These are testing times for every one of us, especially for children with needs. Paediatric occupational therapists are allied health professionals who focus on their resumption of age-appropriate functions (occupation), be it eating, drinking, sleeping, talking or playing. During these challenging times, our children with needs are more likely to be disorganised because of the sudden halt of their routines. A change in routine leads to deprived stimulus, which might hamper their development. This may cause anxiety and distress even for the parents who may run out of ideas.
Self-engagement is always a concern for children with autism, slow learners and those who have praxis issues, since doing any new task is a bother. So, parents are encouraged to facilitate engagement in a more therapeutic way, using home resources.
The following are some of the suggestions to be incorporated along with your given programme:
Hand hygiene is of paramount importance during these days, but it is extremely challenging for our children since they tend to mouth their hands, objects, frequently. So use of tethers, chewy tubes, blowing toys, constant supervision, sanitising their toys, objects and teaching them hand washing techniques through physical cuing, visual scheduling (drawing simple icons in a step by step sequence) will be of great help for visual learners.
Parents can lead by example like doing their regular chores of waking up in time, carrying on morning rituals without any delay or postponement. The above said modelling drives our children to continue their morning chores without any fuss even if they don’t have to go out.
Explaining the current situation in short, simple and in clear phrases to nonverbal children with autism helps them reduce unwanted anxious behaviour and facilitates the desired behaviour; this technique is called social stories. A social story makes them ready to anticipate the day’s new schedule and makes them to acclimatise it imaginatively. Morning chores such as brushing the teeth, toilet, and bathing can be facilitated through modelling, physical cues, verbal prompts and including various positive reinforcements over a period of time, since these can well become part of their ritual.
Sensory stimuli
Allowing children to observe the kitchen during meal preparation gives those rich sensory stimuli through visual, touch, olfactory (smell), and gustatory (taste) inputs. Precautionary measures for hot, sharp objects have to be factored in. Mothers can teach children with real objects in more real life situations like naming, identifying vegetables, fruits, colours, feel different textures of cereals, and smell various spices.
This can be followed by food play/ messy play during their lunch time to desensitise touch, smell, and taste, visual over responses.
Avoid showing the child a mobile phone while feeding, instead go to the balcony and point to things. Parents can gradually substitute junk foods, with homemade organic and healthy snacks.
Best time for stories
Early evening are the best time for listening to stories from their grandparents or picture book stories which encourages good sitting, listening skills and expressive language. Playing music over speakers or wear noise cancelling head phones helps them to counter auditory over responsiveness and organises them. Letting loose to make funny movements and shake a bit relaxes them immensely. Dads can take over evening sessions by taking them to the balcony/terrace to water the plants, to encourage loads of sensory motor activity such as running, jumping, hopping, cycling, climbing, balancing, and ball skills. Children who don’t have access to terraces can arrange furniture for an obstacle course and climb over/crawl under to do picking and dropping tasks. This will help with the much-needed proprioceptive input. A cotton sari hammock suspended from ceiling hooks can be provided to ensure vestibular inputs so as to calm, and facilitate muscle tone especially for children with tonal imbalance, Down syndrome and Cerebral palsy. Table top activities such as drawing, colouring, pattern writing, grid diagrams, coping different geometric figures and shapes will integrate visual and motor components which are the prerequisites for academics and writing skills.
Sleep hygiene is very essential, so start with a warm bath, followed by warm food, bed time stories, lullabies in a less-distracted, cozy environment to put them to sleep. The above mentioned ideas are general guidelines and not individualised and parents are encouraged to follow their respective Occupational Therapist-given sensory diet for your specific needs.
