Child and Parent Occupational Wellness

DbD Toys: Development by Design- Great Toys for Every Child on Your List!

DbD Toys, a company created by Jessica Zarin Kessin (founder & president, professional product designer) and Julie Robbins, OTR/L is a great new company with a focus on developing toys for children of all abilities, special needs included.  They have a great website that explains developmental occupational skills such as gross motor, fine motor, bilateral coordination, motor planning, sensory processing, visual perception, social and pre-academic skills, eye-hand coordination, and oral-motor skills.  For a quick link to explanations of these skills, click on Developmental Skills.

Julie Robbins, the occupational therapist, has authored a series of articles & game ideas available on the website that cover topics in the aforementioned skills areas and how to incorporate activities into the lives of your children to promote good development of the skills.  She also is directly involved with the design, testing, and evaluation of all DbD toys & products.  She has worked extensively with the special needs population and is able to apply her knowledge of this for toy development.

Check out the website at www.dbdtoys.com, where you can sign up for their free newsletter which includes new toys, articles, and information for parents and teachers.  There is something for every child on this site!

Giving Your Children Skills for a Lifetime of Wellness this Holiday Season

As the holidays approach, many people find themselves faced with the big question of "what do we get for the kids?".  Childhood obesity and diabetes is on the rise all over the world but especially seems to stand out here in the United States.  There appear to be a multitude of factors involved: sedentary lifestyle, high calorie processed foods, oversized portions, and poorly balanced nutrition, to name a few.  Unfortunately we have allowed our culture to lose the importance of gathering for a family meal and appreciating the food that we take in while in each other's company.  Family meals have been replaced by fast food, eating on the road, and preparing quick and easy meals at home to put in front of the children, many times leaving them to eat alone at the table.  I just heard a report on the radio this morning about how high calorie fast food meals not only promote oversized portions (16 oz soft drinks, extra large fries), but many of these meals can be purchased for a cheap price, which makes it alluring to busy parents who "don't have time to cook".  Now, let's get one thing straight.  We, myself included, are all guilty of the occasional fast-food run.  But one must keep control over these outings so as not to make their children think that this is a normal part of our diet and lifestyle.  And besides, it's just not healthy.  How many times have you had that double cheeseburger and fries with a soft drink and then felt absolutely sluggish and uncomfortable afterwards?  These are the habits that our children are learning and it is killing their health and affecting their lives.

Children's bodies grow at a fast rate.  Their brains are constantly growing, taking in new information, sensations, etc.  Muscles and bones require the proper nutrients for optimum growth and strength.  Children's blood sugar levels need to remain constant to optimize attention, focus, and work/play output.  In this week's New York Times, Tara Parker-Pope cites a study done at Columbia University about children, nutrition, and food preparation in her article, Beyond Cupcakes: Children in the Kitchen .  She also provides names and authors of the most recent family cookbooks and most importantly, reiterates that teaching a child basic cooking skills will help them to be less picky eaters and make better food choices as they grow into adulthood.  In addition to what is mentioned in the NYTimes article, I have some book suggestions of my own which I have found to be helpful as a mom teaching her children to take part in their food preparation.  I highly recommend the following books not only for cooking, but for learning more about preparing meals for your children that will fuel them nutritionally: 

• The Family Nutrition Book: Everything You Need to Know About Feeding Your Children from Birth Through Adolescence by Dr. William Sears
• Superfoods for Children: How to Boost Your Child's Health and Brainpower from Preconception, Babies and Toddlers, Through to the Teenage Years by Barbara Griggs and Michael van Straten

So, all you adults out there--think about providing the children and parents in your lives with a cookbook or cooking lessons (many supermarkets now, such as ShopRite, offer adult/child cooking classes) as a holiday gift this year.  They will gain invaluable skills that will last them a lifetime. 

Does Your Child Have Handwriting Difficulties?

Now that it is almost the end of October, many parents and teachers can see which children are having difficulty with handwriting in school.  Handwriting is a skill that requires specific learning, practice, and refinement.  It is easy to underestimate the amount of skill that goes into learning handwriting.  This is a subject that is not taught in the schools in the USA as it once was.  Back when I was a grammar school student, "penmanship" was an actual subject listed on our report card!  As schools have had to increase test scores and accountability in recent history, the teaching of handwriting has suffered.  This is not a skill that children can just see once and be expected to learn proficiently.  Good handwriting requires strong visual-motor skills, kinesthesia (muscle memory), visual-perceptual skills, fine motor strength, bilateral control, and coordination.  Children who fall behind in handwriting skills often suffer from low self esteem and a sense of failure as they approach the upper-primary and middle school grades and cannot keep up with the volume required for note-taking in class.

Children need to learn how to write by example.  They need the time to practice and learn it as a motor skill in memory (much like shooting a foul shot in basketball or having a great golf swing!)

As an occupational therapist, I strongly recommend the Handwriting Without Tears  program, created by occupational therapist Jan Olsen over 25 years ago.  It is an award-winning curriculum that has been adopted by many education departments/schools across the United States and Canada.  It is a developmentally-based handwriting program that is easy to learn for typical children, as well as those with special needs.  It is a multi-sensory approach to handwriting that is simple and fun for children.  "Handwriting difficulty" continues to be one of the most popular referrals for school-based OT services, even for those students who are not "special needs".

So, parents...if your child is displaying difficulty with handwriting (poor letter formation, letter reversals, placement on the line, poor spacing, etc.) -- be patient and seek out the assistance of an occupational therapist or handwriting specialist who can guide your child through the appropriate developmental stages of handwriting.  Do not underestimate the multitude of skills that are required to produce good handwriting.  Your children will benefit from patience, proper teaching, and time for refinement of the skill. It is a skill that they will carry with them for life, regardless of whether or not they learn to use a computer! 

Also, I have found another wonderful and thorough occupational therapy website...for more specific information on the components of handwriting (and all things OT!), please click on:

Why Is Handwriting So Challenging?   

Hey Parents, do you have questions about school-based occupational therapy services?

The month of September is nearing its end and most students are getting settled into their new classrooms and schedules for the year.  Many parents who may be concerned about their child's abilities in the classroom tend to have questions about what kinds of services are available in school to help their child succeed in school and maximize their potential.   The following article from the American Occupational Therapy Association  written by Ashley Opp Hoffman addresses some of these concerns.  For more information about school based occupational therapy services, parent tips for helping your child succeed in school, and tips on fine motor development and handwriting, visit www.aota.org.

 

What Parents Need to Know

About School-Based Occupational

Therapy

Ashley Opp Hofmann

When a school informs parents that it recommends occupational therapy for their child, parents tend to have a lot of questions. Their first question?

What is occupational therapy?

Occupational therapy is a health profession in which therapists and therapy assistants help individuals to do and engage in the specific activities that make up daily life. For children and youth in schools, occupational therapy works to ensure that a student can participate in the full breadth of school activities—from paying attention in class; concentrating on the task at hand; holding a pencil, musical instrument, or book in the easiest way; or just behaving appropriately in class.

Occupational therapists and occupational therapy assistants help students perform particular tasks necessary for participation or learning. “The whole purpose of school-based occupational therapy is to help kids succeed,” says pediatric occupational therapist Leslie Jackson. Occupational therapy practitioners don’t just focus on the specific problem that a child’s disability may present; rather, they look at the whole child and tackle individual tasks, helping students find ways to do the things they need and want to do.

Usually, occupational therapy is provided to students with disabilities. But occupational therapy can be made available to other children who are having specific problems in school. Occupational therapy practitioners also work to provide consultation to teachers about how classroom design affects attention, why particular children behave inappropriately at certain times, and where best to seat a child based on his or her learning style or other needs. Occupational therapy may be recommended for an individual student for reasons that might be affecting his or learning or behavior, such as motor skills, cognitive processing, visual or perceptual problems, mental health concerns, difficulties staying on task, disorganization, or inappropriate sensory responses.

A common manifestation of difficulties in school involves handwriting, in many cases because this is a key “occupation” that students must master to succeed in school. A teacher might notice that a student cannot write legibly or has serious problems in other motor tasks. The occupational therapy practitioner can work with the teacher to evaluate the child to identify the underlying problems that may be contributing to handwriting difficulty. The occupational therapy practitioner looks at the child’s skills and other problems (including behavior), in addition to his or her visual, sensory, and physical capabilities. They also take into account the school, home, and classroom environments to find ways to improve the handwriting or to identify ways the child can compensate, such as using a computer.

Accessing school-based occupational therapy is fairly straightforward, but it is the school team who makes the decision of whether or not a student requires occupational therapy. Not every student needs occupational therapy, even if the student has a disability. Those who do may have problems that the teacher can address after consulting with an occupational therapy practitioner and modifying their teaching technique or the environment for the entire class.

The education team could recommend one-on-one services. Usually these services are integrated as much as possible into the child’s routine to promote better integration of skills.

Students with disabilities have been able to receive occupational therapy at school since the 1975 passage of the Individuals with Disabilities Education Act (IDEA), which served as the original impetus for school-based occupational therapy. The law stipulates that students with disabilities must have access to the occupational therapy if they need it to benefit from special education. In 2001, Congress passed the No Child Left Behind (NCLB) Act which requires schools to improve the academic achievement of all students, including those with disabilities. In 2004, the reauthorization of IDEA extended the availability of occupational therapy services to all students, not just those with disabilities, in order to fully participate in school.

Parents, though, have a lot of the responsibility when it comes to their child’s success in school, and their involvement becomes doubly important when an occupational therapy practitioner enters the picture. First, Jackson suggests getting to know the teachers and occupational therapist.

“Share information about what your child does at home, raise whatever concerns you have, find out what sorts of things you can do with your child to help him or her succeed,” she says.

“Occupational therapy practitioners have important knowledge and expertise to share. Take advantage of it.”

Review: An Inspirational Run for Breast Cancer

                                                   

Though it happened months ago, the emotional impact of running the Komen Race for the Cure for breast cancer in Rome, Italy has not left me.  My friend Amy and I flew to Rome for the weekend of May 18, 2008 to take part in a 5k race of over 40,000 runners who were all there for one reason: to support and raise money for breast cancer research.  It was truly inspiring to be surrounded by men and women, young and old, all running for the same cause.  I must say that Italy has certainly worked hard and done its research in setting up these races; service was exceptional and orderly, the race village was beautiful, and the course was perfect.  It was quite amazing to run through Rome, passing ruins and monuments along the way.  My favorite part was approaching and running around the Colosseum.  It was just magnificent.  The people who I met who were involved in organizing the race were professional and compassionate about what they do.  Italy will be hosting many other races to fight breast cancer, in Bologna and Bari , and in other cities which have not yet been disclosed.  Running this race was emotional and inspirational.  It was for a good cause and I encourage everyone to think about taking part in one in a city near you!  Following are some photos from the big day:

 

   

 

Children, Families, and the Occupation of Eating

        

Involving your children with simple meal preparations in your home will positively impact them forever.  In a world where processed food is marketed to kids and childhood obesity is on the rise, we as parents have a real chance to positively influence children in their eating habits and food choices from the beginning.  Besides learning self help and social skills, they are also learning problem solving, sequencing, math, and chemistry, among other things while cooking.  Learning to cook healthy food for oneself and others inevitably promotes good self esteem and healthy food choice preferences.  Plus, it is just plain fun for kids.  Most kids I know will jump at the opportunity to help out in the kitchen.  Just this weekend my 5 year old prepared her first batch of sauteed crimini mushrooms with her daddy as a side to our now traditional Sunday morning "English" breakfast.  She never really liked mushrooms until she helped prepare them herself, and she was incredibly proud to have cooked something that our entire family was able to eat together. 

I have always been a food lover.  Not only was I blessed with a mother who can cook just about anything, but I was blessed with a mother who lived in Italy for a few years and learned northern Italian cooking firsthand from her Italian neighbor, who resided in the same building.  While my parents were living in Italy, my mother was pregnant with me and so I was born in Parma, Italy.  I am not Italian by blood, but my parents, having enjoyed their time their so much, made it a point to always let that experience remain part of me, even though I was so young.  For the first 2 1/2 years of my life, I was presented with some of the best meats, cheeses, pastas, and vegetables that Italy has to offer.  Simple, healthy, and wholesome cooking at its best.  Lucky for me, after we moved back to the USA, my mother continued to provide my siblings and I with meals that leaned more towards the Italian diet than anything.  At an early age I learned to appreciate the tastes of a variety of different foods.  My mother cooked our meals and we ate as a family as much as possible.  Of course there were foods that did not fancy my taste as a child, but I was always encouraged to try them and as I got older, began to enjoy them and appreciate them.  As I got older, my mother would show me certain techniques and easy recipes that I could prepare on my own.  Just those little bits of time spent with her in the kitchen stuck with me and as I got older and was on my own at college and afterwards, being able to cook some smart, healthy, and flavorful meals for myself became one of the greatest gifts my mother has given me. 

In today's New York Times, there is a Question & Answer with Rachael Ray, talk show host and host/cook of the Food Network show "30 Minute Meals" about involving kids in cooking.  In Rachael Ray Wants Kids in the Kitchen  she makes many good points about this subject that I not only agree with, but have also witnessed myself.  Among them are:

• Exposing your children to what you do in the kitchen is a feast for their senses.  Smell and sight play an important role in appreciating taste, so if you want your children to eat certain foods, let them watch you prepare them.
• Today's children need to be steered away from processed foods and have healthy diets that can only come from using fresh and natural ingredients.
• Being able to provide a good meal for yourself is very empowering, and even moreso if you can provide it for others in your family, thereby boosting self esteem and independence.
• You can use different types of utensils such as plastic knives and forks to make cooking and food prep safer for smaller children.
• If you get a little creative with food, you can entice your children into trying new things and teach them to learn to appreciate certain flavors and textures as they get older.

So all you parents out there, get your kids involved in the kitchen.  It will provide you with quality family time and provide them with a multitude of positive life skills.  And while they are playing around in the house with the TV on in the background, keep a food network or cooking channel on in the background.  You'll be surprised how much of it they take in and how interested they become in creating their own meal and trying new foods!

Finally Back on the Circuit

A big apology to everyone for the extreme delay of posts on this blog.  Between an international move and then being out of the country for the entire summer (where I had no internet access), I have many things in store regarding infant development, occupational therapy, handwriting and fine motor skills, and even cooking with your children.  I hope that the beginning of the school year is treating everyone well and that your children are settling in nicely.  Check out the Backpack Awareness tips in the sidebar to be sure about body mechanics and proper weight amount to carry in a backpack.  Children can suffer back pain and spinal injuries if backpacks aren't worn properly.  Also stay tuned for classroom tips about handwriting, positioning at the desk, and homework hints for your school aged child.  Lastly, more information to come on infant massage and motor skills development in children!  Welcome to Autumn!

In the Midst of a Move

I recently completed an international move, so please excuse the short post and the delay of information over the past month.  I have come upon some new and interesting information about children with autism.  One of the main techniques used to treat children with autism is sensory treatment.  The following article describes sensory treatment with autism and provides some information about sensory processing disorders: Sensory Treatment Helps Children with Autism.

In the meantime, stay tuned for a review of the Race for the Cure in Rome, Italy, which I attended on May 18.  Upcoming topics on the blog include sensory strategies and games for summer, handwriting skills and techniques for bridging summer vacation, and promoting fine motor development in young children.

See you soon!

The Positive Power of Touch - Research Studies & Videos about Infant Massage

      

The art of infant massage provides special ways to bond with your baby/child.  It is never too late to begin massaging your child.  Touch is our most powerful sense.  It is the first sense to develop in utero and it is used for the rest of our lives.  The calming power of touch cannot be underestimated when soothing a colicky baby, relieving teething pains, or just as part of a daily routine with your child that provides you both with connection, stress reduction, and a myriad of physical benefits. Tiffany Field, Ph.D. is the director at the Touch Research Institute at University of Miami School of Medicine.  She has been the leading researcher on the benefits of touch therapy.  She has conducted all kinds of studies that report the benefits of touch/massage in all types of individuals, from premature infants, to drug-exposed babies, to children with autism, and senior citizens.  For an easy-to-read list of the results of each study, click here: Massage Therapy Studies- Touch Research Institute

To learn more about the art of infant massage, The Loving Touch Parent-Infant Massage Program,  its technique, and benefits, click here to view a selection of videos:

Infant Massage Videos, International Loving Touch Foundation

DOG-GONE Therapy!!! How Therapy is "Going to the Dogs"

There is much to be said about the human-animal bond, especially for children.  As the daughter of a veterinarian, I grew up with all kinds of pets.  We had dogs, hamsters, rabbits, birds, and fish.  Though I loved them all, I cannot say enough about the wonderful experience of growing up with my rabbits and dogs.  Most people who know me personally have probably heard at least one story about my beloved rabbit, "Cocoa", who came to his cage door when you knocked, who chased a ball, hung out with my dog, and learned to swim in my pool -- yes, you read correctly -- a swimming rabbit.

If people I know haven't heard about Cocoa, they have certainly heard about Raja and Ginger (pictured below), my parents' adorable mother-daughter combo of yellow labrador retrievers with whom I had the great pleasure of spending my adolescent and college years.

            

Companion animals provide many things to their human counterparts.  I can speak first hand about the security, unconditional love, socialization, and friendship that my pets provided me with (not to mention the nurturing skills and empathy that comes along with the responsibility of caring for another living creature).  These are but some of the qualities that make animals (especially dogs) such appealing partners in therapy. 

Therapy dogs are currently practicing alongside their occupational therapist owners/handlers in a variety of ways.  Dogs take part in therapy sessions to increase motivation in the child while the OT directs the treatment process to help the child reach his/her therapeutic goals. 

Some examples of this include:

• Improving gross motor skills such as bilateral upper extremity use, balance, and body awareness (possibly by having the child pet, brush, and do an activity with the dog, among other ways).
• Improving fine motor skills by having the child place objects/treats on the dog's vest, manipulate buckles on the dog's collar, utilizing a leash.
• Sensory integration skills/sensory stimulation - tactile awareness through petting the soft fur of the dog, regulating muscle control/force of upper extremities through touch.
• Visual perception- identifying colors/patterns on dog, categorizing, etc.
• Socialization/Sequencing- by talking to the dog and giving commands, children learn to communicate.  They can learn sequencing skills by following certain directions from the therapist to complete a "task" with the dog.

Dogs are unconditionally loving.  They are non-judgemental and they are social.  These qualities are appealing to children and often times can motivate a child more than a human could.  Children who are typically shy or withdrawn may come out of their "shell" in the presence of a therapy dog and take part more fully in the therapy session.  They can form an emotional attachment and friendship with the dog, which ensures increased motivation for future treatment sessions.

Therapy dogs are currently taking part in programs with children to improve sensory integration, increase social skills, improve literacy and handwriting, improve gross and fine motor skills, and more.  Dogs are specially trained to work with certain populations in a therapeutic environment.  The treatment sessions are directed by the therapist/dog handler.  Check out this report about animal assisted therapy at Columbus Children's Hospital in Ohio:

If this topic is of interest to you as a parent or professional, I strongly recommend checking out the following link, which is a current weblog by an OT in Texas about her practice with her therapy dog and children.  It is a first-hand glimpse into the world of occupational therapy and how a dog is incorporated into sessions to elicit all kinds of responses from children in order to help them maximize their functioning.  The site includes pictures and videos of therapy sessions in action: 

                      Jumpstart Therapies Animal Assisted Therapy Program

Also, the following link is to an article about a literacy program that originated in the western United States and uses therapy dogs: Kids + Dogs = Combination for Paw-rrific Reading Adventures.

For more specific information on animal-assisted therapy (AAT) and the training of therapy dogs and their handlers, click on:

The Delta Society - Improving Human Health Through Service and Therapy Animals.

Lastly, refer to the sidebar of this site under "Animal Assisted Therapy/Therapy Dogs" for future updates on information and articles on this subject.

I welcome any personal stories & anecdotes regarding therapeutic experiences with therapy dogs and/or other animals.  Please share!

Running for a Cause: Breast Cancer- Past, Present, & Future

Exactly one month from today, a very close friend and I will be traveling to Rome, Italy to join thousands of people in running the Komen Italia Race for the Cure.  We will run in memory of her mother, who passed away from breast cancer.  We will run in honor of all women today dealing with breast cancer.  And we will run for ourselves, our daughters, for all women,  and for the future of breast cancer detection, treatments, and hopefully someday, a cure.                                                

Breast cancer is an issue that all women (and a small percentage of men) must be aware of in terms of early detection and appropriate treatments.  Susan G. Komen for the Cure is the leading source of funding, information, and support for breast cancer and I am proud to support it and take part in one of their events around the world.

Women who survive breast cancer can be faced with a number of challenges during and after treatment.  Depending on if they have surgery and what types of surgery (lumpectomy, mastectomy, breast reconstruction) they have, women should be aware that treatment options do exist afterwards in terms of rehabilitation.  There are occupational therapists who run breast cancer survivor rehabilitation programs and specialize in this area.  Focusing on the experience of the survivor, her occupations in life, and physical recovery, occupational therapists can have a real impact.  The following links provide more information on the subject of breast cancer recovery and rehabilitation.  Women and families should know that after a surgery and treatment, there are options out there to help you fully recover physically, mentally, and spiritually.  For further information on this subject, click here:

Helpful Hints for Breast Cancer Survivors - An Occupational Therapist's Perspective

Rehabilitation for Breast Cancer Survivors

Breastcancer.org: Medical Information About Breast Cancer

With all of the advances that have been made in science and medicine to date, early detection and treatment of breast cancer has made big differences in peoples' lives.  It is important that we continue to support this cause so that more advances can be made so that someday, we may find the cure.  To make a donation for breast cancer research to Susan G. Komen for the Cure, click here: Susan G. Komen for the Cure: Donations

And stay tuned for a review of the Komen Italia Race for the Cure 2008 in May!

Halting Hyperparenting

A few months back (see Are We Overscheduling Our Kids?) I wrote about how parents must be aware as to whether or not they are overscheduling their children and as a result, negatively affecting their family dynamics and childrens' happiness and development.  In it I mentioned some tips from Dr. Alvin Rosenfeld, a child psychiatrist who is an expert on this topic. 

Today I happened to come across someone else's recent blog post about the same topic - hyperparenting- and how she stopped doing it.  It is a heartfelt, motherly post about realizing what's truly important in family life and even moreso, in making sure that your child is allowed to just "be a kid", because they only get to do it once. 

Click here to read this post: Life Practice: Hyperparenting

"You're an occupational therapist? That's great! And what, exactly, is it that you do?"

This is frequently the reaction I get from people after they find out what my profession is.  As I explain to them, we tend to get into exciting conversation about "what I do for work", and people are genuinely interested and zealous for more information.  Therefore, I am posting this today not only to promote the world of occupational therapy, but also to convey how much I enjoy working as an OT.  Although it is a challenging career, it offers limitless personal rewards knowing that I played a part, for example, each time I see a parent's joy when their physically disabled baby reaches a critical developmental milestone, or when a traumatically brain injured young adult is able to dress herself independently for the first time since before her accident, or when a stroke victim is able to sit and balance in a chair independently to eat a meal.  These are the types of things that OT's help people of all ages do everyday.  We focus on goals that are personally meaningful to each person in the scope of their life, and we do our best to help them become as independent as possible in the daily occupations that make them who they are.

                                          

In the United States, April is designated nationally as OT Month by the American Occupational Therapy Association (AOTA).  This month is when the AOTA National Conference takes place (this year in Long Beach, CA) and also a chance for us to promote our profession and describe the benefits that OT provides to all kinds of people each day.  Occupational therapists work with all different clients, from babies to teenagers, to older adults.  Some OT's work in acute care hospitals and rehabilitation hospitals (both physical and psychiatric) while others work in schools, early intervention (babies age 0-3), or private practice.  There are also OT's who specialize in certain areas of expertise such as pediatrics, hand therapy, and neurorehabilitation.  No matter what type of client an OT may have, the end goal is always to promote maximum independence in that client's life. 

Some examples of this include:

• a child attending school who has a neurological disorder may have weak trunk muscle control which affects his/her movement and fine motor skills, in turn affecting his or her ability to perform occupations in school such as sitting upright at a desk and handwriting.  An OT would work with that child to increase muscle control and strength, help with positioning for optimum movement, work on fine motor skills such as pencil grasp and finger control, among other things, depending on the child's educational goals.
• An elderly person who suffers a stroke and loses all motor control of his/her left arm may work with an OT to learn adaptations for skills such as dressing, feeding, and bathing to promote independence, all while also working on strengthening and regaining muscular control of the affected arm.
• A person who is admitted to the psychiatric ward suffering from a dual diagnosis (addiction and mental disorder) will work with an OT on skills such as time management, social skills, personal care, and stress management to help them cope with their illness while trying to break their substance addiction or abuse.

In order to highlight the occupational therapy profession more specifically, I am including a link to an excellent article that was published this past January in the New York Times.  It features occupational therapist Jodi Levin, an OT at the Kessler Institute for Rehabilitation in West Orange, New Jersey who works daily with traumatic brain injury clients.  It is a wonderful glimpse into the world of an occupational therapist in the rehabilitation setting and explains exactly what it is that us OT's do for our clients and their families.  To read, click here:

In the Trenches: The Occupational Therapist, Coaching the Comeback

Is It Safe to Post Our Kids' Photos on Facebook or Other Social Networking Sites?

Discussion has recently surfaced among friends of mine who are parents over whether or not it is safe to post your children's photos on social networking sites such as facebook or myspace.  In the age of internet, many people are using social networking sites to get in touch with old friends, keep up with information about close friends and family members, or even to network among other people who share the same careers or interests.  While many of these sites offer privacy settings, parents should be wary of what kind of information they post about their children, whether it be photos, names, or whereabouts.  Reasons for this center mostly on safety for the child and the fact that the child really has no say in the matter (until he or she reaches an age to argue his/her point).  Even though many sites provide security settings, parents must remember that things are never 100% secure on the internet, as much as we'd like them to be.  There are people out there who know how to hack into systems and steal personal information.  There are people looking to steal identities and harm children. If an unauthorized person were to get access to a child's photo, they could easily download it, print it out, and even pick up details from the background (such as location), or worse, the child's name if it was labeled.  Secondly, babies and young children are unable to advocate for themselves whether or not they want their picture included on the public domain.  It is the job of parents and adults to make this decision and then take all the necessary steps to protect the privacy of their child if they choose to share photos online, such as using password protection and keeping the photos available to only a select group of people who one knows.  This may include having a password protected photo album and having a security setting that prevents information from "leaking" to all social contacts that an album has been updated (unless, of course, you want everyone to know about it).  Someday that baby or young child will be a teenager, then an adult.  Parents should stop and think whether or not it might matter to the child as an adult whether or not his/her pictures are on a social networking site.  Or, of course, one can choose to constantly update and delete information as time passes.

Parents and adults who post pictures of children should be aware of posting pictures of children who are not their own (ie. nieces, nephews, children of close friends, etc.).  Parents have different views on privacy and protection of their children.  However, parents also have the right to know if their child's picture is being used somewhere, since they are ultimately in charge of that child.  While you may be able to control your OWN privacy settings on your profile (in terms of who can see your photos, etc.), you cannot control the privacy settings of "your friends" ie. social contacts on these sites.  So, by allowing photos to be available to certain people, you still run the risk of those photos being able to be downloaded and added to a friend's profile, for all of their "friends" to see.  Many sites also have a "share" option, which allows you to share specific photos with your contacts, whether they are your own photos or from someone else.

Lastly, photos are able to be "tagged" -- that is, you can label people with their names, so that when you are looking at the photo, the name of the person will show up on them as you navigate your mouse over the photo.  This is another security risk for children, as their photos could be on multiple people's sites with their names labeled on them.  And again, if someone "tags" you in a photo, you can usually "untag" yourself so that nobody sees your name (if you have an account on the site).  However, if someone labels your child in a photo, all you can do is ask the person who did it to undo it.  But by then, your child's picture and name could have been seen or downloaded by multiple people. This is one of the scarier subjects to tackle on this topic, because we all have friends who have photos of us and our children, and vice versa.  Some people may not have an account on a social networking site, while their friends may.  There is always the chance that someone you know may have photos of you and your family posted on their site without you knowing.  Even if they are a close friend of yours, how comfortable are you with the fact that your children's pictures may be "out there" for other people to see -- people you DON'T know?

If you are going to post a child's photo on a site:

• Be sure to not label their name, or at least use only their first name, or initials.
• If the child is not yours, take extra precaution to protect their privacy by keeping their photo available to only relevant people (in other words, not to the friend from grammar school who you haven't seen or spoken with in 15 years who recently contacted you and lives 2,000 miles away).
• Speak with the parent of the child to make sure that they know their child's photo has been posted, or ask them in advance for permission.  Some parents may not post their own children on their own personal profile sites for privacy reasons, and therefore would probably not feel comfortable with their children's pictures being on someone else's profile, out of their control.
• Lastly, as stated earlier, it is impossible to control what other people post on their profiles.  One can only take precaution by talking to friends about it and asking them to be responsible with photos of your children by keeping them as private as possible from strangers and irrelevant social contacts.

Of course, as the children of today grow older, they will probably want to join one of these social networks as well.  Parents can take precautionary measures with their children by navigating the sites with them and helping them to set it up while teaching them not to give away too much personal information.  The internet is not going to go away, so the best thing parents can do is learn about it and teach their children the best they can about how to conduct and protect themselves online. Following are three links that I found helpful on this topic:

Are Your Child's Photos Safe Online? - Simple facts about information you put into cyberspace and protecting children.

Keeping Your Child's Privacy Safe on Facebook - Guidelines for teaching your children safety on social networking sites.

The Impact of Social Networking Tools and Guides to Use Them - An interesting article from a legal perspective about how personal information you post can be accessed, researched and used as a background check by employers, schools, etc.  In other words, be careful what you write about yourself and whether or not this information could be a hindrance to your goals in life such as schools and jobs.

The Repetitive Movements of Motherhood

I am sure there are plenty of moms out there who share my belief and experience that it is incredibly difficult to get yourself back on the exercise bandwagon after your baby is born.  For me, it is something that in general I have always enjoyed -- keeping in some kind of "fit" form, but at no time is it more difficult than after you give birth.  On top of that, I tend to "reward" myself for "bringing a new life into the world" by treating myself to goodies (mmmm....brownies a la mode, anyone?).  There is no arguing that getting started is one of the toughest things to do.  Let's face it -- recovering from delivery and caring for a newborn takes a physical toll on our bodies, as well as psychological.  Though we are burning lots of calories during everyday tasks with our infants (especially if you are breastfeeding), the movements and positions that our bodies are in can become repetitive over the weeks and months.  First and foremost, our abdominal area is weakened from the 9 months of pregancy itself.  If you had a C-section delivery, you then have to deal with the healing of the incision and muscle weakness that accompanies that.  Because of the weakness in our abdominals, our lower backs are at risk for strain from muscle imbalance (strong back muscles, weak abdominals).  This is important to be aware of, since it is these torso muscles that give us our stability for movements of our limbs.

Secondly, the walking back and forth, bending up and down, lifting the baby, holding the baby on one side, preparing bottles, changing diapers, breastfeeding, and many more tasks -- all can lead to "static positioning".  Over time, our bodies become tight in other areas due to lack of mobility and the constant pulling, tugging and muscle strain in the primary areas we use during our day for childcare. At times I felt like the tin man in the Wizard of Oz, stuck in some areas.  I liken it to what can happen to the worker who is in an office job: something called repetitive stress injury.  For example, someone who sits at a computer all day long for their job using a mouse, typing, etc. can be at risk for certain upper extremity repetitive stress injuries that can affect the fingers, wrists, or entire arms.  There could be nerve impingement (as in carpal tunnel syndrome) or arthritic developments within the joints that are used repetitively in the same motions/positions. 

The everyday demands of newborn care can take their toll on our upper backs, lower backs, wrists, and necks.  Each woman could have different symptoms based on her unique style of carrying a baby, changing, feeding, etc.  For me, I tend to curl my shoulders inward towards my chest while cuddling a baby and nursing.  Over time, I have noticed that my chest muscles are contracted and my upper back and shoulder muscles are overstretched, leading to rounded shoulders (which us women want to prevent, especially as we age and become more at risk for osteoporosis) and neck discomfort.  It is very important that we take the time we need to care for ourselves so that we can be our best for our children and enjoy the occupation of motherhood.  Though there is a lot of information out there recommending exercises for new moms, here are some that really helped me, and don't take a lot of time or energy (very good for those early weeks and months when sleep seems to be an unknown).  Of course, if you think you are suffering from a severe weakness or injury, contact a physician immediately and get checked out.

1. Just lay flat on your back for 10-15 minutes a day! -- Grab an exercise mat or a soft blanket, lay flat on your back on the floor and let gravity do its work.  Allow yourself to "melt" into the floor.  Once relaxed, do some deep breathing and move your limbs, stretching your arms up and out.  You will feel a stretch in your chest muscles.

2. Shoulders back and down -- Throughout the day, try to remind yourself to keep your shoulders back and pulled down towards the floor.  Do some shoulder rolls backwards to allow the shoulder girdle joint to get some mobility in all directions, not just the ones used in picking up and putting down your baby.

3. Neck Stretches -- Try to tilt your head to each side (ear to shoulder) a few times a day to allow your neck muscles to stretch out.  Relieving that tightness can many times relieve any neck pain you may be experiencing due to uneven muscle pull/strain on the neck vertebrae.  Of course, if you are experiencing severe neck pain, see a doctor or chiropractor.

4. Practice good body mechanics- Remember to practice good body mechanics and positioning during your daily tasks/occupations.  When lifting the baby, don't allow too much strain on your thumbs, because this can lead to wrist pain.  During lifting and placing of the baby, keep him/her close to your body so that your core muscles can do the work and you do not strain your back.  Bend at the legs, not at your waist.  Use a pillow to support your arm while bottle-feeding.  Use a nursing pillow to support the baby and your upper body during breastfeeding. 

5.  Avoid sudden movements - Don't forget that pregnancy/birth hormones are still flowing strong in your body after you give birth.  These have a relaxing effect on muscles and ligaments, so beware of sudden movements that could easily strain your muscles or overstretch them.

The Great Balancing Act

About 3 months has passed since my last post.  In that time, I gave birth to my 3rd daughter and have been adjusting to life as the alpha female of a family of 5.  Though many men and women become mothers and fathers (some of only one child, some of many more), it can never be underestimated as to the immense adjustment it is, no matter how many children one has.  As wonderful an experience as it can be, it is challenging to find a "balance" in life between being parents, spouses/partners, workers, friends, and everything else that comes along with being part of life and society.  It is important to be organized and aware of oneself and the needs that must also be met to take care of yourself.  When we, as parents, are running around, caring for children, dressing, diapering, bathing, feeding, transporting, listening, playing, etc. it is easy to forget to chisel out even just 15 minutes for ourselves.  And throw on top of that the housework, cooking, grocery shopping, a job outside the home, or school, and adult relationships to maintain/nurture.  It can all get very hectic!  It is "easy" to say that you'll take time for yourself, and "easy" to advise others to do the same, but it's actually very difficult to "do", because when there is a new addition to the family, the truth of the matter is there barely is any time for the primary caregiver, usually the mother.  Something always comes up, whether it's a diaper change, an emergency bath, an accident, or your toddler vomiting on the floor because they are sick!  Now that my youngest is almost 4 months, things are settling down a bit in terms of a predictable schedule for feeding, naps, etc.  However, those early days and weeks of the amazing newborn are some of the most demanding of our lives.  Who can forget those LONG nights of being up feeding/consoling your newborn?   It can be incredibly frustrating when you are dead tired and everyone else in the family is sleeping around you.  If you have more than 2 children, finding even just 20 minutes during the day to catch up on your sleep is virtually impossible if you are on your own. Keeping a positive attitude and "biting the bullet", so to speak, are just what we have to do to get through it.  Of course, having a supportive partner and some help is a great asset.  But with help or without, we have to keep reminding ourselves that this demanding adjustment is usually only for the first few months and sooner or later things will settle down.  No matter how stressed and tired we are, we have to take some time for ourselves once in a while in order to "recharge" our mind, spirit, and physical self.  By doing this, we do a service to both ourselves and our children.  A mother and father who are calm, relaxed, and refreshed are able to offer more of themselves to their children in the long run.  So, moms and dads out there--take some time for yourself when you can, and accept help if it comes your way.  Be positive and keep reminding yourself that things will settle down soon enough.

Are We Overscheduling Our Kids?

With so many choices out there in society, it can be difficult to choose which activities and how many to put our children in.  Of course, these choices are greatly affected by a child's age, family income, time constraints, and family dynamics.  It seems that anywhere one looks as a parent, there is information flying at you telling you how to "make your child smarter", or "give your child an advantage" by putting them into different activities.  No doubt that some activities are great for children.  Aside from teaching them a specific skill such as a musical instrument, dance, or gymnastics, for example, these kinds of activities also promote social development, self confidence, and friendship. 

The problem in today's society is that parents can easily fall into the "more is better" trap.  That is, they want their child to be a part of as many different "extracurricular" activities as possible.  What some people forget is that a child also needs downtime in their life, just as adults do.  Children need time and space to just play, be home, and explore for themselves.  I think that as parents, we can allow ourselves to be pressured at times into putting our children into things even when we don't feel 100% comfortable with it.  It may be due to societal pressures, or pressures from other parents who push their children into a myriad of activities.  Parents also feel that the world is so competitive that if they give their child a "headstart", it will benefit them greatly later in life (which could be true, if done the right way).  A friend of mine recently felt guilty that her daughter, who is 4 years old, was not going to be able to continue her gymnastics class because she was going to be in school until 4pm everyday.  I tried to remind her that though she would not be going to the gymnastics class, her daughter's day would now be filled with other activities during her school day.  Schedules change and children grow; there will be other times to take a gymnastics class again.

Dr. Alvin Rosenfeld is an expert in child psychiatry and a co-author of the book: The Overscheduled Child: Avoiding the Hyperparenting Trap.  He recommends the following fundamental principles to assist you in making decisions that will work best for your family regarding this issue.

• Limit activities
• Develop Healthy Skepticism
• Give Yourself a Break
• Family is a Priority
• Buyer Beware
• Character Counts
• Be Unproductive
• Childhood is a Preparation, not a Performance
• Pleasure has a Place in Parents' Lives
• Pleasure has a Place in Kids' Lives, too!
• Leave Empty Spaces on Your Calendar
• There is no Single, Right Way to Parent
• Trust Yourself

For more in-depth explanation of these principles and to learn more about hyperparenting/oversheduling children, click on these links: How to Avoid the Hyperparenting Trap and Hyperparenting: the Overscheduled Child, Brown University Newsletter April 2001

I am a proponent of organized activities for children.  Especially in this day and age, when parents are fearful of letting their children play unsupervised outside, it is wonderful to have such choices of kids' activities out there.  However, one must know their child well and read their cues.  Some children can handle more than others.  Some children enjoy doing lots of different activities, while others may tire of it, become uninterested, and withdraw.  The biggest key is monitoring your child's happiness.  Don't forget that downtime at home can be fun, relaxing, and healthy.  It gives the family a chance to spend quality time together, doing new activities.  Downtime also allows children to learn to entertain themselves and have the time to explore their own interests, without somebody constantly directing them.  This goes a long way as they learn to monitor themselves and conduct themselves as individuals in the grander societal scheme.

Building Bonds through Infant Massage

Infant massage is an art that has been practiced for centuries in many cultures around the world.  While somewhat new to the Western world, infant massage is quickly catching on with parents as a way to increase emotional and physical bonds with the child and to optimize the child's growth and development. 

As a Certified Infant Massage Instructor (CIMI) with the International Loving Touch Foundation, I have seen the benefits that both babies and parents derive from infant massage.  More importantly, I have experienced these benefits as a mother myself while massaging my own children. 

Infant massage creates a unique opportunity to bond with your baby through loving touch.  It also provides an enjoyable way to promote healthy growth and development of your baby.  The following is a list of simple benefits for both baby and parent:

Benefits for the Baby

• Emotionally nourishes the baby
• Begins a loving, intimate communication between a parent and the baby
• Helps to strengthen and regulate the baby's primary systems (ie. respiratory, circulatory, nervous, musculature and gastrointestinal)
• Reduces gas and colic and allows the baby to sleep better
• Helps the baby relax and release the tensions of daily stimuli

Benefits for Parents

• Better understanding about their infants' cues of responsiveness
• Enhances communication and emotional ties
• Increases confidence and handling skills
• Greatly improves the bond of affectional attachment
• Provides a means to develop quality interaction time
• Helps the parents relax and listen to their baby
• Massage becomes a perfect avenue for conversation as the child gets older

Copyright 1994, International Loving Touch Foundation

The International Loving Touch Foundation trains instructors around the world in the art of infant massage.  These instructors teach infant massage to parents in homes, hospitals, community centers, clinics, and private settings.  To find a Certified Infant Massage Instructor (CIMI) near you, click here:

Certified Infant Massage Instructors (CIMI) Directory, ILTF

    

Swiss Survey: Majority Supports Breastfeeding in Restaurants

As a follow up to my post from August 23,2007 "When Will Breastfeeding Bashing End in America?", I was notified that this week's "question of the week" in the Cooperation magazine in Switzerland was,

"Does it bother you when mothers breastfeed in a restaurant?"

The percentages were reported as follows:

76% in principal said "NO"

8% in principal said "YES"

16% said I'm split; it depends on the restaurant.

Source: Cooperation, N.35, August 28, 2007

This is just another example of the fact that in Switzerland, breastfeeding in public is tolerated and supported, therefore making it easier for a mother to engage in one of the most important "occupations" of motherhood - feeding her infant.  For those of you who are able to read French, all results of the survey can be seen by clicking here for the link to the article:

Allaiter au Restaurant?

Back To School is Upon Us!

It is the last week of August and all of us parents are busy preparing our children to begin the 2007-2008 school year next week.  In the United States during the month of September, occupational therapists across the country work in conjunction with schools, communities, and families to hold Backpack Safety Awareness Day.  I am including in this post a link about research that has been done on students who use backpacks.  There have been a lot of findings regarding posture, spinal growth, chronic back pain, poor body mechanics, and repetitive stress injuries related to the improper wearing and carrying of a school backpack.  These problems can easily be prevented by knowing how to properly use a backpack.  To read the findings, click on Backpack Research.

In the sidebar under "Student Backpack Safety Awareness" is a nice list of files produced by AOTA about backpack safety.  It includes tips on how to properly pack and wear a backpack, as well as how much weight each student should carry depending on his or her own body weight.  There are also health and success tips for students and backpack information for schools.  I encourage you to check out the lists and print them out so that you can get your child started off on the right foot!

When Will Breastfeeding Bashing in America End?

This post comes as a visceral response to the things I have read in the past month in the news about breastfeeding, and more specifically, breastfeeding in public.  When women become mothers, we have choices to make for the rest of our lives regarding the well being of our infants and children.  One of the earliest and most important decisions we have to make is whether or not we are going to breastfeed our infants.  Some women make this decision during pregnancy.  Others decide just after the birth.  Some women have immense support networks (friends, family, groups) to encourage breastfeeding.  Others don't.  Some women give it a try and for some reason (whether emotionally, physically or medically), it doesn't work out.  Still others decide that "it's not for them", despite the indisputable evidence that mother's breast milk is what's best for baby.

I nursed my two children from birth.  It was a decision I made the moment I became pregnant; it was something I always planned to do if I ever had children.  It is something that I feel grateful for and can never regret.  It is something that nobody can take away from me-or them. 

However, I understand the difficulty of being a first-time mom and getting the whole "nursing" thing down.  It can be very frustrating, and without positive support, one can want to give up easily.  I also understand the difficulty of going back to work while nursing an infant.  The disruptions in feeding, finding time and a place to pump for a milk supply, and the distractions of life at work are just a few of the things that make it difficult to continue.

I was shocked in late July to see such a negative reaction from readers of Baby Talk magazine, a US magazine made for mothers, after they published their August issue about breastfeeding.  What was all the hoopla over?  The magazine cover--a photo of an infant nursing at the mother's breast.  It was a close-up profile shot that showed the baby's head and small profile of the breast; very naturally.  Some readers really had some nasty things to say, and it shows that even though breastfeeding is becoming more common in the United States, many people are willing to make a nursing mother feel badly or uncomfortable while she is feeding her infant, especially in public.  To see the magazine cover and read the negative comments, click here http://www.msnbc.msn.com/id/14065706/.

However, women in the USA are making progress towards nursing their babies more and more.  This is a great thing for women in our society and after reading the previous article, I was happy to learn that in early August,  The Centers for Disease Control and Prevention reported that a whopping 74% of women in the US are breastfeeding their infants for at least some period of time.  This is the highest level of women on record for the US.  You can read the full article about the report here: http://www.babycenter.com/204_u-s-breastfeeding-rates-rise-to-record-high_5174525.bc.

As an American woman living abroad in Switzerland, I am amazed at the difference in respect with which motherhood and breastfeeding are treated between the two cultures.  In America, though it may be improving, breastfeeding in public is still taboo.  If you are an American mother who has breastfed her infants, I'm sure that many of you have had the experience of negative looks or comments from others if you were nursing in public; even if you were completely covered up and discreet about it.  How many of you, in order to avoid the previous scenario, went and sat in a dirty bathroom stall or went all the way back out to your car for privacy?  As we well know, when babies need to eat, they need to eat.  And if an infant is being nursed, he or she has the right to eat wherever mommy may be at the time.  A woman feeding her infant is not taking part in flaunting herself sexually to the public.  So the public should stop "sexualizing" the breast, because the real function of it is to feed our young.

Here in Switzerland, breastfeeding is actively encouraged.  People don't look or think twice when a woman is seated in a waiting room, on a park bench, or in a quiet corner at a restaurant or cafe nursing her infant.  It is part of the cultural society here; motherhood and infancy are held in high regard and are generally treated as such.  There is a particular sense within public life here that "everyone", adults and children alike, have a responsibility to the younger generation to nurture them.  Many children here grow up in a household where they experience their younger siblings nursing.  They learn that at one time, they did that as well.  When children are taught from an early age what the true purpose is of a woman's body in the circle of life, they learn to respect it and accept it as normal, the way it should be.  This carries over into adult society life as they grow.  Boys become supportive husbands to the mothers of their children by supporting them in nurturing their own child through breastfeeding.  Girls become mothers who are willing to try to do the best they can at giving their child the best nutrition from the start, and they don't have to feel as if they are interrupting "public life". The truth is that in America, the people in public who scoff at or make nursing women uncomfortable are, in fact, disrupting one of the most historically natural cycles of life; that of a mother feeding her young.

To exemplify how highly regarded a nursing mother is here in Switzerland, I have included an advertisement for a Swiss insurance company that I found in a local Swiss newspaper (www.20minutes.ch). 

It translates to: 

"A fixed program?" 

            -"A privileged moment."

Someday soon, hopefully, American society will feel the same way.

 

A New Blog About OT, Parenthood, Child Development, and All Things Related

Welcome!  Thank you for visiting Child and Parent Occupational Wellness.  This site serves to be a resource and discussion area for parents, families, and professionals who are interested in topics related to overall family health and wellness and more specifically parent-child occupations.  As an occupational therapist who works with children and families, I hope to be able to supply helpful information for parents and children of all abilities. My aim is for this blog to be both personal and professional by bringing forth some of my own observations and experiences in my daily life as a woman engaged in the "occupation" of motherhood, as well as providing information on different topics related to family life, parenthood and child development.  I look forward to your feedback as the site develops!