Category Archives: Filomena’s Corner

Saturday Seminar: Weighted Blankets and More

Kristi Langslet, OTR/L ended the 2017 Spring Saturday Seminar Series with her enlightening presentation: Weighted Blankets and More for Use in Your Sensory Room or Sensory Carts! She discussed benefits and applications of weighted, compression and fidget products in Sensory Rooms and Sensory Carts.

General confusion and misconceptions abound regarding the use of therapeutic weighted materials, which Kristi dispelled with her seminar. She is an experienced therapist, having worked in a variety of primarily pediatric settings. Kristi began designing and making products for her clients to meet specific needs related to sensory processing. With her sister, Heidi, she developed and launched her therapeutic products company Sommerfly, in 2005, with the goal of “Calm, Sleep and Focus for All.”

Kristi’s review of research findings regarding sensory rooms and weighted blankets was thorough. The research reviewed came primarily from studies in adult psychiatric settings, but was still applicable to broader settings and age groups. Sensory rooms have been validated as safe, effective, anxiety and distress reducers, with weighted blankets being particularly useful for decreasing anxiety. She emphasized the recommendation for the best way to use a weighted blanket is for the child to apply it on himself/herself. Research cited from Tina Champagne, MEd, OTR/L indicates that weighted blankets should weigh more than 10% of the wearer’s body weight to be most effective – with 15-25% of a person’s weight as the guideline for use. She cited studies that indicate the rise in pediatric admissions for behavioral health problems. This fact points to the need for treatment strategies that are accessible, powerful, sensory-based, and research supported.

Sensory rooms are defined as a voluntary, self-managed place to decrease stress; they empower people to care for themselves. In these rooms you might find a Sit Tight Weighted Lap Pad, a Relaxer Blanket, and a variety of other calming sensory materials such as a white noise machine, lava lamp, chewing gum, exercise bandsyoga position cardsnoise cancelling headphonescalming music CD, etc., depending on the child’s age and needs. Kristi referred to Karen Moore’s Sensory Connection books as a having a wealth of information for developing sensory rooms and carts.

In her discussion of compression garments and muscle work, Kristi reminded us that compression garments have a similar effect as deep pressure applied to the skin and heavy work on joints/muscles. Both compression garments and weighted products provide similar touch pressure sensation, with a rapid response time, but heavy muscle work response time varies. The guideline for weighted vests provided was 3-5% of the wearer’s weight is optimal with wearing times of between 15-30 minutes at a time throughout the day; accommodation occurs with longer wearing times.

Kristi reported that since the hands and mouth have a high density of touch and proprioceptive receptors, the perception of sensation in these areas is greater than in other body areas. This may explain why we naturally fidget with hands and mouth with activities like nail biting, smoking, doodling, hair twirling, etc. Hand fidget research evidence shows that distraction reduced anxiety and pain after surgery. She advocated the use of a fidget as a “tool” versus a “toy” with examples like a Wristful Fidget or a Fidgety.

In our stress-filled society, the popularity and use of mindfulness techniques has alerted us to the value of being calm and centered. Sensory strategies we employ personally give us a sense of well being and regulation. Kristi asked us to imagine what effect they might have on a child who is “at risk.” As occupational therapists, we understand the value of and can use self-regulation practices to help people function optimally. After Kristi’s presentation, we understood the application of weighted products and fidgets more thoroughly, particularly with the pertinent research cited by her. When caregivers are given tools designed to help with self-regulation, coupled with other cognitive-behavioral strategies, we can look forward to seeing the effects with our students/patients as they reengage in life occupations.

Take a look at some of the glowing comments attendees provided:

“Great to have research to back up findings. Simple facts and Ideas to pass on to school colleagues and administration.” – Fredda T., Occupational Therapist

“I tend to be relatively skeptical about these issues, but I found Kristi extremely knowledgeable and approachable, and her presentation very informative. Lots to think about!” – Maura K., Teacher

“I liked the trauma informed approach, evidence based and practical suggestions. Really appreciated the update on weight guidelines.” – Kim B., Occupational Therapist

“Great intro course for new therapist and/or parents, teachers, related fields. Most useful for experienced OTs was the research/weight & wearing prescription/demo of products. Organized, straightforward presenter. Warm, open, compassionate, available for questions and pertinent case studies. Thank you!!” – Bernadette W., Occupational Therapist

“Great answers to questions, great products, great suggestions. I like the non toy look for fidgets.” – Anonymous, Occupational Therapist

Thank you, Kristi!

Filomena Connor, MS, OTR/L
May 6, 2017

Saturday Seminar: Sensory Differences and Mealtime Behavior in Children with Autism

Jeanne-Zobel-LachiusaEvidence based practice (EBP) involves the integration of:

  1. Clinical expertise,
  2. Scientific research, and
  3. Patient/caregiver perspective.

The goal of EBP is the improvement of patient outcomes. It holds us accountable for our treatment plans, strategies and outcomes among our peers and other health care professions. According to the AOTA, generating research in the field of occupational therapy is “critically important for advancing the field and ensuring the viability of the profession.”

Jeanne Zobel-Lachiusa, EdD, OTR/L was the featured December Saturday Seminar Series speaker, who shared her research on Sensory Differences and Mealtime Behavior in Children with Autism (AJOT September/October 2015, Vol. 69, No.5).  In summary, the study results helped to identify problem eating behaviors in children with ASD that may be associated with sensory differences. Children with ASD were compared with typically developing age-matched peers. The study concluded that children with ASD who receive occupational therapy that offers sensory strategies might result in less stressful mealtimes.  The findings supported the need for further research in this area of self-care with children who have been diagnosed with ASD.

The seminar attendees were from varied backgrounds, including occupational therapy, speech therapy, special education, social work, psychology, child care, medicine, and parents. They engaged in a lively brainstorming session on sensory strategies in the different sensory domains that might provide mealtimes with less stress for both the child and family. They shared innovative as well as tried and true ideas with the group.

Just a few examples of the many suggestions include ideas for tactile and oral sensitivity:

Hush BuddyFor auditory sensitivity Jeanne suggested:

For children with sensitivity to fluorescent lights that flicker and glare in the cafeteria or classroom, Fluorescent Light Filters, which are magnetic were recommended. Another suggestion was for the student to wear a visor to reduce vision sensitivity.

Jeanne suggested a number of resources for the group including the book, Autism Interventions, and recommended the AOTA website for its user-friendly handouts on mealtime and feeding.

Producing research is essential for validating assessment and treatment strategies. Jeanne shared that her research was motivated by the question of whether interventions are actually effective.  Her current research demonstrated that there was a statistically significant difference in sensory differences and in mealtime behaviors between children with ASD and the typically developing group she tested.  This groundbreaking research paves the way for further studies to investigate specific treatment strategies discussed today for their effectiveness in helping make mealtimes a pleasurable experience for children diagnosed with ASD and their families.

To view Jeanne’s PowerPoint slides, click here.

Following the seminar, attendees provided feedback about the seminar.  Please see a few remarks below:

“It provided an opportunity to review recent literature and share strategies with other therapists.” Kristyn S., Occupational Therapist

“Loved the topic and the format. Jeanne was great!!   Diane H., Occupational Therapist

“Informative, interactive, insightful. It was interesting listening to other OTs experiences and suggestions.”  Sylvia K., OT student

“Helpful to organize sensory treatment with a food tolerance/mealtime behavior perspective.”  Anonymous Occupational Therapist

Thank you, Jeanne!

Filomena Connor, MS, OTR/L

Saturday Seminar: Providing Optimal Services and Supports for Students with Down Syndrome in Educational Settings

Anne Howard“Meaningful inclusion” is a term that supports the premise that all children should receive an education in the least restrictive environment.  To achieve this goal, social barriers must be hurdled and meaningful instruction must occur.  Anne Howard, PT, PhD tackled this issue in her Therapro Saturday Seminar last week entitled: Providing Optimal Services and Supports for Students with Down Syndrome in Educational Settings.

Dr. Howard’s extensive educational background, beginning as a physical therapist, then becoming an educator, to receiving her doctorate in disability policy, has provided the background for pursuing her interest in those with Down syndrome now as a college professor and consultant to families and school systems.  In addition, Anne serves on the Massachusetts Down Syndrome Congress (MDSC) Education Task Force and contributed to the MDSC Educator’s Manual. This manual provides a comprehensive look at the complex learning profile of students with Down syndrome, as well as provides information around educational considerations that are based upon research-proven best practices.

Anne is also the President of the Board of Directors for the Federation for Children with Special Needs.  With her glowing credentials and experience, Anne proved to be a formidable speaker and expert on Down syndrome.

Attendees at the seminar received a comprehensive review of common learning characteristics and associated physical and health care needs specific to students with Down syndrome.   Dr. Howard provided an interactive seminar, inviting attendees to share their perceptions of students with Down syndrome and asking them to determine what they wanted to learn about students with Down syndrome. She discussed strategies to facilitate independence using visual supports and self-management.  Anne reviewed some basics on Down syndrome with some surprising issues that have come to light.  For example, she noted that children with Down syndrome have a greater prevalence of ASD, with some statistics cited that up to 18% of children with Down syndrome have a co-occurring diagnosis of Autism.

Anne discussed encouraging research that shows that fully inclusive education, special teaching approaches that address areas of weakness, and providing opportunities for success can change the typical profile of a child with Down syndrome, citing studies by Buckley, Bird, and Sacks in Down Syndrome Research and Practice, 2006. A chart with “Characteristics of a typical learning profile” with areas defined as Communication, Socialization, Learning and Memory, and Motor was presented along with strategies to address the targeted areas.  For example, if a student has motor weakness characterized by decreased muscle tone which makes writing difficult, along with having shorter fingers, strategies for learning might include providing adequate postural support, with Pencil gripsappropriate seating, motor breaks with tone building activities, and use of adapted materials for handwriting including a slant surface, hand grips, or keyboarding. In addition, she advocated the use of visual supports, which are available for a longer time period for the student, versus using verbal or auditory cues alone. For example, sticky notes, diagrams on the board, photos, calendar, clock /timer, decrease the need for verbal cues. Visual supports are readily available to the student without the need for use of working memory or retrieval of information, which may be difficult for some students.

Finally, Anne provided a Behavior Profile associated with Down syndrome enumerating strengths, learned behaviors, and then identified strategies that support productive behavior in students with Down syndrome. Students can be taught to self-manage with strategies like self monitoring/self-recoding, self-evaluation, and self-reinforcement.  She suggested that the key is to empower the student by letting him/her know what is expected.  By being proactive, negative behaviors can be averted and targeted behaviors can be reinforced.  She noted that the key to developing acceptable and positive behaviors is to build desired behaviors, versus just responding to negative behavior.

Considering the student with Down syndrome and how to help him/her succeed in an inclusion model involves a number of factors.  Understanding the common characteristics and challenges of this diagnosis is a good starting point.  From there, a wide variety of positive strategies can be implemented to help make the educational process meaningful and fulfilling for the individual student.

Anne has generously provided this link to her PowerPoint slides: click here.

Here are some remarks from attendees:

“I really appreciated Anne’s diverse background. She was able to present the information from a different perspective than I might normally consider.”  Micaela C., Physical Therapist

“Helpful as a student to hear real-world application from professionals in practice who were in attendance.  Also great to see theory learned in the classroom reinforced.”  Sam J., OT student

“Clear, relevant, evidence based info/treatment strategies.”  Mary T., Occupational Therapist

“Dr. Howard provided & presented the basic background info for DS well. She provided useful examples for behavior management for children with DS that I hope to implement with my students.”  Anonymous, PT

Thank you, Anne!

Filomena Connor, MS, OTR/L