Author: Bright Eyes Therapy

Hand preference and dominance is a very misunderstood concept and it plays a vital role in functioning. Hand dominance can be defined as the tendency to prefer one hand over the other for skilled tasks such as writing, drawing and manipulating objects. This is influenced by genetic, neurological and environmental factors.  

What is the process of development of hand dominance?

Initially children will use both hands for tasks. As they develop further and their fine-motor skills develop further then a child starts using their hands independently.

Generally, in children of 2-3 years old a child may start developing a preferred hand. This does not have to be significant or consistent but you may start seeing a slight preference such as eating mainly with the right hand. However, with this being said it is still extremely important that children use both hands for certain tasks and swap hands. 

Hand dominance is typically well-established between 6-7 years old. However, it is important to see dominance starting to emerge between 4-6 years but this does not need to be well-established. 

Research has shown that there is a strong genetic tie in hand dominance, however, this is not always the case. However environmental factors, cultural norms as well as exposure to activities may also influence dominance. 

So how do I help my child develop dominance?

Initially: It is extremely important for a child to use both hands and therefore a child should not be encouraged to use just one hand in the early years. Using both hands is one of the first foundational elements from which bilateral integration develops. Games such as throwing, catching and rolling would encourage using both hands together. 

When showing a preference: When a child starts to show a preference it is important not to label them completely as left or right handed. Encourage them to still explore if they feel the need. It is best to always present an item in the middle of their body, so that they can choose which hand they would like to use. Fine-motor activities such as using tongs are beneficial during this stage. 

When dominance is starting to establish: When a child is showing more robust hand dominance it is very important to ensure that their hand continues to strengthen as well as that they are showing the ability to cross their midline. In-hand manipulation and hand strengthening games include playing with clay, manipulating small objects such as coins in their hand and also manipulating smaller tools such as tweezers. 

What if my child is not showing the above: 

• It is EXTREMELY important to never force hand dominance or using a specific hand. This has severe effects on a child later on in their school year. 
• It is recommended that hand dominance is not starting to establish between 4 and 5 that you seek assistance from an Occupational Therapist.

Remember we all develop at our own times but it is extremely important that we follow the general process of development. 

Written by Ashley Brecher (Jones), Bright Eyes Therapy. 

For more information you are welcome to contact us on 0836161662

Did you know that sensory integration development begins in utero and continues throughout the early years of a child’s life? You will frequently find the term ‘early intervention’ when searching through child development articles but what does this mean? According to the Early Intervention  Foundation (https://www.eif.org.uk/) effective early intervention prevents difficulties occurring, or addressing these difficulties, which promotes a child to foster personal strengths and skills that prepare them for adult life. Early intervention aims to promote effective physical, cognitive, behavioural, social and emotional development. 

Which babies/children may be at risk? 

It is vital and recommended that children at risk be closely monitored and assessed. The following children may be at risk:

• Babies born prematurely or with a low birth weight
• Babies admitted to NICU (Neonatal Intensive Care Unit)
• Babies/children diagnosed with medical or genetic conditions
• Fussy/Colicky babies
• Babies that lack response to caregivers
• Babies with delayed milestones

How do I determine if my baby has sensory difficulties:

• He/she may take a long time to respond
• He/she may appear sleepy and lethargic
• Crying frequently and difficult to soothe (in the absence of a medical condition)
• Presenting with signs of overstimulation (hand splaying, placing hands over eyes, back arching, moaning.crying).
• Difficulty sleeping
• Difficulty eating
• Difficulty self-soothing
• Delayed milestones
• Not performing milestones with the correct fluidity and expertise expected for a child of their age (e.g. only rolling to one side). 

How do I help my child to regulate:

• Environment: Be mindful of the environment where your child is. Bright colours and artificial lighting are alerting, therefore, move to a neutral, natural environment (outside works well). Provide calming light such as a lava lamp or night light. 
• Co-regulation: Babies are still very dependent on using a caregiver to regulate. Use your tone of voice, deep pressure (holding your child tightly, placing a warm blanket around them) and rhythmic movement (gentle rocking).
• Oral proprioceptive input: Provide your child with an age-appropriate object to chew or suck on (dummy, bottle, breastfeeding, placing their hands near their mouth). 
• Baby massage: This is a wonderful idea to implement (if you have undergone training in this). Alternatively swaddle your child. 

What if this does not work: 

• It is recommended that if the above steps do not work seek assistance from a Sensory Integration Occupational Therapist or alternatively speak to your pediatrician for assistance.
• During an OT consultation an in-depth history will be performed, followed by an assessment where a sensory diet (what sensory input your child needs) will be provided. Therapy will be given if necessary. 

Remember, “It takes a village to raise a child” and a parent/caregiver’s instinct should always be trusted.

Written by Ashley Brecher (Jones), Bright Eyes Therapy. 

For more information you are welcome to contact us on 0836161662

Concentrate?! How do I help my child or children in my class!

Concentration is a very broad term and has a variety of causes and effects! The mere mention of concentration when it comes to our kids has us in a flat spin. However, there is no need to fear – here is some more information on concentration and ways in which we can help our kiddies!

Concentration can be described as the ability to focus on the task at hand while ignoring distractions (Moran A, 2012). There are three different aspects of attention – namely concentration, selective perception and divided attention (performing two skills at the same time equally well). 

As a general rule of thumb we can use an attention span between 2-3 minutes per year of their age. Therefore the following can serve as a general guideline:

• 2 years: 4-6 minutes
• 4 years: 8-12 minutes
• 6 years: 12-18 minutes
• 8 years: 16-24 minutes
• 10 years: 20-30 minutes

It is however extremely important to note that certain aspects can affect a child’s attention: sleep patterns (Batjat D, Lagarde D, 1999) , hunger and additional factors such as their sensory integration difficulties. Sensory integration plays a significant role in concentration. Children that have sensory reactivity (modulation) difficulties may find it difficult to ignore certain input. Furthermore children with sensory perception and/or praxis difficulties might find a task difficult leading to them not paying attention. 

So with that being said how can we encourage our children to pay attention to certain task:

• Aim to keep tasks within the child’s developmental level. If a task is too difficult or too easy the child will experience difficulty paying attention. 
• Be creative and incorporate as many sensory systems when expecting a child to concentrate. For example use your sense of touch, movement, vision and hearing. 
• Incorporate fidgets for kids needing items to manipulate. A fidget box can be used especially when children are required to listen and sit still. The fidget box can have rules such as each child may pick one and another child is not allowed to be disturbed with this. Effective fidgets include – stress balls, stretchy toys, PopIts and more. 
• Incorporate short breaks where the children can be encouraged to regulate according to their sensory needs. This may be to jump on a trampoline for our children who need more movement, sitting in a tent or teepee for our children needing a quiet space or perhaps receiving some deep pressure by sitting under a weighted blanket. 
• Break instructions down. We recommend breaking each step of an instruction down by visually drawing or indicating what the child should do. You can also explain this to the child.
• Ensure the child is sitting in the correct place in the classroom. This would be according to sensory needs. Children who are very sensitive to visual and auditory input should sit away from windows and doors. 
• Ensure an organized workspace with limited distractions. 

An occupational therapist can assist your child in learning appropriate regulation strategies to help them to concentrate longer or to investigate causes of below average attention span. 

If you have any questions, please do not hesitate to contact us. 

Written by Ashley Brecher, Bright Eyes Therapy. 

For more information you are welcome to contact us on 0836161662 or email us at ashley@brighteyestherapy.co.za

These days we barely have time to sit still for a minute. Grabbing coffee on the run while chasing around between our children’s extra-mural activities, multi-tasking to get through the daily to-do’s and keeping the balance, always keeping the balance, in the hope of giving our children the best life we can offer. When we finally do sit down with our children and appreciate the opportunity to catch a break, the last thing we think of is that we might be sitting incorrectly! So, grab a cup of coffee (or tea if that’s your thing), sit down with us for a moment and find out why paying attention to your child’s sitting position is part of giving them the best life.

Have you ever seen children sitting as shown in the picture above?

This position is called “M-sitting”. The name comes from the shape that their legs make in this position. If you look at the child’s seated position from above, you will see that it resembles the letter “M”. While some people wonder whether there really is a problem with children sitting like this, others, especially occupational therapists, immediately find themselves wanting to help the child into an alternative sitting position.  

Firstly, M-sitting is not necessarily harmful to a child, but if seated in this position for too long, can create challenges. The sitting position is comfortable, due to our hip’s anatomy, especially for children. Statistics show that M-sitting is linked to an underlying problem in about 5% of typically developing children. Though this may seem to be a small number, it is our job as occupational therapists, to ensure that these children receive the intervention they need to avoid further complications later in life (N. Pates, 2020). 

When we see a child sitting in the M-sitting position, we consider how this position influences the child’s main occupation, play, as well as whether it affects their ability to learn and explore. The M-sitting position creates a large base of support and a lower centre of gravity. This results in less core activation to maintain an upright sitting position. Therefore, a child may prefer this position if he or she has poor core strength. 

M-sitting should be corrected for the following reasons (K. Askins, 2014):

1. It increases the risks for shortened hip and leg muscles, if the position is maintained for prolonged periods. This can negatively affect a child’s coordination, balance and gross motor skill development. 
2. It can increase a child’s risk of dislocating their hip (especially if the child has hip dysplasia). 
3. It restricts a child’s rotation of their upper body when engaging in play. This becomes problematic as it can make it difficult for your child to reach across their body and perform tasks that require bilateral hand use. It can also delay the process of developing hand dominance as your child does not use both hands when playing. This has a direct impact on your child’s school readiness skills like writing skills, coordination, and performance of table-top activities.
4. It restricts a child’s ability to shift their weight from one side of the body to the other when engaging in a play activity. Weight shifting skills are essential for standing balance and developing gross motor skills such as running, jumping, etc. 
5. It limits development of strong trunk muscles as your child relies more on their joint structure and wide base support of the legs to keep them upright. This can contribute towards clumsiness. Your child’s school readiness skills may also be negatively affected, such as sitting still for prolonged periods, paying attention in the classroom and sitting with a good and upright posture which is important for writing skills. 

Looking at the facts above, it becomes clear that this sitting position is not ideal. When you see your child sitting in this position during story time, play, etc. you can correct your child by making use of the alternative seating positions shown below to support your child’s development and help them reach their milestones. At first your child might resist these alternative sitting positions, as M-sitting has already become a habit. However, if you are consistent with the repositioning, they will get used to the alternatives. 

Alternative seating positions
Long sitting	Side sitting(try to switch sides)	Cross leg sitting	Squatting
2-point kneeling	4-point kneeling	Puppy prone(lying on the tummy)	Standing
Short sitting on a chair, stool, cushion, or exercise ball

When should you be concerned about your child? The symptoms discussed below could be causes of concern if they persist consistently over a period of time. Then you should consider reaching out to a paediatric occupational therapist or physiotherapist depending on the symptoms that your child presents with (L. Maybin, 2020).

Contact a paediatric physiotherapist if your child:

1. Often complains about pain or discomfort in their hips and legs.
2. Presents with an abnormal gait pattern e.g., in-toe (“pigeon-toed” walking).
3. Presents with flat feet.

Contact a paediatric occupational therapist if your child:

1. Often presents with clumsiness. 
2. Presents with delayed gross and fine motor development.
3. is constantly sitting in an M-sitting position (difficulty to assume any alternative sitting positions). 
4. Fatigues easily, struggles to sit still, and struggles to pay attention. 
5. Does not reach their developmental milestones according to the age norm. 

The takeaway: 

Help your child to be more mobile. Let them move from one position into the other, this can include M-sitting, while playing. Each position has different developmental opportunities for them. Try to make transitioning between positions fun by placing the toys at various places that will motivate your child to change positions and shift their weight more naturally.

We would like to encourage you to pay closer attention to your child’s sitting position, help them to become more mobile and break the habit of M-sitting to give them the best life you can. 

If you have any questions regarding M-sitting, please do not hesitate to contact us. 

Written by Chrisné Niebuhr, Bright Eyes Therapy. 

For more information you are welcome to contact us on 083 616 1662 or email us at ashley@brighteyestherapy.co.za

The tactile system is our sense of touch. It gives us information about things that touch our bodies as well as information regarding pressure, texture, vibration, size, shape, pain and temperature (Tara Delany, 2008). The tactile system contributes to the development of fine motor skills, body awareness and motor planning (E. Yack, P Aquilla, & S, Sutton, 2002).

In Sensory Integration, we talk about tactile modulation/reactivity, as well as tactile perception.

Tactile modulation/reactivity refers to one’s ability to cope with the tactile input in one’s environment, for example: different textures, temperatures, people in your space, physical touch etc. You can either have a typical threshold to tactile input, be over-reactive or under-reactive. Here are some examples of difficulty with tactile modulation:

• Dislikes being barefoot.
• Sensitive to food textures.
• Dislikes being on grass or on the sea sand.
• Dislikes messy play or become overstimulated quickly when exposed to messy play.
• Dislikes being wet or getting dirty.
• Dislikes standing close to friends.
• Dislikes being touched by people other than primary caregivers.
• Often toe walks (to limit sensory input through their feet)
• Seems irritated by tags on clothing, and often avoids wearing new clothes.
• Dislike daily activities such as brushing teeth, washing hair, applying cream etc.

It is important to expose your child to different textures so that they can learn appropriate regulation strategies to cope with tactile input in their environment. Make use of different textures during play such as sand, powder, maize, rice, jelly, shaving cream, cooked spaghetti, instant pudding, slime and play dough. It is however important to slowly grade the exposure to tactile input by first starting with dry mediums and moving towards wet mediums. It is also important to look out for signs of overstimulation such as excessive drooling, excessive blinking, toe curling, finger hyperextension etc. If these signs of overstimulation are evident, remove the stimulus for a short period to allow your child to regulate, or provide an alternative tool to play with to allow participation (such as using a spoon, a toy or a tong).

Tactile perception refers to the ability to understand and interpret what is being felt. For example: if you put your hand in your bag, you can feel whether you are touching a pen, a coin, your deodorant or a sweet. Tactile perception is also very important for growth, fine-motor development as well as for our survival (knowing when something you feel is dangerous, for example feeling a spider running over your arm) (E. Yack, P Aquilla, & S, Sutton, 2002).

Tactile perception is important to learn to tie shoelaces, eat with utensils, unlock a door, write, open a packet of sweets, button a shirt, open a tap, tie your hair etc. Our tactile perception underlies the development of our fine motor skills and together with the proprioceptive perception, it plays a vital role in the development of one’s motor planning and body awareness. Here are a few examples of behaviours associated with tactile perception difficulties: 

• Difficulties with independence in selfcare (dressing self, brushing teeth, tying their hair etc.)
• Often places objects in their mouths to explore them as they have difficulty exploring the objects through touch
• Difficulty with fine motor tasks.
• Difficulty eating with utensils and is often a messy eater.
• Difficulty manipulating small objects in their hands such as Lego blocks, marbles, puzzle pieces etc.

Due to the impact of tactile perception on a child’s daily living and development, it is crucial to stimulate tactile perception during play and common activities at home. Allow your child to practice independence with tasks at home such as buttoning their shirts, opening their own packet of chips, helping to roll up socks whilst doing laundry, helping with preparation of food, eating by themselves, brushing their own hair etc. For fun, close their eyes during bath time and allow them to guess the toy you put in their hand, throw random objects in a bag and ask them to find you a specific object, identify different textures (such as sandpaper, carton, tin foil etc,).

An occupational therapist can assist your child in learning appropriate regulation strategies to cope with tactile input. They are also trained in treating tactile perception difficulties to allow for the optimal development of fine motor skills, body awareness and motor planning.

If you have any questions regarding this system, please do not hesitate to contact us. 

Written by Tanya Kriel, Bright Eyes Therapy. 

For more information you are welcome to contact us on 0836161662 or email us at ashley@brighteyestherapy.co.za

Screen time is a topic that makes any parent feel guilty. In this modern era it is impossible to completely avoid screen time, but let’s investigate the effects of screen time and how to implement screen time in an effective way. Remember screen time includes tablets, TV and cellphones. 

The following duration of screen time is suggested by experts:

• 0-18 months: Children should not be exposed to screen time except to video call grandparents, parents or family members.
• 19-24 months: Focus should be on more educational programs where the parent and child can play along e.g. youtube video showing how animals walk and that you can copy. 
• 2-5 years: Screen time should be capped at an hour a day and under three hours during the weekend. Remember screen time includes tablets, TV and cell phones.
• 6 years and up: Less than 2 hours per weekday.

The effects of screen time on our sensory systems:

• Screen times expose children to large amounts of visual and auditory (sound input). This often results in a child (especially a sensitive child) becoming overstimulated by the amount of input that they are experiencing. This would result in concentration, sleeping and emotional difficulties (tantrums, tears and meltdowns). 
• The above mentioned would also result in a child experiencing difficulty regulating before bedtime which could cause difficulties falling asleep or sleeping restfully. 
• Screen time is a 2D activity, so even if programmes are educational, this is often not encouraging learning in the correct way. Children first need to learn with their bodies and then on a 3D level (blocks, building etc) and then only 2D level. 
• Due to children being sedentary during screen time activities this often affects their vestibular (movement) and proprioception (muscle) system. This results in gross-motor difficulties, ball skill difficulties and postural difficulties. 
• Difficulties with problem solving and planning. Children are seldom expected to problem solve, plan and sequence actions or activities during screen time. If this is not practiced children experience difficulty with this which may affect them socially or result in frustration when unable to be successful in an activity.

How to promote effective screen time usage? 

• Choose shows and programs that are more educational and with less sensory input. Visual images should be slower and noises more natural. 
• Ensure that your child regulates after watching TV and do not use screen time as a regulation technique. 
• Encourage active movement during screen time as mentioned above. 
• Use parental controls to monitor what your child is watching and how much time is spent. 
• Encourage the child to form their own ideas to play rather than watching TV e.g. why don’t you build a hideout and then we can watch TV in your hideout.

Remember that we cannot avoid screen time in this modern era but we can encourage healthy screen time habits.

Written by Ashley Brecher (Jones), Bright Eyes Therapy. 

For more information you are welcome to contact us on 0836161662 or email us at  ashley@brighteyestherapy.co.za

What is the Vestibular system? 

Like touch, smell, taste, hearing and vision, our vestibular system is one of our sensory systems. The vestibular system is one of the 3 senses that is less spoken about (vestibular, proprioception and interoception). The vestibular system is our movement sense and is stimulated by movement (the receptors are located in the inner ear). 

In the sensory integration framework, we look at the vestibular system through two lenses: vestibular reactivity and vestibular perception.

What is the difference between vestibular reactivity and vestibular perception?

Vestibular reactivity: 

Vestibular reactivity refers to how we cope with vestibular input (meaning movement). Do I like merry-go-rounds, ziplines, swinging, running, jumping, bungy jumping or skydiving? Or am I afraid of heights and speed, avoid merry-go-rounds, get car sick easily and prefer more sedentary activities? 

If you were excited reading the first few examples, your threshold would lie more towards the under-reactive or typical threshold – meaning that you cope well with movement and often need more movement than others to get through your day. On the other hand, if the second few examples sounded more like you, you are more over-reactive to vestibular input – meaning that you struggle to cope with too much movement and it can easily over stimulate you.

Here are some examples of how over-reactivity to vestibular input can present in your child:

• Dislikes being thrown up in the air
• Cries when his/her position is being changed suddenly
• Dislikes his/ her head being tilted backwards
• Avoids movement activities (such as swinging)
• Gets car sick easily
• Does not like it when his/her feet leave the ground
• Being overly excited after movement activities (can’t sleep, suddenly cries, laughs louder than normal, poor concentration)
• Look out for signs of over stimulation such as toe-curling, hand-splaying, frowning or  more drooling than usual. 

Here are some examples of how under-reactivity to vestibular input can present in your child:

• Seeking movement all the time
• Can’t sit still for age-appropriate amount of time 
• Riding on their chair whilst sitting at a table
• Improved concentration after movement activities 
• Soothes well with movement (such as swinging or rocking)
• Prefer games with movement

Vestibular perception:

This term refers to  the interpretation and understanding of where our body is moving in space. To understand this term better, let’s explain it with an example. If you were to be thrown in the back of a car’s boot, you can feel when the car is moving forward, accelerating, slowing down, turning left and turning right – thus understanding the movement your body is experiencing.

Vestibular perception together with proprioceptive perception is very important for the development of our balance, postural control and bilateral integration (the use of the two sides of our body simultaneously). A child with difficulties with vestibular perception can appear to be clumsy, have poor balance, difficulty with coordination and participating in sport, accident prone, delayed gross motor development (such as rolling) and even have difficulties with reading or writing.

If you recognise signs of difficulty with this system, it is important to expose your child to regular movement opportunities, such as swinging, jumping, rolling, swimming, summersaults etc. 

An occupational therapist can assist in integrating your child’s vestibular system and develop his/her vestibular perception. They also assist in learning appropriate regulation strategies for over or under reactivity towards movement. 

If you have any questions regarding this system, please do not hesitate to contact us.

Written by Tanya Kriel, Bright Eyes Therapy. 

For more information you are welcome to contact us on 0836161662 or email us at ashley@brighteyestherapy.co.za

Children are constantly learning new things and exploring the world around them. But what happens when a child is struggling to learn a new concept? This may be colours, their body parts, maths sums or even cursive writing. 

As adults we are able to learn concepts by explanation or reading, but for children to optimally learn, this should be done physically or by using an object, preferably in play. 

How to stimulate optimal learning:

• Tap into your child’s interests. If, for example, your child loves Paw Patrol, but is experiencing difficulty identifying colours, then use the Paw Patrol characters to teach colours for example “Which colour is Skye’s clothes?”, or “This banana is as yellow as Rubble’s helmet”.
• Furthermore, if a child is experiencing difficulty grasping a new concept, then bring the concept right back to the foundational levels. Our foundational level of learning is with our body, which we term the whole body approach in OT. What this means is that we first have to learn to do something with our body before we can build or write this (complete on a 3D or 2D level). An example of this would be if your child is struggling to form their letters correctly, then you could draw the letters with chalk on the floor and get your child to walk over the letter. Or if they are struggling to learn their body parts, then complete this in a mirror or on their own body. For example, “Let’s put some shaving cream on our nose in the mirror”. 
• Multisensory learning stimulates a child’s learning. This means that if we incorporate as many senses as possible, then it will promote a child’s learning. An example of this would be when practicing spelling words that your child copies the words in flour or sings a song about how to spell the word… or even BOTH!
• Repetition is a very important factor in learning. The more a concept is repeated, the better a child learns. Research shows that children learning through play will require less repetition than a child who is taught a concept. 

Remember you do not have to use just one of these approaches but combine them and see what works best for your child. No one knows your child as well as you do.

Some extra tips to promote learning? 

• When teaching your child a new concept or assisting them, try not to direct them, as this will reduce their opportunity to learn. Rather, guide them by using questions such as “ I wonder where I should start the letter ‘a’?” or “I wonder if this colour is pink or blue?”. 
• Limit external distractions that could affect their learning. Make sure the TV is switched off and put away any cell phones or tablets.
• Complete the action near the child, so they can watch you for assistance. Don’t do this in a manner of teaching them, but completing an action with them. For example, “I also want to write the letter ‘a’, I am going to write mine here.”. In this way the child will not feel directed and can reference you only if needed. 
• Always break a task into smaller parts and successfully complete one part before moving onto the next. Children love feeling successful!

Remember that we all  learn in our own way and have our own individual weaknesses and strengths. 

Please don’t hesitate to contact an Occupational Therapist should you need  ideas,  or are concerned about your child’s learning. 

Written by Ashley Brecher (Jones), Bright Eyes Therapy. 

For more information you are welcome to contact us on 0836161662 or email us at  ashley@brighteyestherapy.co.za

The 24/7 Job: Parenting. Constantly moving, no break and no time to regulate. 

Parenthood is awesome, but it definitely comes with its own challenges. Some days the busy household, screaming, tantrums, high pitched playful noises, partner demands and a stressful day at work, all add up. This reaches a point where you feel as if your head is spinning from the chaos and you snap undeservedly at your children and partner. This leaves you with guilt and questions like “Am I a bad parent?” or “Am I not cut out to be a parent?”. This feeling is normal, and it is called over stimulation.

What does it mean to be over-stimulated? 

Over-stimulation is a term which refers to being overwhelmed by sensory input or when sensory input is “too much” for your brain to handle. Being overstimulated causes us to become more irritable, forgetful, emotional and often results in us snapping at our partner or children, or even having an emotional breakdown.

Becoming overstimulated can’t always be avoided, especially as a parent. It is possible to become overstimulated at school sport events, if your baby cries, at a friend’s birthday party, doing groceries in a busy shop or just being stressed by work situations.

It is very important to be aware of your sensory profile and triggers, in order to know when you need to regulate.

Common sensitivities to be aware of and which could cause us to become overstimulated:

• Visual sensitivity: getting frustrated with disorganised spaces, feeling overwhelmed by bright coloured walls, disliking fast-paced TV shows,  getting easily distracted by movement in your environment (such as the children running around).
• Auditory sensitivity: Disliking noisy environments, getting frightened by sudden sounds, difficulty concentrating with the TV/ radio or children playing in the background
• Tactile sensitivity: Disliking grooming activities such as applying lotion or brushing teeth, being hyper aware of the tags of your clothes, disliking your hands getting dirty, disliking touch or having people in your personal space.
• Vestibular sensitivity: Dislike merry-go-rounds or swings and getting car/ seasick.

How can I regulate if I feel over-stimulated?

Self-regulation skills are a person’s ability to master  moods, self-soothe, delay gratification and tolerate transitions.” (Anazalone & Lane, 2012). It is important to regulate in order to function optimally and be the best parent you can be. Children also depend on their parents to help them regulate. It is therefore important for the parent to be regulated in order to assist their child to regulate.

Ideas to regulate: 

• Take time out: Give yourself 10 minutes to take a warm bath and relax. You can put on calming music or white noise to help create a calming environment. 
• Exercise: Make time to exercise, move your body, clear your mind and get some fresh air.
• Deep pressure: Use a weighted blanket to help soothe yourself whilst sitting in the living room, watching a movie or lying in bed. You can also wrap yourself in a blanket as it would provide deep pressure which is calming.
• Oral-proprioception: Drinking through a straw/suck water bottle throughout the day or eating something crunchy or chewy. Sucking and chewing provide oral proprioceptive input which has a calming effect.
• Deep breathing: use deep breathing techniques to help you relax. 

As a parent, it is a given that you would become over-stimulated at times. By knowing your triggers, you can better implement self-regulation strategies when needed to help cope with the sensory input from the environment. 

Written by Tanya Kriel, Bright Eyes Therapy. 

For more information you are welcome to contact us on 0836161662 or email us at  ashley@brighteyestherapy.co.za

Bright Eyes Therapy

What is praxis?

Praxis is the ability to plan motor actions and to execute those actions in a coordinated way. Praxis is what enables us to DO. 

According to Ayers (1985), Praxis in the physical world is what speech is in the social world. Both enable interaction and transactions in the environment. Both of these skills are learned, require the integration of sensory input and require planning that enables motor expression. 

Praxis consists of three processes namely: the ability to form an idea (ideation), the ability to plan the course of action (planning) and the ability to execute (or do) the action (execution).

Why is Praxis important to us?

Praxis is the skill that enables us to brush teeth, eat with utensils, braid hair, write, learn to play a new sport, climb a jungle gym, play, dress ourselves, cut with scissors, kick a ball, ride a bicycle and so much more.

In order to DO (execute) any task (such as these listed above) we first need an idea of WHAT we want to do (ideation) and HOW we are going to do it (planning).

Praxis is necessary for us to interact with our environment in an adaptive manner.

How does a child with praxis difficulties present?

• New skills may be more difficult to learn (such as cutting with a knife, riding a bicycle, dressing etc).
• Prefer that their parents help them with tasks. 
• Tends to be more of a follower during play (rather play what the other children are playing than thinking of their own game).
• Finds it tricky following instructions to complete motor tasks (such as an obstacle course).
• Appears as if they are jumping between ideas during play (as they have difficulty organising their game).
• Difficulty getting themselves ready on time.
• Eating only certain textured food (as each texture requires different motor plans).
• A child with praxis difficulties might continue playing only certain games or with certain toys, as new games or toys will require new motor plans.

How can I help my child develop his/ her praxis?

• Prompt your child to think of a plan. Use phrases such as: Mmm? I wonder if we can maybe use something to stand on to reach that toy?; What plan do you think we can make?; What should we do next?
• Break tasks into smaller pieces so that the task seems easier and more manageable for your child.
• Encourage them to first try a task by themselves before helping them. This stimulates their problem-solving and to first try and find solutions for the difficulty they are experiencing. This promotes your child’s independence. For example: instead of saying “Put your foot here to climb down” rather say “Where do you think you should put your foot?”
• Repeat instructions for tasks, as practice is required to master a new task.
• Incorporate as many senses to learn a new task as it provides multi-sensory feedback and thus facilitate the child to learn appropriate strategies to adapt to the physical demands of the task.
• Assist your child to first talk through the steps before executing the tasks (thus facilitating the planning aspect of praxis).

An occupational therapist can assist your child with praxis difficulties using a sensory integration approach. Therapy is fun, playful and addresses all  aspects of Praxis (ideation, planning and execution).