Occupational Therapy and the Child with Down Syndrome
Written by Maryanne Bruni, BSc OT(C)If you are a parent reading this, you likely have a child with Down syndrome, as I do. My intent with this article is to provide you with some information about how an occupational therapist (OT) may be able to help you and your child. Occupational therapists who work with children have education and training in child development, neurology, medical conditions, psychosocial development, and therapeutic techniques. Occupational therapists focus on the child's ability to master skills for independence. This can include:
- self care skills (feeding, dressing, grooming, etc.)
- fine and gross motor skills
- skills related to school performance (printing, cutting, etc.)
- play and leisure skills
When your child is an infant, your immediate concerns relate to his health and growth, development of the basic motor milestones, social interaction with you and others, interest in things going on around him, and early speech sounds and responses. At this stage, an OT may become involved to:
Sports & Therapeutic Recreation Instruction/& Developmental Education (STRIDE) Recreation for Challenged Children
STRIDE's Mission: STRIDE is a not-for-profit, 100% volunteer organization, dedicated to enriching the lives of children with disabilities, by offering sports and recreation opportunities. Challenging people, potential, and possibilities.
Down Syndrome Health Care Guidelines: Ages 1 -5 Years
Sensory Strategies for the Holidays
Joan M. Marini, OTR/L This email address is being protected from spambots. You need JavaScript enabled to view it. Cell- (518) 461-0052
The holiday season is full of new activities, schedule changes and disruptions in routines, which often causes the whole family to feel stressed. These changes and disruptions in routine can affect children with sensory processing concerns and challenges to a greater extent than the rest of the family. As we juggle our schedules to make the holidays happy, it is important to make sure our “sensory kids” are having fun as well.
Some holiday pitfalls include:
- extra shopping trips and increased time at the mall or grocery store
- bright lights and decorations everywhere
- fragile decorations throughout the house; environments that are not “child-friendly”
- crowds in public and/or more people in your home resulting in more accidental bumps and brushing against or accidental touching as you move through the environment
- more noises in the environment
- more smells (food, decorations, people wearing perfume, candles, etc.)
- temperature changes – hot stores, cold outside, warm or cold car
- unfamiliar environments (visiting relatives or friends)
- unfamiliar people (relatives, friends, other children, strangers in public)
- busy, stressed out adults
- disruptions in routines
- extra excitement
Here are some ideas to reduce stress and anxiety and make the season a happy one for everyone:
- Increasing awareness of potential stressful environments and activities can assist in making the appropriate preparations or changes to the environment or activity to increase the chances of fun and reduce the chances of meltdowns.
- Planning ahead can reduce stress for everyone. Before leaving home, know the intended plan, anticipate pitfalls, have strategies in place and as appropriate, inform your child of what to expect.
- Novel sensory environments and unexpected transitions can be difficult. Provide your child with pre-sets, so they know what to expect. Watch for signs of stress so you can change the plan as needed.
- Have a “Safe Space” designated where your child and you, if needed, can go if they are having a hard time. This space ideally is quiet, dimly lit and has comfort toys or items available for your child. Try to retreat to this space before your child has a meltdown by keeping a close eye out for signs of stress.
- If you already have a sensory diet in place, make sure you use those strategies prior to a stressful situation and frequently during the situation to prevent over stimulation and possible meltdowns. Remember that big hugs, back rubs and carrying heavy toys or objects are always great ways to keep the child’s sensory system in check.
- Try shopping at single stores rather than the malls and go at off times so the crowds and noise will be reduced (early am/dinner time). Some children benefit from headphones, wide brimmed hats and/or sunglasses to reduce the overstimulation of sights and sounds.
- Skip events that are guaranteed to cause upset for your child such as a picture with Santa. You may need to settle for a picture by a sparkling tree instead.
- Place a painters tape or masking tape line on the floor around the tree or other decorations to provide a “Do Not Cross” visual boundary line. This will prevent the child from getting too close to the tree, candles or other decorations that could break or injure them.
- Maintain as many daily routines as possible. The more consistently you maintain daily routines the more likely the child’s behavior will be consistent. Morning and bedtime routines are the most important to maintain. For children who nap, try as much as possible to maintain the naptime routine as well. If the child is upset about going to bed, just remember, they will be over it by morning. If they stay up, however, they will most likely be irritable the next day and it may disrupt the routines for a few days.
- Try to maintain the child’s typical diet, mealtime routines and bath time routines.
- Consider being the host of family gatherings. Although it may mean more work for you, children are always more comfortable at their own home. They know where things are, they know the rules and can find a “safe” place to go if they become overwhelmed. Additionally, your home is already “child-proofed”, so you can be more relaxed, which will help your child be more relaxed.
- Consider keeping all snacks or foods on a large table rather than scattered around the room. Smaller tables are more likely to be bumped into causing food spills and messes. Additionally, foods that you do not want your child to have will be out of reach.
- Make a list of any food limitations or allergies your child has and post this in a prominent place such as the refrigerator or buffet table. Make sure guests and relatives see it. Most visitors will understand and respect the list.
- If you have to go to new or unfamiliar environment (e.g. relative or friend’s house), try to enter and leave the space separately from the larger crowd. Upon arrival, let your child move to a quiet area or a pre-designated “Safe Space” until they feel comfortable entering the larger group. This can be used for a break as well so that your child can regroup.
- Never force a child to give or receive hugs and kisses. Although these signs of affection are welcome by those with a functional sensory system, it can be very overwhelming for sensory challenged children to participate in these activities. Remind well-meaning friends and relatives that your child loves them but just can’t show it in that way. A glance, wave or smile should be praised as an appropriate way to engage.
- Take turns opening presents to reduce the commotion and over excitement. Too many new toys at once can be very over-whelming. Consider helping your child pick two new things to play with today and put the others out of sight until later or tomorrow.
- Find the time to look at the toys and games given to your child before the child opens it to play. Make sure they are within the age recommendations and within your child’s skill level. If not, put away until they are ready to play with them.
- New toys mean new learning for your child. They usually need quick success and see the toys potential before they give it their approval. Spend time helping your child play with the toys and experiment with different ways to play. Teaching how to use a toy can prevent the toy from accidentally getting broken.
- Try to keep toys organized by placing in age appropriate containers (bins or cloth bags for smaller children and zip lock bags for older children). This will help keep the pieces together.
- Have an Exit Strategy. No matter how many strategies you have in place, things may become overwhelming for your child. When that happens, it is time to leave. Don’t wait until the child is on the brink of a meltdown. Have a reasonable exit strategy and be ready to use it when the time comes. If your child is verbal and can give you a signal that they need to leave, set up a signal that your child can use. When you see your child needs to leave, leave. Don’t make the good byes so long that the child melts down on the way out the door. Explain ahead of time (pre-planning) to your friends and relatives that you may have to leave suddenly and if that happens, you will call them later or the next day to thank them. You may need to consider driving to events separately from your spouse or other children or arranging for the rest of the family to get a ride home so that the whole family does not need to leave.
- Remember that the Holidays are supposed to be about family and fun. Eliminate those things that create too much stress for your family and enjoy those things that the whole family can participate in.