and teach new word types, like colors (blue car), adjectives (fast/slow), actions (go, push stop), and to teach spatial awareness (up/down). This is definitely one of our kiddo’s favorite toys to play with in our speech therapy sessions!
Kids love these pull apart eggs and there are so many skills you can practice! Your kid is not just going to play with this toy, but they are going to learn too! Children can match colors and shapes, develop visual motor skills and work on their problem solving skills. This is also another great toy to target language development and speech sounds!
Kids love to play with this tunnel! My favorite thing to do is to throw toys/objects in the tunnel and have our little ones crawl through after them. This is not only a great motor activity, but amazing for targeting language skills like prepositions “in” and “out” and working on word combinations!
Little kids really have fun with this play set! Your kiddo can will build color recognition and critical thinking skills as they sort and match fruits and veggies and learn new vocabulary for food items. Not only is this set a great independent play activity, but it is a great way to encourage pretend play skills as your little one explores their imagination!
Bake and create delicious cookies with your little one with this amazing (and durable) wooden cookie set! Model new vocabulary for baking and food items, work on fine motor skills like cutting and slicing, expand language by combining words together and work on turn taking skills too! This pretend play set is one of my favorite speech therapy activities and children love playing with it!
All the fun of sand without the mess (well…kinda)! I love to hide mini objects in the sand and have my kiddos dig to find them. Not only is this a great motor skill activity, but it is a great way to introduce new words, target speech sounds, and increase your little one’s language development. Help your little one combine words together to describe what they dig up in the sand, answer questions (like “what do you see”) and follow directions! Kinetic Sand is a therapist favorite at Valued Voices when targeting speech and language goals!
Reusable sticker pads are great for in the home or when you and your little one are on the go! These sticker pads empower your kid’s creativity and are a great way to encourage speech and language development. Your little one can point to items you name, label items, describe what they see/what they are doing, and follow directions. Your child will love learning through play as they discover new places, like airports, farms, grocery stores, and so much more!
Empower your little one’s imagination through a classic toy that kids adore! Legos help develop fine motor and critical thinking skills as your child stacks, pulls apart and creates from their imagination! Legos are also a great way to work on color identification, following directions, turn taking, and language development through combining 2-3 words together. Children love playing with this toy for hours on end!
This Activity Board helps children develop basic life skills all while playing! Empower your child’s cognitive skills as they develop hand-eye coordination, problem solving skills and discover life skills like getting dressed. This busy board contains so many fun activities for your toddler and is great to take with you on the go!
Play Sets:
Theme-based sets encourage open ended play and what better way for kids to learn than through playing! Play sets are a great way for kids to practice their language skills through exploring their imagination, including their social language skills! Below are some of my favorite play sets:
As you begin your holiday shopping, I hope you find this guide useful in finding the perfect gift for your children and those of a friend or family member.
Don’t forget, less is more! Often the most simple toys are the best way to develop your little one’s skills and empower their expression! Happy shopping and wising everyone a beautiful, warm and love filled holiday season!
Sholeh Shahinfar is the founder of Valued Voices, and a licensed Speech Language Pathologist, Child Communication Specialist and Certified Oral Motor Therapist. She is passionate about uplifting children’s voices in the world and inspiring self-expression. In her free time, she loves going to the ocean, exploring nature with her pup Kobe, and spending time with her family and friends!
Dysregulation and an increase in arousal level doesn’t always happen during visits to the park or while playing at home. It is more likely that an increase in “silly behavior” or decreased regulation occur during those situations you least want them too. Dysregulation in environments like dining out at a restaurant, while sitting at church, during a holiday shopping trip, etc. can cause a lot of stress for you, your family, and your child! Especially during this time of year, when family gatherings and social situations are occurring frequently, having a series of tips and tricks to help calm your child can alleviate family stress and anxiety.
Dysregulation and an increase in arousal level doesn’t always happen during visits to the park or while playing at home. It is more likely that an increase in “silly behavior” or decreased regulation occur during those situations you least want them too. Dysregulation in environments like dining out at a restaurant, while sitting at church, during a holiday shopping trip, etc. can cause a lot of stress for you, your family, and your child! Especially during this time of year, when family gatherings and social situations are occurring frequently, having a series of tips and tricks to help calm your child can alleviate family stress and anxiety.
1. Animal Walks: Whether it’s bear walks, crab walks, or bunny hops, animal walks are a great way to provide whole-body proprioception. There are so many wonderful youtube videos with how-to’s, but some of my favorites are bear walks, army crawls, and monster walks. 2. Chair Push Ups: These are simple and easy to implement even in the car! Having your child push their body up away from their chair is a quick way to provide intense input to the upper extremities and core. 3. Theraputty: Theraputty is a fun way to shift your slime-loving child to an activity with fine motor strengthening and proprioception benefits! Hide small items or beads in the putty for a fun treasure hunt, or roll the putty into snakes or snowmen. 4. Yoga Poses: Yoga is a fun way to calm the body, especially when the space you have available isn’t large enough for animal walks. Try downward facing dog, snake pose, tree pose, or bridges (some of my favorite ones to use with my clients!) 5. Squeeze balls: There are so many different varieties of squeeze balls and resistive balls available, so it’s hard to recommend a specific brand or type. Try looking for something that isn’t too hard for your child to squeeze, but isn’t so light that it will break with intense use. This is a fun thing to include in your car-trip bag to help with regulation on the go! 6. Carrying Weighted Bags or Backpacks: The one thing almost always accessible for long trips is a heavy suitcase or backpack. Provide your child opportunities to push, pull, drag, or carry weighted bags or backpacks for extra heavy work in airport terminals or before you load up the car to drive home. Be careful not to make it too heavy for your child. You want your child to be able to carry or push/pull the bad with good posture and form.
If you have additional concerns regarding your child’s self-regulation, contact Valued Voices for a consultation or screening with our occupational therapist!
Kaelyn Green is a licensed occupational therapist at Valued Voices. She is certified by the University of Southern California in Sensory Integration and is an advocate for addressing underlying sensory functioning in order to improve occupational performance. She is passionate about meeting children and families where they are at and seeks to tailor interventions to the unique needs of her clients. When she is not working, you will find Kaelyn taking care of her two goldendoodles, working in her garden, or taking trips to the Central Coast.
Are you at the beginning stages of getting your little one set up for speech, occupational, physical or behavioral therapy? If you answered YES, then this blog is for you!
This can be a very intense time as you are researching providers and wanting to make sure you are doing everything right for your child. Below are some tips I have for you that will make this experience not only smoother for you, but will make therapy more successful for your kiddo!
In my complimentary parent consults, I always ask parents “what does your child like” or “what are some of his favorite toys and games.” This answer helps set up our first few sessions for success. Bring one of your kiddo’s favorite toys to the first few sessions. When you first start therapy, the initial sessions are spent on establishing rapport, or a relationship with your child. At Valued Voices, we want to create a safe space for your child where they feel nurtured and loved. When you let your therapist now beforehand some of your child’s interests and favorites, the therapist can better set up the session to reduce any feelings of anxiety that your child may be experiencing. Instead, that initial session becomes fun and empowering!
2. Decide if you want to sit-in or separate
This is completely and 100% YOUR CHOICE! There are some kiddos that will go into a new office, filled with fun toys and easily separate from parents, while others take some time to warm up. Either way, this is your child and your decision! Personally, parents sit-in our sessions as they are able to see how we are interacting and creating opportunities for speech, language and communication, and therefore, better able to utilize those techniques and strategies at home. On the flip side, there are times when I suggest the parent to step out, just to see if there is a difference as sometimes, our little ones tend to cling to mom or dad and not explore as much as they would if they were alone. Whether you choose to sit in or separate, just stay consistent and communicate that with your therapist and child.
3. Schedule your sessions with intent and clarity
Scheduling can often feel like the hardest part of parenting and therapy. Schedule your kiddo’s therapy at a time that is most optimal for them, when they are the most alert and engaged. If you know your child has a hard time paying attention after a long day at school, book your appointments early in the morning. If you know your little one takes naps, don’t book anything right before or right after naptime. At Valued Voices, we provide early morning, evening and weekend availability to make scheduling easier for you and more importantly, to ensure that your kiddo is having the most successful and productive session possible. Ask your therapist if they are able to do the same.
4. Ask your therapist questions
Ask your therapist questions, in fact, ask a lot of them! In most cases (except if your kiddo is receiving services in a school), your therapist will allot the last few minutes of the session to let you know how things went. This is your time to ask questions! Ask your therapist what they worked on today, what goals they addressed, where your kiddo shined and where they may have struggled. You should also ask questions about things you can do at home to facilitate the skills your child is learning in therapy. This is probably the most critical part of therapy for your child. When you have a great understanding of what is going on in the sessions and are able to carryover those skills at home, then your child is likely to show way more progress. The more you know about what is going on in the sessions, the better! If you can’t make a session, don’t feel bad, just communicate your questions via email or even a communication notebook that goes back and forth.
5. Keep your therapist updated
Just as you want your therapist to update you, make sure you are keeping your therapist updated too. It is super important that you share with your therapist changes that are going on in the environment that may play a role in your progress. For example, if you are potty training and your child is presenting with a ton of new behaviors, this is something you should tell your therapist. Some other examples of changes that you should share with your therapist include (but are not limited to):
Changes in family dynamic (expecting a baby, family member moves in/out, loss of family member, new babysitter)
Relocating homes/school
New jobs
Changes in diet or medications
Changes in sleep
You may think “my child isn’t old enough to be aware of these changes” but trust me, they do.
6. Make it a team approach
This is another big one! I am a huge fan of team collaboration and I automatically get information about everybody else on the team. Team members include (but are not limited to): teachers, doctors, audiologists, occupational therapist, speech & language pathologists, physical therapists, behavioral therapists, dentists, ENTs, parents, siblings, family members and the child! If your child is receiving other types of therapy, it is very important that everyone be in consistent communication with one another and on the same page. When the entire team is working together, this has major impacts on your child’s success. From day one, get everyone involved. Set up monthly meetings or set up an email dialogue between all team members.
As you embark on this journey, make sure you are finding members of the team that are aligned with your vision and values for your child. At the end of the day, we should all have one common goal and that is to help support you and your child.
Sholeh Shahinfar is the Founder of Valued Voices, a licensed Speech Language Pathologist, Child Communication Specialist and Certified Oral Motor Therapist. She is passionate about uplifting children’s voices in the world and inspiring self-expression. In her free time, Sholeh embraces a vegan lifestyle, loves going to the ocean, exploring nature with her pup Kobe, practicing yoga, traveling, and spending time with her loved ones.
One of the hardest things to deal with as a parent may be having to make the apology rounds to your child’s classmates, parents, and teachers after a biting incident. After all, no one enjoys having to endure the disapproving looks from other adults or having to speak with your own child on the car ride home about the consequences of biting/hurting others. So why does my child bite their friends? How can I stop it before teeth marks show up on all of my child’s classmates?
Frustrated or Excited? Biting friends is more common that you think. A lot of toddlers have difficulty expressing themselves or expressing their emotions in a healthy way. Many times, toddler biting incidents involve three main emotions: anger, frustration, and excitement. Determining which one is the most frequent cause can help narrow down how to prevent the behavior in the future.
Frustrated: Having a friend take your toy, losing your preferred carpet square, not being understood, or not getting to go on the slide can be really maddening for a toddler. Sometimes, they deal with the anger and frustration by biting peers or adults surrounding the incident. Additionally, sometimes toddlers use biting as a way of making themselves and their boundaries understood when language is not a reliable option.
Helping the Frustrated Biter: Identifying and helping the frustrated biter be more easily understood is the best method of prevention. This could include modeling the language, providing alternative solutions (like asking a teacher for help), or reaching out to a speech therapist for assistance in developing expressive communication.
Excitement: Have you ever seen a child jump up and down uncontrollably when they learn of the upcoming Disneyland vacation? Or run around the house without “settling” when they hear a favorite relative is coming to visit? These kinds of movements and reactions help with self-regulation. Oftentimes, when a child bites themselves or others when excited, it is a method of helping regulate those feelings.
Helping the Excited Biter: The best way to prevent the excited biter from, well, biting, is to provide a substitute activity. Whether it is pushing a laundry basket full of clothes, climbing stairs, completing wall pushups, or jumping on a trampoline any kind of heavy work can substitute for biting. If your little one demands an oral motor method of heavy work, chewing a crunchy snack or sucking a thick liquid like yogurt or applesauce through a straw can be beneficial.
If self-regulation or expressive communication seem to be an issue for your child, please contact Valued Voices for a screening and additional resources.
Kaelyn Green is a licensed occupational therapist at Valued Voices. She is certified by the University of Southern California in Sensory Integration and is an advocate for addressing underlying sensory functioning in order to improve occupational performance. She is passionate about meeting children and families where they are at and seeks to tailor interventions to the unique needs of her clients. When she is not working, you will find Kaelyn taking care of her two goldendoodles, working in her garden, or taking trips to the Central Coast.
Amongst all of the mountains of solicited (and unsolicited) advice parents of toddlers receive, someone down the road has likely mentioned something along the lines of, “Whatever you do, don’t let your child W sit!”. But what even is W sitting? And is it really bad? I mean, does anyone care how my child sits when they watch Paw Patrol?
The short answer is: Yes and No.
What is W sitting? W sitting occurs when the child sits with both knees bent behind their body and off to the side. While the child does not notice a difference, this type of seated posture can result in hip and knee problems and decreased core strength.
When is W sitting a red flag? Children oftentimes move in and out of W sitting during play, and while it is not encouraged by any means, it is not exceedingly harmful unless it is your child’s main sitting position, your child sits like that for a long period of time, or they are unable to sit criss cross applesauce.
Okay, so no W sitting, but what ways should they sit? I like to tell my client’s families that variety is key. Ideally, your child is able to play and move into and out of many different seated positions. The more, the better as this means they are developing a variety of motor plans.
Types of sitting include:
Sitting with legs outstretched
Sitting in crisscross applesauce
Sitting in high knees
Lying in prone while propped on elbows.
If W sitting or core strength seem to be an issue for your child, contact Valued Voices for a screening and additional resources.
Kaelyn Green is a licensed occupational therapist at Valued Voices. She is certified by the University of Southern California in Sensory Integration and is an advocate for addressing underlying sensory functioning in order to improve occupational performance. She is passionate about meeting children and families where they are at and seeks to tailor interventions to the unique needs of her clients. When she is not working, you will find Kaelyn taking care of her two goldendoodles, working in her garden, or taking trips to the Central Coast.
Addressing the misconceptions and commonly asked questions.
As an occupational therapist, the number one question I get from parents, caregivers, and even other professionals is “What is pediatric OT?”. Occupational therapy encompasses so many areas of function, it can be hard to button down pages and pages of information into a succinct blurb in the moment. Below are some clarifications and answers to the most common questions surrounding occupational therapy.
Occupational therapists can work on many different areas including: dressing skills, grooming skills, feeding, sensory processing, handwriting, and pre-writing, attention and executive function, gross motor skills, fine motor skills, emotional regulation, etc.
Why do you find jobs for children?
Short answer is, “We don’t!”. The term “occupation” used to mean anything you do, and in more modern iterations has taken on meaning for “work or career”. Occupational therapy focuses on promoting independence with anything you need to do, want to do, or have to do as part of your daily life. Brushing your teeth, going to Target, getting dressed, swinging on a swing at the park can all be considered occupations. And those are the areas OT’s work on with children and adults!
So, you are basically a PT, right?
Nope! While we love our PT colleagues, and there can be a lot of overlap, we actually have very different jobs. Physical therapists work to “improve their [clients] ability to move, reduce or manage pain, restore function, and prevent disability” (APTA, 2021). Occupational therapists work to promote independence in daily occupations – whether that be improving strength, coordination, balance, fine motor skills, adapting the environment, etc. in many different performance areas.
Why do your sessions look like play?
If you have ever seen an occupational therapy clinic or an OT session, it probably looks like the clinician is just playing games with the child or being silly. In reality, we want the sessions to look like that. In order to develop rapport with your child, and to keep little ones engaged, we often disguise our exercises in games or movement activities. This way, your child has fun with their OT, while also working towards their goals. Rest assured, we are making progress towards the goals and improving function while being silly and fun.
Do you have any other questions about occupational therapy, or if your child would benefit from occupational therapy services?
Kaelyn Green is a licensed occupational therapist at Valued Voices. She is certified by the University of Southern California in Sensory Integration and is an advocate for addressing underlying sensory functioning in order to improve occupational performance. She is passionate about meeting children and families where they are at and seeks to tailor interventions to the unique needs of her clients. When she is not working, you will find Kaelyn taking care of her two goldendoodles, working in her garden, or taking trips to the Central Coast.