Kids sometimes have trouble transitioning between tasks or environments. Transitions are hard for many kids. They may demonstrate increased negative behavior or avoidance. This is a skill that kids frequently use in the classroom at school. It is necessary for increased engagement in daily activities. Unlike adults, kids have limited understanding regarding the concept of time when they are asked to stop playing, go to bed, or move to a new space. This can be incredibly challenging. But, the good news is that parents can support kids with these transitions to minimize behavioral outbursts and increase understanding.

Strategies to support transitions

• Firstly, routines. Each time a transition occurs, establish a sequence of consistent events, such as singing a song or clapping hands. This informs the child a transition is coming and can establish familiarity and comfort. Learn how an evening routine can help.
• Visual Schedules: When a schedule remains the same from day to day, we can include pictures on a board to signify the sequence of events. The child will remove each picture after they complete the task. Make a picture schedule on board with Velcro and place it in an accessible location in your home. The schedule is individualized and based on the child’s needs and abilities.
• Timers: Timer apps exist on most smartphones and contain fun, enticing pictures that the child can view. It is important to notify the child that you are about to set a timer and what to watch for when time is up.
• Representational objects: Find a special object that represents the task the child is transitioning to. For example, use a ball to assist with transitioning to a ball activity or a crayon for coloring. The child will then take the item to the desired location of where activity is about to occur.
• Make sure you give explicit instructions and be specific.
• Encouragement is important.
• Allow time for your child to process a verbal request for change.
• Lastly, provide specific feedback on performance after the completion of the transition. This is highly motivating for most kids and builds confidence.

Reference

1. Occupational Therapy for Children 7th Edition, Jane Case-Smith, Jane O’Brien

Many individuals are experiencing the short and long-term symptoms of the COVID-19 virus. The COVID-19 virus impacts the musculoskeletal, cardiopulmonary, neurological, and psychological systems, as well as communication. Therefore, many individuals have lingering symptoms of the virus. This is impairing their ability to do the things that mean the most to them. However, there is good news! Occupational therapy for COVID-19 can help your recovery. Occupational therapy is appropriate for treatment of long or short-term impacts of the COVID-19 virus by maintaining a holistic person-centered approach to care. For some people, a recent stay in the ICU due to the impact of COVID-19 causes impairments in emotional well-being, physical function, and lung function.

Firstly, early intervention to address such symptoms is of the upmost importance for regaining function and returning to meaningful occupations. During your evaluation, your occupational therapist will assess the person, occupations, and environment. They will further investigate impairments impacting function and healing in order to provide individualized treatment to address difficulties in all areas.

Areas Impacted by Covid:

• Cognition and communication
• Physical abilities and fatigue
• Myopathy/neuropathy
• Perception and vision
• Mental health (depression/anxiety)
• Independence and mobility

How Occupational Therapy Will Help Your COVID Recovery

• Energy conservation strategies
• Environmental modifications to support function in daily activities
• Emotional support/relaxation
• Strengthening and activity tolerance
• Balance and safe mobility
• Vocational rehabilitation
• Strategies for managing cognitive impairments

So, if you are struggling with post COVID recovery, call MOSAIC today to schedule an evaluation. Additionally, for more tips on how occupational therapy can help adults, check out this MOSAIC blog.

Reference

1. A Quick Guide for Occupational Therapists: Rehabilitation for People Recovering from COVID-19.

Youth sports can have a very positive impact on children. These activities aren’t just good for their growing bodies, they also are good for their minds. Sports teach important life skills. The physical benefits of children participating in sports is obvious. This is becoming increasingly important as so many of today’s kids spend extended time being sedentary, engaged in screen time activities. While screen time can be positive too, often it takes the place of physical activity. Physical activity has been shown to stimulate chemicals in the brain that promote emotional wellness

Benefits of Youth Sports

The developmental benefits of sports go well beyond simply learning new physical skills. Sports include winning or losing. It is important to recognize that even if your child is not winning, they can still have fun and enjoy playing the sport. Losing can teach children how to bounce back from disappointment and develop coping skills. It promotes the development of becoming resilient. It is not necessary for children to always win because they need to experience what it feels like to lose. This teaches empathy.

Of course winning is not bad! Winning boosts self confidence and self esteem. Sports can also help in developing patience and understanding that it may take a lot of practice and hard work to develop their skills. Being a part of a team can help develop children’s self esteem when the environment is healthy, supportive, and encouraging. The support of the team members, positive coaching (and parenting), and seeing their skills develop will help boost a kid’s self esteem. 

Social Benefits

There are many social benefits of being involved with team sports. These skills are used throughout life. It can help develop the skills of listening to other players, cooperation, and how to support each other. It can give kids a sense of belonging as well as helping develop new friendships.

Another key part of playing on a team is following directions and accepting discipline. Kids are expected to follow the rules of the sport and accept the consequences when they do not. Kids learn how to take directions from the coach, referees, and even other team mates. They learn what team work is all about! 

The Role of Parents in youth Sports

A component that is often overlooked is the parents’ role in team sports. Many parents are not aware of how their response and comments impact their child. Parents, focus on your child having fun and being active, rather than winning or losing. Be positive! This includes praising your child or team efforts, even when they do not win. Be aware of your side line comments, keeping them positive to the players, coaches, and referees. Be your child’s and team’s biggest cheerleader. Let the coaches and referees take charge of the team. 

The following was taken from The Thinking Branch. It captures so many points, especially our role as parents, which is often a very big key in how a child responds to playing team sports. 

It was HER that said it.

On the way home from the soccer field, my goalie daughter said:

“Mom, I should have turned my wrists down on that last goal they scored instead of keeping my hands flat. It would have made the ball go to the ground like Coach Erik teaches me instead of it going up and over me like it did. I’m gonna get better at that.”

I glanced in the rearview mirror to see if her face showed the excitement I thought I heard in her voice.

“That’s so cool you noticed that,” I said. “You’ve been working hard on your technique, and it’s so fun to watch you play.”

As I continued down the road, she and her little sister were already discussing what slushie flavor they were going to get – but I kept thinking about what she said.

Instead of beating herself up for a mistake, you could tell she felt empowered that she knew what she did wrong – without anyone else having to point it out – and could adjust the next time.

This was different from other rides home where – before we got out of the parking lot – I’d suggest something she could have done better or ask her why she didn’t do something in a certain way – not to be hard on her, but (in my mind) to “help” her.

But those conversations never went the way this one did.

Those left her feeling frustrated. You could see it on her face she felt attacked and like she was letting me down. I’d remind her I was “just trying to help” and she’d ask to change the subject.

But in that recent moment, I realized how powerful it can be when you let coaches coach and let kids find the answers within themselves.

How powerful it is when you accept your job as a parent is to support their growth and not always point out where it needs to happen.

How powerful it is when you see your kids gain the tools to self evaluate…and you start to do some of your own about your role in their sports journey.

I’m not always going to get it right.

But just like my goalie plans to tighten up her technique the next game, on the drive home after it – I’ll tighten up mine, too.

By letting the coaches coach and my player play.

And staying in MY lane where my job is to give her space to grow and keep reminding here I’m here for her along the way.

Here are a few youth sports options in our local communities. Many offer scholarships if there is a financial hardship. Your area Chamber of Commerce may also be a resource in locating activities.

• Belgrade Girls Softball
• Bozeman Girls Softball
• Soccer (AYSO)
• Bozeman Swim Club
• Belgrade Baseball
• Bozeman Baseball

Click here to learn how to minimize your child’s risk for sports related injuries.

Do you know where your tongue rests in your mouth? Chances are you have to stop and think about it. Proper tongue resting placement is when the tongue tip is elevated to the roof of the mouth, just behind the front teeth. Don’t worry if that isn’t where your tongue rests. Incorrect tongue resting posture is common. A lot of people rest their tongue low in their mouth or farther back, and they are still perfectly functional. BUT if your tongue is resting incorrectly, AND you aren’t sleeping well, you breathe through your mouth instead of your nose, or you are having trouble eating, there may be a bigger problem known as an orofacial myofunctional disorder (OMD).

Causes of Orofacial Myofunctional Disorders

To put it simply, OMDs are abnormal movement patterns involving the face and mouth. This may include the tongue, lips, neck, mandible, etc. OMDs in adults may be due to a multitude of factors including chronic orthodontic issues, sleep disordered breathing, restricted oral frenula (tongue and/or lip ties), facial trauma, weakness, or a variety of other neurological or craniofacial disorders. The lack of intervention during critical periods of development may result in such a disorder.

Signs and Symptoms of Incorrect Tongue Resting Posture

In adults and OMD may present itself in a variety of ways, including the following signs and symptoms:

• Breathing habits (daytime): mouth breathing, audible breathing, open mouth posture
• Breathing habits (nighttime): teeth grinding, not sleeping through the night, waking up multiple times to use the bathroom
• Airway obstruction: sleep disordered breathing (snoring, apnea), enlarged tonsils and adenoids, tongue falling into airway
• Tongue, lips, or cheek restrictions
• Picky eating or difficulty eating
• Oral aversions
• Chewing habits
• Poor oral control, messy eating, audible eating, forward tongue protrusion during swallow
• Reflux
• Malocclusion, orthodontic relapse
• Forward head posture
• Teeth grinding or facial pain
• Articulation errors
• Low forward tongue placement with open mouth posture

How Therapy May Help

You may have an OMD and still be functional. Therefore, it’s not a problem for you. However, if you have one or more of the symptoms listed above and it’s negatively impacting your health or day to day activities, it may be beneficial to get evaluated by a speech-language pathologist who has specialized training in assessing and treating OMDs. Speech pathologist’s often work with a team of other professionals including: allergists, ENTs, orthodontists, physical therapists, and even oral surgeons, or plastic surgeons if necessary. This is to address all of the underlying weaknesses and structural issues that may be affecting your swallowing/speech patterns. Once any underlying issues that may be affecting breathing or tongue placement have been remedied, a speech pathologist can work with you to acquire new orofacial myofunctional skills and strategies.

If you have any questions about OMDs feel free to reach out to one of the OMD trained speech pathologists at MOSAIC Health & Rehab at 406-388-4988. For more information on this topic, check out our earlier blog post Oromyofunctional Disorders: What Exactly Are They?

Have you ever noticed a baby with their hands in their mouth? Babies are learning to explore through the hand-to-mouth connection. Mouthing is an important development for babies to learn new sensations in the world, as well as calming oneself. There are different mouthing learning periods, lasting to 2 years and beyond. Let’s explore why it is important for babies to mouth, the learning periods, as well as how to support a baby in each stage.

Generalized Mouthing Period (Birth to 4-5 Months of Age)

At birth, babies show a rooting reflex where your baby’s mouth searches for the touch near the mouth with small side-to-side head movements. As a baby grows, decreased rooting reflex emerges when items touch a baby’s mouth. This is the generalized mouthing period. Sensations of soft and firm are being explored. Around 2 months of age, a baby will begin to bring hands to mouth while laying on back or belly. Then, around 3 months of age, a baby will begin to grasp a toy and bring to mouth, suckling. Lastly, between 4-6 months, the biting reflex increases, and the gag reflex is coming under control.

Many changes to a baby’s facial structure happen in the first mouthing period, from jaw growth to the space between a baby’s nasal area and mouth increasing. It is important for a parent to support the baby’s sucking and suckling of hands and safe, appropriate toys to prepare the transition to discriminative mouth period.

Discriminative Mouthing Period (5-6 Months to 9 Months of Age)

Discriminative mouthing is very important for a baby’s development. In this period, a baby will move items within the mouth to explore, learning of tastes, temperatures, sizes, and textures. Biting, chewing, and tongue movement is also explored using safe toys, fingers, and foods. This promotes development of the jaw and teeth to emerge, as well as providing more developmentally appropriate methods for the baby to calm oneself. It is recommended to wean off the pacifier after 6 months of age as extended use of a pacifier can be detrimental to overall facial development. Subjectively, babies who skip or have little time in the discriminative mouthing period have greater difficulty in developing feeding and speech skills.

The Beginning of True Mouth Play (9 Months to 12 Months of Age)

More mature and precise biting, chewing, and manipulation of toys within the mouth occur. Desired diagonal rotary chewing and jaw movements is emerging. Babies will have less mouthing and more intention in using the mouth appropriately with toys. Therefore, to help, a parent can support these skills with supervised horn blowing and bubbles.

True Mouth Play (12 Months to 24+ Months of Age)

Babes achieve many skills in this stage. Respiration is maturing, and babies use lips and cheeks together to shape for straw drinking and horn activities. The tongue thrust swallow is decreasing, and the jaw and tongue learn to move independently of one another. By now, chewing, open cup drinking, or straw drinking have replaced sucking for calming.

However, it is important to remember these are not rigid timelines. We recommend parents support the child no matter what stage the child is within. The following are item suggestions for each period:

• Generalized Mouth – Baby’s own hand, parent’s finger, rounded teethers, easy to grab teething toy balls
• Discriminative Mouthing – Elongated teething toys made to isolate the molar area (promote chewing), foods cut as “match sticks” to isolate molar area and promote chewing while providing consistent supervision (if foods have been introduced and are going well)
• Beginning and True Mouth Play – Baby horns, bubbles, and pop tubes all with parent supervision

For more resources, check out MOSAIC’s Patient Education page for a teething toy handout and recommended cups for kids 6 months and up.

Resources

1. Bahr, D. (2001). Nobody Ever Told Me That! (Or My Mother) (pp. 91-108). Arlington, TX: Sensory World.

It will surprise nobody to hear that Physical Therapists work with muscles. But we bet a lot of people would be surprised to learn that the muscles inside your pelvis are included. While the pelvic muscles don’t get as much attention as the biceps or hamstrings, they can still cause problems that need treatment. Physical therapy for your pelvis can help. Here are a few examples:

Urinary Incontinence

Urinary incontinence is the involuntary leakage of urine. More than 13 million people in the United States have this issue. There are different types of incontinence, but the most common are stress and urge incontinence.

• Stress incontinence is when leakage happens during coughing, sneezing, or laughing.
• Urge incontinence is a result of the bladder being overactive or unstable. People with urge incontinence often often have triggers that cause the involuntary loss of urine, such as hearing running water.

Pelvic Pain

Pelvic pain is as any pain that occurs either internally or externally in the pelvic or genital area. This can affect both men and women, but it’s more common in women.

What’s the Cause?

Issues with the pelvic muscles causes most incontinence – either from weakness or tightness. However, there can be other contributing factors like spasms that cause bladder contractions. Or, conditions like anxiety may increase the urge to empty the bladder.

Causes of pelvic pain usually include either tightness or weakness of the muscles of the pelvic floor. The pelvis is made up of three bones, forming three joints where they meet. These joints need stabilization by an outside force. The job of the muscles and ligaments in and around the pelvis is to  provide that stabilizing force. If the muscles are too tight, the joints will have an excessive amount of compression on them. Too loose, and the joints of the pelvis can experience shear forces. Both conditions result in pelvic pain.

What can Physical therapy do for the Pelvis?

Because incontinence and pelvic pain are usually musculoskeletal conditions, physical therapy can offer a lot of effective treatments. Some examples include:

Exercise – strengthening or stretching of the pelvic muscles or the core can help correct imbalances, improve pelvic stability and reduce pain.

Biofeedback – This involves using sensors placed on the body while doing exercise to help the patient identify which muscle groups are working and bring awareness to areas of tightness or weakness.

Education – For incontinence, learning how the bladder normally functions can help you to understand changes that can be made to improve symptoms. Learning about posture and how to improve alignment of the pelvis and the trunk can help to reduce pain and improve tolerance for positions like sitting and standing.

Manual Therapy – joint mobilizations, trigger point release, soft tissue massage, myofascial release, and other techniques can help improve mobility of the pelvic joints, decrease tone in spastic muscles, and reduce pain. So, if you’re experiencing pelvic problems, a specially trained physical therapist can complete a comprehensive evaluation, help determine the cause, and design a customized treatment plan to help.

References: