Occupational Therapy Consulting, LLC


Archive of ‘Occupational Therapy’ category

Easy peasy shoe tying

I had the pleasure of participating in the launch of our “I CAN…” classes yesterday at Occupational Therapy Consulting, LLC!  I say “participating” because, 1) I wasn’t leading the class, which may have contributed to some of my pleasure given that I could relax, follow the lead of Miss Erin (COTA), and jump in only if/when needed and 2) I was reminded first-hand by our young participants, that the drive to succeed and the satisfaction of doing so, is awesome! I watched two little boys learn to tie their shoelaces.

These two young boys, ages 4 and 6 did not succeed every time, they did not succeed on their own every time, and  they did not give up! They DID say things like, “Easy peasy!”, “I can do this.” and “I did it!” with the confidence and drive of an Olympian.  They also WANTED to learn, tried new things in new ways, and practiced, practiced, practiced, with joy and anticipation of the moment that this time it would work!

Some things we did that you can do too:

1) Hide & Seek with shoes – the purpose (other than having fun so everyone  could get used to each other) was to interact with shoes in a different way and have fun with shoes, instead of being intimated by them; to make shoes playful because kids learn through play!

2) “Make a Tee Pee; Come inside; Pull it tight so we can hide; Over the mountain; Around we go; Here is my arrow; Here is my bow” – The rhyme used to help everyone learn the sequence of steps for tying laces. Miss Erin taught the rhyme through gross motor actions paired with the words. Movement helps with learning! One child sat on a ball and played with his shoe instead of doing the actions every time but he learned the words! And by sitting on the ball he practiced balance (which helps build the body coordination needed to use both hands at one time for things like tying shoelaces), and he used both his hands while he balanced to play with his shoe (and what cool new orange laces he was flaunting…so proud)! Not surprisingly, after balancing on the ball and showing off his shoes, he chose on his own to do the actions and later showed them to us again, ALL ON HIS OWN! (Meeting kids where they are developmentally, increases their engagement in an activity which helps them master that step/stage so they can move forward and on to mastering whatever  challenge comes next). KIDS WANT TO LEARN!

3) We practiced tying  using jump ropes on our bodies first! Sometimes fine motor skills are too difficult for young children (meet them where they are), so learning the steps in a “big” way first, can help get little brains and bodies ready for the fine muscle work and motor planning that is needed for tiny fingers to use smaller laces.4) Each child made a shoe practice board! So many young kids these days wear velcro fastened shoes so the opportunity for daily practice is limited.  Daily practice is important to master any skill but practice takes time, and practicing “in the moment”, when mom and dad are trying to get out the door is not conducive to optimal learning (time constraints can increase anxiety in both mom or dad AND the child, AND the reality of needing to get out the door often results in mom or dad stepping in to assist too soon or too often, which leaves the child feeling like they’ve failed, and without sufficient opportunity to practice).  The practice board is personalized (think favorite colors & designs) so the child “owns” it and wants to, and different colored laces are used to help with visually organizing the task.

5) Practice in real life is important (with the playful rhyme on their own shoes, on mom and dad’s shoes, on a favorite toy, or by making bows on presents, and eventually yes on a child’s own shoes as they are heading out the door…key word eventually).  Practice might not make perfect but it makes for functional skills!

Shoe tying can be fun!  Well done Miss Erin and to our little “I CAN tie my shoes!” class members.



You did it! Easy peasy!


Gifts given

2013 has been a busy year at OTC! We have added staff (welcome again to Erin and soon to be introduced Laura), we have added space and services (a new treatment room has enabled mid-day, afterschool, and Saturday treatment slots), we have increased our caseload three-fold, we have expanded our community partnerships (Tummy Time at the Dancing Bear, we’ve done parent and teacher workshops at  Visitation Academy,  and are planning the same at Calvary Preschool) and most of all, we’ve continued to offer the advanced skills, specialized assessments and individualized consultations our clients and colleagues have come to know and expect. Amidst this growth and busy-ness of building my practice however, I pause.  For all this growth would not come if it weren’t for the gifts I’ve been given by family, friends, and from those with whom I work.

The gift of trust – every client puts trust in my work and shares with me, not only their struggles and their child, but their hope, that things can be better.  Thankfully, most times…that’s what happens (see testimonials).  Every colleague who makes a referral, or collaborates with me regarding a client, is trusting my judgment and skills  and even me as a person, to continue and support the therapeutic relationship they’ve already built with their clients.  I don’t take this trust lightly, and while yes, it sounds “nice” to say “Thank you for your trust”…every time I say it, I mean it.

The gift of time – every client commits time, and for some a whole LOT of time, both at home and at the office.  Families organize their lives around their child’s treatment sessions and without that commitment of time for months (and sometimes years) on end, my work can’t be effective.  I also have many colleagues, who have shared with me information that helps me in my work, and who take the time to brainstorm and problem solve the best way to help my clients. I now have staff, who give of their time, to make our services better and run more smoothly.  For these invaluable minutes, I am grateful.

Finally, the ability to commit financial resources to the services I offer, is a reality which makes my job possible.  I know private therapy is expensive and all the ideals in the world don’t make up for the fact that people need to be able to and willing to pay for it.  Ability to pay is one important thing for which I am eternally grateful.  That said, the willingness to pay is another and so the first gift listed, trust, is what I try to create and build on, and it is why I work so hard to make my services as effective as possible.

Moving forward into 2014, OTC is working on plans to bring new services, more treatment slots, and new community partnerships.  More importantly, OTC has made a commitment to continuing education and hiring qualified clinicians, thus all therapists will either be certified or working on certification in sensory integration, to ensure effective services and advanced skills in all that we do.  Parents can watch for an increase in sharing of ideas for home.  The emphasis of this blog will change from mostly reflections, to offerings that will hopefully help to make daily activities easier for families and new programs (if we can) will target daily activities that kids struggle with most; sleeping, eating, toileting, homework, and playing with friends.

If you have ideas of things you’d like to see us offer, please let me know!  With thanks, we wish you a happy, healthy, and playful 2014! What was your favorite gift this year?

Tactile Defensiveness (think steel wool)

Touch is powerful, to say the least.

I am reminded daily of it’s power, both at home and in my work.  When the sense of touch goes wrong, it can be debilitating.  We rely on our sense of touch to work with the rest of our senses and our body, for so many things we do and the way we interact in so many of our relationships every day.  Whether someone is “touchy feely” or not, the skin marks the point at which our bodies end and the rest of the world begins; it is the physical barrier OR connection to our inner selves and the outside world.

For some however, their sense of touch gives them mis-information about the world around them and because the sense of touch is “distorted” they physically feel bad, much of the time (think steel wool, prickly cactus, or ticklish feeling all day long).  When things feel this way for someone ongoing, they may learn that the world can be a scary or unknown place.  Tactile “distortions” can happen for a myriad of reasons, including abuse & neglect, sensory processing disorder, other diagnoses such as autism, damage to nerves from things like stroke, brain injuries, severe burns, or even diabetes.  Some people have the capacity to compensate for this distorted sense of touch and some do not, depending on the reason for and the type(s) of differences they experience.  That said, the type of touch distortion I see most commonly, in my work with children, is called tactile defensiveness.

Tactile defensiveness is not “injured nerves”, “damaged skin”, or injury of any kind (like one would find as a result of a stroke, a spinal cord injury, burns, or diabetes.  With tactile defensiveness, the brain misinterprets the messages sent by active tactile receptors.  In fact, the receptors may be “over-active” which causes “tactile defensiveness” or tactile hypersensitivity.  The following video does a MUCH better job than I can here of describing “tactile defensiveness” (leave it to interns with lots of energy and grades on the line to show up those of us working in the field):

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A recent resource I bought to share with parents is a book called, “I’ll tell you Why…talking about Tactile Defensiveness.” (Note: I am getting zero compensation for my endorsement of this product.  I simply love it). This book is an aesthetically beautiful presentation of photos, coupled with easy to understand words and prompted blank pages for children to color/draw/write about their own experience of touch.  This book offers encouragement, validation, and information that can lead to understanding, for kids and families who struggle with this extremely real, but frustrating, and sometimes debilitating condition, known as tactile defensiveness.

I am not only an OT, but I am the parent of a child who has struggled with tactile defensiveness at some level, since the day she was born (translation.,,many battles and meltdowns during dressing and still only being able to wear two brands of socks or none at all, specifically putting on shoes and socks at the exact time we are struggling to get things together and get out the door, major freak outs as a toddler that lasted the duration of our entire trip across town because of being buckled into the car seat, arguments over temperatures of foods and bathwater, limited snuggles because sitting too close to people makes her feel “sweaty”, and upset -hers and mine- over hair brushing, face washing, hand washing etc. – or lack thereof).  I FEEL a parent’s pain at the daily challenges of raising a child with tactile defensiveness.  (Sidebar, I consider myself lucky to have had that as one small piece of parenting to contend with, amidst a myriad of other potential challenges that so many parents have to face).  I raise my experience to highlight that tactile defensiveness can be one of those “hidden” challenges, that so many kids (and families) face, not obvious to outside observers, but such an integral part of that child and family’s daily experience, and without support and information for how to address it, it can make family life, less than enjoyable and extremely, NOT what we want our lives to be (how’s that for technical?).

For those parents raising a child with tactile defensiveness and the accompanying struggles that ensue, I encourage the watching of this video for information and the purchase of this book, for at least initiating conversation.  Resources are also included in the book for reference.  Occupational Therapists have strategies that can be useful for addressing tactile defensiveness and with the right interventions, support, and information, life can become a little MORE like we DO want it to be!  (save the steel wool for scrubbing dishes).