Growing and evolving as a parent…. :)

As my son grows each day, I am growing with him in my role as a parent. In the beginning, I was practicing to juggle between my work and my role as a mom. In doing so, the balance was very well achieved but somewhere something went wrong because unknowingly my motherly love got mixed with the toxic emotion of stress, this toxic emotion came in from somewhere and it just sneaked in. I really don’t remember when it came in and got mixed with the color of my love …..

Maybe sometimes, I used to over do being a mum. I used to work when my son was at school or sleeping and tax myself. I was really being very hard on myself in trying to become a good mom. I would be with him all the time but gradually there was a separation- I was physically there with him but mentally doing all the stuff that was supposed to be done while he was playing. And all this happened so slowly and suddenly that I didn’t even realise that my work was creeping in and taking space of me as a mom.
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I very clearly remember a time when I used to sit with him and give him my complete attention (away from TV/mobile/ipad) only while he was studying or doing academics. I used to pin point every single mistake that he would make and completely ignore on all the wonderful work completed by him, even the stars given by teachers !!!! I used to scold him for one single crooked letter in the full page of beautifully formed alphabets. This made him really angry and he used to throw tantrums. I got even more frustrated with these new tantrums. In my perspective, he was making mistakes and writing crooked letters, and when corrected, he was throwing tantrums. I thought I was failing as a mom….

I was blessed by an opportunity where it dawned on me that I am frustrated with myself and not on my son. I started realising that I am not doing things that I used to love doing before (because I was a mom now !!!! as if its a life imprisonment…)

I changed and started doing things which I loved doing, buying things I liked, eating things I liked and pampering myself. As I felt loved and got filled with love, it became easier for me to pass that love to my son and other family members. I believe that taking care of myself is taking care of my son. I cannot have a life of deprivation and sacrifice to make others happy. Happiness begins with me. When I am full of it, I give it out. So I started giving myself a lot of “me time”.

I feel that there has to be a lot of emphasis on giving “free time” for the kids also. In this time, the child does all that he wants to do.

Also, “special time” is equally important where the parent spends time with the child engaging and commenting on what the child is doing.

I remember times when I used to quickly work on replying to emails and completing my household chores when my son was watching TV. I later realised which I do now is watch TV with him, laugh on those little jokes and ads which are important to him. All that he wants is me and my attention which I can give by showing interest in doing things that he likes to do. So now I combine “free time” with “special time” without intruding his space. And let me correct myself here, he does not need my attention- he needs my love which any child wants from his parents.

So now, once I have given myself the “me time”, giving “special time” to my child is easy. And then the special time is not just with academics, it is while playing down in the park, watching TV, cooking food, serving food, while playing games on ipad or playing board games, while just doing some silly things which don’t make sense.

Today and now, I am able to separate the toxic emotion from the pure emotion of love. I now see my son’s homework and do not pin point only to the mistakes rather very casually tell him that it is important to learn from them and not repeat them again. Secondly, the frustration of making him study is gone and my son says “lets read together”. It so happens that I am tired and he still wants to go on reading because this special time is wrapped in a blanket of “love” that he gets from me and that I get by engaging in “me” time.

Reena Singh

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Matrix Reimprinting

After completing my EFT training, I was keen to know about the Matrix Reimprinting program and how it helps. I was told that EFT is the base and that the matrix is a level above the EFT. EFT helps in removing the negative memories and negative beliefs but matrix helps to reimprint the same memory or the belief with a new pleasant one. In such a case, when the person attempts to remember the negative memory, only the new imprinted one is retrieved.

Most of this sounded good as a theory and I wanted to learn this so that I could blend this at Khushi. I wanted the therapies at Khushi to be more holistic. Whenever, parents would come to me for therapy, I used to sense that the family dynamics is shaken up because of the diagnosis and also in general because of stress. I also believe that the plant (child) will grow and develop if the soil (family) is enriched and provides all the nutrients (positive emotions in the form of love and appreciation) that are needed.

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So here I was in this training which was led by Dr. Rangana Rupavi Chaudhari. She usually teaches the concept and then does a practical demonstration. She asked the participants about who will be keen to do the practical demonstration with her on the “hot seat”. I decided to go not realizing what I was entering into. When I did the process, I was shocked, amazed and even disoriented for a short while, I was automatically regressed to two memories which had a grip on me so strong that I felt them everyday in every waking moment of my life. Those memories had changed my personality and the way I expressed myself.

I first went into a memory when I was just coming out of my mom’s birth canal. Another one which came up was when I was in my mom’s womb, five months old. There were harsh words spoken to my mom which felt like a current of impulses entering into my being while I lay there helpless and numb but still protected in her womb. The same harsh words were spoken while I was just coming out of the birth canal and my mom was scared before the umbilical cord was cut. That feeling of fear and the deep sigh stayed with me till now.

The entire experience was like an eye opener and I came out of the whole experience feeling “free”.
The entire memory has changed and so also is my personality after that session. I am very grateful to have been a part of the session which helped me so very much. I got to know myself and it was nice getting introduced to my own TRUE self. I experienced my first “satori” moment and had an “out of the body” experience in this exercise.

I did the technique with many parents who come to me at Khushi and its amazing how easily every one regressed back into their childhood memories, womb memories or memories of the past life. It is a lovely process of cleaning – and a gentle process of clearing. After, all those negative memories are clean, all that is left is only peace and calm…… And more than that, I see the kids doing well in therapy because our emotion is just energy in motion. When we are stuck with them, the energy is stuck. Post the matrix sessions, the family dynamics got better, the ability to deal with stress got better. Parents passed feelings of love and positivity to the kids because they felt positive and loved. This has impacted the therapy gains and kids are improving faster. It is like taking care of the plant and also ensuring that the soil is enriched….its just amazing!!!

Reena Singh.

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Earthing …..

Earthing

My son was invited for a birthday party and after dropping him to his friends party, I and my husband had nothing to do. We decided to go to the beach and just take a walk in the sand. We walked for nearly two hours in the water and then came back home. This beach walk was done after many years.

I was feeling very light and calm and some feeling which cannot be described. There was this state of bliss and rapture. I didn’t know what was happening but told my husband that there is something good that I am feeling.

We planned to go to Juhu beach again -this time with our son. Since my son wanted to just have fun in the waves, we allowed him to just sleep in the water, jump over the waves or dig out shells from the sand. While my son was busy doing all of this, I stood with my husband in the sand enjoying the feel of my feet sinking deeper with each wave. It was a lot of fun just being there and enjoying the sunset.

It was around two hours now but my son wanted to make some sand castles. We sat there for around an hour doing something with the sand, had some yummy corn and headed home. After reaching home, I was again painted and immersed with this feeling of calm and peace. I was getting addicted to this feeling and it accelerated my work efficiency. I saw my son being more calmer and peaceful too. I was curious to understand what was the reason for this feeling.
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Tried reading about earthing and then realized that I was “grounded” and “earthed” because I allowed my feet to touch the bare skin of mother earth. I know it sounds strange but we have covered mother earth with cemented roads, paver blocks, tiles and so many things. At around this same time I came across this book called Earthing-The Most important health discovery ever by Clinton Ober and Stephen Sinatra which gave me more inputs about earthing.

I realised that earthing helped my body to achieve an optimum electrical state. Our planet Gaiea is a battery which is getting constantly charged by the sun rays on the outside and the molten core from inside. A battery is needed to run every car or appliance and that same way, our human body and all living beings are getting constantly charged by the rhythmic pulsations of the earths natural energy. The rhythm of the earth keeps us in rhythm.

The sole of our feet are richly covered with 1300 nerve endings per square inch. The foot is the plug through which we get connected to the earth to get charged. It kind of extracts and sucks in the energy from mother earth.

Technically, earthing helps our bodies to maintain the natural electrical state which promotes optimum health. Maintaining contact with the ground allows body to receive the negative electrons from the surface of the earth.These negative electrons are the most powerful antioxidants known. By neutralizing the free radicals in our body, antioxidants help to ease inflammation as well as cell and tissue damage.

Just as our clocks and watches need batteries, the same way our biological clock needs to be continually calibrated by the pulse of the earth that governs the circadian rhythms of all life on earth.If you go back to the past, most of the activities we did were done in contact with the mother earth. But now in the present world, we are insulated from earth which means we are not getting charged which leads to electrical imbalance in our bodies which gives rise to ill health.

I remember my dad used to tell me to walk on the grass early in the morning, he never knew why but his ancestors told him it helped. My grand-mom used to tell me that I should try and walk barefoot on the mud, it helps!!! My grand mom always said that soil soothes, cleanses and heals.

Earthing/ grounding help us to stay healthy and fit. But how do we do this

1. Walk on the grassy or the muddy areas bare feet.
2. Expose any part of your skin to any natural water body such as a lake, pond, river or an ocean. Walking bare feet in this water body also helps.
3. Lean on to a tree

Mother earth just wants us to hug her and she is ready to bestow all her healing properties on us. Why are we disowning her and embracing ill health?

Reena Singh

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My journey with EFT

So while I was learning a special class called “Face the Fear” to become a consultant of Rhythmic Movement training, I was introduced to tapping. I learnt that there are various points on our body which when tapped helps to release blocked emotions. There are points called “meridians” which are the energy highways in our body. “Highways…….energy highways….. I was really confused and at the same time equally interested to understand about them and find some way to learn about them.

It was a long journey for me to understand more about tapping -I learnt that it came from TFT and EFT, these words seemed so much greek and latin to me. I googled and found that the tapping came from “thought field therapy”and also used in “emotion freedom techniques”. Still, nothing made sense and my inquisitiveness to learn more about “tapping” was growing to an extent that I could not contain it. I was now really getting impulsive to learn more about it.

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I contacted a lot of people and then met Dr.Rangna Chowdhari who introduced me to EFT in her level 1 and 2 class. I was very happy that finally I will get to learn about the various points on which I will learn to do the tapping but she kept tapping on similar points over and over again while speaking different things. I was puzzled. I asked my “impulsive” self to calm down and relax and trust the process. I told myself that I was there for a reason and that I really needed to believe in my instructor.

Over the next two days in the 3 days of training, I saw a lot of changes in myself but the “Ms. Skeptic” in me kept fighting and telling me that it was not helping. After completing the 3 days, I came out as a different person who was no longer carrying weight of guilt/ hurt/ worry. I realised that I was really tired carrying so much weight which gave me breathlessness (for which I was advised a pump), dust allergy and lactose intolerance. I loved “kheer” but every single spoon of “kheer” used to have a thunder and lightning in my stomach followed by massive diarrhoea. Ufff….it was a tragic life situation where I used to literally feel that I will have to take another physical form on this earth to eat “kheer”. Also, old dust and spider webs would give me flu and incessant sneezing and literally drain me out like how we drain water out of sponge. Oh my God…it was a pain !!! But I had learnt to live with it and accepted myself with the way I was. I have always been trekking ever since I was in Class XI but climbing up the slope used to make me breathless. I used to start wheezing and after that used to wait that I will soon be breathless and die. There used to be a block of big rock which used to get stuck in my windpipe leaving no space for the oxygen to pass into my lungs.

Now, I was out of the EFT training and thought that I was better since I had released all the pain and hurt that I have been carrying. After a week, my mom had made “kheer”. Believe me, I really could not resist. There was fight in me -one telling me to have just a spoon and forget about diarrhoea and the other one was a strict teacher inside me teaching that I was behaving like a child. It was too much to resist and I had a spoonful of “kheer”-closed my mouth and felt the bliss in my mouth, Oh my goodness, the taste was out of the world. As soon as I gulped it down my throat and before it could reach my stomach, the teacher in me was angry and screaming at me for this foolishness. I was really sad and also guilty as I sat on a sofa in a corner waiting for the thunder and the lightning. I was waiting and waiting and waiting….. as the screams and cries got louder as time passed by. Now it was half an hour and I was fine, usually I start getting my symptoms in a matter of just 5 minutes. I was wondering “whats wrong or right with me?”. Now it was more than 3 hours and no symptoms. I was even scared to think that I am free of that allergy….The next day, the “child” in me decided to plunge even more and I had a bowl of “kheer” waiting for something to happen but …………..NOTHING!!! I had to believe that I was free. All my allergy was because of the negative emotions that I had been carrying with me since my childhood.

Its been more than 6 months now…I eat all the food stuff that I was once “allergic” to and enjoy the thunder and lightning in the monsoon -not in my stomach.

And I am sure you can guess by now, that my dust allergy is also ……….Swoooosh ….GONE.

This simple looking tapping really goes deeper and does all the cleaning that is needed inside. It has cleaned me completely. And now,I am so intrigued and impressed by EFT that I have become a practitioner and doing it to the parents who come to me at Khushi. I also do surrogate tapping for the kids with special needs and also group tapping to help each other through “borrowing benefits”.

Sounds amazing but not real…..to me even now !!!

Reena Singh

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Primitive reflexes and RMT -What exactly is it ?

We all learnt about reflexes when we were in school- they were called as reflex actions.

Some examples of reflexes are

blinking of our eyes when something comes close to our eyes,
sneezing,
coughing,
Shivering
yawning

These reflexes are automatic and happen without your thinking-it is something on which you do not have control upon. They are protective in nature and they help us. Reflexes are also present in animals.

So what are Primitive reflexes?

· As you know the word primitive means crude or old.
· Reflex means something that happens without our conscious control like sneezing.
· And as I link the words together, a primitive reflex means something which is very crude and happens automatically which is not under your control.

In very simple terms, it means like using an old bulky slow computer of the 80’s in the age of sleek and fast processing laptops. Child is born with these reflexes until they mature by one year of age and the control of these primitive reflexes are released and the higher centers of brain take over. As the connections develop, the HOLD of the primitive reflexes on the body decreases. But if the connections do not develop, then these reflexes stay active and do not allow the other systems to express themselves.

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It is like many ministers of various states fighting to exert control. Each minister is in control of a particular state (part of the brain) which is assigned to them. These ministers have to be in sync and manage the functioning of the country (brain). But instead of working together to bring about efficient functioning of the country (brain), they all dominate their own self defined rules which makes it difficult for the country to prosper. To develop the synchronicity, these primitive reflexes need to be integrated and connections need to be established with higher centres. This happens when we do primitive reflex integration.

So what happens in primitive reflex integration?

It means allowing your child’s system to upgrade from old bulky slow computer of the 80’s to sleek and fast processing laptops. It also means that now all the ministers are in complete coordination with each other to bring about increased efficiency.

I am sure you will agree that the functionality is very different and so it will be for your child. You will be able to release the control of primitive reflexes of the lower brain centers through integration as the brain starts linking up. As the control releases, more independence and higher level control is achieved which leads to more of desirable behaviors by your child

You may be wondering how the retained primitive reflex manifests . So here it is

Fear Paralysis Reflex- This causes shut down of the systems when faced with stress or any kind of change. It causes mutism, shyness in social situations, depressions, constantly feeling overwhelmed, very fearful of any kind of change- fear of separation from a loved one, sleep and eating disorders.

Moro reflex – Retained Moro reflex causes rigid behaviour patterns, hypersentivity to light, sound, taste, touch or smell, resistant to changes or transitions, allergic to specific food substances, fluctuations from extreme hyperactivity to extreme fatigue, reading and writing difficulties.

ATNR – Retained ATNR causes difficulties in reading, writing and math skills. It also causes confused handedness – uses both hands for writing, eating etc.

SGR – Retained SGR reflex causes difficulties like bed wetting and wriggling behaviors ( like ants in the pants) which causes hyperactivity and fidgety behaviours making it difficult to pay attention.

TLR – Retained TLR reflex causes difficulties with space, understanding the relations of space such as up-down, right -left, difficulty in judging space and the speed of movement, toe walking, hunched posture and coordination difficulties.

What is RMT?

RMT is a short form for Rhythmic Movement training. It was developed by a psychiatrist Dr. Harold Bloomberg in 1980’s on the basis of work of Kerstin Linde when he saw that rhythmic movements had remarkable differences in his patients with psychiatric conditions. He also studies with other movement specialists. Moira Dempsey, an Australian Educational and Developmental kinesiologist became interested in the role of retained reflexes in learning and behavioural challenges in the mid 1990’s. Moira Dempsey met Dr. Blomberg in 2003 and started using the movements herself and with clients. She noticed remarkable results.

When the rhythmic movements are given, it helps to develop connections in the brain which were not developed before. These movements help in linking the different parts of the brain with each other which helps in efficient functioning of the brain. It also helps to integrate primitive reflexes.

If there has to be an analogy then, I see the rhythmic movements to be like water and fertilizers for the plant to grow. As the movements are done, new connections grow just like branches of a plant and help to synchronise the functioning of the brain.

The movements need to be planned by a therapist who is trained in RMT. Two or three movements are started initially and changed every 15 days to a month depending on how the body responds to them. Results can be seen within 10 days to a month. To maintain the results, the movements need to be done for a period of 12 -18 months. We combine RMT at khushi with other treatment approaches.

If there is a history of seizures the movements have to be very carefully monitored and done with neurologist’s opinion. Also, caution needs to be taken while doing it with kids with Downs syndrome.

When the brain starts linking up because of the rhythmic movements, the body starts releasing toxins and muscle tension. This causes side effects which may be physical or emotional in nature. These effects suggest that linking is happening and helping. However, if the side effects are not manageable, then you need to follow up with your consultant and change or decrease the movements as needed.

RMT is not necessarily to be done for kids but it can be done for anyone who has active primitive reflexes.

Reena Singh

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Lets understand Sensory Integration!

It is a term coined by the Occupational therapist Jean Ayres

Before we go into the theory of Sensory integration, lets read a story on how sensory integration helps in forming beautiful and wonderful memories of childhood!!!

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Ruhie is a little girl who has just come back from school and she jumps in the puddles. Sometimes the water in the puddles was lots and sometimes it was really mucky. Ruhie would sit into the puddle and dig her hands into the muck. With these hands, she pushed her hair behind as they came over her face. Enjoying the gooey muck, she knew how to zoom the lenses of her eyes and focus only on the swing in the midst of so many children running and jumping around, sometimes occluding her view of the swing. Her vision was sharp like that of the eagle’s who will grab her swing immediately as someone vacated it. Then she would sit on the swing and enjoy the movement till it was full for her. And then amongst the sounds of birds chirping and the children playing, she hears her mom calling. So Ruhie runs back home. As soon as she entered the house the smell of the yummy food pulled her towards the kitchen when she was asked to wash her hands and face. And then once all clean, she got to relish the delicious meal. She ends her day by finishing her homework.

You must be wondering what Sensory integration has to do with all of the above- All that Ruhie did above was sensory integration. Read this along to know as I explain.

1. Proprioception and jumping in the puddles –
Ruhie could jump because she has an intact proprioceptive sense that helped her to decide how hard or gently to jump.
Proprioceptors are present in all the joints of our body. They help us to understand the position of body in space and also helps to grade the movement.

2. Tactile sense and Jumping in the mucky water-
Gave Ruhie the tactile input.
Tactile sense is the sense of touch which tells us what are we touching or where are we getting touched.
It also tells us the pressure of the input.
Touch helps us to understand the world.

3. Vestibular sense and swinging –
Helped Ruhie develop vestibular sense.
This is the sense which is present in our inner ears. It tells us about movement of body in space and also the kind of movement. So it tells us whether we are on a swing or a car or a roller coaster ride and guess what ….it also tells the speed.

4. Vision-
While Ruhie played in the muck or the mud, her eyes were glued on the swing.
This is the visual system which tells us how to focus on what we want and ignore other distractions.

5. Auditory-
While Ruhie played amongst the sounds of children shouting and screaming, crow cawing away, she was very clearly aware of her mom calling her!!
This means that we have the ability to separate ambient sounds from focal sounds.

6. Olfactory-is the sense of smell which helped Ruhie know what was cooked for dinner.

7. Gustatory- is the sense of taste helped her to relish the food.

8. Interoception- It is the sense responsible for detecting internal regulation responses, such as breathing, hunger-thirst, bowel bladder and heart rate cycle.

What else was happening
1. Attention- as you read all of the things above, it must be clear about how attention is a by-product or fruit of the 8 systems working effectively.
2. Motor planning- this was needed for Ruhie to grab her swing whenever someone vacated it- the speed and the coordination of her body to run quickly. Motor planning is needed to wash hands, feet and face after she finished playing. And also to complete her home work. So a lot of motor planning is needed in our day to day tasks.
3. State of arousal- Even though Ruhie was very tired after school, playing in the playground was something that she could not never miss out. She could SELF REGULATE and keep herself active in the playground. But once she was home, she was dull and lazy- she had control over the knobs of arousal which helped her to be dull or active.

All the 8 senses were integrated, Ruhie will grow up challenging her limits and exploring her surroundings. She will want to re-live it.

Now what happens when the senses are not integrated- lets consider Ruhie again. One thing to remember is that whenever there is a sensory processing disorder- the sense will work less(hypo), more (hyper) instead of just right (optimal).

1. Jumping in the puddle may not happen because of poor motor planning or there may be a big need to just jump irrespective of anything else.
2. Jumping in the puddle may be avoided because of the texture of the mud or water.
3. Touching mucky or gooey things may be just impossible because of tactile defensiveness. Or the child seeks just that irrespective of anything else. Because of the tactile sense of being more or less, tastes are either seeked or avoided making them into picky eaters.
4. Swinging may be avoided completely or it may be the only thing that is seeked.
5. Because the child gets absorbed into the input, attention suffers.
6. Visual attention or looking around and focussing on what is needed may be difficult because of poor filtering.
7. Listening to mom’s call or any sound directed towards the child maybe ignored because the child is again absorbed into one of the senses intensely seeking it or completely avoiding it.
8. Lot of smell seeking is there or child is completely oblivious about it.
9. And then I am sure by now, you know what happens to play and forming connections. Everything is broken and shattered because there is no integration of senses.
10. There is poor self regulation or regulation of arousal states making it really difficult to fall asleep – child may fall into patterns of no sleeping, difficulty falling asleep, irregular timings of sleep and so on.
11. And then you can imagine what it will be like to live with an interoceptive system which does not tell you when you are hungry and how hungry are you. How much to eat and when to stop eating? This system also signals when to go to pee and poop.

So, coming back to sensory integration- it is a process by which all the senses work together to make sense of the world – wanting to live and enjoy the world and seek and make connections.

And when the senses are not integrated, or when an individual has a sensory processing disorder, life is difficult !!!!

The good news is that Sensory integration can be facilitated by occupational therapists by providing “just right” opportunities and kids can have a lovely childhood with memories to cherish for lifetime!!!

Reena Singh

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So how exactly should I control my child’s screen time?

Do you remember your childhood days?
I remember playing till I was dead tired….just running around!!
Sometimes pretend play and sometimes board games!!!
Then there was exploring nature and climbing trees…
So many of those games where hands and feet were dirty with mud and muck…
Sometimes watching the birds go home and sometimes gazing at the stars…
I was so very connected and rooted to mother earth.
I got the precious memories of being rooted and embracing my mother earth!

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And here comes me today, coming back home in the evening to greet my son and getting back to my whatsapp (screen) or my facebook (screen) !!!
Oh yes! The emails (screen) need to be answered also and so many calls to be returned.
And then I think I should just chill and relax ..so I put on the TV( Screen).
And then you know I have my sacred book of scriptures on my ipad (screen) so I will pray too!
And when thats done and my son plays down, I can read some great books on my kindle (screen)!!

And as my son plays around while I do all of the above,
I teach him that he is not supposed to watch too much TV!!
I teach him that he is not supposed to play on his ipad and that he should control himself and limit the time he spends on it!
I teach him that he is not supposed to see videos on my phone!!
I teach him that he is supposed to look at me and talk rather than answer while watching TV!!!

But is my son going to learn from WHAT I DO OR WHAT I TALK?????
I really need to think …
I know of all the ill-effects that screen time has on kids …
But is it not true for me????
Do I need to get back to my mother earth ?
Don’t I need to put a curfew on my screen time?
Don’t I need to stop all my screen work and look at him when he talks to me ?
Am I just blaming him or I need to be blamed?

I really need to think about this….AND WHAT DO YOU THINK?

Reena Singh

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Supporting kids with SPD during Diwali

Yay!!!!

The festival of lights has come….

So what is special about Diwali

  1. Vacations
  2. Lots of friends and relatives who come to us or we go to meet them
  3. New clothes
  4. Crackers and the noise of crackers
  5. Lots of homemade sweets and chocolates to munch on

While, I very strongly believe is that kids with Sensory Processing Disorder (SPD) should be “given opportunities” to participate in all the activities and create their own bank of memories for each event. However, in doing so, parents can play a key role to ensure that these memories are positive and not traumatic or painful. This can be done by understanding the needs of their kids and respecting their limits.

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Vacations:-

Kids with sensory processing issues need predictability in the midst of all the chaos that their body constantly presents them with. Routines help kids with SPD to establish predictability. During vacations, the routine is disrupted and also unpredictable which increases the stress levels for kids with SPD.  Increased stress levels make  children very vulnerable to meltdowns. The use of consistent approaches to daily schedules and carefully planned transitions can help a child adapt to daily expectations. This means that as a parent you need to ensure that you prepare and guide the child through the daily plan through pictures or text as per your child’s level of functioning. When the child is prepared for what is coming next, he will be able to flow through the day’s routine very easily even it is unpredictable.

Lots of friends and relatives who come to us or we go to meet them:

This helps because the child gets an exposure to meet new people and also learn from them. But if the child is not prepared for this kind of a situation, you may again experience tantrums and meltdowns. In such cases, a Social story on Diwali can help. Use of Visual Schedule will also help especially with a surprise card in the middle of the schedule which can be used when the visit of your guests is unexpected.

Also, when we attend to our guests, our kids feel ignored and they start engaging in unwanted behaviors to get attention. So, it will help if the kids get the attention and their presence is acknowledged while you have a conversation with your guests. Also, it is really important to make your child understand about how long the guests will stay. Some stay for days in which case it will be better to usecalendar and explain to the kids on the number of days that they would stay. In case, the guests will stay for an hour or so, then visual timers are very helpful. There are applications on iPad which have timers or even a simple sand clock timer would be good (which has 30 minutes or an hour). If your child can read time, then it will help to show them the analogue clock and explain the passage of time with the movement of the big hand on clock.

Doing these things will ensure that the kids have predictability in the middle of unpredictable situations.

New clothes:-

Most of the times kids have tactile issues which make it difficult for them to wear the Diwali kind of traditional clothes. In such a case, it will be preferred to respect their discomfort and allow them to wear what they are comfortable with. I am not meaning to say that this is how it will stay forever because most of these tactile issues can be worked upon but not at a time when everything else is also changing. It will be great if the traditional kurtas or the salwar kameez’s are tried at other times during the year while working on the tactile issues using Sensory integration.

Crackers and the noise of crackers:-

Many kids with SPD have sensitivity to the sounds and the sudden bursting of crackers makes it really worse because they are really unpredictable. The first thing to do will be to acknowledge that the reactions of the child due to the sound of crackers is real and not a tantrum. It can be taken care of by Therapeutic Listening. But when the sensitivity is not taken care of and you are already on the Diwali day, then other things can be done. Headphones and earplugs offer instant comfort and relief. Noise-canceling headphones are the most effective, because they replace irritating environmental noise by producing calming white noise. Earplugs are usually made of either foam or wax, and it is worth trying both types to determine which is more comfortable. You can take a break from your city and move to safe and quiet environments. You can show the child what the source of the sound is with small crackers such as gun rolls if comfortable. On several occasions, the anxiety of the child is because he does not know what the sound is and where is it coming from. I am sure you know the power of distracting your child. By giving them something like an iPad to focus on or an unusual privilege such as bringing along a favorite toy from home, it becomes possible to direct attention away from the offending noise.

 

Lots of homemade sweets and chocolates to munch on :

There are a lot of sweets that we eat during Diwali. It will be a good idea to give them in moderation to our kids. Research suggests that children are more sugar sensitive than adults, and the effects are more pronounced in younger children, according to Dr. Keith Conners, author of Feeding the Brain. This could be related to the fact that the brain grows rapidly in the preschool years, exaggerating the effects of sugar on behavior and learning. While studies show that activity levels go up in both hyperactive and normal children on high- sugar diets, the hyperactive children also become more aggressive.

 

Diwali is special and fun…so let’s make it fun for our kids as well….

Wishing you all a very happy Diwali…….

Reena Singh

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Occupational therapy and Children.

 

A lot of parents who come to meet me for the first time- ask me if I am an Occupational therapist? And when I answer yes – the question is “what do we do?” and what exactly is Occupational therapy?”

The main job responsibility of an Occupational therapist is to put the person back to his Occupation. Occupational therapists works with various strata of people right from schools to hospitals to geriatric care.

Since I have explored my role of an Occupational therapist with kids, I would like to describe more about how we help the kids. Also, my explanation or description is only about my experience and it does not in any way limit what Occupational therapists do in various other setups in which they specialize.

 

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Do kids really have an Occupation ?

Does Occupation mean only working to earn money or it means constructively and independently engaging in activities which we love?

Some of the roles in a child’s occupation are

To play and make friends

To take care of his own self care needs

To be able to learn in school

To be able to participate in all events or activities that happen in his or her community.

Does the child need any skill to be able to do the Occupation of a child?

What does he need to play?

Early social play- this is the play which is mostly initiated by adults in the form of silly sounds, peek a boo etc. Infants as young as 6 weeks start learning and setting the base for later language development. Infants learn to pay attention, understand the use of language by adults and learn to read the intentions of the care givers. There is a lot of base being set in play for future development.

Exploratory play- Child is learning to explore the environment through the sensori-motor play by banging toys, mouthing them, throwing them, smelling them and feeling them. They are little scientists in making who need the inquisitiveness and the intrinsic motivation to sustain the exploration and to make that exploration fun. Main focus is on their own bodies. They are developing a large repertoire of sensory experiences and also laying foundations for body scheme which will be needed for motor planning or praxis. Lot of learning is happening till this time roughly from 6 months to around 15 months of age.

Constructive play – They learn about cause and effect, simple fixing, pulling and stacking from around 12 months of age. In doing so, they are training their postural muscles, attention skills and also gross and fine motor skills. They are learning to effectively use their body while they are playing. The play becomes more goal oriented and they learn to expect results of making a tower of cups or blocks or stacking rings and completing them. Their little brains are also developing social connections of getting praised for their attempts and also a lot of language development is happening.

Pretend play- this starts as early as one year of age where the infant is holding a remote to his ear and pretending to talk on the phone. They are trying to eat from a empty bowl with a spoon or drink from an empty cup. First words emerge with pretend where they learn the names of objects that they play with. When a sequence of play is done, they learn to understand two word sentences and even understand “first- then” relationships.

Parallel play- Children play next to each other and not with each other. They learn by observing their peers. Lot of imitation skills develop at this stage. Their own basic level of pretend play is expanded and extended by observing other kids. Their language skills also expand and they also learn to coordinate their actions with other kids. They are also learning to manage their own materials and toys.

Socio- dramatic play- This play emerges at around 30 months of age. They play simple doctor doctor, fireman, lift man or whatever that they are exposed to. So the play develops language which they use to convey their imagination to other kids. They also learn to mind-read whether the other child is interested in them or not. They start developing preferences for those who listens to them or understands them well. Inter-personal relationships start developing by now and whole big world of social development is now open for learning. They are learning to incorporate their friends ideas in their own play and thus learning what to and what not to imitate. They learn to act out their fears and adults help them to understand how to express and how to manage fears and anxieties. They are learning a very critical skill called self regulation. They are learning to manage their own toys and maneuver within space- not to wander away too much. They are also learning to organize their behavior through self regulation.

Games- Kids start this from 48 months of age and stay through life. Here is where the abstract language starts developing. Games such as hide and seek, stone, paper scissors start coming in.

So what exactly does a child need to perform the occupation of play?

I am sure by now you must be convinced that a lot of skills are needed in just playing and these skills lay the foundations for further learning and development. An Occupational therapist’s role is to help the child to play by checking where is he stuck in development because of what reasons and to take him from where he is stuck to restart the process of development that has stopped. All that is done is to provide the child with the right opportunities which he did not get and got stuck. Using activities to assist play is what an Occupational therapist will do to assist play.

Self care needs include

Eating – requires fine motor skills and good eye hand coordination, requires good integration of the tactile input so that the child is fine with messy food textures. The development of the oral motor system is also important as kids may stuff their mouth with food because of not being aware of food or become picky eaters. Kids also need to have developed interoceptive sense so that they know when they are hungry or thirsty and also to know when they need to stop eating or when they are full.

Dressing- This requires a good body scheme and also good coordination to be able to dress and undress independently. Tactile system also needs to be developed so that all fabrics are tolerated well.

Grooming and Bathing-Again tactile system and a very good body scheme is very crucial because kids have to be comfortable with brushing teeth, washing hands, wiping hands and so on. And when the body scheme is developed well, kids will be able to plan the actions well.

Toilet- Child needs to have good interoception so that they know when they need to use the toilet. Good coordination and body scheme is needed to clean themselves after bowels

Manage space and community mobility – how far they can go how safe is “safe”. They understand that it is safe to go to a neighbors house on the same floor but not safe to go to neighbour’s house on a different floor. They gradually expand their limits and start understanding that it is safe to go to a neighbour’s house in a different wing of the same building or a different building.

What do kids need to learn in school?

Visual perceptual skills

Attention

Fine and gross motor skills

Integrated primitive reflexes

Most of the above skills develop when the child gets enough opportunities to play while young. However, sometimes there is a scatter in development because of prolonged illnesses or a medical diagnosis.

What do kids need to be able to participate in the community activities or events?

Self concept

Self confidence

Self esteem

Inquisitiveness

The base of the skills is built on opportunities that the child receives when he is very young and playing.

So, the role of an Occupational therapist is to check what is coming in the way of the development and what is stopping the child from performing his Occupation. Some of them are

Poor body scheme

Poor fine and gross motor skills

Poor visual perceptual skills

Poor pretend and imagination skills

Poor mind reading skills

Poor attention and concentration

Active Primitive reflexes

Inadequate development of postural or righting reflexes

Difficulty coping with academics because of poor handwriting, reading or spelling skills

Poor self help skills

Poor confidence

Low self esteem

No inquisitiveness

Poor self regulation

Poor management of space

Poor eating habits /picky eating

Delay in toilet training

Not understanding when to stop eating

Difficulty understanding Social skills or abstract concepts

Difficulty making friends

 

All of the above is developed by engaging the child in meaningful activities suited to their level of development and developing a Occupational therapy plan where the goals are decided monthly. Goals need to be revised monthly or quarterly and assessment needs to be done to check how much progress is achieved. Goals need to be modified if the child is not improving and all of this needs to be done according to how normal development happens for any other neurotypical child.So when an outsider sees an Occupational therapist work with kids, it just looks like play and fun…..But there is a lot of deeper work happening within the therapist to make that work look like fun and play!!!!

 

Hope I have done justice in explaining about what Occupational therapists do, fellow OT’s reading this, feel free to add more whatever that I have missed.

Reena Singh

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Autism and Therapeutic Listening

It was a long day at work in June 2013 and I was waiting to finish seeing the last child and go back home. And here came the Barbie doll who actually looked prettier than Barbie and had a cute smile on her face. After going through the papers, I found that she is in the spectrum of Autism and was referred to me through a parent.

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Barbie did not talk and was three and half years of age when I met her for the first time.

  • She had no receptive language and did not follow any instructions at all. The only way she communicated was by taking the person to the object.
  • She was not settling in the regular school and was extremely rigid in her behaviors.
  • She had a good eye contact.
  • She was not toilet trained and did not enjoy being with kids rather she did not even acknowledge their presence.
  • Parents were really concerned regarding her rigid behaviors.
  • She could sing songs and tunes but did not use her speech for communication.

We started her on Occupational therapy sessions thrice a week. We added Therapeutic Listening, Astronaut training and Sensory integration to her therapy program.  After 3 months of therapy, there was a long break because parents had to focus on the elder sibling who was getting left out because of Barbie’s therapy and they needed time to balance both. We saw Barbie after 6 months and there was just slow progress rather she was so rigid that therapists had a tough time to just settle her. There were a lot of sound seeking behaviors when parents decided to start therapeutic listening at home along with therapy. We did only modulation chips with her for three months.

I saw her now when she is going to turn 5 in two months. Parents were delighted with the changes. Her mom who was so dull and low when she met me for the first time and  was all glowing and had so much to tell me now. She was really not letting me talk. Her mom went on to say that Barbie is very communicative now and uses sentences to communicate for her needs. She has also started sitting in the class and following all the instructions given by her teachers. She has also started writing which was a major concern earlier.

With respect to her social skills, she has now started playing with kids. She still cannot maintain the conversation but her initiation and interest in kids has improved and she prefers to be with kids rather than being at home. She is very aware of everything and has also learnt to complain and tease. Barbie feigns coughing to get her favorite cough syrup. When mom smiles, she runs away. Barbie’s grandfather took her cup to have his coffee. She was furious and went straight to her mom and complained about it. Mom was in tears and so was her grandfather to see her complain in her own sweet way. Tutors come home to teach Barbie’s elder brother and she greets each and everyone and strikes a conversation with them in her own way. She is still not asking questions but started using “where” questions.

And here is another development with her play skills– Barbie can do pretend play now! After Raksha Bandhan, she puts the dupatta on her head, takes her plate and ties a string to her brother every other day. She takes her mom’s cosmetics and does her complete makeup. Mom was very angry and asked her what she was doing, to which Barbie cutely replied that she is a “dulhan” (bride). She wears new clothes from the cupboard and then asks mom to take her picture and then comments” beautiful” to herself.

I was really in awe after seeing the improvements that our little Barbie has shown and waiting to see much more.For more details on Therapeutic Listening Click here and check more case studies.

 

Reena Singh

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