Nail Care Tips for Sensory-Sensitive Children

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Written by Sandra Ellis, Student OT, McMaster University

Recently, I was talking to a parent who was having trouble getting her sensory-sensitive child to let her cut his nails. This prompted me to wonder what kinds of parent-friendly strategies I could offer parents facing the same challenge. Many kids with sensory challenges can be adverse to personal hygiene activities like nail care because their super-sensitive finger tips may perceive the sensations involved in the activity as uncomfortable or painful. This reaction can result in a really stressful experience, both for the child and the parent. So, what’s a parent to do? Here are a few suggestions that may help you to conquer the nail cutting beast:

  • Try using alternative tools like nail scissors or baby nail clippers – these tools can be easier on the finger nails, creating a less of a sensory impact. They are also smaller, so less of the nail is being cut at one time, which may also be less stimulating for the child. Additionally, these tools can have a less intimidating appearance which might help avoid triggering any anxiety in your child.
  • Try cutting your child’s nails after a shower or bath, or soak the nails with some soothing aromatherapy oils – your child’s nails will be wet and soft, rather than dry and hard which will make the cutting process quicker and easier and may be less of a shock to your child.
  • Give your child’s hands, fingers, feet and toes and gentle massage or gently press on the centre of the nail before cutting – deep pressure can help to reduce overall sensitivity.
  • Cut only 1 or 2 nails per day – This way, nail cutting can be a short experience at first and becomes an everyday activity. The child will get more practice having his or her nails cut and can become desensitized over time. Once your child gets used to this, you can gradually build up to more and more nails at a time!
  • Model the activity for your child – let your child watch you clip your own nails, this way the child knows it is a normal and safe activity.
  • Stay calm and comfortable – It is important for you to stay happy and calm during the process too! If you are frustrated or upset, your child may pick up on this and it could trigger a negative response from them. More importantly, they may come to associate the activity with these negative feelings which could make nail care even more challenging in the long run. So, remember to keep a calm voice, calm and steady breathing, and calm controlled movements. You can even try to make the activity fun by singing a soothing song or counting softly during the process!
  • If your child is old enough, try teaching them to cut their own nails – this may reduce the surprise or anxiety of not knowing what to expect.

Grooming is important and can be a major challenge for kids with sensory issues, but with some patience and a few strategies, the process can be made a little easier. Nail care is just one of many personal hygiene activities that can be difficult for our sensory kids. An Occupational Therapist can help determine the best way to approach sensory issues with your kiddo and can provide strategies and work with kids directly to overcome these underlying sensory challenges.

G-Tube Transitioning

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By Kayla Brown, Student Occupational Therapist, McMaster University.

A gastric feeding tube (g-tube), provides a long-term solution for children who are unable to get enough nutrition through traditional feeding methods. This ensures that a child can get the nutrition they need to grow and develop. However, as time goes on, many children are able to transition off of the g-tube and receive the majority of their nutrients through oral feeding. This transition can be a challenging process for many kids, but there are multiple ways that an occupational therapist can help your child have a successful transition.

Depending on their feeding history, a child may have unpleasant memories or pain that they associate eating. These can be conscious or unconscious memories. This can cause the child to fear eating even if the issue that caused pain or discomfort in the past has resolved.  Occupational therapists take a gradual approach to introducing your child to food, which helps to provide a safe and comfortable feeding experience. This slow and steady approach helps a child learn to view eating as a safe and enjoyable activity.

Although we don’t often think about it, chewing and swallowing requires a fair amount of strength and endurance from the muscles of the lip, jaw and tongue. Just like your leg muscles need regular exercise to stay strong, the muscles we use to eat can become weak if they are not used for an extended period of time. An occupational therapist can develop an exercise program to strengthen the muscles involved in feeding, and to help the child learn or relearn how to safely chew and swallow food.

If a child has been getting nutrients through a g-tube for an extended period of time and has not been using their mouth to explore different foods, eating can be an overwhelming experience for the child’s senses.  The different textures, tastes, and smells involved in eating may feel like more than a child can handle.  An occupational therapist can develop a plan to gradually introduce the child to these different sensory experiences so that they become comfortable with more stimulation over time.  In addition issues with sensory stimulation from food, the child may also be unable to sense where the food is in their mouth, which leads to swallowing difficulties and food rejection.

In addition to helping your child develop feeding skills, an occupational therapist can help you as a parent to learn how to best support the child during this transition to oral feeding.  He or she can provide education on which foods are safe to try, strategies you can use to decrease your child’s stress during mealtime, and help you set realistic goals and expectations.  In order to help your child to have a safe and comfortable experience, the occupational therapist may start with non-food items to teach chewing and proper use of the jaw, and then move on to food as skill develops.

Learning language through daily routines

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By Victoria Vanderstoep (Student Communicative Disorders Assistant, Durham College)

It’s never too early to begin encouraging communication in young children. But teaching language is not something parents need to set aside extra time for – it is something that happens by sharing time with parents and siblings, and exploring the world around them. When children are beginning to learn language, they need to have experiences to do so. Then they need to learn the words to talk about those experiences, and finally, they will need someone to talk with. Engaging your child in conversations as you are going about your day provides them with experiences and the words that go along with those moments.

Routines are an excellent opportunity for language learning – during these parents can talk about what is of interest to their child. Children begin to make sense of their world by participating in daily routines, such as getting dressed, brushing their teeth, eating meals and going for a ride in the car. Not only are they learning about the organization of their world through these routines, but they are also learning about social roles and the language that is used in these routines. During these routines parents give their children the important words for that routine. For example, providing the child with language during bath time, allows the child to have the language needed to express excitement over bubbles popping in the tub.

Each of these routines has a series of short steps that need to be done in a specific order. Parents can use this to their advantage. By labelling items, such as the clothes the child is putting on, or the ingredients being used to make cookies, parents are exposing their children to new words which will make their vocabulary grow.

Language learning doesn’t have to be an activity that time is set aside for each day. Use every opportunity of your day to engage your child in what you’re doing. It’s important to be flexible, and following the child’s lead. Share their interests, build language into what they want to explore, and their language will begin to blossom. It’s amazing how quickly children begin to pick up the language they are exposed to.

Functional Recreation for Children with Special Needs

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By Sandra Ellis, Student Occupational Therapist, McMaster University

Many parents of kids with special needs have concerns about involving their kids in recreational activities. Often parents wonder: Do the benefits of recreational activities outweigh potential risks?

This question reminds me of a topical issue in Hamilton, where an existing tobogganing ban was recently reinforced, due to the health and safety risks for children involved. While this bylaw has not been heavily enforced through ticketing, it has the potential to reduce the already limited winter recreational activities available to children (especially those accessible available to kids with motor or coordination challenges). This situation is a prime example of what can happen to recreation when the fear of risk is determined to outweigh the benefits.

Recreation is a huge part of young people’s lives – like we have jobs as adults, a child’s main job is to play. This is how kids learn certain skills, like social skills, that will become even more important later in life. Recreational activities such as biking, swimming, skating, and team sports (to name a few) are a great way to work on physical, social and cognitive skills like coordination, turn-taking, communication, and planning. Plus, if a child is able to participate in more activities with their peers, they can build self-esteem and independence.

Reaction can offer children many positive, developmentally important experiences. Success and failure are two vital learning curves in reaction activities. It is important for a child, just like it is for adults, to feel successful at something important to them – this builds confidence and life satisfaction. Equally, it can be beneficial for a child to not always succeed at new challenges because failures help us develop problem solving skills and perseverance, and makes the eventual success so much more rewarding!

However, it can scary to let our kids stumble a bit, so to speak. Many parents worry that their child with special needs may not be able to succeed at a particular recreational activity or that they may get hurt trying. This is when an Occupational Therapist might be able to help.

Occupational Therapists have a knack for breaking down challenging complex tasks into smaller manageable steps – we call this “task analysis”. Using this skill, an Occupational Therapist can work with kids to figure out how to modify the activity or the expected outcomes (making several smaller goals instead of one big goal). In doing so, an Occupational Therapist can create a program that allows for success and a reasonable amount of challenge, while creating a safe environment. By getting to know a child, and with input from parents, an OT can tell if the an activity needs to be modified based on how the child is performing on any given day. Sometimes a child may need to learn an activity in a different way than other kids or may need special equipment to participate – these are also things that Occupational Therapist’s can help with.

Functional recreation can be a great way for kids to develop important skills while being fun and fulfilling. If you are not sure about how to begin a recreational activity with your kiddo, are worried about how to do it safely, or if you notice that your child is having trouble learning the activity in the traditional way, it may be helpful to talk to an Occupational Therapist.

3 Tips for Packing Lunch for Picky Eaters

PickyEaterBy Kayla Brown, Student Occupational Therapist, McMaster University

Brainstorming what to pack for your child’s lunch can be a tricky task, especially if he or she is a picky eater. Whether they are in daycare or 5th grade, kids do a lot of work and play during the school day, and a nutritious lunch can give them the fuel they need to help them succeed. But what do you do if your child regularly doesn’t eat the lunch you prepare for them? Below are a few tips and tricks to help you pack a lunch your fussy feeder will actually eat.

  1. Involve your child: If you left your child to their own devices, they might have chocolate pudding with a side of jellybeans for lunch every day!  However, if you work together, you can pack a lunch that makes both of you happy.  One option is to give your child a choice between two options you approve of; this way, they will feel like you have considered their ideas, and you can rest assured that they are getting the nutrition you want.
  2. Make food fun: Cookie cutters can be used to cut sandwiches into cool shapes.  Or, you can pack their veggies in a Tupperware container with their favorite television characters on it.  Appealing to their interests can help your youngster view lunchtime in a more positive light.
  3. One step at a time: If introducing a new food at lunch, or packing an item that isn’t a favorite, it is best to include it in small portions along with other foods you know they like. This way you know that even if they don’t eat the new food, they still have enough food to fuel their day.  Encourage them to try the new food, but let them know it’s ok if they don’t finish it. Change takes time and your child may require multiple exposures to a new food before they feel comfortable enough to give it a chance.

For tips and tricks that are individualized to your picky eater’s needs, consider contacting an occupational therapist. Canoe offers various feeding groups (Little Munchers currently offered and Monster Munchers in March) to help children make progress with foods.