Discrete Trial Teaching

By Amy Zier, M.S., OTR/L and Kimberly Garvey Hoehne, M.A. What is Discrete Trial Teaching? Discrete trial teaching (DTT), often used in Applied Behavior Analysis (ABA) programs, is a methodology aiming to help children learn developmentally appropriate skills of imitation, receptive/expressive language, pre-academic concepts, social relations, toy/peer play, and self-help/adaptive abilities. A discrete trial consists of an instruction or question to the child, the child’s response, reinforcement or consequences, and prompting, followed by fading prompts, as necessary. Skills are broken down into small, manageable tasks according to the child¹s level of ability.  The method promotes natural learning by teaching children how to learn from their environment. What does sensory processing have to do with DTT? Children who have difficulty processing sensory information often cannot efficiently utilize the range of learning activities used in discrete trial teaching. They may respond to the daily experience of touch, movement, sight and sound with a variety of negative behaviors and be unable to sustain…

Writing Skills and Autism, ADHD and Other Developmental Delays

Here’s help about writing skills and autism, ADHD and other developmental delays. Given the right environment, handwriting can be fun. You may be familiar already with the Handwriting Without Tears kits, available from Therapro <www.therapyproducts.com> or 1-800-257-5376. Let’s look at four other programs designed to help children who strive to write legibly. 1) Callirobics (from CALLIgraphy and aeROBICS) is a series of simple exercises set to music. This self-guided, creative approach, devised by handwriting expert Liora Laufer, is for home or school use. The multisensory exercises improve: eye-hand coordination fine-motor skills self-esteem and work habits Many children succeed with Callirobics because the activities are brief (one to three minutes apiece), and the task of tracing abstract shapes is easily grasped. Exercises are set to appealing music such as “Danny Boy” and “London Bridge,” as well as to original melodies. Each program comes with a workbook and audiocassette. Two levels of Callirobics are available: Pre-Writing Skills with Music (ages 4-7), and…

Prioritizing Interventions for Autism, PDD-NOS, SPD and ADHD

by Patricia S Lemer, M.S. Bus., NCC, Chairman of the Board, Epidemic Answers Families sometimes share that they are confused about the order in which to pursue interventions for their child. They hear from well-meaning friends, parents and teachers about the benefits of various treatments. Which should they try? B6 and Magnesium? Auditory training? Special glasses? Tutoring? If only a sequence were available to guide them…. My editorial attempts to grant your wish. I have devised the following chart to clarify how to prioritize interventions for autism, PDD-NOS, SPD and ADHD. OPTIMUM THERAPIES AT EACH AGE LEVEL Age Primary Therapies Secondary Therapies Extra Fun Therapies 0-3 SI-based OT/PTNutrition Speech/LanguageOsteopathic Movement 4-7 SI-based OT/PTSpeech/Language Speech/LanguagePlay Therapy Music Therapy 8-12 Vision TherapyAcademic Speech/LanguagePsychological Martial ArtsPerceptual-Motor 13-18 PsychologicalAcademic Vision TherapyNutrition Hippotherapy 19-Adult Social-EmotionalVocational AcademicNutrition Hobbies Remember that every child is unique. Find experienced professionals within each specialty who will take a very thorough developmental history before suggesting an individual protocol. Then, get a…

“Over the Counter” Occupational Therapy Strategies for Teachers

by Tammy Wheeler, MS., OTR/L, and Diana Henry, MS., OTR/L All teachers want their students to succeed. Many teachers, however, are overwhelmed with the huge responsibility of providing quality education for students with different learning levels and needs. Without specific training, educators may misinterpret sensory processing deficits and/or attention deficit-like behaviors and may think that referrals for medications are the only solution. There are alternatives to drugs, fortunately. These “over the counter” options are low cost and enjoyable, have no side effects, and can help every student succeed. Magic potions? No, sensory-motor activities! Equipped with the knowledge of how sensory-motor development impacts learning and behavior, occupational therapists are providing “user-friendly” OT strategies to teachers, students and parents. The therapists show educators how activities can be easily integrated into the classroom to help students learn and feel good about themselves. We can all see that children love movement; in fact, they often crave it. There are many types of movement. Rhythmic,…

Farm Therapy: A Natural Approach to Improve Sensory Integration

by Lois Hickman, OTR Occupational therapy on a farm, with real jobs that must be done regularly to maintain the land and the animals, improves sensory integration, self-awareness, and relationships with others. Farms, like children, involve growth, nurturing, hard work – and down-to-earth fun! The connectedness inherent in this way of life can promote healthy change at all levels for children with developmental delays. The interconnection of the natural rhythms of weather, seasons, daily responsibilities, play, music and dancing, story and song can bring especially important life experiences to individuals with physical, emotional, or intellectual challenges. Children with an aversion to touch may overcome this defensiveness when the goal is preparing a soil bed for flowers or carrots, or brushing angora rabbits to collect hair for spinning and weaving. An incentive for conquering the fear of being off the ground may be climbing the ladder to the barn loft to get cartons before gathering eggs. Children with physical challenges or…

Goodness-of-Fit of a Multidisciplinary Team for Special Needs Children

by Susan Snell, MA., MS., Educational Consultant, St. Columba’s Nursery School, Washington, DC, and Family Therapist, Fairfax, VA For many parents, finding the “right” service providers for their child is a challenge.  Most parents initially experience this process as they choose a pediatrician.  There must be a “goodness-of-fit” in your multidisciplinary team for special needs children. For some, this is as simple as following the recommendation of a neighbor or going to the first practice listed in the managed care provider booklet.  For others, this process includes careful investigation, interviews, and even a trial run before feeling comfortable with their choice. The process is similar when parents seek other pediatric specialists. Many children see a speech/language pathologist or an occupational therapist on a weekly basis. Others go for vision therapy or nutritional consultation; some work with social workers or play therapists.  The success of any treatment relies partly on “goodness-of-fit” between the therapist, the child’s receptivity and capabilities, and the…

Sensory Processing Disorder Early Intervention

by Carol S. Kranowitz, MA Every day, Sensory Processing Disorder receives new recognition as a common problem among children.  Recognition is good, but those of us who know about it and see the benefits of a healthy sensory diet want more.  To prevent sensory integration dysfunction from hindering our children’s development, we want Sensory Processing Disorder early intervention and identification. One way to encourage parents, teachers, and other early childhood professionals to address SI dysfunction is to help them see it as a developmental problem.  Kids don’t grow out of Sensory Processing Disorder; they grow into it, unless we spot it and treat it — the sooner, the better. Early identification is often possible if children attend a center with an occupational therapist (OT) or a savvy teacher on staff, who can observe their behavior over time. Sensory Processing Disorder can also be detected by a pediatric team using a multidisciplinary approach.  Another avenue is a screening.  A screening is…

What Is the Difference Between Autism and ADHD or Other Developmental Delays?

Those of you who have struggled though the maze of medical tests and diagnoses know that the difference between autism and ADHD or other developmental delays such as pervasive developmental disorders or Sensory Processing Disorder are sometimes difficult to distinguish. It is true that a diagnosis can be helpful from a medical point of view or for insurance reimbursement. However, when one focuses on appropriate therapeutic treatment and educational programming, the label is of far less value. An emphasis on physiological status and sensory processing works from the inside out; the focus is on each child, not the diagnosis. Inside out treatments ready a child’s body for learning at all levels.  A generalist starts by taking a health and developmental history. Many clues are there as to why a child may have had function and lost it or never gained it in the first place.  Digestion, neurology, metabolism and the immune system take priority over sensory processing. If any of…

ADHD Causes

ADHD Causes

ADHD Causes

Kelly Dorfman, MS, LDN, discusses ADD and ADHD causes. Attention Deficit Disorder (ADD), with or without hyperactivity, is a subjective diagnosis that physicians apply to a standardized cluster of behaviors and symptoms. ADD/ADHD is on the “less severe” extreme the autistic spectrum, with PDD (pervasive developmental delay) and autism on the “most severe” end. Doctors sometimes “upgrade” autism or PDD to ADD or ADHD as sensory and cognitive function improve. Identifying ADD and ADHD causes assists in determining effective treatments. Attention deficits can result when one or more of the following areas is affected. Biochemical/Nutritional Nutritional Culprits Nutrition alters brain chemistry. When nutrition is compromised, the body is more likely to absorb toxins, causing further distress. Keeping a record of your child’s nutritional intake over several days can be enlightening. Look for these commonalities: A high carbohydrate or sugary diet; Over two cups of juice or sweetened drinks per day; Limited or no vegetables- especially  green leafy ones; Picky eating….

Recovery from Sensory Processing Disorder, Reflux, Asthma, Eczema

Maria Rickert Hong‘s Children: Recovered from Sensory Processing Disorder, Acid Reflux, Asthma and Eczema, and getting healthier everyday! Let me tell you about my sons’ recovery from sensory processing disorder, acid reflux, asthma and eczema. I used to wonder a long time ago if these issues were related to each other and to their developmental delays, anxiety, failure to thrive and mitochondrial dysfunction, and now I know that they are. All of these issues are related to gut dysbiosis (in their case, a system Candida infection) and toxicity.  They are both full of heavy metals (mercury, lead, arsenic, cadmium). My older son is at the 97th percentile for heavy-metal toxicity; my younger one at the 90th. They both got it from me when I was pregnant with them.  I didn’t find out until after my older son was over 4 years old that we were all full of heavy metals. My concerns about my sons’ problems were dismissed by all…