Separation Anxiety Activities and Tips

separation anxiety activities

Today, we have a couple of separation anxiety activities that can support kids who struggle with school drop off. Many times, kindergarten or preschool drop off is full of tears, especially those first few weeks of school. Here, you’ll find a great connection activity to help preschoolers and parents find a way to make preschool drop off easier by connecting through the book, Owl Babies. Use this Owl Babies activity to help with that preschool separation stage. This post shares movement based separation anxiety activities that can help kids who are experiencing separation anxiety in preschool drop off, with ideas based on the children’s book.

Separation Anxiety in Preschool or Kindergarten

Step into a preschool classroom on the first day of school and you will likely see a few tears here an there (possibly some of those tears coming from the parents dropping off their child for the first time!).

Separation anxiety in preschool age is normal! But here’s what you need to know about that visible preschool behavior that may be fueled by something besides getting used to leaving mom/dad/caregiver for the first time…and how to help with a simple preschool self-regulation strategy.

The movement-based, sensory activity we share below can actually be used with preschool through kindergarten:

  • the 3 year old preschooler who is just being dropped off for the first time
  • the 4 year old preschool student
  • pre-k kids
  • kindergarten students
  • older, grade school students who are sad or upset on the first day of school

preschool anxiety

So, what is happening with preschool anxiety that causes tears, meltdowns, and clinging to mom or dad at the day care or preschool drop off?

You have probably seen it before:

Every Monday, Wednesday, and Friday, it’s time for preschool. The routine at home is the same: excitement, packing the bag, and gearing up for a day of learning colors, songs, preschool activities, and nursery rhymes. Getting into the car and driving to preschool is no problem.

But then you pull into the parking lot and the worries begin.

Tears, crying, clinging to Mom, negotiations, promises of seeing the little one in just 2 short hours.

Two minutes later, she is happy, playing with play dough, and dry of all nose drips.

It might even seem as if the preschool separation meltdown is just part of the morning routine.

As a momma of four, I’ve seen plenty of tear-filled drop-offs.  

And it just never stops breaking your heart.

Separation anxiety is actually considered a normal process that occurs in early childhood, as a result of a maturing physical, cognitive, and emotional development. Specifically, the areas of development that lead to a period of separation anxiety in young children include:

  • Visual processing system (visual memory, visual closure)
  • Executive functioning skills (working memory)
  • Self-regulation skills (connecting emotions with behaviors)
  • Social-emotional maturation (emotional connections, attachment, and feeling safe with certain individuals)

Despite the normal development that results in fears, worries, or flat out meltdowns following or leading up to a period of separation, severe separation anxieties do have the potential to negatively impact a child’s social and emotional functioning and this is especially true when the young child then avoids certain places, activities, and experiences that are necessary for healthy development.

Separation Anxiety Disorder

Sometimes, the family, parents, or caregivers also avoid these places, experiences, and activities. This can lead to even more negative experiences. When the family supports avoiding certain places or situations because of the young child’s separation, we can have situations where separation anxiety “hangs around” longer than is part of typical development.

Officially, Separation Anxiety Disorder (SAD) is defined as “developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attached” (American Psychiatric Association, 2000). However, for the young child, separation angst does not mean a disorder is present. It is only when the anxiety levels are so severe that they are not appropriate for developmental age that the official diagnosis of Separation Anxiety Disorder should be investigated.

For those with severe symptoms, Separation Anxiety Disorder may result in school refusal and a disruption in educational attainment, refusal to attend doctor’s appointments, dentist visits, or other situations where a child is separated, no matter the physical distance, from the parent or caregiver.

What causes Separation Anxiety Disorder?

There are many developmental areas that enable to progression of separation anxiety in toddlers and preschoolers from levels of worry and age-appropriate anxiety at separation to an inefficient and “disorder” level of worry.

Studies show us that some of these considerations may include:

  • Parenting behavior
  • Low parental warmth
  • Poor attachment
  • Trauma to the parent during the baby’s young years (death in the family, environmental, or other big situation)
  • Trauma to the child (Adverse childhood experiences, both large and small)
  • Insecure or anxious attachment styles
  • Diminished sense of control over one’s environment
  • Overprotective and over involved parenting behaviors
  • Parental intrusiveness- including extreme decision making on the part of the parent
  • Parental intrusiveness- including providing excessive assistance in the child’s daily activities (beyond age-appropriate ability)

Common signs of separation anxiety in kids

The natural and developmental stage of separation anxiety occurs from around age 6 months when the baby is able to notice that something is missing from their field of vision. This skill requires development of several areas:

  • Visual perception
  • Attention
  • Working memory (executive function)
  • Sensory motor

Separation anxiety typically continues from around 6 months of age to about 5 years of age, however signs of separation anxiety can persist after age 5 and through age 6.

However, the cognitive and emotional development that occurs during this age allows for kindergarten and younger elementary aged individuals to separate from their loved ones and know that they will be there even when the are not in view.

Once the underlying areas noted above develop (around 6 months of age), you may see some common signs of separation anxiety:

  • Crying when the parent leaves the room or home
  • Upset and crying when a babysitter or caregiver comes into view
  • Tantrums
  • Avoidance behaviors (refusing to participate in activities that require separation)
  • Clinging to parents
  • Refuse to attend certain situations
  • Apprehension about harm coming to parents
  • Fears the parent will leave and not return
  • Running from the classroom/school bus/appointment setting

Today, I’m sharing a simple trick for helping kids with separation anxiety at preschool or other drop-off situations like our weekly church nursery adventure.

Separation anxiety activities

separation anxiety activities



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Social Stories- Use social stories to create a visual narrative about how drop offs go and that parents will be back to get the child. Social stories can offer a verbal narrative for the child to use during these situations. Some of our social stories include:

Self-Regulation Strategies- Practice the regulation tools that support the individual’s emotional status with self-regulation strategies. Select a set of calming or heavy work strategies that can be used in preparation for the separation situation, whether that be using at the school bus stop (like this deep breathing school bus exercise) or while driving into school. Having those set of strategies readily available and discussing how the child feels will go a long way.

Movement-based separation activity – One fun way to work on separation anxiety in preschoolers that becomes part of the routine…here we are talking about the preschooler or kindergarten aged child that cries, clings to Mom or Dad, but then warms up to the classroom activities.

Practice routines- Do the same thing every day during the week in preparation for school, including bed times, morning routines, and transportation routines. These visual schedules can help with some individuals.

Wearable Charm- Another similar strategy is to create a DIY separation anxiety charm. Kids can make this along with the family adding heavy work through the hands. then, wear the charm to know that parents and caregivers still love and miss them even when not in view.

Get enough sleep– Practicing good sleep hygiene is important for the child as well as the parent or caregiver. This has an impact on behavioral response and self-regulation.

Books about Separation- The activity listed below uses the book Owl Babies. But we added a heavy work goodbye sign that parents and children can use at school drop offs to ease separation anxiety. Or, this activity could work for kids that struggle with the transition to the classroom, because they are missing Mom and Dad or other caregiver.

Use the book, Owl Babies by Martin Waddell!

Owl Babies Activity

We read the book, Owl Babies  and fell in love.  

The sweet little Owl Babies in the book wake up from a nap to find their mother gone from the nest.  The owl siblings go through a series of concerns and thoughts about where their mom might be with a little almost-tears.  

My older kids thought the book was pretty awesome and decided that each of the owl babies in the book were one of the girls in our family.  There were a few similar personality traits that aligned with the owls in the book and the sisters in our house.  

The idea of knowing that mom comes back when she leaves is a lesson we’re going through at Sunday School each week and one that happens so often with kids.  Just like the Owl Babies, it can be hard to stay calm and not worry when mom goes away.  

We decided to come up with an owl themed movement activity that kids could do when they are feeling anxious after leaving mom or dad.  

Try this trick to help with separation anxiety in preschoolers, based on the children's book, Owl Babies.


School Drop Off Anxiety

This activity would be perfect for preschool kids who are experiencing separation anxiety at the start of school or in a new classroom situation. For kids that cry at school drop off, or really struggle with missing Mom or Dad, this school drop off anxiety activity can help.

To do the activity, first read Owl Babies together.  Then, talk about how the owls in the book must feel when they see their mother has gone out of the nest. Finally, talk about how when the mom or dad in your family has to go away for a little while, they always come back and that they are thinking of the little one in your home while they are gone.

Try this trick to help with separation anxiety in preschoolers, based on the children's book, Owl Babies.


One easy way to help with separation anxiety is to come up with a hand signal.  We decided that making a bird wing sign would be a lot like an owl in flight.  Hook your thumbs together and spread your fingers out to create the wings of an owl.

Then, wrap both hands around your thumbs to create a little owl baby of your own.  Now, squeeze your hands tight to give them a hug.  Your child can do this motion when the are feeling sad or nervous at school.  Tell them to think about the owl babies in the book and how they felt when their mom came back.

School drop off anxiety activity for separation anxiety in students

Squeezing the hands tightly can provide a bit of proprioceptive input that is calming in a stressful situation like the preschool drop-off.  A simple hand hug might be just the thing that can help! It’s a self regulation activity that supports the whole body as a mechanism to address emotional regulation needs that show up as crying, clinging, and bolting “behaviors”.


Then, when you pick up your little baby, be sure to swoop them up in a big hug!


This activity would work with preschoolers who are a little older than my two year old.  She really enjoyed the book, Owl Babies, though and we have read it again and again!


Let me know how this tip to help with separation anxiety works with your preschooler!

Use this separation anxiety activity to support kids that struggle at school drop off with anxiety or worries.

 

Try this trick to help with separation anxiety in preschoolers, based on the children's book, Owl Babies.


 

Auditory Sensitivity in the Classroom

Auditory sensitivity in the classroom

In this blog post, we are covering an important aspect of the classroom environment: auditory sensitivity. Students with auditory sensory overload are challenged to learn and participate in classroom activities. Let’s discuss auditory processing with the focus on classroom sounds with sensory tips and strategies, as well as supports to set up a classroom for success. This blog post is a great resource aligned with our post on visual noise in the classroom.

Auditory sensitivity in the classroom

Auditory Sensitivity in the Classroom

Students are VERY busy! Whether they are at home, school, or out in the community, children are affected by their surroundings. Setting up a preschool classroom for success is essential. The environment can make children “hyper”, or calm them down. Sometimes preschool (and older kids) have ears sensitive to noise that impact learning and participation in their education. Noise impacts a child’s ability to calm, that can be modified by adults in any environment. We are going to dive into how to support children who are sensitive to noise throughout this blog!

Setting up a Preschool Classroom for Success

Have you ever noticed when there is a lot going on, children tend to lose focus? A child sensitive to loud noises will be challenged to be successful in the classroom environment because the sensory need takes priority. Adults, when they have multiple senses engaged, can be overwhelmed by chaos as well.

This is especially true when there is overwhelming auditory input.

One way to look at this concept is by experience. Think about an amusement park and all of the sounds happening around you in a noisy crowd. While one of my favorite places to go is an amusement park, it can be very overwhelming! I love the rides and the shows. But, when I go to the food court, I start to get overwhelmed. Children are usually crying because they are hungry, parents are annoyed, people are talking on their phone as they wait in 30 minute lines for a $10 hot dog, and there are attendants screaming “next”, or “move along!” There is so much going on auditorily, that many adults get frustrated, and want to find a quiet corner to eat with their family. 

What is the noise like in your Classroom?

In a typical preschool classroom there might be 24 or more children running around, laughing and screaming, while a CD player is playing rambunctious music, and parents are talking about what their child had for breakfast. The preschool setup can become very noisy.

In an elementary classroom, you may have more towards 28 or more students. Kids having conversations, dropping books, running the electric pencil sharpener, screeching tennis shoes, or scraping chairs. Then there is the announcements over the loud speaker, teacher instructions, hallway noises, and the lawn mower outside the classroom window. It can get noisy, quick!

With different types of sounds echoing throughout the classroom, auditory overstimulation can affect behavior and engagement. For ears sensitive to noise, this can be huge.

According to an exploration of sensory processing and the limbic system, the sensory system receives sensory messages, like sound, and directs them to the part of the brain that needs to process them. This process is also responsible for keeping your body safe. Sometimes it will trigger an automatic safety response called a ‘fight, flight or freeze’ response.

This response is a protective mechanism based on our ancient ancestors who had to be on constant alert for saber tooth tigers rustling bushes. While we no longer need to worry about the threat of danger lingering in our periphery, we have this awareness of auditory input that keeps us safe in other ways. Our brain and body regulate the sensory input that comes in so it’s not too overwhelming for us.

An example; when you jump if you hear an unexpected sound.  The “sensory traffic controller” in the brain tunes in to help locate and identify the sound.  You may be instantly more alert if you hear your head teacher, or manager’s voice. Researchers think this part of the brain processes sounds differently in children or adults who are overwhelmed by sounds, noise, or auditory sensory input.

Auditory overload often occurs when there are too many sounds happening at the same time, or if the noise is at a certain frequency.  In addition, the brain can also become overwhelmed by a constant noise which has occurred over a period of time. This information is important when setting up a preschool classroom.

Tips for setting Up a Preschool Classroom

In order to create a calm preschool classroom environment, the sound needs to be purposeful! Being cognizant of all of the different environmental sounds, is key to creating a soothing classroom.  

Here Are aspects of your preschool classroom setup to keep in mind when addressing noise

  • Music – Depending on the time of day, music is a wonderful addition to any classroom. This can be through singing or the electronic media. Use calming/soft music to calm down a classroom during free play and nap time. This can include nature sounds, white noise, soft melodies and children’s music. 
  • Echoing noise – Every classroom is created differently, keep track of where there may some extra echoes. Hearing noise from multiple places at once can be very overwhelming, especially when echoes are coming from multiple children. This can be important when it comes to hallway noises, outside noises (lawnmowers), or echo within the classroom. Some ideas to support echo sensitivity include adding padding to the bottoms of shoes or desks. Felt sheets or foam sheets are inexpensive options for this. Other things to consider is going into the cafeteria, gymnasium, or area with higher ceilings and larger groups of children such as special events.
  • Sensory Headphones- One tool to support students with sensitive ears is a pair of sensory headphones. There are many on the market that can reduce the auditory stress of a child in the day to day noise of a classroom. Other options include sensory noise-reducing earplugs and noise cancelling headphones. To increase sounds try a DIY whisper phone.
  • Consider Other Students – Children are noisy, especially during free play! When indoors, encourage children to use an inside voice, while they are playing and talking. When children are focused and engaged, they tend do this naturally. Creating learning centers that support engagement is the best way to keep noise down, and children learning. Some children who have difficulty regulating their verbal output may need extra help in this area. Check out all of the learning stations (block, art, science, manipulative, sensory, dramatic play) ideas on how to set up your classroom by the age of the children you teach in this Early Childhood Environmental Rating Scale.
  • Consider Other Adults – Keeping tabs the adults in the room is key when thinking about the noise in a classroom. Caregivers tend to talk loudly when around a lot of children, either to get their attention, or intervene when they see a problem about to occur. If caregivers practice talking to children, while getting down to their level, and making eye contact, the level of our voices naturally decrease. You can also try a “do not disturb” sign in the door during important lessons or instructional periods. Consider these auditory attention activities.
  • Consider Classroom Pets – Classroom pets are wonderful additions when setting up a preschool classroom. Although they are fun, they can also be noisy! The most popular classroom additions are fish tanks and guinea pigs. The sounds of the bubbles can be soothing for some, but loud to others. Guinea pigs are quiet until they start shuffling around and squeaking. When thinking about where to place a fish tank or cage, keep in mind where the children will nap, and where the quiet spaces are. 
  • Small group activities – When children are actively engaged in activities as a group, their voices tend to become loud. This is a great time to teach children how to take turns, by waiting for others to ask questions. Allowing children to communicate with each other, have discussions, and engage in play, is more productive when they are using their inside voices. 
  • Consider the classroom sound system- There are many options when it comes to auditory needs in the classroom. We talked about the low tech strategies above, but along those same lines is a “high tech” classroom auditory system. This can include things like wireless voice amplifier for teachers, a classroom sound system with wireless microphone, a classroom speaker system, a voice amplifier for classroom, and other technical pieces of equipment.

Auditory input can affect behavior

Young children can feel overwhelmed by many environmental components. This can affect their behavior at home, and in the classroom. The sensory system, and the way the brain processes information, varies for each person. The ability to respond to the environment, greatly depends on how sensitive you are to sensory stimuli. 

The OT Toolbox has a great sensory processing checklist to better understand the sensory systems. You can learn more about this sensory processing checklist here.

What happens when a child is so overstimulated by their environment, they are nor able to calm down, without being redirected?

One strategy is having a safe space such as a calm down corner. Consider setting up a preschool classroom with a calming area.

Including a space in your classroom or home that allows children to take a break form their environment, along with using calming techniques (such as deep breaths, squeezing a ball, sipping water), are wonderful ways to help a child center themselves, so they can reintegrate into the classroom in a more calm state of mind. 

Enourage the use of visual, tactile and auditory calm down cues when setting up a preschool classroom, that two year olds understand. 

*If you notice a child having a hard time calming down, even with the removal of noise, they may have more sensitivities to stimuli than others. This is a sign that an Occupational Therapy evaluation might be appropriate, to determine if they need more supports with their sensory system. The occupational therapist will review the sensory systems, triggers, and behavioral outcomes.

A therapist may then suggest a sensory diet as part of the plan. For more information about a sensory diet, check out this search on the OT Toolbox. In addition, this amazing printable includes 130 different ideas on introducing a sensory diet for your child.  

Auditory classroom management is just one aspect of setting up a preschool classroom

Other aspects to consider are:

  • visual input – is your class cluttered, messy, or busy
  • tactile – is there a lot of touching going on, are children in close proximity
  • olfactory – what are all the good/bad smells in the class
  • vestibular – are there times for movement breaks and outlets for energy

Preschool classrooms are a lot of fun, and children are born to be noisy, but if caregivers take the time to create a classroom that has more soothing sounds indoors, children learn to socialize in a calm way. This allows for classroom management to be easier and more productive, supporting every child’s needs. When planning your classroom, home environment, or an outing with your child, notice the auditory stimuli, and how it is affecting your child.

Free Handout: Classroom Auditory Sensitivity Strategies

We’re coming up on the end of our Summer Handout Series here on the OT Toolbox. Want to print of a list of strategies to support auditory sensitivities in the classroom? Use this printable handout as an educational tool to support auditory needs.

This handout is also available inside our Member’s Club. Just go to the handouts section to grab it without entering your email address.

Get the handout by entering your email address into the form below:

Free Handout: Auditory Sensitivity Strategies

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    Jeana Kinne is a veteran preschool teacher and director. She has over 20 years of experience in the Early Childhood Education field. Her Bachelors Degree is in Child Development and her Masters Degree is in Early Childhood Education. She has spent over 10 years as a coach, working with Parents and Preschool Teachers, and another 10 years working with infants and toddlers with special needs. She is also the author of the “Sammy the Golden Dog” series, teaching children important skills through play.

    The Auditory Processing Kit is one tool to support auditory needs. Use this auditory processing kit to support learners with hyper-responsive or hypo-responsive auditory systems. Use the hands-on activities to support learning and active listening through play and handwriting tasks. Use the handouts and posters to teach about the auditory system and auditory sensitivities, with strategies to support individualized needs.

    The Auditory Processing Kit supports listening and comprehension activities into multisensory learning styles.

    Visual Noise and Learning

    Visual noise in the classroom

    In this post you will be discovering how to create a calm classroom, specifically tips to avoid the visual noise that distracts learning in the school environment. Classroom décor and organization can directly effect the engagement level of children in any classroom or learning space. When the environment is too visually stimulating, a student’s ability to focus becomes difficult. Keeping children’s attention can become frustrating. When a classroom environment that is soothing and organized is created, children are better able to stay engaged. In this blog, you will learn about the three different ways to make your classroom visually calm. 

    Visual noise in the classroom

    What is Visual Noise?

    When working with children, teachers think about all of the colors of the rainbow, and want to make classrooms bright and cheery. So many classroom theme sets have fun colors, bright designs, and patterns, contrasting bulletin board boarders, etc. Many believe that having a colorful classroom will keep children interested and engaged. 

    Visual Noise is just that: a visually distracting, or “noisy” visual scene in the classroom. A lot of teachers set up bulletin boards throughout the room with cut-outs in various themes: animal/monster/any theme , alphabet stickers, and painted murals on the walls. Maybe your classroom has a circle time rug that includes the ten different color squares. Perhaps you want to make sure all the children have something they like to do, so you have 20 fine motor choices in the manipulative area. 

    There is just one problem with using these types of visuals in the classroom, they are distracting! 

    • The bulletin boards all around the room are adorable, and fun to look at. So during circle time, you might find a child gazing at the wall, figuring out what new item is there. 
    • When there are rugs filled with colors, you may notice children looking down at the rug, maybe at the bright colors, while singing the color song in their head.
    • If teachers provide too many choices in one area of the classroom, children work with one toy for three minutes, then they are onto the next, without honing in, or practicing the skills that were intended.
    • For young children, and lots of adults, less is more! 

    visual processing

    Humans use vision from birth, to engage with the world around them. The way your brain process what you see, impacts how you interpret your interactions with the environment, and the people around you. To learn more about vision, this amazing PDF discusses visual hypersensitivity and under-sensitivity (or sensory seeking). 

    There are some visual processing red flags that may indicate difficulties with visual processing or ocular motor control:

    • Increased sensitivity to light
    • Easily distracted by visual stimuli, or difficulty sustaining visual attention to an activity
    • Frequently squints, rubs eyes, or gets a headache after visually demanding tasks such as reading, using a phone/tablet/computer, or watching television
    • Loses place in reading or writing
    • Trouble finding things they are looking for, even when they seem to be “right in front of them”
    • Distractions with reading
    • Difficulty tracking visual information
    • Difficulty initiating or holding eye contact
    • Difficulty focusing on one piece of visual information
    • Increased fear of, or desire for, being in the dark
    • Difficulty discriminating between similar shapes, letters, or pictures
    • Letter reversals or number reversals
    • Difficulties with handwriting such as letter reversals, sizing, spacing, or alignment of letters
    • Frequently loses their place while reading or copying
    • Often bumps into things
    • May be slow or hesitant with stairs
    • Difficulty with visually stimulating activities, i.e., puzzles, locating objects in pictures, completing mazes, word searches or dot-to-dots
    • Trouble knowing left from right or writing with both hands

    How to reduce visual noise when planning your classroom

    When planning out your classroom, visual stimulation is important, however there are many ways to make sure there is reduced visual noise, so the environment is not overwhelming.

    Think about how you feel when you go to the spa. Those deep earthy wall colors calm your bodies and nerves instantly! The Montessori and Reggio Emilia educational philosophies advise visual components as a way to keep their classroom calm and focused.

    The Reggio Emilia philosophy recognizes the environment as the child’s third teacher. What is in a child’s environment, how it’s organized, and what it looks like, directly impacts what a child will learn that day. 

    two ways to make sure your environment is visually calming 

    Colors – When picking out colors for your classroom, whether it be for the furniture, rugs, or wall decor, the best way to support a calm visual classroom, is to choose more natural colors. These include blues, greens and browns.

    • Choose toy baskets, or white bins, as opposed to brightly colored ones.
    • Consider turning toy shelves around or covering with neutral fabric to further reduce visual noise.
    • Choose predictable carpet rugs (Amazon affiliate link) like this one, instead of random colorful squares. Carpet samples of neutral colors are an excellent idea to create boundaries while limiting visual distraction.
    • When decorating your walls, allow for empty blank space, and use more of children’s artwork. Consider the use of cloth and fabric.

    Classroom Organization – When choosing how many activities and materials to place in each are of your classroom, keep in mind that less is more! When children have too many options to choose from, this can create a short attention span, and overwhelm from choice overload.

    Organization in the classroom can mean stacks of papers, tons of sticky notes, messy desks, and disorganized files, too.

    In a typical preschool classroom, there are 8 areas of learning: art, fine motor, science, reading, dramatic play, block, large motor and snack! When you use furniture to visually create specific spaces for each center, the classroom is organized, and children know what is expected of them in each area.

    Older classrooms may not have the toys, block areas, and motor components, but there are designated areas: group areas, centers, desks, cubbies, or lockers, teacher areas, information centers, etc. All of these areas can be considered when it comes to visual input.

    This blog from Lovely Connection, on preschool classroom set up, includes important aspects to think about as you plan your classroom layout. She includes information about including noise, popularity, supervision, boundaries, space, and the race track (when kids run around the room in a circular pattern!)

    What happens when children are still overwhelmed, even when the environments are visually calming?

    When a child feels overwhelmed for any reason, having a calm down corner, that is easily accessible and they can stay in as long as they need, is a must have.  My Soothing Sammy Emotions Program.” is an effective calm down area because students are excited to spend time with the adorable golden retriever Sammy. Not only does “The Sammy Program” teach children how to calm down, it guides them through communication and problem solving situations in a visual way that isn’t overwhelming.

    Check out this great blog about visual processing and visual efficiency from the OT Toolbox archives. When a child has visual processing difficulties, they have a harder time taking in visual information, and processing it in order to make sense of it.

    This visual processing bundle, also available in the Toolbox, can support children who are demonstrating visual processing challenges. 

    The Sensory Lifestyle Handbook (also available on Amazon) written by Colleen Beck of the OT Toolbox, is a great resource to start understanding sensory processing disorders.

    A final note about visual noise

    Visual noise doesn’t only occur indoors, it can happen outdoors, especially if there is a lot of activity and sunlight. Being mindful of the visual stimuli outdoors, is just as important as setting up an indoor classroom.

    If you have a child who is having a hard time visually processing their environment outside, these visual sensory activities can be completed outdoors to support their sensory system.

    While considering visual sensory overload in the classroom, also be sure to check out our resource on auditory sensitivities in the classroom. Both are very useful in setting up an inclusive classroom environment for success.

    Classroom themes are adorable and cute! When planning your classroom, keep in mind how “busy” and overstimulating different colors and amount of objects can be. This will help keep your students calm and engaged. Although everyone processes their environment differently, anyone can all benefit from a more calming environment, especially when learning new skills! 

    Jeana Kinne is a veteran preschool teacher and director. She has over 20 years of experience in the Early Childhood Education field. Her Bachelors Degree is in Child Development and her Masters Degree is in Early Childhood Education. She has spent over 10 years as a coach, working with Parents and Preschool Teachers, and another 10 years working with infants and toddlers with special needs. She is also the author of the “Sammy the Golden Dog” series, teaching children important skills through play.

    Co-regulation

    In this blog, you will learn how the environment, and the feelings of those around us, directly affects behavior. You will learn simple ways to support children in calming down, while in our care, through co-regulation. This important skill is part of our emotional intelligence and one that takes fostering and nurturing. Let’s go over what coregulation means, how this skill develops, and how we can support co-regulation through practical strategies.

    Co-regulation information, facts, and references for developing this emotional intelligence skill in children and peers.

    CoRegulation

    The feelings and behavior of people in close proximity to us, directly impact how we feel, and respond to our own emotions. When children become upset, if those areound them stay calm, demonstrating how to calm down, the child can calm down quicker.

    How would you feel if your neighbor was yelling at the mailman for stepping on their freshly cut grass?  Do you feel annoyed? Can you feel the fear the mail man is feeling?

    How would you feel while walking past someone doing yoga in the park? Do you feel calm?

    In the same way adults are impacted by others actions, children pick up the moods of others around them. When people around us are behaving a certain way, we can be directly affected, responding both internally and externally. 

    When witnessing an uncomfortable event such as the confrontation at the mailbox, internally you might feel your heart start to pound, or clench your teeth as nervousness sets in. You might run and hide behind the window curtain to try and separate from yourself from what is making you feel uneasy (while still peeking in horror). 

    Once separated, you are often able to calm down using strategies to regulate your sensory system. I like to sip water and take breaths of lavender. My husband likes to go for a run and lift weights to decompress. As adults, we have learned how to adapt and overcome these intense feelings through different strategies. Children need support to separate themselves from stressful situations, and regulate their emotions.  They are not able to understand the triggers and determine an acceptable calming mechanism.

    Co-regulation definition and terms

    What is co-regulation?

    The definition of co-regulation is– the ability to regulate emotions and behaviors to soothe and manage stressing internal sensory input or external situations, with the support and direction of a connecting individual. Co-regulation is nurturing connection of another individual that supports regulation needs through the use of strategies, tools, and calming techniques in order to self-soothe or respond in times of stress.

    Co-regulation and self-regulation are part of the developmental process. In order to move from a co-existing place to a place of independence, the child needs to develop emotional intelligence and social emotional learning. All of this is part of typical development.

    Development of co-regulation

    Co-regulation is a part of development. Before one can self-regulate, they need to co-regulate.

    • Co-regulation begins in infancy. Before a young child can self-soothe, they need a parent to help them. When an infant is crying a parent picks them up, holds them close, rocks, and wraps them up in a tight swaddle, and offers a pacifier. All of these strategies are tools to provide correct sensory input that calms and regulates the baby’s system. This is co-regulation; the parent is offering tools and strategies to support the infant’s needs. 

    As caregivers we play a huge role in helping children calm down. When children are upset or overwhelmed, they look to us for help with regulating their emotions. This article explains how to support co regulation in infants through three year olds. A caregiver needs to project calmness in order to soothe their infant. This is very difficult for an anxious or upset parent.

    • Co-regulation in toddlers might look similar, but with more input from the child. The toddler prefers to be active and jump, run, roll, or move, rather than be held and cuddled all the time. The caregiver offers toys and activities to get the child moving in the way they enjoy. If the toddler only does these alerting activities, they might run themselves down, and move into a meltdown state. The parent then offers a calming tool such as a cool sip of water, a slow walk, singing a song, a break from the action, or a moment to stop and look at something interesting (also known as mindfulness). All of these are co-regulation strategies for toddlers. The parent offers strategies to the young child, and hopefully, the child accepts them. 

    As children grow into toddlers, the most successful way to support their feelings is to calmly use words and gestures to redirect them when they are upset. When adults are feeling anxious or upset when trying to redirect the child, children respond with increased adrenaline, becoming more upset and dysregulated.

    They match or mirror the energy of their caregivers. When adults stay calm, children can become calm. When children become or stay calm, they are able to listen and problem solve. 

    • Co-regulation in preschoolers can be similar to that of a toddler. As they develop, preschoolers are able to offer more input as to their preferences, interests, and dislikes. For example; the young child can request a certain sippy cup they like. They may not know why they like certain activities or items like the long straw on their favorite cup, or the weight of a plush toy, but they know that it feels good. Similarly, adults often do not understand why they choose to run or listen calming music, they just know it helps. Parents can help young children co-regulate sensory and emotional needs through providing ideas for strategies and activities. 
    • Co-regulation in older children– Preschoolers, kindergarteners, elementary aged children and teens are able to self-regulate using skills taught to them while being supported through co-regulation at a younger age. As children grow, they have more autonomy. They have more ability to move from co-regulation to self-regulation. 

    The ability to self-regulate occurs through co-regulation with parents, teachers, and older peers. Typically, it’s through the first 7 years of life that children need support to regulate emotions, sensory input, and external stressors.  Even after the age of 7, most kids need help! 

    Self-regulation development continues over time, but the ability to co-regulate begins to move from a supported mechanism, to an individual and independent ability.

    Co-regulation parenting tips and strategies to support emotional development.

    Co-regulation Parenting

    The above paragraph should help explain what coregulation means in young children, but how can we help support kids with co-regulation, so they can develop these self-soothing skills?

    We can focus on co-regulation parenting as a tool and a means to support our children.

    Many adults struggle with self-regulation. This is where we see additional problems. When young children need support to co-regulate, sometimes the adults in their lives are not offering the tools and strategies as a support person.

    If a parent responds to a young child’s meltdowns or behaviors with emotional outbursts, anger, stress, and anxiety, the young child cannot soothe themselves.

    It is important for adults to take a look at stressors, internal anxiety, and emotional state so they can support the young child. 

    • How many times have you witnessed frustrated teachers/parents/caregivers yelling at children?
    • Does it calm them, or make them afraid and shut down?

    This is why it is important for caregivers to step away from a situation where the toddler is “pushing their buttons”. Take a deep breath, get a date night out, go for a run, or some other mechanism of self-regulation.  I often said, “Mommy needs a time out.”

    self regulation

    You have probably heard the term “self-regulation” which refers to the ability to control oneself in any given situation by balancing and calming internal sensory systems within the world around us. 

    Before young children can self-regulate, they need the support of adults around them to teach and help them develop the abilities to regulate on their own. They need to co-regulate, or co-exist with parents, teachers, and others, who can “show them the ropes” and learn to balance and calm their internal and external systems. Co-regulation comes before self-regulation developmentally.

    Neuroscience of Co-regulation

    What does co-regulation look like in the brain?

    Brains are amazing machines, capable of processing the environment, including the feelings of others. Dr. Caroline Leaf, neuroscientist has stated “As you co-regulate with someone, the mirror neurons in their brain are activated, and this enables the person in the deregulated state to literally ‘mirror’ your calmness,” For long-term benefits and effective results, Johnson recommends practicing co-regulation often. “It will effectively rewire the brain so that over time, things that once were triggering or set off alarms no longer have the same effect and happen less often.” 

    Wow! The brain can process the feelings of others in milliseconds, directly affecting our our own moods and behaviors. No wonder all of the children in a preschool class feel overwhelmed, as soon as one child becomes dysregulated. 

    How do you prevent the whole room from becoming overwhelmed, when only one person is stressed? Co-regulation is the first step for a person to learn self-regulation. 

    According to this research article by Howard Beth, “Neuroscience shows that humans develop their abilities for emotional self-regulation through connections with reliable caregivers who soothe and model in a process called “co-regulation.” … In time, the child internalizes the expectation of a soothing response which provides a foundation for learning self-regulation. “

    It is the responsibility of caregivers to support co-regulation, which directly impacts a child’s ability to self soothe as they grow. When children are upset, the most important thing for caregivers to do, is remain calm.

    If caregivers become upset or overwhelmed in response to another person’s behaviors or actions, everyone will continue to feel stressed, and the situation will explode.

    Co-regulation activities and strategies to help kids with emotional development of cooregulation skills.

    How to help kids with co-regulation

    My own regulation techniques were put to the test once, when I was teaching at a preschool that backed up to a farm. The children (all 2-5 year olds) were inside eating lunch and I was setting up their nap mats. We had a futon in the classroom for children to relax and read books on.

    Out of nowhere, a humongous snake slithered out from under the futon! The initial shock wore off quickly, and my nerves set in. The snake was coming towards me, and I had 24 preschoolers eating lunch only ten feet away! I calmly helped the children walk out the door to the playground with the aide, breathing and saying “It will be okay. No need to worry.” 

    The kids walked out of the room curious, but not frightened. I raced to the phone and called for help (my voice was much more panicked as I talked to the janitor about the huge snake in the room)! I knew nothing about snakes, and I wasn’t about to get in its’ way. Luckily it ended up being a garter snake, removed quickly by a specialist and relocated, far away from my classroom!

    At that moment, I knew that I had to “keep my cool”, so the children wouldn’t become scared. They co-regulated off of my calmness, and were able to safely follow directions and watch the situation unfold from outside.

    Children learn new skills through hands-on activities. Regulation skills are learned the same way.

    Regulation Strategies:

    1. Deep Breathing- Deep breathing exercises for kids teaches young children how to calm down through pausing, and taking large breaths. Relaxation breathing is a great strategy for adults and kids to do together. The ones on this site use a fun and engaging strategy that introduces breathing techniques using visuals and imitation. The printables in this resource form the OT Toolbox teach kids all about breath control using fun pictures, arrows, and places to pause, and hold their breath. Print out the free PDFs, show the child the picture and the arrows, and practice deep breaths. When your child becomes upset, immediately start to “breathe like a polar bear”, or “do rainbow breaths” and watch as your preschooler starts to calm down too!

    Some of the most commonly used deep breathing tools include on the OT Toolbox include: 

    1. Toys and stuffed animals- Using a preferred toy or stuffed animal integrates strategies from DIR Floortime therapy strategies.  Kids gain the emotional vocabulary, and strategies to use in co-regulation, through play. I developed the Soothing Sammy (affiliate link) learning system. It is a great tool for co-regulation, because of the picture books and activities included with the emotional regulation toy. 

    In my book, Soothing Sammy, a golden retriever puppy, teaches children how to calm down using a variety of sensory strategies (such as jumping in place, blowing bubbles, sipping water, singing a song and squeezing a ball or play dough). First, read the Soothing Sammy story, where children visit Sammy in his dog house. He provides them with all of the tools needed to calm down. Once calm, the children are ready to play again. Use the stickers and shipping container to have your own preschoolers create a space for their own calm down items and place Sammy, the plush dog, inside! This is your child’s very own Sammy house to visit, just like the children did in the story.  When children are overwhelmed, experiencing big feelings, they are easily redirected to these activities by saying “Sammy Time.” Help children co-regulate by creating your own Sammy House and using items to calm down when they are upset, modeling calm and soothing behaviors.

    1. Go outdoors and co-regulate!

    Sometimes all we need is a little bit of fresh air to help feel better. Use these outdoor sensory diet cards to discover calm down strategies to use outside with children. These cards contain outdoor play challenges to get kids moving, experiencing various sensory systems, and receiving calming input from the great outdoors. Included, are over 180 ideas on how to calm the bod through movement. The outdoors is a great place for a sensory diet. In the backyard there is a variety of movement opportunities. A playground is another great space for calming and regulating play. Check out this blog post on sensory input at the playground

    Children, especially toddlers and preschoolers, depend on adults to show them how to calm down or self-regulate.

    tools for adults to learn self regulation

    Being that co-regulation requires the ability to support another individual with regulation needs, it’s important to address emotional and coping needs as the adult in a parent/child (or other adult/child, peer/peer relationship). As a support person, regulating ones’ own needs can go a long way in modeling appropriate reactions, coping strategies, and following through with regulation needs.

    Below are some great tools for adults to learn, or improve self-regulation so they can be models and important roles in the co-regulation relationship include:

    If you’ve ever flown on a plane, taken a cruise ship, you’ve heard the safety information: In the event of an emergency, adults should place the breathing mask over their faces before they attend to their child.

    Parents should put on their life jacket before they put the life jacket on their children. This seems backwards and selfish, however these life-saving mechanisms are of no use if the adult is struggling.

    If they don’t put on their own face mask or life preserver first, there is no chance to support and help the child. The same is true for regulation; parents must first self-regulate in order to help co-regulate their children’s internal and external needs.

    Empathy versus Empath

    Empathy is being able to understand a person’s feelings, or realize why someone might be angry or sad. It is an important social skill, especially if you are the one causing the upset. Young children do not have the capacity to understand the complexity of empathy.

    An empath is a person highly attuned to the feelings and emotions of those around them. Their ability to discern what others are feeling goes beyond empathy (defined simply as the ability to understand the feelings of others) and extends to actually taking those feelings on; feeling what another person is feeling at a deep emotional level.

    Try this empathy activity to teach these concepts to children.

    According to this article, What we do know is that researchers have discovered what they’ve dubbed “mirror neurons” in the brain which may help us to mirror the emotions of those we come in contact with.1 And it appears some people may have more mirror neurons than others; suggesting that empaths may exist.

    The positives of being an empath are being able to offer support to others, knowing when someone is in need of assistance, and reading a person’s energy to see if they are a good fit for you.

    The cons of this “ability” are that it is draining taking on the emotions of others around you, it feels like you are too sensitive, and you feel burdened taking on so much.

    Being an empath can be described as feeling like a vacuum cleaner, sucking up the emotions of those around you, often before they realize how upset they are.

    Empaths need to be experts at co-regulation because of the amount of sensory and emotional input they are “sucking in”.

    A final note on co-regulation

    Children aren’t born knowing how to manage their feelings in a positive way. As infants, they depend on their caregivers to soothe. As they grow into toddlers and preschoolers, children continue to depend on cargivers to teach them new strategies to calm down. When they sense how calm their caregiver is, they calm down also. The best way for caregivers to help children develop their self-regulation skills, is to support them in co-regulation, by showing them calming activities they can learn to use on their own.

    To learn more about sensory processing disorder and strategies, check out The Sensory Lifestyle Handbook and this resource on sensory processing disorder chart to understand all aspects of SPD.

    *Note: The term caregiver has often been used instead of parent. This is to be inclusive. Caregivers can be parents, older siblings, grandparents, teachers, daycare workers, bus drivers, coaches, and many more.

    Jeana Kinne is a veteran preschool teacher and director. She has over 20 years of experience in the Early Childhood Education field. Her Bachelors Degree is in Child Development and her Masters Degree is in Early Childhood Education. She has spent over 10 years as a coach, working with Parents and Preschool Teachers, and another 10 years working with infants and toddlers with special needs. She is also the author of the “Sammy the Golden Dog” series, teaching children important skills through play.

    Perineal Hygiene

    perineal hygiene and pericare tips

    Here, we are covering an aspect of potty training that comes up for every parent: pericare, or perineal hygiene, and teaching kids how to wipe when toilet training. So often, a young child learns to use the toilet and other aspects of potty training, but then struggle for a long period of time with the wiping aspect. Teaching children to wipe thoroughly is a hygiene task that can be limited by many underlying areas. Here, you’ll find strategies to help wiping bottoms and interventions for perineal hygiene.

    How to teach pericare, or perineal hygiene needed to wipe completely during toileting.

    What is pericare?

    For the uninitiated, pericare (or peri-care) is short for perineal care. Perineal care refers to the hygiene and self-care of the perineal area following toileting, cleaning, and wiping of the perineal area of the body is the “private parts” area. Pericare is a term for the hygienic tasks involved in this part of the body, such as wiping one’s bottom.

    Anyone of any age may need help wiping their bottom with their perineal care, but it is especially important to teach our little ones the proper way to manage their bottoms as they become more independent. 

    This component of toileting is one that impacts overall independence and self-care with the toileting process. So often, we cheer and celebrate making it to the toilet on time, but the perineal hygiene aspect is equally as important.

    Related: Potty Training Seats for Special Needs

    You may be thinking, “Why do I need to teach my child how to wipe!?!”. For something that is such a natural task for many, it can feel odd to teach somehow how to do it.

    However, learning how to maintain a clean bottom is important for one’s health and confidence. Wiping properly, washing gently, and wearing appropriate clothing decreases the risk of yeast infections, urinary tract infections, and odors. Plus, discussing peri-care can open the door to many other conversations about the body, health, and safety – if that’s something you are interested in exploring with your child.   

    A great time to educate your child about peri-cares is while potty training. It is easier to teach the correct way first than to re-learn how to do it later. If you are stuck on potty training, we feel you there! Check out this Toliet Training Book that can help you help your children of varying needs.

    Don’t be discouraged if your child is already potty trained and they have yet to learn how to take care of their bottoms independently – it can take time and practice! 

    Development of Pericare

    An important area to cover first is the development of pericare skills. It is so important to remember that we are talking about young children who are learning a whole new skill with toileting. There are many considerations: autonomy, body awareness, interoception, self-awareness, the sensory processing and interoception aspect, family perspectives…potty training can be very overwhelming for kids.

    Then, to break it down even further, the hygiene aspect of toileting is another ball game!

    In our book, The Toilet Training Book, we cover the development of potty training and really cover what underlying skills play into potty training and independence with toileting.

    But, one important thing to remember is that a three year old child may be able to make it to the toilet in time to go, flush, and wash their hands, but the wiping aspect can developmentally, come with time.

    Developmentally, perineal hygiene, or wiping completely after toileting, may be a skill achieved during a range of 4-6 years. This range is so wide due to the underlying skills, sensory considerations, motor skills, and cognitive growth needed for perineal hygiene including knowing when and where to wipe after a bowel movement or urination, using enough pressure on the toilet paper to clean completely, wiping enough times to clean completely, and maturity to complete the task.

    The emergence of these skills takes time, but there are ways to support development of perineal hygiene.

    GET COMFORTABLE with perineal hygiene

    Everyone wants a clean bottom, let’s start there. It can be smelly and embarrassing to talk about, but it is an important step to understanding personal healthcare.

    We want to give you the confidence to discuss this in any way that you and your family feel comfortable with because it is a “touchy” subject for some. The more comfortable you are with peri cares, the more comfortable the child will be. 

    Let’s start off the potty training wiping techniques by talking about good hygiene.

    Here are some ideas to talk about perineal hygiene with kids:

    • Make it silly: Some people respond best to humor but watch out for demeaning jokes. 
    • Make the conversation about pericare hygiene scientifically accurate: It becomes less embarrassing when you hardly know what is being said! 
    • Make pericare sound similar to washing hands: We have to clean away the germs; they can make us sick! 
    • Make discussions about perineal hygiene your own: You know your family best. Think about terminology that works for the individual. In what ways can you increase trust and comfort for all? 

    GENERAL GUIDELINES for teaching perineal hygiene

    Here are some general tips for a healthy bottom that should be shared for children and adults alike. Please speak to your family physician if you have any questions or concerns related to your child’s unique needs. 

    • Wear breathable (preferably cotton) underwear that is not too tight. Change daily or when soiled. 
    • Don’t hold it in. While it is good to wait to “go” until you reach the toilet, holding in pee or poop for too long can result in a variety of issues
    • If it is comfortable, sit on the toilet with elevated feet. You may have heard of the (Amazon affiliate link) Squatty Potty – placing the legs in more of a squatting position helps bowel movements pass. More importantly, children should have access to a either a smaller potty or a footstool (or a box,etc.) near the toilet so that their feet do not dangle. 
    • Wipe from front to back to reduce bacteria entering the urethra. Talk about anatomy and why wiping front to back is effective and safe.
    • Wipe gently with 3-4 squares of folded toilet paper (each household can determine the amount – some kiddos use way too much!) until clean. I always recommend to look at what you are wiping away so that you learn about how much you need to wipe. 
    • Consider use of warm or cool wipes over toilet paper.
    • When bathing, wash the genital area gently with mild soap and rinse with clean water. No soap should be entering the body through the anus or the vagina. 
    • For bathing a uncircumsized child, refer to this article for great information and consult your family doctor for personalized advice.   

    Pericare INTERVENTION IDEAS

    Children will not know unless we lead them, so here are some fun ways to teach pericare! 

    Areas that can be broken down to increase overall self-care include:

    • Address balance
    • Pulling up and down undergarments
    • Wiping front to back
    • Wiping thoroughly
    • Wiping with enough pressure
    • Gripping the toilet paper
    • Washing hands after wiping
    • Reaching around to the back

    Each of these areas can include aspects of balance, gross motor skills, fine motor skills, strength, coordination, sensory processing, executive functioning skills, and visual motor skills. It’s important to look at each individual’s area of difficulty and then break it down into the underlying areas that are impacting success with pericare.

    First look at the area of difficulty. Then, consider how underlying areas are impacting that particular area. Come up with intervention strategies that support that need and create a “just right” challenge to build independence and pericare functioning.

    Let’s look at each of these areas of perineal hygiene…

    Pulling up and down undergarments:

    • Fine motor strength and coordination fine motor activities to the rescue! There are so many fantastically fun ways to increase this skill, but here are some that are more directly associated with potty training. 
      • Lei Obstacle Course: Grab some Hawaiian-inspired leis, hula skirts, or long necklaces and create a long pathway. As a child walks through the pathway (hopefully to another fun activity in the course), they must step inside the lei and pull it up as high as it will go. If it fits over their arms/head, they can wear it as a necklace. Pulling up the lei and wiggling their body through will strengthen the same skill as in pulling up pants. Reverse the challenge to mimic pulling pants down.
      • Silly Socks: Grab a variety of socks in fun colors and different sizes and see how many you can put on in one minute! Layering socks up the arms and legs (and removing them, too!) mimics the skill of pulling up and down undergarments. 
      • Stickers: Challenge them to peel off stickers all along the waistband of their pants. Don’t forget the backside! 

    Pericare: Wiping Activities

    Balance and reach are huge parts of perineal hygiene. Staying balanced on the potty while wiping is a big challenge for our core strength, flexibility, and range of motion. To practice this skill through play-based activities, see the ideas below! 

    Play-pretend: Place peanut butter on the back of a disposable or washable diaper and have your child wipe it off. Any familiar paste will do – sun butter, nutella, cookie butter…anything to wipe! When they think they are done wiping, show them the diaper to see if they actually cleaned it. 

    Art-based: Wipe a plastic plate with toilet paper to create an art project – the toilet paper acts as the paintbrush. They must wipe clean the whole plate! For an extra challenge, place the plate behind their backs, and the work of art in front of them. 

    Play activity: Using static electricity, tape, or velcro, have your child squat to “pick up” pom-poms or other sticky and lightweight items on their bottoms (think: window stickers, damp tissues, etc.). They carry them carefully to a container and remove them one by one. You can really make this game your own!

    Wiping Front to Back

    There are so many ways to work on perineal hygiene to cover other aspects besides the balance consideration. Consider these strategies to teach kids to wipe front to back:

    • Use toys, books, clothing, and other items to work on teaching front and back directional concepts.
    • Teach children to count to help with wiping a certain number of times.

    Reaching Back to Wipe During Perineal Hygiene

    • Clip and unclip clothes pins on the back of clothing to work on reaching back and around..
    • Use a pool noodle to reach around and through the legs to work on reach, visual attention, scanning, and eye-hand coordination. You can tap the pool noodle on a target and create a game.
    • Practice wiping the backside in the bathtub.
    • Put a handkerchief or scarf in their back pocket for the child to reach for and pull out.
    • Put stickers on the child’s back or pants for them to reach for and grab.

    Wiping with enough pressure

    • Work on tearing paper for hand strength and eye-hand coordination to pull off appropriate sizes of toilet paper.
    • Use play dough, LEGO, tong activities to develop hand strength.
    • Wipe dry erase marker off a dry erase board. Then, position the dry erase board on the ground between the feet to bend and wipe. Then, position it behind the back to reach and wipe.
    • Wipe peanut butter or washable paint from a plastic baby doll.
    • Help kids to wipe thoroughly by painting with toilet paper with having them try to wipe a blob of paint off a plastic plate and remind them to keep going until the plate was empty.

    More perineal care and potty training tips

    Looking for more information on underlying considerations that impact toileting? Need strategies, supports, and tools to facilitate independence with toileting skills? Need support strategies for potty training an older child, but not know where to begin?

    Looking for ways to help individuals with toileting skills when cognitive, behavioral, motor skills impact participation in independent toileting? Trying to initiate or progress with potty training when a diagnosis of Down Syndrome, Autism, or a motor skills challenge is at hand? Check out the Toilet Training Book: A Developmental Take on Potty Training for Kids of All Abilities.

    Sydney Thorson, OTR/L, is a new occupational therapist working in school-based therapy. Her
    background is in Human Development and Family Studies, and she is passionate about
    providing individualized and meaningful treatment for each child and their family. Sydney is also
    a children’s author and illustrator and is always working on new and exciting projects.

    Preschool Pre-Writing Skills

    pre-writing skills

    This pre-writing skills resource is a resource for anyone working with preschoolers. The fact is that in the preschool years, developmentally, preschoolers should not be writing. Rather, pre-writing is the area of focus. A huge topic of discussion for pediatric occupational therapy professionals is the fact that preschool pre-writing skills are developed rather than introducing handwriting at this young age. Developmentally, there is a lot of progression in the preschool years and pre-writing skills are just one of the many areas. Refer to more information on preschool activities for other developmentally appropriate activities.

    pre writing skills needed before preschoolers can write with a pencil.

    Pre writing Skills in Preschool

    Many times, parents of very young children don’t think about handwriting skills. It’s not typical to think about holding a pencil, writing words and sentences, and copying letters when children are just mastering building with blocks, learning to pull on socks, and creating finger paint masterpieces.  

    But the truth is, when young preschoolers are playing, they are building the very important precursors to handwriting.  

    The skills needed for managing a pencil, copying letter forms, and managing pencil control when copying lists and paragraphs into a space on a page are initiated in the early childhood years.  Below, you’ll find more about preschool pre-writing skills and the components of pre-writing skills that are developed through play.

    Pre-writing skills development begins with preschool aged children through play.

    What are Pre-Writing Skills?

    Preschool is prime time to develop the underlying skills needed for handwriting. So often, the older, school-aged kids that are struggling with handwriting are missing the underlying areas that make up the skills of handwriting.


    First, it’s important to recognize that handwriting is made up of so many areas. Handwriting is much more than holding a pencil (pencil grasp) and forming letters and numbers!  

    There are many pre-writing skills that transfer to accuracy in written work. These areas need to be developed and refined before handwriting can be successful. These skills are pre-requisites to even holding a pencil to form shapes and then letters.

    Consider the following skill areas that relate to handwriting: 

    1. Sensory Motor Pre-writing skills
    2. Fine motor pre-writing skills
    3. Visual-motor pre-writing skills 

    Let’s go into each area separately.

    Sensory-Motor Pre-Writing Skills- The sensory motor component is closely related. Consider the pyramid of learning and the developmental base that enables refinement in higher levels of development. The closely related areas of sensory and motor skills are pre-requisites for pre-writing before copying lines and shapes is even possible.

    • Gross motor development
    • Motor planning
    • Initial core control and core body strength
    • Bilateral arm and hand use
    • Crossing midline
    • Imitation of movements
    • Ability to learn novel motor movements
    • Tactile sensory awareness
    • Discrimination of sensation
    •  

    Fine Motor Pre-Writing Skills- From holding the pencil to moving and controlling the pencil when writing letter forms, handwriting requires a variety of motor movements that all must work together.

    These fine motor pre writing areas of development include:

    • Hand dominance
    • Pinch precision (using a tip to tip grasp)
    • Finger opposition
    • Finger isolation
    • Separation of the sides of the hand
    • Hand strength (endurance in play)
    • Fine motor development
    • Separation of the two sides of the hand, including:                    
      • Development and control of the skilled side of the hand                  
      • Development and control of the strength side of the hand stable side of the hand
    • Thumb Isolation and use as a stability point
    • Thumb dexterity and strength
    • Finger Isolation
    • Development of a dominant hand and an assisting hand
    • Manipulation of objects and dexterity of the hand with objects
    • Grasp strength

    Note that preschool can begin as early as 2 years old with some preschool classes. There is a big difference in development from the 2-5 year range in all areas, including fine motor development. A young 2 year old will developmentally have more primitive fine motor skills than a 5 year old child.

    Young preschoolers will develop precision and refinement of fine motor skills through play.

    Visual Processing Pre-Writing Skills- Additionally, there are the eyes.  What is seen and recognized needs to be coordinated with the hand.  Visual processing has a huge component in written work!

    During the preschool years, visual processing skills are developed through play. These components include:

    Cognitive Pre-Writing Skills- In addition to the motor components are the cognitive skills. These include the ability to follow directions, pay attention, and focus. The cognitive areas are closely related to the motor skill prerequisites.

    • Direction following
    • Attention and focus
    • Directional concepts
    • Memory
    • Sequencing
    • Awareness of left-right concepts in books and written work

    When Preschoolers are asked to write letters

    When young children are asked to write, trace, or copy letters before these skills are developed, bad habits can form. In these cases, you’ll notice that older students tend to have difficulty with handwriting.

    There are many things happening all at once that develop poor motor plans and bad habits. Because preschoolers are not developmentally ready to write with a pencil, you may see these issues:

    1. Immature grasp on the pencil/writing utensil
    2. Inability to form diagonal lines
    3. Forms letters from bottom to top
    4. Forms letter segmentally and inappropriately
    5. Weak grasp on the writing utensil
    6. Inconsistent hand use
    7. Weak pinch and base of support on the pinky side of the hand
    8. Poor posture
    9. Inattention
    10. Difficulty identifying letters and copying complete parts
    11. Many other issues!

    These mentioned issues with starting handwriting in preschool is just the tip of the iceberg when it comes to introducing letter formation before kids are developmentally ready.

    Pre-Writing Lines in Preschool

    It is very important to mention pre-writing lines. These are the pencil strokes that precede formation of letters. Here are some resources you’ll want to read over and utilize in this important step in preschool development:

    1. We cover a great deal about pre-writing lines here.
    2. Use this pre-writing lines activity to work on this essential step.
    3. Consider this pre-writing lines slide deck when working with preschoolers in a virtual setting.
    4. Read about the developmental progression of pre-writing lines.
    5. Use this pre-writing leaf activity to work on the development of underlying skills as well as pre-writing line formation.
    6. Use these handwriting activities to work on pre-writing skill development.

    If any of these areas might be an issue for your child with handwriting troubles, consider grabbing The Handwriting Book as a resource that covers all of the underlying skill areas related to handwriting.

    So how are all of these areas addressed as a pre-writing skill in preschool? 

    The answer is through play!

    Can you believe that all of these areas are being addressed htrough play in the early childhood development stages?  And that all of these areas are building and developing with a resulting use in handwriting?  Amazing, right?  

    Pre-writing skills start to develop in preschool aged kids.

        Stop by later this week to find out easy ways to encourage development of the above skill areas in group settings in the preschool environment.  It can be difficult to address the needs of a preschool class when there are 16 four year olds that need reining in.  I’ll have easy ways to encourage development of fine motor skills, visual motor skills, and attention skills in fun and creative ways…coming soon!  

     The Handwriting Book

    BUY The Handwriting Book NOW    

    Want to know more about The Handwriting Book?  Click on the image above to find out how to address every underlying area related to handwriting skills.     Click here to BUY NOW.

     
     

     

    Use these Fine Motor Kits for hands-on activity kits to develop fine motor skills, strength, dexterity, and manipulation. Kids LOVE these fine motor kits for the motivating activities. Therapists love them because it’s fresh, fun ways to work on pinch, grip, manipulation skills, and much more. Try some of these themed therapy kits:

    Colleen Beck, OTR/L is an occupational therapist with 20+ years experience, graduating from the University of Pittsburgh in 2000. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. As the creator, author, and owner of the website and its social media channels, Colleen strives to empower those serving kids of all levels and needs. Want to collaborate? Send an email to contact@theottoolbox.com.

    Early Intervention for Sensory Differences

    Early intervention and sensory differences

    Our sensory system is very complicated. A lot of times when we hear about sensory, we think about our 5 senses (taste, touch, sight, smell and hearing.) This blog will take us into a deep dive of early intervention for sensory differences and the definition of different sensory processing areas. Early Intervention services provide supports for children birth through age three who demonstrate developmental delays.

    These delays could be caused by a variety of reasons, from autism, chromosome abnormalities, drug exposure, prematurity, motor impairments, language delays and more. 

    Early intervention for sensory differences

    Early Intervention for Sensory Differences

    One of the areas that is always assessed when determining if a child is eligible for Early Intervention services is the area of sensory processing. These areas include Low Registration, Sensation Seeking, Sensation Sensitivity, and Sensation Avoidance. Also addressed are the areas of Sensory and behavioral including general, auditory, visual, touch, movement, oral and behavioral differences.

    We will explore these areas in more detail throughout this blog post. Sensory diets are one of the most common and impactful ways to support children with sensory differences.

    This article describes sensory diets as “A sensory diet is a set of activities that make up a sensory strategy and are appropriate for an individual’s needs.  These are specific and individualized activities that are scheduled into a child’s day and are used to assist with regulation of activity levels, attention, and adaptive responses.  Sensory diet activities are prescribed based on the individual’s specific sensory needs.”

    There are four quadrants in a sensory profile. This visual clearly defines the similarities and differences between seeking, sensitivity, registration and avoidance.

    The infant/toddler sensory profile is a common assessment used to determine the needs of a child in the following areas If a child is over-responsive to sensory input, they would fall in the sensory seek or slow to register sensory input sections. If a child is under responsive to sensory input, they would fall in the sensory sensitive or sensory avoider sections. 

    What are sensory differences  and neurodiversity? This article explains.

    What are sensory differences?

    These areas of sensory diversity make up the term sensory differences. Beyond the four quadrants, however, there are other sensory differences to consider. These are described below.

    All of these sensory differences described are part of the neurodiversity of human life. We all are different when it comes to sensory, and we are all sensory. Just like the diversity of physical attributes, personal preferences, characteristics, sensory differences are just one more difference that makes us who we are.

    Sensory Seeking

    This area determines if a child seeks out sensory input. If a child is scored higher than most in this area, you may see them move around more, look at items that spin (such as fans or toys with wheels) be attracted to fast paced and brightly colored television shows.

    Here are some wonderful home ideas for children who are sensory seekers.

    Sensory Sensitivity

    This area determines a child’s ability to notice different senses. If a child scores higher than most in this area, you may see a child always needing a routine to stay calm, startle to certain sounds, become upset during routine hygiene activities (such as getting hair brushed or nails trimmed) and significant preferences on types and textures of foods.

    Here are some ways to support children in a controlled way, who show needs in the sensitivity area.

    Sensory Registration

    This area determines how a child responds to sensory input from others or their environment. This article by the pediatric development center explains how important registration is for a child’s functioning and learning.

    It describes registration as: “Sensory registration is the process by which children respond or attend to sensory input in their environments.  The nervous system must first notice the sensory information, once registered the memory compares it to things they have heard or seen, and thus gives new information meaning.  Children who fail to respond or have delayed responses to sensory information have diminished sensory registration.  Diminished sensory registration is often associated with one or two weaker sensory systems, such as the auditory or vestibular system.  Without sensory registration, no other learning can take place.”

    If a child scores higher than most in this area, you may see a child miss sensory input more than others do. A child in this section may miss eye contact, pay attention to only specific tones, and ignore most sounds. These children are harder to engage or seem uninterested in activities. They may need tactile, auditory and visual cues to initiate engagement in conversation or an activity.

    Here are some ways to support children with low registration.

    Sensory Avoidance

    This area determines how a child’s need to control the amount and type of sensations at any given time. If a child scores higher than most in this area, you may see a child resist playing with other children due to overwhelm, resist being cuddled when it’s not on their terms, frequently become upset if their hands are messy, have a hard time calming down in new settings and isn’t interested in trying new foods.

    Here are some tips on how to support an avoider.

    General Processing

    General Processing items measure the child’s responses related to routines and schedules. This could include daily schedules, routine schedules or task related routines including how children respond to questions, others actions, busy situations, sleeping routines, eating patterns and hygiene needs, daily transitions and other schedule related activities.

    These first/then visual boards are a wonderful tool in supporting routines and schedules.

    Auditory Sensitivity

    This area addresses how children respond to things they hear. Auditory input includes responding to their name,  how easily it is for someone to get their attention and how distracted they become in noisy settings. The brain processes the sounds in our environment and according to this article, sensitivity to sound could be a reaction to a part of our brain that pays more attention to sounds then it needs to. One article explains it this way:

    “When there is no medical reason to explain the auditory sensitivity, researchers think that the brain is not processing sounds adequately. Researchers suggest that the part of the brain that receives and filters noise and sound, the amygdala, is working differently.  The amygdala decides on how important noises are.  It decides and which sounds we should attend to and which ones to ignore. When someone experiences sensitivity to sounds, it is thought the amygdala pays more attention to sounds than it needs to.”

    Visual Sensitivity

    This area addresses how children respond to things they see, including bright objects, such as lights and toys. It describes how they respond to reflections in mirrors and their responses to objects that spin or move suddenly. According to this article our brains interpret the light we see through our eyes, and:

    “The visual system uses light to detect information through our eyes and then interprets or makes sense of that information in the brain. It works closely with our vestibular and auditory systems to help us safely navigate our environment by orienting us to where we are in relation to other objects. The ability to cognitively process information we take in through our eyes can be broken down into several categories, called visual perceptual skills. Those with trouble in one area of visual perception may present with strong skills in another area, meaning that deficits in processing of visual information can take on many forms.”

    Tactile/Touch Sensitivity

    This area addresses how children respond items that touch their skin. This includes bath/water play, getting their nails trimmed and hair brushed, touching different sensory rich objects, being messy and receiving hugs. When children have a tactile sensitivity, their skin reactors are feeling the object more intensely. According to this article:

    The tactile system, or sense of touch, refers to the information we receive though the receptors in our skin. It alerts us to pain and temperature and helps us discriminate the properties of things we come in contact with, i.e. texture, shape, size, and weight. From very early on in development this sense plays a crucial role in helping us gain awareness of our own bodies and understand everything we come in contact with. And how frustrating it must be to learn new skills when you can’t adequately feel the objects you’re using!”

    Movement Seeker

    This area describes how children move within their environment, including if they enjoy movement activities, seem accident prone or clumsy, seek out spinning and/or preferring to walking on their tip toes. Movement is how our bodies know where we are in space and how we respond to a variety of movement activities. This article explains movement seekers as “someone who has a high threshold for vestibular input. The vestibular system is housed in our inner ear, and is responsible for sending messages to our brain about the position and movement of our head. The vestibular system is activated anytime our head is tilted, upside-down, inverted, if we spin, if we run fast or run slow, when we’re on a swing or going down a slide.

    We need vestibular activation and an efficient vestibular processing system in order to maintain an upright position, feel balanced, have a full sense of our body in space and focus. Some people have low thresholds, in which they perceive vestibular activation at much higher rates (e.g. hypersensitive to movement). Others have high thresholds, which means that they need more intense, more frequent and longer duration of movement in order to register it and activate their vestibular system.”

    Oral

    This are addresses how children respond to new foods and different textures, if they tend to overstuff their mouths, how they control chewing/swallowing foods and liquids and if they tolerate their teeth being brushed. Our oral system is based on how our sensory receptors in our mouth recognize what is in our mouth. Some people have increased sensitivities for foods while others have decreased sensitivities to food. There are differences and optional interventions explained in this article:

    “We have sensory receptors in our mouths that allow us to recognize information about temperaturetexture (e.g. smooth like yogurt, hard like chips/pretzels, or a mixture of textures like cereal with milk), and taste (e.g. sweet, salty, bitter, sour). They may be over responsive or have increased sensitivity to oral input, causing them to be resistant to oral sensory experiences like trying new foods or brushing their teeth.

    Other children may have decreased sensitivity to oral sensory input and therefore seek more oral input in order to help them organize their behavior and pay attention. Our brains receive further proprioceptive input from the joint of the jaw as we bite and chew on foods with different types of resistance (e.g. a crunchy carrot or a chewy sweet/gum).  Oral sensory processing also contributes to the way we move our mouths, control our saliva, and produce sounds for clear speech.”  

    Behavioral Differences

    This area describes children’s behaviors such as how frequently they have meltdowns, if they are clingy, how hard it is to redirect them, if they are upset in new surrounds and how hard it is to help them calm down.  Teaching children how to calm down using a variety of sensory input, will benefit every child. Soothing Sammy provides opportunity for a child to create their own behavior support tool that is tailored to their specific needs. Weather they respond better to auditory, visual, tactile or others, Sammy the Golden Dog can make redirection to a calm down corner a positive experience for the child and the adult.

    Creating a sensory diet is one of the most important ways to support children with any type of sensory difference. These sensory diet cards is a must have resource if you are working with or have a child with a sensory need. 

    If you are concerned about your child, you can contact an Early Intervention provider to complete an evaluation from the day they are born all the way until they turn three years old.

    Early intervention occupational therapy services support children in all areas of sensory needs, and can help caregivers create sensory diets that will help children in a variety of situations. Visual, tactile, auditory, oral and movement interventions that are supported in a controlled environment, can help every child learn how to adapt and respond to different situations and environments.

    Jeana Kinne is a veteran preschool teacher and director. She has over 20 years of experience in the Early Childhood Education field. Her Bachelors Degree is in Child Development and her Masters Degree is in Early Childhood Education. She has spent over 10 years as a coach, working with Parents and Preschool Teachers, and another 10 years working with infants and toddlers with special needs. She is also the author of the “Sammy the Golden Dog” series, teaching children important skills through play.

    Early Intervention and Autism

    early intervention autism

    When it comes to the early signs of autism spectrum disorder and potential interventions, early intervention for autism can cover a variety of areas. Here, you’ll discover strategies for parent advocates to add to their toolbox.

    There are many different signs associated with autism, and research strongly shows the earlier a child receives intervention supports for autism, the more progress they make in all areas of their lives. Early intervention, a federally funded program, provides support for the youngest children, ages birth through three years old, who demonstrate developmental delays. This blog will talk about the early signs of ASD and interventions that support development in all areas. 

    Early intervention and autism as well as early signs of autism and interventions to support development.

    Early Intervention and Autism

    Today, autism affects 1 in 44 children. According to the CDC, autism spectrum disorder is four times more likely to occur in boys. The best way to support children who are showing signs of a developmental delay is to get them therapy supports as early as possible. These supports are available from Early Intervention Programs, Health Insurance and private agencies. 

    Every child is different and develops at different rates, so how are we supposed to determine if an Autism Evaluation is appropriate for a child under three years old?

    The Early Intervention program is available to all children ages birth to three that live in the United States. The purpose of this program is to help identify and support children who have delays in all areas of development, with or without a diagnosis of autism.

    One of the most commonly used questionnaires to determine if a child does have red flags for ASD is called “The Modified Checklist for Autism in Toddlers (MCHAT). This questionnaire can be filled out for free by a clinician or a parents. You can find the free online version here.

    The five areas typically monitored when determining if a child should be referred for an autism evaluation are joint attention, social engagement, receptive language, expressive language and behaviors. I

    f there are concerns in some or all of these five areas, completing the MCHAT assessment and talking to your child’s pediatrician is the first step to determining if more testing should be administered. 

    1. Joint Attention

    Joint attention is a skill that affects a child’s ability to interact with others.

    The definition of Joint Attention is when two people purposefully pay attention to the same thing and for the same reason.

    For example, when an adult calls a child’s name, and the child responds by looking at the adult, they are engaging in the first step of joint attention. The adult would then ask the child a question and when the child responds, the adult and child are talking to each other about the same thing, in that very same moment. The same goes for when an adult points to an object and the child follows that point to see what object the adult is showing them. Together they are able to talk about the same item.

    According to the UNC School of medicine, Children who are learning social and communication skills in a typical way will often show examples of joint attention from the time they are 12 months old. Joint attention is important in helping people communicate with each other all through life. Children with autism have a hard time with this kind of communication. For these children, delays in developing joint attention skills lead to delays in developing language.”

    1. Social Engagement

    As soon as a baby is born, they are in awe of their mothers voices and eyes. Infants thrive off social interaction, from playing peek-a-boo, being sung to and engaging in simple play activities.

    As they grow, social skills become the foundation for other areas of development. They learn spoken words through imitation of adults and peers, babies and toddlers model behaviors of those they see around them, they get the attention of others to share their wants and needs, and they imitate other children’s play and movement.

    One component of autism is a lack of social engagement, such as when a child doesn’t show interest in playing near or playing with other children or using words to communicate with primary caregivers.

    1. Receptive Language

    Understanding the meaning of words is the first step to language development. Without understanding the meaning of words, children won’t be able to use spoken words to communicate their wants and needs with adults.

    Children start to show understanding of words as early as 4 months old, when they look towards objects and family members when they are named. As they get older, they start following points, imitating gestures and show interest in imitating sounds and words that adults use. 

    Autistic children may have a harder time engaging in social reciprocity which impacts their receptive language development. This article from Raising Children describes how joint attention directly affects receptive language development in infants:

    “Autistic children might have difficulty learning language because they tend to show less interest in other people in the first 12 months of life. They might be more focused on other things going on around them. Because they might not need or want to communicate with other people as much as typically developing children do, they don’t get as many chances to develop their language skills. For example, a three-month-old baby who is distracted by a ceiling fan is less likely to tune into a smiling and tickling game with their parents. By nine months, if the baby still isn’t tuning into parents, the baby is less likely to point at things they want to share with parents. The baby is less likely to listen to their parents as they name things. This means the baby misses these chances to build vocabulary.”

    1. Expressive Language

    Expressive language is the key to communicating our wants and needs with others. This can be through visuals, verbal words or using gestures.

    When infants start to use gestures (such as pointing, waving “hi”, and lifting their arms to signal wanting to be picked up,) adults are able to understand what their child is wanting and respond to their requests.

    From there, expressive language develops quickly into babble, jargon, word imitation and then children using one, two and three word phrases to communicate with those around them.

    Children that develop early signs of autism don’t typically follow this language progression. Children might be more quiet then others, babbling less, use rote phrases (lines they hear in movies), use language that isn’t functional in nature, or label a variety of objects. This article does a wonderful job explaining the differences between a language delay and language concerns that point to Autism. 

    1. Behaviors

    Behaviors associated with children who may have Autism may also be an indicator of sensory differences. An autistic child may show repetitive movements (such as rocking consistently), showing aversions to being touched or sensitivity to sounds and lights in unpredictable environments (such as the grocery store.)

    Children sometimes become upset for unknown reasons and are hard to calm down. Some autistic children become fixated on objects, only wanting to complete tasks in specific ways (such as lining up toys), always wanting to hold onto specific objects or getting upset when someone else changes the play sequence. Children who show signs of ASD also tend to need consistent daily routines and become upset when their routines change. 

    The most common diagnostic tool for Autism in young children is called the ADOS (Autism Diagnostic Observation Tool), a play based assessment that is completed by a clinician with the child present. This assessment can be given to a child as early as toddlerhood. There are four different modules that can be administered to young children. Clinicians determine the correct module to use based on the skill level of the child. The ADOS assessment, along with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) results will determine if a child meets the criteria that pertains to autism spectrum disorder. 

    The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is a completed diagnostic tool completed by the American Psychiatric Association that encompasses different psychiatric diagnostic criteria. The diagnostic criteria for Autism in the DSM-5 is described in this article. 

    “A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history. 

    B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history.

    C. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities or may be masked by learned strategies in later life).

    D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.

    E. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.”

    Interventions for children with a diagnosis of ASD:

    1. Early Intervention Services

    The Early Intervention Program is a federally funded program that supports children in all areas of development, including language, cognition, motor skills, social skills and adaptive development.

    The services available for children under the age of three are directly associated with every child’s individual needs. These could include feeding therapy, nutritional supports, speech and language therapy, occupational therapy, physical therapy, behavioral therapy, social language groups and more!

    If a child is enrolled in the early intervention program, their parents or guardians play a key role in the implementation therapy services. Therapies usually occur at home, with parents involved. When a child turns three, their therapies are funded through the local school district Special Education Program to support school readiness, and medical insurance to support medical needs and behavior supports at home. 

    1. Visual, Tactile, and Auditory Supports

    Children with low social reciprocity and joint attention skills benefit from other forms of communication. These communication strategies utilize other senses and break down communication to simple and direct forms. If a child is having trouble calming down, creating a calm down corner using Soothing Sammy Emotions Programsupports a positive calming experience with a golden retriever dog and sensory tools. 

    Visual cue cards such as these First/Then choice boards and transition cards,  give children the ability to follow daily tasks and routines in a way that is easy for them to follow, without the need to look those who are talking to them.

    Early intervention services can support with strategies:

    • To increase on-task behavior or social interactions
    • To teach new skills e.g., life skills, communication skills, or social skills
    • To maintain self control and self monitoring procedures to maintain and generalize job-related social skills
    • To generalize or to transfer skills from one situation or response to another (e.g., from completing assignments in the resource room to performing as well in the mainstream classroom)
    • To restrict or narrow conditions under which interfering behaviors occur (e.g., modifying the learning environment)
    • To reduce interfering behaviors e.g., self injury

    As children become more comfortable with back and forth interactions with adults, first/then boards can be used as a back up option for communication. These visual schedules help children transition from one activity to the next. 

    A final note on early intervention and autism

    If you have  concerns about a child’s developmental progress, it is best to seek out professional assessments through a pediatrician or an Early Intervention team. If the child is over three, requesting a developmental evaluation through your local school district is also an option.

    When children receive the intervention therapy they need at an early age, their skills in all areas of development improve. There are many different interventions we can do to support even our littlest family members. 

    Jeana Kinne is a veteran preschool teacher and director. She has over 20 years of experience in the Early Childhood Education field. Her Bachelors Degree is in Child Development and her Masters Degree is in Early Childhood Education. She has spent over 10 years as a coach, working with Parents and Preschool Teachers, and another 10 years working with infants and toddlers with special needs. She is also the author of the “Sammy the Golden Dog” series, teaching children important skills through play.