More Than A Toy

For a child to develop physically and emotionally, playing is of vital importance. After the first year during which the parents' main priority is learning motor functions like standing upright, social play based tasks become the main task in a child’s life.

At this foundational stage, kids learn through play and as such, most therapy approaches use play as a medium of impact.

Toys are tools we use in Therapy to facilitate therapeutic play.When children create a make-believe world through play; for example, using toys to build a tower of blocks or race a friend to the top of a hill, they acquire the social and intellectual abilities needed to be successful in school even up to adulthood.  Nearly all meaningful play includes toys.

 A single, engaging toy can transform a child’s play from simple to academic, from repetitive to inventive, from solitary to social. Toys can be activated by switches, voice, proximity, touch, mounts and splitting.

 

There are many do-it-yourself adaptations that can be made by therapists or parents.
Creativity is needed by adults and children alike.

Toys for gross motor development includes, trampoline, bicycle, scooter boards, matching band/drum set kits, exercise balls which are great popular toys to get those arms and legs moving in a fun way as their body grow stronger.

This promotes balance and, ideal for kids with special needs and group social play activities.

Fine motor skills involve the small muscles of the body that enable such functions as writing, grasping small objects, and fastening clothing. It develops as the neurological system matures.

The level of development of fine motor control in children is used to determine the developmental age of the child.

Fine motor control requires awareness and planning to complete a task. It also requires muscle strength, coordination and normal sensation.

Tasks such as stacking blocks, cutting out shapes with scissors, drawing lines or circles, tearing paper, buttoning a button, and holding and writing with a pencil can occur only if the nervous system matures properly.

Your child’s fine motor development is a very important part of their physical skill set. He/she needs to learn to use their hands competently in order to manipulate toys and to acquire self-help skills such as feeding and dressing.

Play is a child's "work" and it is a very important part of their physical development. Babies and young children need to have ample opportunity to play. By the age of 6 years, a child's fine motor skills have developed sufficiently enough to complete writing, dressing, and feeding tasks adequately for the average child.

They will have enough bilateral coordination, eye-hand coordination, and dexterity to complete cutting and writing tasks. Children will continue to develop and improve these skills, but the groundwork needs to be developed and established within the first six years.

This is why a child will need toys, games, and activities to perform and improve these skills during his early childhood. Fine motor skills are important in most school activities as well as in life in general.

Weaknesses in fine motor skills can affect a child's ability to eat, write legibly, use a computer, turn pages in a book, even to perform personal care tasks such as dressing and grooming.

Toys for improving fine motor include, crayons, lego bricks, beading and lacing sets, markers, plastacine sets, all pretend play sets (barbershop, make up set, playing Doc set, Kitchen, work tool bench) are great fine motor activities.

For more you could visit the Sensory care Therapy Shop.
The sensory care therapy shop


Image courtesy:  pinstopin.com, forthemommas.com, parentinghub.co.za, zmescience.com, picsant.com, alibaba.com, dailymail.co.uk, wonderbaby.org, reallookautism.com, sensationalkidsot.com.au, citytheorist.com, kidbility.com, themommytalks.com, cliparthut.com, tsxmsc.com, offset.com, creativegardenschools.com, learning-difficulties.blogspot.com, thespiritscience.net, popsugar.com. b57d13e35bad3848709750de2b297a349f54c3dcaf31c14044

The School and the Parents...

Recently, a parent called and scheduled a meeting with the school and therapists working with the child. I was really happy- wow! she is really putting her child first this time.
You can imagine my surprise when the meeting turned out to NOT to be a meeting but a written down dictation on what she expects her son to be doing now.

"I want him placed in basic three instead of two."
"No more practical work for him. Move totally to abstract."
"Stop all one-on-one therapy time. He should do full time like his mates."
"No more cutting of his work load. Give him the full load like his mates."

This is a boy who has almost succeeded in coming out of the spectrum but is still having challenges with abstract teachings; he also had a penchant for giving up on a task easily (still working on that) and his mum is too busy to hear any progress report.

I asked her why the sudden meeting and dictates and she replied
“his mates are in basic 4 now” he is taking too long ah!"
I gently reminded her that when we started she had told us that if only he could just communicate his needs and write that she would be okay, now she was dictating the pace. She replied,

 "....eeeehn…I thank God ..but he should do fast and join  his mates."

I told her of the challenges we were facing, the teacher also told her about the IEP we had already drawn up; also that if she would patiently go through it with us, she would see that it suited him well.
She vehemently refused stating that this was what she wanted, that her hubby and a friend discussed it yesterday and they had already come to a decision.

Unfortunately, this is the trend in schools; some parents dictate what is to be taught, styles of teaching  and punitive measures or if possible, no punitive measures whether it conforms to the school style or not and then giving the school an ultimatum..."do it my way or I withdraw my child” and you see schools doing their bidding to avoid losing their students.

All this dancing to the whims of parents and not focusing on enhancing the child's abilities.

The resultant effect?
Lack of disciplinary measures
The schools lose their integrity.



Image courtesy: www.dalmain.lewisham.sch.uk, www.bbc.co.uk, www.inquisitr.com,           www.telegraph.co.uk, blog.losingcontrolfindingserenity.com

Choosing a school for your special child

Impressive right? well, as we say in Nigeria, "No be by dat wan abeg..." There are a lot of things to consider when picking a school for your child.

In Nigeria, children with special needs can be enrolled in a main stream class with additional supports, in a support class in the school, in a special school or center affiliates. Parents need to explore each option and decide on what they feel is most appropriate.

Guide and Checklist for Choosing a School.

As more and more people are agitating for inclusive education for special needs kids. It is imperative for parents to look for mainstream schools with good special education programs.

There are a lot of schools that seem to be offering these services but are they effective?

A parent lamented on the fact that her son has really regressed after a term in a mainstream school in Nigeria. A therapist complained about the way the teachers and cleaning staff ignored the child and expected her to see to the child’s needs. The child, a 3 year old with budding cognitive abilities who just started gaining speech was placed in the toddlers unit. It was with reluctance, after several meetings that she was then moved to a higher class.

Parents should consider the following tips and checklists in choosing a school for their kids.
Plan as early as possible in developing checklists of what you expect of a school for your child.
Visit websites of schools and ask parents with Special needs their opinion on schools.
Visit each school’s open day and talk to the principal of the school.

 School Culture and Inclusion
• Does the school culture fit with your child?
• Did the principal and staff seem genuinely supportive?
• Does the school philosophy specifically acknowledge different abilities and learning styles?
• Do you feel that the school staff will understand your child’s needs?
• Are there signs of inclusion?
• What programs are in place to effectively deal with bullying
• How many children with disabilities (or receiving additional funding) does the school currently
• Is the parent community supportive and involved?

 Class Size and Teaching strategies
 Are your child’s capabilities, strengths and challenges understood?

• Is there one staff member who has overall responsibility for the children with special needs        (e.g. Learning Support Teacher) and do they allow for parents to hire a shadow special education therapist to be with the child?

• Does the school have access to therapists (e.g. occupational therapist, speech therapist etc)?
• Do staff members undertake professional development in disability?
• What is the student to teacher ratio for all classes?


Is there a quiet place for one on one therapy follow-up session with his personal therapist or to calm the child down if he/she experiences sensory overload or melt downs?

Is there a general consensus by the parents and the child’s educational team to use the IEP
  [an individualized plan] for the child?

Do you think the IEP addresses the child’s challenges and will bring a positive outcome?
Are there Therapy materials in carrying out the IEP of the child?

What type of Assessment is being done?
Is it too structured or is it flexible enough to take into cognizance, the child’s challenges and progress attained?

Additional Services

Does the school have an introductory program to assist children transitioning into the school or an organized transition program for children moving from primary to secondary?
• How structured (prescriptive or open-ended) is the curriculum? Is there enough flexibility? How does the school support those students needing additional support in transport etc?
• What does the curriculum offer beyond the statutory subjects? Co-curricular activities?

• Does the school offer clubs, interest groups, etc?
• Do all students have access to specialist facilities (e.g. library, art rooms, science and technology laboratories, etc)?

 


What are the strategies in narrowing it down to the child so that learning takes place?

Social Skills and Inclusion.
Are the school grounds safe and secure?
What other signs of inclusion do you see?
Are there structured activities at lunch time and break time to encourage social skills and inclusion?

.........No comment.........

Image courtesy: logbaby.com, techloy.com, www.adeadegbiteschools.com, www.nairaland.com, meadowhallschool.org, www.coface-eu.org, helenogradydramaacademy-lagosislands.blogspot.com, www.stlouissisters.org, e4pr.blogspot.com, www.vanguardngr.com, woodlandschoolsng.com, www.thethresholdschools.com, www.loyolajesuit.org, www.ondostate.gov.ng

It's Lego time

One of my special children, Udoh has ADHD. Last week during one of our therapy sessions, I found out that he had only simple large no-theme lego bricks.

He could use it to make cars, houses and other shapes and was really bored with this activity...and really too big for this size of lego. He needed another set of small sized lego with a theme to encourage more complex pretend play. 

Bricks are one of my favourite toys for fine motor drills, concept development, pretend play. As such, it was another opportunity to go lego hunting and window shopping. 

I entered the themed lego place and I was really impressed with the wide range of sizes and themed legos. After describing to the lego- crazy attendant what complex skills I needed Udoh to develop and what cognitive stage he was in; that is, I wanted him to learn to construct castles, houses, transit 2d to 3d concepts (spatial relation), to increase his concentration and attention and really improve hand function (complex) and also encourage pretend play and mid level between difficult and easy.

I finally settled on a car race/car repair themed Lego very smallest size. He was really excited, his expression of surprise was priceless. 

Okay he didn't look this excited...

At first I was scared it would be too difficult for him when he started tinkering with it but it's not as hard as I thought it would be. I am trying to teach him to use to use the miniature tool set (spanner, screw driver, hammer screws, nails crow bar) and he is so willing to be taught. Although the picture step by step manual is really really challenging for him.

The amazing thing is that Udoh actually sat quietly for 30 minutes!!!

Image courtesy: www.amazon.com, metro.co.uk, www.marchoftherobots.com, www.sodahead.com,                               lego.wikia.com, www.nkayesel.com, lego.brickinstructions.com,                        lego.brickinstructions.com

Watch that Splint

I promise this is an interesting topic...

After the Hip Ankle Foot Orthosis (HAFO) was made for Dewunmi who had severe Hemiplegia caused by Cerebral palsy, his mom was so excited but Dewunmi did not like this extra load and inconvenience. He was cranky all through the fittings. 

"Madam I need you to wear him at least 8 hours daily and we have to be consistent because the more he wears it, the better to prevent gradual joint stiffening."

She replied, "Don’t worry, trust me he will wear it even to sleep."

"Ahh!!! No o! Madam this is not a night splint and it could be very uncomfortable, 8 hours is very ok for his age."

After a month, we noticed sores on Dewunmi’s caudal region, I immediately knew that she had ignored my instructions. The HAFO had caused uneven pressure on the caudal bony prominence which had resulted in the development of the sore.

This is why I decided to write a short post on splinting.

Splints and orthosis are temporary devices in neurology used to correct or ensure proper anatomical positioning and sometimes movement and also prevent joint stiffening and subsequent deformity especially for spastic children. It also helps to reduce risk of injury, improve mobility performance and stabilize the joint.

How do Orthosis or splints work?

They work by applying forces to the body. By encompassing parts of the body and preventing movements, muscles and joints can be stretched. Many muscles cross two joints (for example, the calf muscles cross both the ankle and knee). 

To exert stretching effect, either both joints must be held by the device or activities that stretch the joint (passive and active exercises) not in the device should be encouraged. 

Splints and orthosis can also provide stability to help some children stand and walk. 

This is the bio-mechanical explanation of how the device works. 

Materials used include high temperature thermoplast, neoprene and even lycra garments etc.

The following considerations must be properly adhered especially at first fitting and through out the day:

1. Ensure that the splints are well contoured.

2. Always maintain Anti-deformity position (proper body alignment)

3. Snugly position and tighten straps to allow blood flow or veinous return (not too tight, not too      loose).

4. If the splints are too tight or inappropriately placed, circulation is compromised.

5. If a child cannot monitor the status of the affected area, Parents should be instructed to examine the body part for evidence of muscle strain, swelling, redness or sores between straps or muscles around the region.

6. Allow motion out of the splint at periodic interval (parents should learn some passive exercises to perform at these intervals).

7. Avoid or minimize bony prominence.

Foreign Pre-formed Splints

A lot of parents prefer the foreign splints because of the materials and its aesthetic beauty but they have the challenges of “one-size fits no one”  and as such, still have to be custom-fitted by a really experienced Occupational Therapist or Physiotherapist and Orthotist.

Lastly, Orthosis are never an answer in themselves but in many cases they are an extension of the therapist’s arm while away from hands-on active treatment.

The usual trend is this, when a splint, orthosis or an assistive device is made for a child, the parents are usually excited and are consistent within the next few months or weeks, after then, they start faltering, becoming inconsistent with some even totally stopping. 

I understand this because I also see this trend in myself (with abstinence from junk food) but for the device to do what it’s made to do, there has to be consistency and proper adherence to the rules.

Image courtesy:  arthritisbroadcastnetwork.org, www.nopcoclinics.com, www.oandp.org

                            haydentrigg.blogspot.com,  www.wannatowel.com, orthoinfo.aaos.org

                            www.dailymail.co.uk, www.ncmedical.com, www.splints.co.za