Safe and Sensory-Friendly Trick-or-Treating

Halloween is a week away, and while it can be a fun holiday enjoyed by many, it can also be stressful or overwhelming for family members with special needs.  Set yourself, and your child, up for success by planning and setting realistic expectations for the day.  Here are some ideas for preparing for and enjoying Halloween with your family:

  • Prepare your child for the holiday by discussing some of the associated traditions and activities.  Read a book, create a story, or role play.  Many Halloween traditions clash with established rules, like taking candy from strangers.  To help your child understand what Halloween is – and is not – review your values and establish rules and boundaries.  Visual schedules and social stories can help to set these limits and boundaries, and create expectations for the event.
  • While shopping for a costume, think about your child’s comfort – children with sensory sensitivities can become overwhelmed by an outfit that is too scratchy, tight, slippery, or stiff.  Test your child’s comfort when walking, reaching, and sitting.  If your child has facial sensitivity, avoid make-up and masks.  
  • On the other hand, hats, earmuffs, and glasses could help reduce sensory stimulation if your child usually tolerates them.  Be creative with incorporating comfort items into their costume.  A superhero’s belt could have weighted added for proprioceptive input, or tight spandex can be worn under, or as part of, a costume.
  • If you want to try trick or treating, focus on a quiet street with sidewalks.  Trick or treating while it’s still light out helps to reduce anxiety and increase safety.  Practice the sequence of walking to the door, saying “trick or treat,” putting the treat in the bag, and saying “thank you.” 
  • If your child is nonverbal or has difficulty communicating effectively, think about having a note card that states something like, “I may not be able to say ‘trick-or-treat,’ but I’m trying!”  
  • If possible, go only to homes of family and friends to keep the comfort level high.  Skip homes with flashing lights, loud noises, and scary decorations.  
  • If trick-or-treating sounds too overwhelming, remember that many children enjoy handing out candy just as much as receiving it.  Staying at home means that your child still gets to see other children in costumes, but can also stay comfortable. 

By Krista Flack, MS OTR/L, Pediatric Occupational Therapist

Container Baby Syndrome

Container baby syndrome is a collection of movement, behavior, and other problems caused by a baby or infant spending too much time in a container, any commonly-used piece of baby equipment that resembles a container. A “container baby” is a newborn baby or young infant who is placed in a container for an excessive amount of time in a given day. Containers include car seats, strollers, bumbo seats, bouncy swings, rockers, bouncer seats, nursing cushions, and vibrating chairs.

These forms of baby support and transportation are used to keep the baby safe from accidents, allow parents to more easily transport the baby, and give the baby play time. However, this equipment also acts as a container, immobilizing the baby in 1 position on the baby’s back. Spending a lot of time lying on the back in the container allows little to no movement of the baby's neck, spine, or body. While some parents believe that leaving the baby in the container or equipment is safer, more convenient, and enjoyable for the baby, this kind of immobilization can actually cause delayed development of common skills, like rolling, crawling, and walking. Staying in the container for a prolonged time and over days and weeks can even cause severe, possibly lifelong problems.

Container Baby Syndrome is 100% preventable! Expectant or new parents are strongly encouraged to follow these guidelines, and contact a physical therapist to learn specific preventive skills. You can protect your baby from developing CBS from day one! Here is how you can prevent container baby syndrome:

  • Limiting the baby’s time in containers, such as car seats and strollers, to only when the baby is actually being transported somewhere.
  • Increasing the time the baby lies on the tummy when awake (with adult supervision).
  • Holding the baby in their arms or a sling for short periods, instead of leaving the baby in a container.
  • Allowing the baby to play freely in a playpen.
  • Allowing the baby to frequently play on the floor on a blanket (with adult supervision).

-Matthew D’Antonio, PT, DPT

Pediatric Physical Therapist

Feeding Therapy

If you've ever watch a feeding therapy session at Lowcountry Therapy Center, you might have observed a child poking, smelling, licking, kissing, and smooshing foods before eating them.  While it may look like play, it's learning - and it's an important part of eating.

When an adult is given a new food to try, we automatically start analyzing it with as many senses as we can. We notice its odor. We look at the color, and what we can tell about the texture based on appearance. We might even see or hear someone else eating it, giving us valuable information about the consistency, so we begin to prepare what our teeth and tongue will do once it gets in our mouth. We may poke our fork into the food, or pick it up with our fingers. Depending on how the food responds to that touch, we get more information about how hard our teeth are going to have to work while eating.  Descriptive words like bitter, sour, and spicy, or comparing/contrasting to other foods we’ve tried before, are meaningful to an adult, and further prepare us for what to expect. 

Now imagine being asked to close your eyes, plug your nose, and open your mouth for an unknown food to be placed in.  Does that make you anxious?  For a child that doesn’t know how to analyze food using his or her senses, every bite of a new food feels like that!  They can physically see the food, but do not know how to analyze it to prepare for what to expect – that shininess can imply wetness, for example.  They can feel the food with their fingers or fork, but may not know how that translates to what their teeth and tongue will need to do with it.  Furthermore, until taught, a child may not understand descriptive words, or may not have the experiences to compare/contrast to similar foods.  On top of all of this, motor deficits, sensory-processing deficits, and past negative experiences can further influence feeding difficulties. 

So the next time you see your child poking and smooshing a food, consider helping describe what they may be feeling.  Talk about how you already knew it would be wet, because it was shiny.  Talk about how that hard cracker is going to mean that your teeth will have to bite down hard to crunch through it.  And exaggerate those bites (mouth open and all), so the child can see what YOUR tongue and teeth do with it.  If you feel silly doing it, that’s okay!  Making mealtimes fun can help your child feel calmer, and maybe even be more willing to touch, kiss, lick, and even bite that new vegetable you, put on their plate.

By Krista Flack, MS OTR/L, Pediatric Occupational Therapist

Older Kids Gross Motor Milestones

Kids learn and develop new gross motor skills every year. For babies these include rolling, crawling, sitting, and walking. As a parent, these are all skills you are made aware of during child classes and reading baby books. What most parents don’t know are the skills children need to develop as they grow and when they should develop them by. Below is a list of common gross motor skills and the ages at which a child should be able to complete them.

2 Years Old

  • Running without falling
  • Walking backward
  • Jumping forward with 2 foot take off 4-12 inches
  • Walking up and down the stairs without using a railing with both feet on each step
  • Standing on 1 foot 1-2 seconds

3-4 Years Old

  • Jumping forward 24-34 inches
  • Jumping over a 2 inch obstacle with a 2 foot take off
  • Walking forward on a line
  • Hop on 1 foot
  • Complete sit-ups with feet held
  • Ride a tricycle

5-6 Years Old

  • Skip
  • Gallop
  • Ride a 2 wheel bike
  • Jump over a 10 inch obstacle
  • Can complete 3-6 sit-ups without help
  • Catch a ball with hands only

If you are nervous that your child may not be meeting their milestones on time please give us a call. We can offer several types of screening free!

-Matthew D’Antonio, PT, DPT

Pediatric Physical Therapist

The Teal Pumpkin Project

One of my favorite holidays is coming up: Halloween!  Not only are there SO many great sensory experiences to discover this time of year (from carving pumpkins to playing with goops and slimes), but it also means trick-or-treating! 

It is so much fun to dress up as a favorite character, cute animal, or scary creature.  Sometimes decorating and making the costume is half the fun for us adults, but I think most kids would agree that it’s all about the CANDY! 

Unfortunately, that is what makes this holiday stressful, or downright frustrating, for those with food allergies, sensitivities, and special diets.  Food allergies are a life-altering and potentially life-threatening disease, and a growing public health issue. In the U.S., one in 13 children has a food allergy – that’s roughly two in every classroom. For these children, even a tiny amount of their allergen has the potential to cause a severe reaction.

Virtually any food can cause a reaction. Many popular Halloween candies contain nuts, milk, egg, soy or wheat, which are some of the most common allergens in children and adults. Additionally, many miniature or fun-size versions of candy items contain different ingredients than their full-size counterparts and some miniature candy items may not have labels, so it is difficult for parents to determine whether these items are safe for their child with food allergies.

The Teal Pumpkin Project was launched as a national campaign by FARE in 2014, and encourages people to raise awareness of food allergies and promotes inclusion of all trick-or-treaters throughout the Halloween season.  FARE works to reach families across the country and around the world with the Teal Pumpkin Project’s messages of awareness, inclusion and community. 

The steps to participate are:

  1. Provide non-food treats for trick-or-treaters.
  2. Place a teal pumpkin – the color of food allergy awareness –in front of your home to indicate you have non-food treats available.
  3. Display a free printable sign or premium poster from FARE to explain the meaning of your teal pumpkin.

Non-food treats provide a safe, fun alternative for children with food allergies and other conditions for whom candy may present a problem.  

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

National PT Month

Every year since 1992, the American Physical Therapy Association (APTA) has used this month as a way to help raise awareness and educate the public on various topics. This year the APTA has chosen to educate the public on the use of physical therapy as a safe way to manage pain. Physical therapists treat pain through movement, helping patients improve strength, flexibility, and range of motion. Physical therapists also can educate their patients about pain, which has been known to improve outcomes.

So why choose physical therapy? First physical therapy has been found to be as effective as surgery for some conditions such as osteoarthritis, meniscal tears, and rotator cuff injuries. According to the Centers for Disease Control (CDC), Physical therapy is effective for numerous conditions and there is high quality evidence supporting exercise as part of physical therapist treatment for familiar conditions like low back pain, hip and knee osteoarthritis, and fibromyalgia. Second, physical therapy plans are individualized. This means that everyone’s pain management therapy is different and tailored around you, your needs, and your pre-existing conditions. Lastly, physical therapy can help identify other potential risks and health issues beyond what the patient initially reports.

In June of 2016 the APTA launched their new campaign titled #ChoosePT to help educate the public on choosing physical therapy as a way to manage pain. Click here for more information on the #ChoosePT campaign and other resources on how physical therapy can help with pain

For more information physical therapy in general check out the APTA’s website here


-Matthew D’Antonio, PT, DPT

Pediatric Physical Therapist

Down Syndrome Awareness

October is Down Syndrome Awareness Month, a chance to spread awareness.  During the month of October, we celebrate people with Down syndrome and make people aware of their abilities and accomplishments.  It’s not about celebrating disabilities, it’s about celebrating abilities!

Below are some tips shared by those with Down Syndrome, and by their family members and advocates:

·         Use person-first language!  For example, instead of "a Down syndrome child," we can say "a child with Down syndrome." Feel free to add in other adjectives that describe the person (like “awesome,” “sweet,” and “kind,” as every child should be described by their positive attributes, rather that defined by a diagnoses).

·         Don’t assume that all people with Down Syndrome will have similar abilities or traits.  People with Down syndrome have an increased risk for certain medical conditions such as congenital heart defects, respiratory and hearing problems, Alzheimer's disease, childhood leukemia and thyroid conditions.  A few of the common physical traits of Down syndrome are: low muscle tone, small stature, an upward slant to the eyes, and a single deep crease across the center of the palm. Every person with Down syndrome is a unique individual and may possess these characteristics to different degrees or not at all.  If in doubt, always assume competence.

·         We are more alike than different.  People with Down syndrome are active participants in educational, social and recreational activities. They are included in the typical education system and take part in sports, music, art programs and any other activities in the community.  They work, participate in decisions that affect them, have meaningful relationships, vote and contribute to society in many wonderful ways.  People with Down syndrome are valued members of their families and communities, and make meaningful contributions to society.

·         Visit The National Down Syndrome Society website to learn more about Down Syndrome, advocacy, and participating in your local Buddy Walk (THIS Saturday in Savannah, sponsored by The Lowcountry Down Syndrome Society!). 

Fall Activities

Fall is here, and there are plenty of fun ways to incorporate seasonal crafts and activities into your life, which can focus on improving fine motor and visual motor integration skills, as well as to tap into the sensory system!  Here are a few of my favorite fall (and Halloween) crafts.

  1. Use different materials to create beautiful fall trees.  After drawing the branches onto paper (or tracing your arm and hand for the trunk and branches), try gluing buttons or wadded-up tissue paper to make the colorful fall leaves.  You can also paint them on using finger paint, or dot them on with the end of a cotton swab.  Get creative; this is a great way to add some tactile sensory play into your day.
  2. Use nature!  Trace or paint around leaves (or color over them with crayons for a fun textured stencil), stamp with apples, or turn a pinecone into a funny-faced critter or bird feeder.  See what else you can find in your backyard that can be glued, traced, or painted!
  3. Turn your handprint or footprint into a fun Halloween image.  Put your two hands together to form a spider, or your foot (turned upside down) can make a spooky ghost or monster.
  4. Use cotton swabs to make a skeleton on black paper.  Cut out a head from construction paper, then use cotton swabs to make the spine, ribs, arms, legs, and even fingers and toes!  Cutting or tearing the cotton swabs in half for the smaller body parts is a great fine motor task.  This is also a great opportunity to talk about body awareness where our body parts are located and how they connect to each other.
  5. Make scented dough. There are endless recipes online for making your own play dough.  You can search for ones that are edible, or allergen-free, or require little prep.  Its worth noting that the doughs that require some cooking are often the ones that last longest and maintain consistency best.  But if making it is half the fun to you, then go ahead and explore all of the different recipes out there to find the one you like best.  Here is one example of a recipe to make pumpkin spice and apple spice scented doughs.  

Backpack Awareness Day

Backpacks are worn to school every day by millions of kids around the world, but have you ever thought about the serious health effects that backpacks can cause children? The American Occupational Therapy Association (AOTA) has stated a backpack awareness day to help raise awareness about how to properly wear a backpack and how heavy it should be. According to the AOTA, in 2007 over 2,000 backpack related injuries were treated in emergency rooms and physician offices. In one study with American students ages 11 to 15 years, 64% reported back pain related to heavy backpacks. Twenty one percent reported the pain lasting more than 6 months.

According to the AOTA there are 3 simple steps to backpack wearing to help reduce the risk of injury. The first step is to pack it properly.  Make sure to utilize all compartments and pockets of the backpack to help distribute weight, and keep the heavier items closer to the back center of the backpack. A backpack should weigh no more than 10% of your child’s total body weight. The second step is put it on correctly. Make sure your child is picking up the backpack by bending and lifting in the knees instead of the waist to prevent back injury. The third step is to make sure the backpack is adjusted and worn properly. Always use both shoulder straps and make sure the backpack rests snugly against the back. Make sure that the backpack does not go above your child’s shoulders or below the top of the hip bones.

National Backpack awareness day is September 20th.  Next week, September 25-29th, we  will be hosting backpack weigh-ins and fit checks.  Bring you backpack with you to your therapy appointments, and we will help to make sure your backpack is:

  • the right size and weight for your body, and
  • adjusted and packed correctly to distribute weight evenly.

We will also provide information on avoiding injuries during use and wear, tips on carrying other styles bags (including purses and briefcases), and general tips for school success!  You may even win a prize for participating! 

Backpack awareness links and more information

-Matthew D’Antonio, PT, DPT and Krista Flack MS OTR/L

Childhood Obesity

Childhood obesity is a major public health problem. According to the CDC, 1 in 6 children (17%) in the United States suffers from obesity. Children with obesity are at higher risk for having other chronic health conditions and diseases, such as asthma, sleep apnea, bone and joint problems, and type 2 diabetes. They also have more risk factors for heart disease like high blood pressure and high cholesterol than their normal weight peers. Children with obesity are more likely to have obesity as adults. This can lead to lifelong physical and mental health problems.

Childhood obesity is influenced by many factors. In the recent years, technology has had a huge impact on childhood obesity causing less physical activity. Another major problem is the ease of access to inexpensive high calorie foods and beverages.

It is important to provide your kids with healthier snack options like fruits and vegetables. Also limit screen time and encourage your children to go outside and play. Encourage your kids to drink water instead of sugary drinks. Be sure to check out Krista’s blog about the importance of eating fruits and vegetables.

Idea’s to help children maintain a healthy weight

CDC physical activity guidelines

Tips for proper nutrition

Rethink your drink

Matthew D’Antonio, PT, DPT

Pediatric Physical Therapist

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