The word “fidget” has come across my radar multiple times this week, and while the word itself doesn’t sound inspiring, the difference it makes for those who need it, really can be. To help highlight the significance of this little word, I give you some background or context as to why it holds such relevance for me in my practice.
One role I play as an OT, is to help establish “sensory diets” for the kids with whom I work. A sensory diet is exactly what it sounds like…making sure a child gets their daily requirements of necessary sensory inputs to fuel the brain and body, to optimize function or health of the nervous system. Every person has individual preferences and needs for certain types of inputs, based on their individual neurological systems. Some people need more movement, some people need more sound, some people need more chewing, and some people prefer to touch everything they can get their hands on. The theory is (and I’ve seen it work) when a person gets the inputs they need, their nervous system is more organized and efficient and that person can function more optimally to meet the demands of what is going on around them, whether it be work, school, conversation, or reading a book. Case example, one young boy I worked with had difficulty staying awake at school but when he was awake spent much time touching other people, invading their space, and/or touching their belongings. He was constantly seeking food or drink and the ongoing requests for snacks or walks to the water fountain became disruptions to the classroom routines and the learning for other students. Not to mention the negative social interactions and aggression that ensued, when this boy invaded other people’s personal space and belongings. In OT, we implemented multiple activities for him to do at school at various intervals throughout the day, such as use of a bite and suck Camel Bak water bottle (see previous post), trigeminal face-tapping 2-3x/day, use of an inflated seat cushion, chewing gum, use of therapy putty to squeeze, regular walk-breaks, and use of deep touch pressure in the form of a steam roll, as often as could be provided. This young man no longer falls asleep on the floor, he is able to complete approximately 80% of his written work vs. refusing all of it, he remains in class x approx. 20 min’s at a time vs. 5 min’s and while he still seeks food and drink and touches other people way too often, he has decreased those incidents by nearly 30%. While this boy has received multiple interventions in addition to his sensory diet including medication, therapy, and behavioral incentives, he is now able to ask for the input he desires or needs, and clearly changes his ability to participate in class, when he is using them. This boys “sensory diet” included fidgets, which helped him meet his daily needs of various sensory inputs. Fidgets can be like little snacks throughout the day that prevent us from needing a larger meal or tide us over until it’s time to really eat. By tuning into our small activities that help us focus or “feel better”, like fidgeting, we can begin to help ourselves function better in multiple environments and for kids with problems of attention, offering fidgets can be one way of helping them learn to manage some of the more difficult tasks they face.
Many people are familiar with the word “fidget” as a verb, meaning to move around nervously: to move around in a restless, absent-minded, or uneasy manner (Bing dictionary). But in my (OT) world it can also mean doing an activity that uses a sense other than that required for the primary task (think doodling while talking on the phone, clicking a pen while giving an oral presentation, or listening to music while doing homework or reading the newspaper). According to Sydney Zentall, Ph.D., fidgeting can enhance performance in children with ADHD. A great overview on use of Fidgets: Toys or Tools can be found at KidCompanions blog. They reference several books that are now on my work list of books I want to read. If a person shows a need for fidgeting, putting something in their hands to hold, manipulate, feel, or play with, could actually improve their concentration. In the case above, the young boy I worked with was able to improve his class participation by adding things he could do at the same time as his classwork or lessons (water bottle, chewing gum, therapy putty, wiggling on the seat cushion). These types of inputs likely work because our sensory systems are all designed to work together simultaneously and spontaneously. When one sensory system (or several) are not doing their job(s), the brain and body struggle to make sense of what’s going on around us or to figure out how to automatically respond. Thus some people (and many of the kids I work with) seek out more input. It is the nervous system’s inherent way of getting the input it needs to make sense of the world. A child who is touching everything, may be looking for more touch input. A child who is constantly moving, may need that movement to get more information about where he is in space. If holding or playing with something in the hands gives more input through the sense of touch and the small movements of the fingers and hands, why not use it? If it becomes a distraction in and of itself, that item clearly isn’t meeting the need and other options may need to be explored.
I talk with teachers, parents, and direct service staff about how to use “fidgets” appropriately, all the time. Unfortunately, people assume that giving a child a “stress ball” will limit temper tantrums, and is in and of itself a “sensory diet”. This is not the case. My general approach is to use fidgets as “helpers” and small doses of increasing the tactile input a child might get throughout the day. If a child reaches the point of being so upset or so distracted that they are aggressively interacting, or they have already created or engaged in a power struggle, we’ve missed the opportunity for a “fidget”. Small hand-held items are not going to offer the intensity of input that child needs to re-organize. Additionally, there are kids who look like they are “seeking” extra input when in fact they are looking for ways to self-calm, and so identifying the root of why that child is moving around so much, becomes the primary task. If the fidget isn’t working, a referral to an Occupational Therapist trained in sensory integration, may be in order. It’s not the fidget that failed, there may be underlying sensory processing problems that need to be addressed in order for that child to improve their function. Carol Stock Kranowitz (author of “The Out of Synch Child”) writes in her blog, about look-alike conditions such as SPD & ADD, and gives an overview of the sensory diet concept.
Locally, The Dancing Bear Toy Store, is one source for many enticing and developmentally appropriate fidget toys, like stress balls and magic mud. Online, Fun and Function offers many fidget options like squoosh pets, therapy putty, and theraband. Parents can likely find many fidget options at a party store near them (finally a use for those trinkety little party treat bag toys I routinely throw in the garbage). Use of fidgets within the context of a sensory diet can make a significant difference for people with sensory processing and/or challenges of attention and for those without significant attention problems, can serve to make things, just a little more fun! Who doesn’t want that?!
I bought a fruit smoothie at Panera Bread the other day and what impressed me, aside from the yummy icy mango flavour, was the size of their straws! Those straws are HUGE!!! Now to the average person, this might not mean much. But to me, an OT, who struggles to turn off that part of her brain (ask my husband, my kids, and my close or not so close friends…) I saw a therapeutic opportunity. Those straws could be used in SO many ways. They would be great for oral motor activities (blowing) and to decrease the sucking demands for young kids still learning to drink from a straw, or for those who don’t have the oral strength to to close the seal for suction, OR to use in some kind of bimanual (two-handed) craft activity. They would also be a great thing to use for learning to cut with scissors. Some straws make a nice “pop” sound, when you snip them, so it’s fun for kids who are learning, and straws are stiff so they are easier to cut than paper (sometimes). These doozies from Panera, might be ever so slightly thicker and thus ever so slightly harder to cut, raising the inherent challenge of the cutting task. It got me to thinking, how absolutely versatile straws can be, and how parents might be surprised to learn the many developmental applications of straws…beyond sipping (of course).
Believe it or not, while formulating my thoughts, I came across this highly relevant recent “pin” on pinterest; and then this one. It seems, I’m not the only one interested in the many uses of straws! Below is a list of things that parents can do with different types of straws, to boost their child’s skills:
Straws can be fun: Try bubble blowing, play marshmallow games, have a “blowing” race (put cotton balls on the ground and see who can blow theirs across the finish line first!)
Straws can be crafty: Try blow painting with straws, bubble fish painting, making prints with straw pieces, polka dot painting, and many many other craft projects
Straws can help kids learn to cut: snipping straws in pieces to make straw confetti or small little “beads”; helps to strengthen hand muscles for scissor skills and helps kids to learn the motion of opening and closing the scissors; the adult can hold the straw while the child cuts and as the child’s skills progress, you can make it more challenging by having the child use both hands; one to hold the straw and the other to cut the pieces
Straws can be stylish: use small tubes (from above snipping) to make straw jewellery by threading the pieces onto string, yarn, or for toddlers or kids with weaker fine motor skills, use pipe cleaners instead of string (the pieces don’t slide off as easily)
A little known fact…straws can be calming. buy silly straws or “crazy” twisted straws. Per the HANDLE Institute, “drinking through a crazy straw can help to improve many functions: interhemispheric integration, binocular functions (eye teaming), light sensitivity, sound sensitivity, articulation, bowel and bladder control, tongue and lip control for articulation, facial muscle tone for nonverbal communication, and more.”
If you get a Camelbak Water Bottle with a bite valve, sucking and sipping from this water bottle simulates an oral motor sequence that is similar to what most babies use when nursing or bottle-feeding and thus it not only strengthens the small but essential muscles of the tongue and mouth for things like talking and eating, it also gives calming input. Nursing or bottle feeding is one of the earliest most primitive means of comfort that every human gets in their lifetime. If that experience was not positive or was interrupted somehow for a person, it might be helpful to find ways of offering similar input. Not only is drinking lots of water healthy and often calming to the body, but the action of drinking it from this water bottle can be a gentle and subtle way of offering healthy input to the brain and body.
I often offer drinking straws to the kids I work with, while we are doing an activity. They choose to fiddle with it to help them concentrate or more often than not, they chew on them. The stiff nature of the straw makes for more resistance and the “tough to chew” aspect provides calming input to those who seek or need more input than the average child. Sometimes kids who are feeling upset need to chew (and some grown-ups too…think comfort eating) and once given the opportunity to chew, they feel much less frustrated, more focused and more relaxed. It’s true! (Note chewing on straws has zero calories!)
While I am tempted to recount my highschool Science Olympics experience of using pins and straws to build a contraption that kept a raw egg safe upon impact after being dropped from a 20 ft. ladder, I will refrain (the egg survived by the way…I had a lab partner who is now a materials engineer). That said, I urge you to think beyond the obvious purpose of sipping, the next time you suck on a straw, and if you have or spend time with children, have some handy. You may be surprised at how helpful these little (or big) suckers can be!
As you may know, I went to Austin, TX this past weekend to attend a certification training in “Interactive Metronome.” While there, I had the great pleasure of visiting a friend who is an OT and has her own private practice, KidVentures. Needless to say, I was inspired. The training was fine, and I believe holds good clinical and business promise, but my brief time spent at KidVentures with my friend, was my favourite professional part of my weekend.
My friend and I met early in our careers, when we worked in the same program and lived close enough to one another to commute and save money on gas and the expensive parking permit at the expensive downtown garage. Over the course of that time we got to know each other pretty well (there is much bonding that can happen when you’re not that long out of college, commuting to work over hazelnut coffee, and working in adult psychiatry). I went on to move out of the city, start my family and stay home with my kids. My friend went on to move to Austin, find her family, and start her own practice. My friend and I have kept in touch and as I’ve now started my own practice, she has become an invaluable resource to me, both personally and professionally (it’s amazing how those two worlds overlap), sharing information, forms, lessons learned, and her personal and professional wisdom.
When I decided to visit Austin for this training and to visit my friend in her practice, I knew, because I know my friend, it would be a valuable experience. What I didn’t know, is how motivated and inspired I would become, simply by being there. Of course, I asked her lots of questions, we shared discussion about the training we attended, and thankfully (but not surprisingly) we continue to share similar opinions on many clinical issues currently related to our field and profession. That said, what was most helpful to me while visiting my friend, was the validation and simple suggestion, of what was possible. Just being in her space, reminded me of what to strive for, and reminded me to aim high.
As my friend gave me the “grand tour” of her facility, she passed on bits of information she probably didn’t know she was sharing; phrases like, “compared to our old building…”, “when we first started…”, “this will one day be…”, “I’m working on…”, “I’d like it up and running by summer, but we’ll see…”, “I’m not sure…”, and “We took a leap!” These little words and phrases told me it was a process, and if she has this amazing space and this thriving practice, but it’s still a work in progress, then I need to be realistic and not expect too much too fast. BUT…I am on the right track, I am laying the foundation for success and if I aim high, I will get there too. I have much to offer our community.
Finally, the other thing I realized is the influence of one’s surroundings. Simply by way of being IN her facility, I was able to see outside my own immediate experience and see concrete different physical ways of doing things. It made me remember how important it is to surround myself with people and things that make me feel positive, people I trust, and people who support my efforts. I need to spend time in places that force me to think outside the box of my current experience and beyond what’s in front of my face. While I am grateful I have this personally, professionally I work on my own much of the time, so visiting my friend’s practice was invaluable.
I know the saying goes that change is as good as a vacation, but in this case I’m thinking, that my vacation made for some really nice change! Now here’s hoping I can use what I’ve learned and what I’ve been encouraged to remember, to make some really nice change for my clients.