Our first occupational therapy session

Last week I made an appointment with an occupational therapist because I wanted to get AngelicA assessed on her fine motor skills development and areas we need to work on. Besides, the developmental pediatrician who had done her developmental assessment had suggested that we start Angel on occupational therapy. So yesterday, we made the short trip to the early intervention center to meet the occupational therapist.

Initially, when we got there Angel started fretting a bit and was clinging to me. She does this quite often now. But once the therapist gave her some beads, blocks and other stuff to play with, she got comfortable and played while we chatted about her.

He told me to show her how to string some beads and Angel caught on quite quickly. After a while, he told her to put the blocks back into the box and she did as she was told. He told her to stack some cups and she did that too. But after a bit Angel was distracted and wanted to play with Elle, somehow whatever her sister's doing always seems more interesting so she scampered over to Ellie.

All the while, this therapist kept observing her and making notes. I wasn't sure what he was making of it. Until all of a sudden he asked me - Is she always like this? And I was a bit puzzled. Like this? Excuse me, like what? And then he asked me again, is she always hyperactive? I just didn't get it. Among all the kids in our extended family, Angel is the most placid and amiable. Yes, she has started jumping around like a little monkey now that she can stand without support and climb pretty well, but don't all children do that? I told him so but he still insisted that OT will help us to address her hyperactivity!!! Can you believe that? So that remained a moot point in the course of the assessment.

At the end of the assessment, he said that he doesn't see too many issues with her but because she has 'a condition' it would help to get her started on OT so that she is able to reach her milestones more or less in line with typical kids. He suggested that we do some of the exercises at home with her. I had already started getting her to do a few things like coloring with crayons and playing with beads. I've been showing Angel how to unzip and zip up the zippers on cushions to help her develop a more mature pincer grasp. And sometimes she pulls down the cushions so she could go at it herself. Now I'm looking for some peg boards that could possibly be as useful.

I've picked up some suggestions from About Down Syndrome and listed them here.

- Picking up small items (i.e. uncooked macaroni, cheerios, etc. and putting in cups or bowls.)Always, always stay with your child when doing this and make sure he does not put these items into his mouth.
- Putting together snap lock beads
- Manipulating puzzle pieces ( the kind with the pegs for picking up the pieces)
- Brushing or combing his hair (or yours, but beware, he might get overzealous!)
- You can give your child a crayon and piece of paper and let him go at it (make sure to supervise this activity)
- Alternatively, a magna doodle might do the trick
- Peg boards

Another interesting article on Bright Hub recommends that toddlers should be encouraged to use the index finger and grasp tiny objects as they engage in the following daily activities:
- Point during finger play songs
- “Paint” with the index finger in whip cream
- Put small pieces of crackers inside large container openings
- Stack blocks
- Put large pegs in or out of a board

The article goes on to say that two-year-old children are ready to practice the following fine-motor activities that will develop these skills:
· Stringing large beads
· Putting objects inside containers/ dumping them out
· Opening food wrappers
· Opening and closing lids such as the top of a band-aid box


Pic source: Brighthub.com

Suggested activities for three and four year old children include:
· Opening and closing squeeze clothespins
· Using toy pliers to move around objects
· Opening or closing screw caps
· Winding up toys

I would love to hear from you about all that you have been doing at home to develop your child's fine motor skills. Please do write in to littlemommysunshine@gmail.com.

Thanks for reading,
JD

Baby talk

We've finally started Angel on speech therapy. Yesterday, we met a therapist who was recommended to us by the pediatrician at Ummeed. And I'm happy to say that it was a nice, positive experience.

I was initially apprehensive that we were probably very late in starting Angel on speech therapy considering she is already 15 months old. Thankfully, Palak (the speech therapist) reassured me that it was fine to start now.

She did an assessment of Angel's speech even as the two of them carried on a conversation. It was great to watch them both talking. I could see Angel was in a happy place, what with the new toys and someone actually 'understanding' what she was saying. That itself was a big learning for me.

Palak drew up an therapy action plan for us to work on with a two month timeline. What I really liked was that all of it can be done easily at home. The key actions that we have to incorporate in our daily routine are:
- We have to use short sentences, stretch words and use a lot of gestures while speaking with Angel.
- She has to learn to sign 'eat' and 'finished'.
- We have to incorporate doll play into our routine. We have to take the doll everywhere and make the doll do whatever Angel is doing.
- For oro-motor stimulation, Palak recommended we buy a set of training toothbrushes and use the beginner brush - which looks more like mini paddle - and roll it around her mouth five times each day. The brush has to be dipped alternately in honey and lemon juice and we need to do five repetitions each time.
- We have to record Angel's vocalizations and play it back to her.
- We have to imitate her vocalizations and do vocal play with her.
- We also have to talk for her. So when she says boo....we say boo...book? Do you want your book?
- Within the next two months Angel must be able to recognize 20 commonly used objects.
- We need to buy her some cause-effect toys. If you'd like to pick up such toys make sure you have the time to look around all the stuff before you pick what will really benefit your child.
- We have read the book 'The new language of toys'
- Palak also suggested that we play a DVD on signing for her. It's called - My baby can sign. We haven't managed to locate this and the book yet but as soon as I get them, I'll add the details to this post.

I left Palak's clinic happy and with a sense of having achieved a milestone even though it was just the first step. I guess you, dear parent, will know what I'm talking about.

We'll keep you posted on how the talk therapy is going with us.

Thanks for reading,
JD