Screen Time through an OT lens

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

The Vestibular System

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

Help your child the OT way

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

“I am overstimulated too” – Regulation as a Parent

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

Praxis – What is this and how can I help my child?

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).

HELP!! My kind is ‘n “Picky eater”!

“Picky eating” is ‘n algemene probleem wat ons in Arbeidsterapie sien. “Picky eating” affekteer baie aspekte van ‘n kind, insluitend skoolprestasie, sosiale vaardighede, asook hul funksionering by die huis. 

Wat neem ons oor die algemeen waar met “Picky eaters”?

  • Onwilligheid om nuwe kos te probeer 
  • Onwilligheid om te eet 
  • Sterk voorkeure vir sekere kos
  • Verkies om meeste van hulle kalorieë te drink
  • Verlengde etenstye
  • Emosionele gedrag of reaksies tot eet
  • Fisiologiese reaksies tot eet, soos byvoorbeeld braking

As ‘n kind was ek onwiillig om te eet in die publiek, wat vir my baie probleme veroorsaak het. Skool kampe was veral moeilik vir my, omdat daar van ons verwag was om saam om ‘n tafel te sit en saam te eet. Om te gaan fliek by die fliek teater was vir my net so moeilik, aangesien ek nie die reuk van die springmielies, of die geluid van almal wat kou, kon verdra nie.  Na baie geduld en tegnieke wat my ma geïmplimenteer het, kon ek hierdie probleme oorkom en gemaklik saam ander ‘n ete geniet.

“Picky eating” kan deur soveel faktore beïnvloed word, soos byvoorbeeld: 

  • Sensoriese reaktiwiteit/ modulasie – Sensoriese reaktiwiteit of modulasie verwys na hoe ons sensoriese stimuli om ons ervaar. Ons kan oor-sensitief (wat beteken ons is sensitief vir sensoriese insette), tipies, of onder-sensitief wees (menende dat ons nie reageer op sensoriese insette nie, en baie sensoriese insette nodig het om te funksioneer). Kinders wat oor-sensitief is vir tas, reuk of smaak sensasie is geneig om “picky eaters” te wees. 
  • Praksie/ motor-beplanning – Praksie is die vermoë om motor-planne te vorm, en om dan hierdie motor-planne uit te voer. Eet, kou en sluk vereis motor beplanning, en verskil van elke tekstuur wat ons eet. Baie dikwels vind kinders met hierdie probleem dit moeilik om verskillende tipes kos te verdra. Hulle sal, byvoorbeeld, slegs Woolworth’s nuggets eet en nie ‘n ander handelsmerk nie. Deur dieselfde handelsmerk te bly eet, laat dit hulle toe om voorafbestaande motor planne te implementeer. 
  • Traumatiese ervarings – Traumatiese ervarings met kos soos druk om te eet, emosionele reaksies en geobserveerde gedrag is geneig om “picky eating” te beïnvloed. 
  • Oraal-motoriese funksie – Dit verwys na die bewegings van die spiere in die mond, lippe, tong and kieste en beïnvloed suig, byt, lek en kou aksies. 
  • Mediese kondisies kan ook ‘n groot invloed hê op “picky eating”. 

“Picky eating”, afhangende van die oorsaak, kan behandel word deur Arbeidsterapeute, Spraakterapeute of sielkundiges. As ‘n Arbeidsterapeut (wat opgelei is in Sensoriese Integrasie), behandel ons enige onderliggende sensoriese probleme, praksie probleme en  modulasie/ reaktiwiteit. Intervensie word gedoen in ‘n spelerige en prettige manier, waar kinders behandel word afhangende van hulle onderliggende probleem, en waar nuwe kos geproe word sonder om druk of spanning te ontlok. Die kinders geniet dit om op hierdie manier te leer om nuwe kos te proe en verdra/ aanvaar. 

Help!!! My child is a picky eater?!?

Picky eating is a common difficulty that we as Occupational Therapists address regularly. Picky eating affects many aspects of a child, including their school performance, social skills, as well as their functioning at home. 

What do we commonly observe with picky eaters?

  • Unwilling to try new foods
  • Unwilling to eat
  • Strong preference for certain foods
  • Prefer to drink most of their calories
  • Lengthily eating times
  • Emotional responses to eating
  • Physiological responses to eating such as gagging and vomiting

As a child, I was unwilling to eat in public which caused me numerous difficulties. School camps were especially difficult for me, as we were all expected to sit around one table and eat. I remember crying in the bathroom during school camps, when it came to meal time. Movies were also extremely difficult, as I could not tolerate the smell of popcorn and the sound of people chewing. After much patience and  techniques implemented by my mother, I overcame these difficulties and can now enjoy a meal with others. 

Picky eating can be influenced by many factors such as:

  • Sensory reactivity/modulation – Sensory reactivity/modulation refers to the way we experience sensory input around us. We can be over-responsive (which means we are sensitive to the sensory input), typical, or under-responsive (meaning we don’t respond to sensory input and need lots of sensory input to function). Children that are over-responsive to tactile input, olfactory (smell input) and gustatory (taste input) are commonly picky eaters.
  • Praxis/motor planning – Praxis is the ability to form motor plans and execute these actions. Eating, chewing and swallowing, all require motor plans and differs for each type of food or texture we eat. Very often children with this difficulty find it difficult to tolerate different types of food. For example they will only eat Woolworth’s nuggets and not another brand (as the texture differs). By eating only a known brand, allows them to implement pre-existing motor plans.
  • Traumatic experiences – Traumatic experiences with foods such as pressure to eat, emotional connections to certain food or observed behaviours (for example mom doesn’t like fish), commonly influence picky eating.
  • Oral-motor functions – This refers to the movements of the muscles in the mouth, lips, tongue and jaw and influence sucking, biting, crunching, licking and chewing.
  • Medical conditions can also have a significant influence on picky eating. 

Picky eating (depending on the cause) can be treated by Occupational Therapists, Speech Therapists or Psychologists. As an Occupational Therapist (trained in Sensory Integration), we treat any underlying sensory difficulties, praxis difficulties and modulation/reactivity. The intervention is presented in a playful manner, where children are exposed and treated relating to the underlying difficulty and no pressure is elicited to taste food. The children love this playful approach ta  learn to tolerate foods and to be open to try a variety of food.

Written by Ashley Brecher (Jones)

Sensoriese Integrasie

Wat is Sensoriese Integrasie?

Sensoriese Integrasie verwys na ons vermoë om al die inligting rondom ons deur ons sintuie waar te neem (te registreer, moduleer en diskrimineer), en dan die sensoriese inligting te organiseer sodat ons kan sin maak van ons wêreld.

Deur die sensoriese inligting rondom ons te integreer, vorm ons doelgerigte gedrag in reaksie tot ons omgewing.

Sensoriese integrasie vorm die basis van effektiewe emotionele regulasie, sosiale vaardighede, vermoë om te speel, perseptuele, grof- en fynmotoriese ontwikkeling.

Sensoriese Integrasie bestaan uit Sensoriese Modulasie asook Sensoriese Diskriminasie.

Sensoriese modulasie: Verwys na jou vermoë om jou reaksie op inkomende sensoriese inligting te gradeer, en dan daarop te reageer en op ‘n gepaste manier op te tree.Sensoriese diskriminasie: Verwys na die vaardigheid om akuraat een stimulus van ‘n ander te onderskei, bv. Die verskil tussen die blaf van ‘n groot en klein hond, of om tussen ‘n R1 en ‘n R2 in jou broeksak te onderskei.

Indien u kind een van die volgende tekens wys, is daar ‘n moontlikheid dat hy/sy met sensoriese integrasie sukkel:

  • Oor of onder reaktief tot gevoel, beweging, visuele inligting of klank
  • Maklik afleibaar
  • Sosiale of Emotionele probleme
  • Impulsief en verlies aan selfbeheersing
  • Moeilik aanpasbaar in nuwe situasies
  • Onderontwikkeling van spraak, grof en fyn motoriese vaardighede
  • Verlaagde akademiese prestering
  • Oor-emosioneel en geneig om “meltdowns” te hê
  • Sukkel met selfsorg aktiwiteite, bv, hare kam, bad, tande borsel

Sensoriese integrasie behandeling:

‘n Arbeidsterapeut kan help met sensoriese integrasie. Terapie vind plaas in ‘n kamer vol van swaaie en prettige apparate, waar die arbeidsterapeut die kind deur spel sensories stimuleer en ontwikkel. Terapie fokus op sensoriese modulasie, diskriminasie en die regulering van sensoriese inligting.

What is Sensory Integration: Sensory Modulation

Sensory Integration is a term that many would have heard in recent years, but what exactly is it? Is it necessary for me to know more about it?

We are exposed to sensory input throughout the day and in everything that we do. As you sit reading this, you can feel the clothes on your body, hear the birds chirping outside, you are using your fingers to scroll through the post and so much more. Sensory Integration is defined as the process where we take up sensory input from our environment, organize it and respond to it appropriately. To make Sensory Integration easier to understand I like to divide it into two categories: Sensory Modulation and Sensory Discrimination.

Sensory Modulation has to do with the amount of input you process from the environment around you. Each of us has a threshold (which is how much input we take up from the world around us) and we can lie anywhere from hyper-responsive/over-responsive to hypo-responsive/under-responsive. I liken this to us and our kiddies being a pot plant. The size of the pot is our threshold and the water that we receive is the sensory input around us. A hyper/over-responsive person would be a smaller pot and a hypo/under-responsive person would be a large pot. A small pot can only take a small amount of sensory input before it overflows, which is detrimental to its growth. Likewise, a bigger pot needs LOTS of water if it doesn’t receive enough this would also be detrimental to its growth. We, therefore, need to receive the right amount of input according to our pot size.

Although we can differ for each of our systems below are some indications for where you may lie.

If we receive too much sensory input this leads to a state called overstimulation. Overstimulation can be seen by the following characteristics:

I believe sensory modulation is central to everyday life and if we know our pot size as well as our children’s then we can better respond to situations that may arise. This also plays a significant role in emotional regulation.

If you have any queries or concerns regarding your child’s modulation it would be beneficial to speak to an Ayres Sensory Integration trained OT.