4th of July

While many of us look forward to the parades and fireworks on the 4th of July, it can be overwhelming and stressful for children with Autism or sensory processing difficulties.  Below are some tips for making this Independence Day enjoyable for the whole family:

Prepare your child for the day’s events.

  • Social stories work well to prepare your child for what they may experience and how it may make them feel, and provide scripts and reminders of sensory strategies that will be available to them.
  • Visual schedules can add an element of routine and predictability to the day. Seeing the day’s events and being able to refer back to it can be easier for a child to understand than being told verbally what to expect (especially if your child has language delays or deficits). Remember, visual schedules can be as structured or as flexible as you want or as your child needs/can handle. A dry erase board allows you to make quick changes for when things are not going as planned.
  • Watch videos of parades and fireworks.  Start with the volume down and gradually increase it. Talk about the crowds, the noise level, and the visual stimulation. Make sure this conversation is positive and calm, but also communicates what can be done to reduce stimulation if needed.

Come armed with sensory strategies that will help your child calm down if overstimulated.

  • Headphones or ear plugs can reduce noise.  If your child has never worn them before, try them at home in the days leading up to the event so that they are familiar.
  • Sunglasses or a billed hat can reduce visual input by dimming the light or cutting the visual field.  A small pop up tent or umbrella can provide your child with a safe space with reduced visual input and lower risk of being touched/bothered by others when he or she needs a break.
  • While crunchy snacks can be alerting, chewy snacks (or those that require a sucking motion) can be calming. Licorice, beef jerky, and bagels are foods that require heavy chewing!
  • Heavy work can help to prevent over-stimulation, and can calm your child if they get to that point despite using the above strategies.  Passive heavy work can include things like ankle weights, a weighted blanket/backpack/lap pad, or firm hugs/squishes. Get your child moving for more active heavy work options, like bear crawling, crab walking, swimming, and jumping.

Be observant, flexible, and realistic about expectations. Watch your child’s reactions; you know him or her best.  Even if you use all the tips above, your child may still become overwhelmed and overstimulated. Try not to stress about it or let it ruin your day. Watching fireworks from the car, or heading home early and playing games can still result in a fun day for all!

For some fun 4th of July themed crafts you can do at home that are OT-approved (like Star-Spangled Slime, Shaving Cream Firework Art, and Confetti Launchers), check out our Pinterest page!

Author: Krista Flack, MS OTR/L

Hurricane Preparedness Week

Governor Henry McMaster has proclaimed May 27 through June 2 to be South Carolina Hurricane Preparedness Week. SCEMD, county emergency managers and the National Weather Service urge citizens to take time now to prepare for major emergency like hurricanes by reviewing their family emergency plans, developing a disaster supplies kit and talking with family members about what could happen during a crisis.

The S.C. Emergency Management Division releases the official 2018 South Carolina Hurricane Guide this weekend as part of this year’s S.C. Hurricane Preparedness Week, which details useful information on what residents should do before, during and after the landfall of a major hurricane. Download the 2018 South Carolina Hurricane Guide here: www.scemd.org/stay-informed/publications/hurricane-guide/ 

This guide includes the following tips for residents with special needs:

  • Put your most important identification and medical records into a digital format for easy safekeeping and quicker movement because paper documents can easily get misplaced or damaged during a significant weather event. 
  • Put your name and contact information on your equipment in case it gets misplaced during the excitement of evacuation, sheltering, or shelter consolidation. 
  • Ask for help if you need it. Call your local emergency management office. Some offices have a list of people who need extra help during an emergency. 
  • Know yourself and have your plan ready and in place. Make sure other people know your plan too. Leave as soon as you can so you can reach your destination safely ahead of a storm. 
  • Review the hurricane preparation checklists in this guide. Think about any additional things you may need like batteries for hearing aids and similar devices, extra oxygen tanks, electrical backups for medical equipment or special food requirements.

Other resources:







Children’s Mental Health Awareness Day

The National Children’s Mental Health Awareness Day is Thursday May 10th, 2018, with a theme of: “Partnering for Health and Hope Following Trauma.” On this day, more than 1,100 communities and 170 national collaborating organizations and federal programs plan local Awareness Day activities and events around the country, including an event in Washington, DC, hosted by the Substance Abuse and Mental Health Services Administration (SAMHSA), which will bring together governors’ spouses, youth and family leaders, senior federal officials, and executives from leading professional health organizations for a town hall discussion on how to transform child serving systems to be more trauma informed. Trauma-Informed Care is a hot topic in pediatric healthcare right now. The American Psychological Association defines trauma as “an emotional response to a terrible event,” which can include experiencing a natural disaster, neglect/abandonment, abuse, or witnessing violence.

Trauma-Informed Care is a paradigm shift, a lens in which past traumatic experiences are understood to have the potential to alter a person’s nervous system and development, thus impacting one’s behavior and functioning as a result. AOTA has a great factsheet regarding OT’s role in childhood trauma, which can be found here.

Below is a list of other resources relating to childhood trauma:



The primary website of the National Child Traumatic Stress Network (NCTSN), NCTSN.org offers information on various aspects of child traumatic stress, including trauma types, treatments and practices, and trauma-informed care; the site also provides access to over 875 free resources (including training curricula, fact sheets, resource guides, and videos) to help child-serving professionals as well as parents and caregivers better support children who have experienced trauma.

NCTSN Learning Center for Child and Adolescent Trauma


This source for online training offers free courses and resources on various aspects of child traumatic stress, including hundreds of webinars, eLearning modules, and videos (many offered for continuing education credit) on special populations, clinical training, service systems, and Psychological First Aid.

What is Child Traumatic Stress?


This fact sheet, produced by the National Child Traumatic Stress Network, provides an overview of child trauma, describes traumatic stress symptoms, and identifies ways children may be affected by trauma.

Age-Related Reactions to a Traumatic Eventhttps://www.nctsn.org/sites/default/files/resources//age_related_reactions_to_traumatic_events.pdf

This fact sheet, produced by the National Child Traumatic Stress Network, describes how young children, school-age children, and adolescents react to traumatic events and offers suggestions on how parents and caregivers can help support them.

Understanding Child Trauma and the NCTSN


This resource provides an overview of child traumatic stress and the National Child Traumatic Stress Network.

Sensory-Friendly Kazoo Factory Tour

We have an exciting event planned for next Saturday! Kazoobie Kazoos and Lowcountry Therapy are teaming to provide a sensory-friendly tour of the kazoo factory, to see how kazoos are made, start to finish, learn about the history of the kazoo and similar instruments, and make you very own kazoo!

Did you know?! The kazoo factory in Beaufort is the largest producer of kazoos in the world. Kazoobie Kazoos has sold millions of kazoos to kazoo players all over the world. Kazoos have been sent to Japan, Hong Kong, Singapore, Great Britain, Scotland, Australia, New Zealand, Sweden, Belgium, Switzerland, Italy, Canada, and most of the United States including Hawaii and Alaska.

Our sensory-friendly event will take place Saturday May 5th from 10am-12pm at Kazoobie Kazoos. The address is 12 John Galt Rd, Beaufort, SC 29906. Tours must be scheduled in advance! This is to ensure that groups remain small. You can schedule by calling Lowcountry Therapy. Tours will cost $4 per child.

What does “sensory-friendly” look like? There are 2 options! If your child is sensitive to noises, you can request a “quiet” tour, which will avoid demonstrations of the loud instruments and equipment, while still touring the facility and making your very own kazoo to take home. If your child doesn’t mind loud noises, a sensory-friendly event can mean less waiting, less crowds, and more room to move!

Call (843)970-2899 and ask to speak to Mr. Matt to schedule!

Lowcountry Autism Foundation

Tomorrow Lowcountry Autism Foundation (LAF) will be holding an event called Ales for Autism. It will take place on Saturday April 21st from 5:00pm – 9:00pm. It will take place at Southern Barrel Brewing Company. Southern Barrel will donate 10% of sales from 5-9pm to LAF. There will also be raffles and a silent auction. Please visit our Facebook page for more event details. 

Lowcountry Autism Foundation (LAF) is located on Hilton Head Island and helps to provide resources for children with autism and their families. All programs and resources are FREE and covered by LAF. Sign up and receive free programs and resources. Below is a list of the different resources and programs offered by LAF.

Family Support Services

This program provides families with multiple resources based on the specific diagnosis a child receives. The program features a one on one relationship with you and a LAF representative. LAF provides information, service coordination, and direct assistance to families affected by autism spectrum disorder and other developmental disabilities. The group meets on the 4th Tuesday of every month from 6-8 in Summerville, SC, and childcare and refreshments are provided. For more information on this program, visit afinc.org. 

Art Therapy

Art therapy is a mental health profession that uses the creative process of art making to improve and enhance the physical, mental, and emotional well-being of individuals. The Art Therapy Program integrates the fields of human development, visual art, and the creative process with models of counseling and psychotherapy. Art therapy is provided with a standard of 10 hours. After the 10 hours the therapist will re-evaluate the child to see if additional sessions are necessary. For more information on this program, visit afinc.org.

These are just a few of the programs and resources available thru the Lowcountry Autism Foundation. For more information on LAF and the programs they offer , visit afinc.org.

April is Occupational Therapy Month

April is Occupational Therapy Month, and we are excited to celebrate this awesome field and the wonderful occupational therapists who promote OT on a daily basis! I’ll start by answering this frequently asked question:

What is occupational therapy?

According to the American Occupational Therapy Association (AOTA), “Occupational therapy is the only profession that helps people across the lifespan to do the things they want and need to do through the therapeutic use of daily activities (occupations).” A child’s life is made up of many “occupations,” or daily activities, including playing, learning, and socializing. Occupational therapy practitioners work with children and their families to help them succeed in these activities throughout the day. Here are just a few areas of development that OT can help address:

Attention span and arousal level

If a child isn’t interested, fidgets constantly, or simply doesn’t look at what she is doing, she can’t learn effectively. An OT can help you discover what motivates your child and makes his body ready to learn, pay attention and stay focused.

Sensory processing skillsEvery day, our bodies are exposed to sensory input from the external environment (seeing, hearing, touch, smell, and taste) as well as from inside our bodies (movement, balance, and internal body awareness). All this input must be registered by sensory receptors, processed in the brain, and acted upon in an adaptive way in order for a child to function at her best.

Fine motor and gross motor skills

OTs can help children with fine motor skills such as drawing, using scissors, buttoning, and stringing beads by improving the strength, coordination, and dexterity needed to complete these tasks. OTs also work on gross motor skills, such as throwing and catching a ball, coordinating both sides of your body (bilateral integration), and planning and carrying out movements smoothly and efficiently.

Activities of daily living (ADLs)

Children have many ADL tasks to master, and most children love becoming independent with these tasks. OTs help children learn to eat with utensils, get dressed and undressed, use the toilet, and handle grooming and hygiene tasks appropriately for their age.

Visual-perceptual skills

From stacking blocks to doing puzzles, a child must be able to perceive differences and relationships between objects in his environment. An OT can help a child to perceive these relationships in order to better understand the world around him.


Handwriting skills, from writing your name to taking class notes legibly, can be extremely difficult for some children to learn. OTs use a multisensory approach to handwriting, and look at how the child’s fine motor, visual-perceptual, and other skills impact handwriting performance.

Read more about what the role of occupational therapy is when working with children and youth by click here.

Purple Day

Today is Purple Day!  Purple Day is an international grassroots effort dedicated to increasing awareness about epilepsy worldwide. On March 26th annually, people in countries around the world are invited to wear purple and host events in support of epilepsy awareness. Last year, people in dozens of countries on all continents including Antarctica participated in Purple Day!

Did you know?!?!

  • 50 Million people have epilepsy world wide 
  • There are approximately 2.2 million Americans living with epilepsy.
  • It is estimated that 1 in 100  people have epilepsy
  • In 50% of cases the cause is unknown
  • Epilepsy is NOT contagious. Epilepsy is NOT a disease. Epilepsy is NOT a psychological disorder.
  • There is currently no “cure” for epilepsy. However, for 10-15% of people with epilepsy, the surgical removal of the seizure focus – the part of brain where the person’s seizures start – can eliminate all seizure activity. For more than half of people with epilepsy, medication will control their seizures. Additionally, some children will outgrow their epilepsy and some adults may have a spontaneous remission.
  • Not everyone can identify specific events or circumstances that affect seizures, but some are able to recognize definite seizure triggers. 

Some common triggers include:

  • Forgetting to take prescribed seizure medication
  • Lack of sleep
  • Missing meals
  • Stress, excitement, emotional upset
  • Illness or fever
  • Low seizure medication levels
  • Medications other than prescribed seizure medication
  • Flickering lights of computers, television, videos, etc., and sometimes even bright sunlight

First aid for seizures is simple:

  • Stay calm.
  • Time the seizure – Usually there is no need for a trip to the hospital, unless the seizure lasts longer than five minutes (not including the postictal phase), the person has more than one seizure in a row, or if a person is injured, pregnant, or has diabetes.
  • Remove objects that may cause harm - clear the area of sharp or dangerous objects.
  • Do not hold the person down or restrain their movement.
  • Do not put anything in the person’s mouth: it is not possible for someone to swallow their tongue.
  • Turn the person on his or her side as the seizure ends to allow saliva or other fluids to drain away and keep airway clear.
  • Do not offer food or drink until the person is fully alert.
  • Stay with the person until they are fully alert and thinking clearly. Reassure the person when consciousness returns.

Trisomy Awareness Month

During Trisomy Awareness Month in March, the NICHD joins other agencies and organizations in raising awareness about trisomy conditions and the challenges they may pose to individuals and families.

Most people have 23 pairs of chromosomes in most or all of their cells for a total of 46 chromosomes in all. These chromosomes include DNA and other material that provide a blueprint for “building” a person.

Some people have trisomy conditions—those related to having an extra chromosome in most or all of their cells, for a total of 47 chromosomes in all.

An extra chromosome can cause a variety of health problems ranging from mild intellectual and developmental disability (IDD), to severe physical problems.  

The specific health issues of a trisomy condition and how severe those issues are depend on:

  • Which chromosome: An extra copy of some chromosomes is lethal; for example, an embryo with three copies of chromosome 1 will not develop.
  • Whether there is a partial or complete extra chromosome: If cells include only a partial extra chromosome, symptoms are usually milder than if cells have a complete extra chromosome.
  • How many cells have the extra chromosome or partial chromosome: If the extra chromosome is in only a few cells, the symptoms are usually milder than if the extra chromosome is in all or most of cells.
Health conditions and problems associated with trisomy include physical abnormalities, such as extra fingers or toes; physiological issues, such as irregular heartbeat patterns; and problems related to intellectual and developmental functioning.

Most of the time, trisomy conditions are not passed from one generation to the next, but result from a random error that occurs during cell division very early on in development.

Trisomy can occur with any chromosome, but the most well-known syndromes are:

  • Trisomy 21, more commonly known as Down syndrome, occurs in 1 in 691 live births in the United States each year, according to the Centers for Disease Control and Prevention. People with Down syndrome usually have mild-to-moderate intellectual and developmental disability (IDD), heart abnormalities, and are at risk for hearing and vision loss and a number of other health conditions. Learn more about Down syndrome on the NICHD Down Syndrome: Condition Information webpage.
  • Trisomy 18, also called Edwards syndrome, occurs in about 1 in 5,000 live births each year in the United States. Infants with Trisomy 18 often have severe IDD, as well as serious heart problems and other life-threatening issues. Learn more about Trisomy 18 at Genetics Home Reference Trisomy 18 webpage.
  • Trisomy 13, also called Patau syndrome, occurs in about 1 in 10,000 to 16,000 live births each year worldwide. Trisomy 13 is associated with more severe IDD and multiple physical problems, including serious heart problems. Learn more about Trisomy 13 on the Genetic Home Reference Trisomy 13 webpage.

Support Organization for Trisomy 18, 13 and Related Disorders, or SOFT, is a non-profit, volunteer organization that has helped families having children with trisomies for over three decades and is recognized as a primary source of information about trisomy 18, 13 and related disorders. SOFT is a network of families and professionals dedicated to providing support and understanding to families involved in the issues and decisions surrounding the diagnosis and care in Trisomy 18, 13 and other related chromosomal disorders.  Support can be provided during prenatal diagnosis, the child’s life and after the child’s passing.  SOFT is committed to respect a family’s personal decision and to the notion of parent-professional relationships.




Krista Flack, MS OTR/L
Pediatric Occupational Therapist

Importance of Core Strength

Core strength refers to the development of the trunk muscles. They help to stabilize and align the trunk, and help the body to maintain proper posture. The core is the center of control for everything else the body does. The muscles associated with core strength include the muscles of the abdomen, pelvis, and back. Poor core strength can cause poor posture which can affect gross motor ad fine motor skills. Poor core strength can also affect breathing and have an effect on speech.

Tummy time is one of the first ways we begin to develop core strength. It allows babies to develop the muscles of the neck and back. It will also prepare the infant for such developmental milestones such as crawling, rolling over, and sitting up independently. For school aged children play is the best way to develop and build core strength. Children with poor core strength tend to slump or lay down when playing with toys, have poor endurance, and a round posture. Below are some great examples of exercises and play activities to build up core strength.

  • Wheelbarrow walking

  • Swinging

  • Sit-ups and superman

  • Riding a bike

  • Various animal walks

  • Sitting criss cross instead of w sitting or lying down

Check out these links for more info on the importance of core strength and some different core strength exercises






-Matthew D’Antonio, PT, DPT

Pediatric Physical Therapist

Winter Olympics

The Winter Olympics begin this weekend, and here at Lowcountry Therapy Center, we have fun activities planned for the occasion!  Next week, when you bring your child to therapy, he or she can participate in some Olympic-themed events to earn a medal of their own.  A few of our events include:

  • using scooter boards to race in the “luge” and the “bobsled” competitions

  • being “cross-country skiers” by doing scissor jacks

  • “speed skating” while categorizing sports

  • “figure skating” a figure-8 pattern

  • scoring a “hockey” goal with a bottle cap

  • jumping from one side of the “halfpipe” to the other (or just over an obstacle maybe!)

These activities promote speech, occupational, and physical therapy skills like naming items in a category, comparing and contrasting, oral motor skills, fine motor skills, bilateral integration, ocular motor skills, coordination, strength, and endurance.  Kids learn best through play, so incorporating skills into games is the best way to make it stick!   

You can plan your own Olympic-themed activities with just a quick Pinterest search.  There are numerous Olympics-inspired crafts and games, along with printable worksheets to learn about the history of the games. 

Author: Krista Flack, MS OTR/L, Pediatric Occupational Therapist

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