TheraTree Pediatric Therapy - TheraTree Blog #occupationalTheraTree Pediatric Therapy - TheraTree Blog #occupationalhttps://www.theratreepeds.com/blogs/tag/occupationalWed, 12 Nov 2025 18:51:04 -0800http://zoho.com/sites/<![CDATA[Animal Assisted Therapy]]>https://www.theratreepeds.com/blogs/post/AATOur Animal Assisted Therapy program has begun with Bo the Certified Therapy Dog!]]>

Animal Assisted Intervention

Our Animal Assisted Therapy program has begun with Bo the Certified Therapy Dog! 


Animal Assisted Intervention (AAI): An alternative or complementary type of therapy intervention that includes the use of animals as a means to deliver therapeutic intervention in a treatment. Animal-assisted interventions are goal-oriented and structured interventions that intentionally incorporate animals into health, education and human service for the purpose of therapeutic gains and improved health and wellness. There are  three specific delivery methods of AAI: 

  • Animal-assisted therapy (AAT)

  • Animal-assisted education (AAE) 

  • Animal-assisted activities (AAA)

Animal Assisted Therapy

Animal Assisted Therapy (AAT) is a complimentary type of therapy intervention; meaning, it’s added and incorporated into the child’s existing therapy plan of care and goals. The therapy clinician determines if using AAT will help forward progress of your child’s current established goals. If the clinician and family agree that AAT could be beneficial for the child, the clinician will create the therapeutic interventions within their scope of practice that are goal-oriented, planned, structured, documented, then invite the certified Therapy Dog and it’s certified handler to the appointment. 

Examples of AAT:

  1. A child learning to button dresses up the dog in a button down shirt.

  2. A child working on speech skills gives the dog commands like “sit” or “stay”.  

  3. A child who is afraid of heights jumping with the dog from a platform. 

Key Features of AAT:

  • Must be overseen by a health and human service provider as part of their profession. 

    • A wide variety of disciplines might incorporate AAT include physicians, occupational therapists, physical therapists, certified therapeutic recreation specialists, nurses, social workers, speech therapists and mental health professionals. 

  • Must incorporate the animal as part of his or her own specialty. 

    • Clinicians acknowledge and work within their own level of competence, education, licensure, and skill set.

    • Example: A social worker must incorporate the animal in the context of social work. If the same social worker takes the animal to visit a group of children on an informal basis, the visit would be considered AAA, not AAT. 

  • Interventions are planned and goal-directed. 

    • Activities and interactions with animals are goal-specific and measurable, such as improvement in range of motion or fine motor skills. 

    • The goals must be identified and defined in the plan of care before the session or the session can't be considered AAT.

    • The activities may or may not include direct contact with dog. 

    • The focus of treatment is on the therapeutic process and outcomes. This may include the set-up, planning, and organizing of activity, additional preparation for dog, rather than just completion of a task.

  • Documented and Billed. 

    • Each session is documented in the client's record, with the activity and progress noted. 

    • Because AAT is incorporated into an existing skilled therapy treatment (not a separate service) the intervention is billed as usual to insurance reflecting the purpose of the intervention.

Animal Assisted Education

Animal Assisted Education is a goal-oriented, planned and structured intervention directed by a general education or special education professional. The focus of the activities is on academic goals, prosocial skills and cognitive functioning, and student progress is both measured and documented. 

Key Features of AAE:

  • Overseen by a credentialed general or special education teacher.

  • Planned and goal-directed. 

  • While any visit with an animal might be beneficial for a student, unless the goals are identified and defined before the session, the session is not considered AAE.

  • Documented in an educational setting this may mean it is part of a specific lesson plan or has an associated assessment which documents student progress. 

  • In special education, it may be part of an Individualized Education Plan.

Examples of AAE: 

  • Classroom presentation as part of a unit on responsible pet ownership.

  • An elementary school coordinates a reading program for youth with speech impediments to practice reading aloud to animals. The session is supervised by the speech therapist who records student progress.

Animal Assisted Activities

Animal Assisted Activities provide opportunities for motivational, educational and/or recreational benefits to enhance quality of life. Although these activities are more informal in nature, they’re delivered by a specially trained professional, paraprofessional and/or volunteer in partnership with an animal. 

Key Features of AAA:

  • This does not occur during a healthcare type setting - this is not the type of intervention completed at TheraTree
  • Specific treatment goals are not planned for each visit 
  • Content is spontaneous and may only last a few minutes 
Examples of AAA:

  • Volunteer type situations at events, or meet and greets 

  • Animal interacts with a non-patient in a healthcare setting

  • Although the term “pet therapy” was widely used several decades ago, it should be avoided, because it’s inaccurate and misleading. The currently preferred terms imply that the animal is acting as a motivating force to enhance the treatment provided by a well-trained person. 

  • Animal-Assisted Crisis Response (AACR) A subset of animal-assisted activities, animal-assisted crisis response provides comfort to those who have been affected by natural, human-caused or technological disasters. The response environment has the potential to be complex and unpredictable. 

  • Animal-Assisted Workplace Well-Being (AAWW) A subset of animal-assisted activities, animal-assisted workplace well-being incorporates therapy animal interactions in workplace settings, for benefits that range from stress reduction and decreased blood pressure to socialization and community building, along with the potential for increased productivity. 

Benefits

The goal of animal-assisted intervention is to address and improve a patient's goals which may including but not limited to the following: 

The Human-Animal Bond (HAB)

A mutually beneficial relationship between humans and animals. Animal-assisted interventions exist because of the power of the bond which has beneficial psychological and physiological outcomes for participants. While we often focus on the benefit to humans receiving AAl, it's important to remember that animals also experience benefits from their relationship with humans. It has been found that companionship and social support helps pets and animals live longer, healthier lives. 

Physical

  • Fine and gross motor skills

  • Wheelchair skills

  • Standing balance

Cognitive

  • Attention skills

  • Sequence

Empathy

Identifying with and understanding the feelings and motives of others. Studies report that children who live in homes where a pet is considered a member of the family are more empathetic than children who live in homes without pets. Children might see animals as peers. It's easier to teach children to be empathetic with animals than with humans, because most animals have such straightforward body language. As children age, their ability to empathize with animals generally carries over into their experiences with people.

Outward Focus

Bringing individuals out of themselves. Interactions with animals can help people who tend to focus on themselves pay more attention to their environment. Instead of thinking and talking about themselves and their problems, they can watch and talk about the animals.

Educational

  • Increase vocabulary

  • Aid in improving long- or short-term memory

  • Improve knowledge of concepts such as size and color

Nurturing

Promoting the growth and development of another living thing. Nurturing skills are learned. By being taught to take care of an animal, children who haven't learned nurturing skills through other channels can develop them. Furthermore, a person who is engaged in nurturing activities is also, to some extent, fulfilling his or her own need to be nurtured.

Rapport

Building a relationship of mutual trust or a feeling of connection or bonding. In therapy settings, the presence of an animal in the therapist's office can help clear a path through the client's initial resistance and open a channel of emotionally safe, nonthreatening communication between the client and the therapist. Children are especially likely to project their feelings and experiences onto an animal.

Acceptance

Offers favorable reception or approval. Animals have a way of accepting without qualification. They don't care how a person looks or what the person says. An animal's acceptance is non-judgmental, forgiving, uncomplicated and unconditional.

Socialization

Seeking out or enjoying the company of others. Studies have shown that when dogs and cats come to visit a care facility, there's more laughter and interaction among residents than during any other entertainment or therapy time. In an inpatient setting, the presence of animals encourages three types of socialization:

  • 1. Among clients

  • 2. Between clients and staff

  • 3. Among clients, staff, and family members or other visitors

Mental Stimulation

Occurs because of the opportunities that animals provide for communicating with other people, recalling memories and entertainment. In situations that are depressing, the presence of animals serves to brighten the atmosphere, increasing amusement, laughter and play. These positive distractions might help decrease people's feelings of isolation.

Physiological Benefits

Much has been written about the correlation between touch and health. Infants who are touched very little might have difficulty developing healthy relationships with other people and might fail to thrive and grow physically. For some people, the touch of another person isn't acceptable, but the warm, furry touch of a dog or cat is. In hospitals, where most touch tends to be painful or invasive, the touch of an animal is safe, non threatening and pleasant. In many programs for people who have been physically or sexually abused, staff members and volunteers aren't allowed to touch the clients. In these places, having an animal to touch, hold and hug can make a world of difference to people who would otherwise have no positive, appropriate physical contact.

Motivational

 Positive effects on the basic functioning of the body. Some consider a biopsychosocial framework for AAT, since it affects clients on biological, psychological, and social/environmental levels (Blazina, Boyraz, & Shen-Miller, 2011). An extensive amount of research shows the medical benefits of spending time with animals. The Centers for Disease Control and Prevention list some benefits as: Lowered blood pressure, Lower cholesterol, More likely to exercise, Lowered risk of diabetes, Lowered cortisol (Fine, 2019a). In fact, oxytocin (the “love hormone”) plays a large part in our connection to animals. Oxytocin is the hormone that is released to help parents bond with their children and when people fall in love. It helps us feel good and allows us to feel emotionally secure, content, and happy. Oxytocin also increases in humans when we spend time with animals; we naturally feel better when they are around (Compitus, 2021a). Tests have shown that the decrease in heart rate and blood pressure can be dramatic. 

Request Animal Assisted Intervention

If you would like to Animal Assisted Therapy to be included in your child’s therapy: 

  1. Email Contact@theratreepeds.com

  2. Discuss AAT with your child’s therapy clinician at your next appointment. 

Qualifications of Animals & Handlers 

At TheraTree we have a commitment to excellent and evidence based care. Therefore, it’s our policy for clinicians to first complete a 5 hour Animal Assisted Therapy continuing education training which is free, internal, a credit toward required state CEUs, and at their own pace before incorporating AAT into treatment. 

Handler Standards: 

  • Must be the active handler during the dog's certification tests and maintain certifications.  
  • Handlers must be able to act quickly enough to remove themselves and their dogs without assistance from a facility in the event of an emergency. 
  • Must maintain Current Animal First Aid Certification 
  • Must maintain professional liability insurance.

Animal Behavior Standards:

  • Must complete the following standardized behavior certificates.
    • AKC Canine Good Citizen Certified 
    • AKC Community Canine Certified 
    • AKC Urban CGC Certified 
    • Alliance of Therapy Dogs Certified
  • Must pass on site competency by TheraTree’s AAI Coordinator 
  • Affect: enjoyment, relaxed, confident, focused 
  • Interactions: welcomes attention from stranger, interaction in suitable ways, neutral when encountering other dogs, maintains good communication with handler, 
  • Obedient: exhibits self control, reliable, predenticle, controllable, responds to basic obedience cues. 
  • Safe: maintains loose leash, stay close to handler, licks only when cued, doesn’t vocalize, 
  • Equipment: Must have all the required equipment to promote safety and wellbeing. 
  • Leash: Maintains safe and close leash walking behaviors. 


Animal Health Standards:

  • Current on vaccination and certification of health by their veterinarian including: Bordatella (kennel cough) vaccine, Distemper, Adenovirus, Parvovirus, +/- Parainfluenza, Canine influenza, Leptospira, Lyme disease, Rabies (Titer levels of 0.5 IU or greater are acceptable and must be measured every two years to ensure levels are acceptable.)
  • Must be free of any signs of ill health while in the clinic. Animals with physical and medical disabilities must have veterinarian approval documentation that their disability does not pose harm or a safety risk to themselves or any other staff or patient in the clinic. Participation must not compromise the animal’s health and wellbeing. 
  • Dogs must be clean and well groomed. (See AAI requirements for specific definitions) 
  • Must be non-shedding.

The goal of animal-assisted intervention is to address and improve a patient's goals which may including but not limited to the following: 

]]>Mon, 29 May 2023 13:08:00 -0500<![CDATA[Preschool Readiness: What Parents Need To Know]]>https://www.theratreepeds.com/blogs/post/preschoolPreschool Readiness: What Parents Need to Know]]>

By Jessica Hatfield, MS, OTR/L

Preschool is a big step for both parents and child! As a parent of a 3 year old you might be wondering: “Is my child ready?” “Did I do enough?” “Can we please start tomorrow?!?”. Whichever space you’re in is fine! If you learn you child is on track - great! If you learn your child might need some more help - great! Now you know and can take actions on catching them up to their peers. 


It’s important to keep in mind that preschool is more about emotional and developmental readiness than knowing and writing all their numbers and letters. Those traditional educational/cognitive skills can be further taught through preschool. Developmental milestones are critical to establishing your child’s confidence and self esteem. Children who do not perform developmentally appropriate tasks may struggle with preschool. While it doesn’t mean they can’t attend preschool, they may need extra help now to prepare and catch up to their peers from therapists who specialize in child development like at TheraTree. 


Here are the big five areas we help parents look for: Emotional, Motor, Independence, Language, and Cognitive Development  

Emotional Development

Separation: Most children who are emotionally mature are eager to go to school and make friends. They can emotional handle being away from you for short periods of time.  The unknown of how the first day will go might be the most nerve racking part for parents. While it is normal for a preschool to be a little apprehensive or upset while saying goodbye the first day or even week, when they continue to be upset throughout the day it become a problem. A child who demonstrates fear, anxiety, worry, panic, or meltdowns when separating are clear red flag they need some extra support developing their emotional maturity. How to test this: Practice separation. Start with a short period of time (30 minutes) and work up to longer (4 hours). Drop them off at a trusted neighbor while you take a walk about the neighborhood. Leave them with friends while you run to the grocery store. Leave them with close family outside the household for a sleepover. Try out daycare for a day or two.


Willingness to Try New Things: Most children are curious to learn and explore. While they may (and hopefully do) demonstrate some caution in new situations, it’s typical for them to be willing to try something new. They will attempt new tasks knowing it’s ok to make mistakes. If you child refuses new experiences or even the thought of something cause fear or anxiety, this is a red flag they may need some extra help.


Transitions: They can generally transition between tasks quickly. Most preschools have a structure schedule throughout the day. Children are expected to transition between snack time, circle time, or play centers without much notice or verbal cuing. Similarly, when they have a usual routine, they should be able to anticipate what comes next. While is normal to show some disappointment when it’s time to leave their favorite task, they should be able to move fairly smoothly to the next task. If your child stay stuck on a task or demonstrates moderate upset, they may need some additional help. 


Social Skills: Is interested in engaging with peers. Generally children want to make friends. Now, they may not always be great at it, but there should be a desire to connect with others. Look to see if your child will smile, wave, greet others, recognize other’s emotions, take turns, share, follow rules and limits, and cooperates when playing in a group.


Response to Problems: While a 3 year old is clearly not equip to solve problems like an adult, their response can tell you a lot about their emotional maturity. Do they show concern for friends. Will they attempt to use works when they're angry or frustrated or do they first act with physical aggression?  Will they attempt to use please, thank you, and excuse me to help prevent problematic situations. Do they attempt to help friends when needed. Is their behavior is easily redirected.


Need help with any of these skills? Ask for an Occupational Therapy and Behavior Therapy Evaluation to improve your child's skills in this area. 

Motor Development

Gross Motor: These are big body movements, usually move a child across space.

  • Enjoy outdoor play such as: running, jumping, climbing
  • Navigate a set of stairs with alternating pattern
  • Ride a tricycle
  • Bounce a ball
  • Kicks a ball
  • Throw and catch a ball
  • Hops 3-5x on each foot
  • Navigate around obstacles in environment 


Fine Motor Skills: These are smaller more precise movements, usually done with the hands and fingers.

  • Puts together a simple puzzle
  • Makes continuous cuts with child-safe scissors
  • Cuts a piece of paper in half with scissors
  • Draws with a crayon, marker, or pencil
    • Hold using their fingers vs their whole fist
  • Copies a vertical and horizontal lines and circle
  • Traces around the edges of basic shapes
  • Interested in writing letters and numbers (although may not be able to form the correctly)
  • Stacking and building with blocks 
  • Holds a book properly and turns pages
  • Begins to show if they prefer their right or left hand

Need help with any of these skills? Ask for an Occupational Therapy and Physical Therapy Evaluation to improve your child's skills in this area. 

Independence Development

Dressing Self: And enjoys doing this! 

  • Puts shoes on correct feet
  • Fastens large buttons
  • Attempts to smaller buttoning, zip their coat
  • Attempts to tie shoes
  • Putting on their own coat and other cold-weather gear


Brushes Own Teeth: May not be 100% accurate, but engages independently 


Potty trained: Most preschools do expect children to be potty trained. Independence with toileting is a skill that has a great impact on self esteem. Now, it’s not uncommon for children this age to still need help with washing up or even may have an accident on occasion. However, this may not be a requirement at all pre-schools or if your child has extenuating circumstances.


Self feeding: Be able to feed themself a snack or smile meal. This may be a little messy but food should not everywhere. Attempts to use a napkin to wipe their face and clean up dropped food (even if they’re not accurate) 


Independent Play Skills: 

  • Play on their own without needing interaction or constant redirection from adults. 
  • Find their way around the space/room.
  • Pick an activity from choices in a learning/play center. 
  • Clean up their toys when asked 
  • Uses realistic toys in pretend play or to imitate household routines 
  • Engages in dramatic play with others to act out simple play scripts, such as playing house

Need help with any of these skills? Ask for an Occupational Therapy Evaluation to improve your child's skills in this area. 

Language Development

    Expressive Language: 

    • Talk in complete sentences 
    • Talk about everyday experiences
    • Begins to use descriptive language such as adjectives for color and size (“That’s a big dog with brown spots”)
    • Asks for help  
    • Tells or retells a story


    Receptive Language: 

    • Responds to “wh-“ questions (who, what, where, when, why) 
    • Understand expectations 
    • Remembers short sequences of events of 2 to 3 steps
    • Follows simple 3-step related commands ( ie, get your coat off the hook, put it on and get in line)


    Speech and Sound Production:

    • Uses most speech sounds correctly
    • Likes to imitate sounds and rhythm; might have a favorite song
    • Able to express themselves in a way that an unfamiliar adult can understand

Need help with any of these skills? Ask for a Speech Therapy Evaluation to improve your child's skills in this area. 

Cognitive Development

Literacy Skills:

  • Recognizes first name when written
  • Recite the ABC’s
  • Able to name capital letters
  • Able to name lowercase letters
  • Knows letter sounds 
  • Knows the main characters in familiar stories
  • Identifies rhyming words (ie, cat / hat) 
  • Enjoys reading books with others 


Math Skills: 

  • Knows their colors
  • Identifies shapes
  • Able to count to 10
  • Identifies numbers 1-10
  • Recognizes and matches small quantities to the number words 1, 2 and 3 
  • Shows interests in patterns and sequences
  • Match / sort / group /compare items 
    • by color and shape
    • bigger, smaller, 
    • heavier, lighter
    • over, under, above, below, through, front and back
  • Understands the order of the day, and begins to use some time words such as "morning" and “night"
  • Show an understanding of the passing of time


Science Skills:  

  • Identifies all the parts of the body
  • Draw a picture of himself/herself that includes a head, body, arms and legs?
  • Identifies all 5 senses (sight, smell, taste, touch and hearing)
  • Asks many questions about how things work 
  • Shows interests in tinkering with objects by taking things apart and putting them back together 
  • Considers and offers explanations of how things might work
  • Develops object permanence and understands that objects continue to exist even when out of sight 
  • Understands and explores empty containers and full containers

Need help with any of these skills? Ask for an Occupational Therapy, Behavior Therapy, and Speech Therapy Evaluation to improve your child's skills in this area. 

Next Steps

If you've learned you child needs more help, you're in the right place. At TheraTree we believe in partnering with parents to best help your child. Sometimes parents come in with guilt that they didn't ask for help sooner or they were more persistent with getting a referral. We're committed that no parent should feel like they missed the bus on an opportunity to help their child. When parents come in for an evaluation or one of our free screenings, it's always perfecting time because you're getting the help right now in the present moment. If you have any concerns about your child's developmental don't hesitate to ask for help! 


Call or Text 270-688-8449

Email: newpatients@theratreepeds.com 

Or click the button below! 
Get help now!
]]>Fri, 20 May 2022 19:21:59 -0500<![CDATA[Anxiety in Children ]]>https://www.theratreepeds.com/blogs/post/anxiety However, some children consistently demonstrate difficulty adapting because of a perception of danger surrounding a task. Particularly if there is un ]]>

By Jessica Hatfield, Ms, OTR/L

Children are constantly learning, growing, and adapting to their environment. Even when we give the most stable and routine environment, things still always and inevitably change. Change is normal and children seek to feel safe and secure.


It is important to note that some worry and stress is normal and even needed for survival. The primary purpose of our ‘fight or flight’ response is to keep us safe. Stress and worry are also useful to our growth because we are challenged to try different things. We want our children to grow and adapt for the ever changing pace of life.

However, some children consistently demonstrate difficulty adapting because of a perception of danger surrounding a task. Particularly if there is uncertainty or there has been a previously negative association. At time several less intense events can build up to cause an overwhelm. Both of these negatively affect their daily living. Pediatric anxiety has grown to be one of the major mental health issues facing children. Anxiety is experienced in the pediatric population at increasing rates. 7.1% of children aged 3-17 years (approximately 4.4 million) have diagnosed anxiety. (Ghandour 2018) 

What is Anxiety?

Anxiety is apprehension about the future. Behaviors will also begin to affect thinking processes. For example an expectation is unrealistic and in turn leads to ruminating or negative thoughts. Anxiety can cause negative mood and physical tension. There are many different types of anxiety including separation anxiety, OCD, perfectionism, social phobias, or generalized anxiety etc. Anxiety is different than fear and panic, although a person can experience these as well. Fear is an immediate alarm to current danger, physical arousal, and avoidance. Panic is fear at an inappropriate time. It’s abrupt, intense, and physically arousing.

What Causes Anxiety?

A variety factors can contribute to anxiety in children. Children may observe and replicate anxious behaviors of others. Life experiences may also trigger anxious feelings and behaviors. For example loss, serious illness, bullying, or other types of abuse. Genetic factors that effect brain chemistry can cause a child to be more predisposed to developing anxiety. 

What Causes Anxiety?

  • Agitation, jittery, or restlessness
  • Sleep Deprivation or nightmares
  • Easily upset or crying on a regular basis
  • Panic Attacks, heart pounding, palms sweaty, trouble breathing
  • Somatic symptoms of physical pains, e.g. headaches, tummy aches, nausea
  • Repeated behaviors or phrases that are familiar
  • Tantrums, including meltdowns before school about inconsequential issues like socks
  • Clingy to the point it is disruptive
  • Constantly seeking the reassurance from others
  • Tries to get others, particularly adults, to do things for them
  • Asks for assistance for tasks they can complete independently

Children  may say phrases like: 

  • Something terrible will happen. 
  • I don’t have any control over it. 
  • It will be my fault if it happens. 
  • I don’t know what to do!
  • I have to get out of here!
  • I need to know for sure that it’s okay
  • I can’t make any mistakes
  • Always on the lookout for danger and checking to make sure things are safe.
  • Dislike or avoidance of new or difficult tasks
  • Avoidance behaviors or trying to stay home from school
  • High expectations of self
  • Low self-esteem and confidence 
  • Delayed social skill development and difficulty maintaining relationships
  • Decreased motivation for certain tasks

Child might demonstrate a few of these behaviors occasionally and some of these signs may be cause by other factors not related to anxiety. However when negative, anxious behaviors become more common or intense, your child may qualify for an anxiety diagnosis. When experiences these frequently or at extremes, the natural protective responses triggered no longer serve as protective and become debilitating. High levels of anxiety can make it difficult for a child to participate everyday activities including school, play and friendships. When anxiety interferes with your child’s ability to play and learn, it’s time to talk to a professional.

What Causes Anxiety?

For children experiencing anxiety, it is a natural response for parents to want to step in and solve the problem. However this is not the best long term strategy to actually help your child with their anxiety. By removing or allowing your child to avoid, you are unintentionally reinforcing their anxieties and removing opportunities to develop coping skills and resilience. Therefore it is important to give your child the opportunity to work through their fears in order to develop these highly important skills. This is best done by working with professionals. There are several profession who help with anxiety: 

  • Occupational Therapists to apply concrete strategies. 
  • Psychiatrists and nurse practitioners to prescribe medication. 
  • Psychologists, social workers, and counselors to provide emotional support.

How Occupational Therapy Helps

Occupational Therapy (OT) can be thought of as the therapy of taking action! There are many ways we can talk to our children about their worries and fears, but by teaching them concrete strategies we empower children to become independent in their own lives! Occupational therapy providers step in to bridge the gap so children can learn to function and feel how powerful they really are when it comes to their thoughts and abilities. Occupational Therapy intervention addresses anxiety through the followings ways:


Proactive strategies

The purpose of proactive strategies is to prevent the anxiety from occurring. This provides a short term benefit but is not helpful long term as our environment is always changing and adaptability is a survival skill. Some proactive strategies include establishing routines, visual schedules, and adapting the environment (ex sensory-friendly environments, fidget toys, quiet corners etc). 


Teaching, Thinking, and Applying Strategies 

The purpose of these strategies are to increase both interoception and communication strategies so children can manage themselves to identify and prevent anxiety. These provide the most long term benefits in their life. These strategies include interoception, effective education, cognitive restructuring, and communication to adults about what they are experiencing and their wants/needs. 


Reactive Strategies

The purpose of reactive strategies is to help in the moment while a child is experiencing anxiety. This has both short and long term benefits. However the difficulty with teaching reactive strategies is bridging the concept of “what to do” with actually being able to recall and apply them in the moment. Generally these skills take longer to develop because of this. These strategies include Guided Imagery, deep breathing, distraction, quiet time, calm/comfort techniques


Parenting Strategies

As with all Occupational Therapy intervention, parent education is important. Parents have a big influence on how their child with learn and respond by the tone they set. Occupational Therapy Providers teach parents how to be both proactive and reactive with their child. They teach what not to do. Often parents need to utilize calming strategies of their own when interacting with their child who is in a heightened state of arousal. When children are in a heightened state, they may have difficulty understanding complex language. So simplifying the words spoken to them can have a big impact on their reaction. Occupational Therapy Providers also teach parents by example and self reliance. 


What's Next?

If you have any questions or concerns about your child please reach out to an occupational therapist at TheraTree. You can reach us by phone at 270-688-8449 or email at newpatients@theratreepeds.com.

Get Started Now

References:


Ghandour RM, Sherman LJ, Vladutiu CJ, Ali MM, Lynch SE, Bitsko RH, Blumberg SJ. Prevalence and treatment of depression, anxiety, and conduct problems in U.S. children. The Journal of Pediatrics, 2018. Published online before print  October 12, 2018 


Gobrial, E., & Raghavan, R. (2017). Calm child programme: Parental programme for anxiety in children and young people with autism spectrum disorder and intellectual disabilities. Journal of Intellectual Disabilities, 1744629517704536.

]]>Wed, 21 Jul 2021 17:32:20 -0500<![CDATA[Successful Developmental Milestones, Occupational Therapy Can Help! ]]>https://www.theratreepeds.com/blogs/post/developmentalOTChildren develop many important life skills during their first 5 years. If your child is not meeting the milestones expected for his or her age - Don’t wait! The earlier that a child’s developmental delay is identified and supports are put into place, the better the outcome will be for the child.]]>

By: Kaitlin Kralj, MS, OTR/L, ACSM-EP

Children develop many important life skills during the first 5 years of life. These skills are commonly referred to as “developmental milestones.”

   

Skills such as rolling over, smiling for the first time, babbling, waving goodbye, pointing, and taking first steps are examples of just a few of these developmental milestones. 

   

Even though children will develop at their own pace, most kids will reach these developmental milestones at around the same age. When a child is consistently reaching the developmental milestones at the normative age, it can be a good indicator that the child is developing as expected.

Performance Areas: 

Developmental milestones include several performance areas, such as:


Fine Motor Skills

- Small movements that are made with the fingers, wrist, toes, lips, and tongue

- Needed for eating, drawing, dressing self, writing, playing, etc.


Gross Motor Skills

- Moving, controlling, and coordinating our arms and legs with large muscle groups
- Important for sitting, standing, walking, running, balance, etc.


Cognition

- Thinking, learning, reasoning, remembering and problem solving


Social and Emotional Skills

- The ability to relate to others and express emotions
- Important for developing relationships, cooperating with others, and responding to the feelings of others.


Daily Living Activities

- Personal hygiene, eating, dressing, toileting


Communication

- Using body language, gestures, and speech


Common Developmental Milestones: 

3 Months 

  • Raise their head and chest while laying on their stomach
  • Turn their head towards a sound
  • Bring hands to mouth
  • Swipe at dangling objects with hands
  • Begin to imitate sounds or babble

6 Months

  • Roll both ways
  • Use their voice to express pleasure and displeasure
  • Sit with support
  • Respond to others’ emotions and enjoy social games (such as peek-a-boo)

1 Year

  • Pull up to stand on furniture

  • Use simple gestures (shaking head no, waving bye)
  • Poke with index fingeroke with index finger

2 Years

  • Use simple phrases
  • Walk without assistance
  • Point at objects
  • Follow simple instructions
  • Pull toys behind him or her while walking

3 Years

  • Begin sorting by shapes and colors
  • Play make-believe
  • Uses simple phrases
  • Walk up and down stairs
  • Run  
  • Pedal a tricycle

4 Years

  • Follow 3 step commands
  • Draw circles and squares
  • Name some colors
  • Understand counting
  • Share and take turns with others
  • Dress and undress themselves
  • Know opposites (big and small; hot and cold)

The cause of developmental delay is not always known. Some common factors include heredity, pregnancy complications, and premature birth.

 

Signs and symptoms of developmental delay will often vary. While signs can sometimes be recognized in infancy, there are also instances where the delay is not noticeable until the child is in school.


Reaching milestones earlier than expected means that a child may be advanced in comparison to peers of the same age. When a child is not reaching milestones during the expected time frame, or if they are reaching milestones later than their peers, their development may be termed as ‘“delayed.”  A developmental delay is more than being “a little behind” their peers. Children that are facing challenges with reaching developmental milestones may require extra support to help them reach their full potential.

Occupational Therapy Can Help

Occupational therapy practitioners work with children of all ages throughout the rehabilitative process. After collaborating with caregivers to identify the child’s needs and any potential barriers that may be impacting functional performance, the intervention process begins. Occupational therapy practitioners possess the skill and knowledge required to provide skilled intervention, parent education, and make equipment recommendations as needed to help your child’s development. Occupational therapists have skilled training in helping your child develop motor skills, self-help skills, problem solving skills, social interactions skills, and play skills.  


An occupational therapy practitioner will teach skills and/or strategies to help children and their families in all aspects of their daily lives. This process may include adaptations of activities, materials, and even environmental conditions so that children are able to participate in a variety of settings (including schools, homes, sporting events, community programs, etc).

Get Started Now

Fine Motor Skills

  • Manipulating toys and puzzles
  • Grasping a pencil
  • Coloring, drawing, tracing, prewriting strokes
  • Handwriting, letter/number formation
  • Cutting with scissors
  • Using silverware at an age-appropriate time
  • Using zippers, buttons, and shoelaces

Gross Motor Skills

  • Coordinating both sides of the body
  • Understanding the concept of right and left
  • Navigating up and down stairs
  • Upper extremity strength
  • Balance
  • Milestones such as rolling, sitting unsupported, crawling, pulling to stand, etc.
  • Using appropriate force
  • Throwing/Catching
  • Core strength
  • Crossing midline play activities and school related taskss

Visual Processing 

  • Recognizing letters, numbers, or shapes
  • Copying shapes or letters
  • Visual tracking
  • Stacking blocks
  • Copying from the board or another paper
  • Completing puzzles
  • Concept of right and left
  • Putting things in appropriate sized containers

Sensory Processing

  • Designing and implementing a sensory diet to decrease things such as toe walking, constantly jumping or crashing,
  • Responsiveness to certain sensations
  • Responsiveness to touch, sound, and movement
  • Calming self when upset
  • Therapeutic listening
  • Copying with change
  • Gravitational insecurities
  • Body awareness

Social Interaction

  • Interacting and engaging with family members and peers
  • Adapting to new environments
  • Coping skills
  • Following instructions
  • Social appropriateness
  • Conversation skills
  • Recognizing emotions
  • Impulse control

Executive Functioning

  • Organization
  • Attention
  • Flexible thinking
  • Problem solving
  • Time management

Play Skills

  • Sharing and turn taking
  • Imaginative play
  • Sustained attention
  • Exploring toys appropriately

Self Care Skills

  • Toileting
  • Bathing
  • Self-Feeding
  • Dressing
  • Tying shoes
  • Brushing teeth
  • Brushing hair

Early identification of developmental delay is key! 


It is important to remember that all children are different, and each child will develop these skill sets at their own pace. However, as a parent, you know your child best! If your child is not meeting the milestones expected for his or her age - Don’t wait! The earlier that a child’s developmental delay is identified and supports are put into place, the better the outcome will be for the child.

 

 If you are concerned about your child’s development, speak with your physician and check out our developmental screening tool here: 

Click Here: Developmental Screening Tool
]]>Tue, 09 Feb 2021 15:59:10 -0600<![CDATA[Part of our TheraTree Vision: Growing Minds]]>https://www.theratreepeds.com/blogs/post/Part-of-our-TheraTree-Vision-Growing-MindsBy Jordan Arvin, COTA/L A word from our Owner/CEO, Jessica Hatfield: ” It is my role to give children and families access to living happy, healthy, a ]]>

By Jordan Arvin, COTA/L

A word from our Owner/CEO, Jessica Hatfield: ” It is my role to give children and families access to living happy, healthy, and well balanced lives. This access is created through developing the skills and giving the tools for living life.


It's an access for their VOICE to be heard, their BODY to move, and to become INDEPENDENT...


It is my mission to create a community aligned in this vision; to give children and families access to happy, healthy and well-balanced lives through removing barriers.

Together, we grow minds, bodies, and spirits.

Growing MINDS by sprouting learning and strategies for life.

Here at TheraTree Pediatrics, our mission is: a well-balanced child mind, body, and spirit; a well-balanced family. In this blog series, we will discuss the parts of our vision, why they are important, and how we address these items at TheraTree. We do so through occupational, speech, and physical therapy.

Occupational Therapy

Occupational therapy is the practice by which therapists help children develop the skills they need to gain independence. One of my personal favorite things about pediatric practice is growing a child’s mind through play activities. As a child, your main occupation is play. It is so beneficial to use play activities to teach important skills children need to have. For example: attention span, socialization, turn taking, flexible thinking, and self-regulation are things that can be taught and improved upon through play. In your child’s OT session, they may complete a puzzle or play a game with their therapist. Some board games we use, and you could use at home to encourage a growing mind in your child, are:

  • Battleship
  • Uno, and other card games
  • Suspend
  • Spot It
  • Don’t Break the Ice
  • Jenga
  • Mouse Trap

Sensory

Sensory integration is another huge part of occupational therapy practice. Through integrating our senses, our bodies are able to perform tasks with increased independence, identify emotions and label body feelings as well as identify needs for self-regulation. Sensory integration identifies and focuses on the way our brain processes various inputs. Various sensory-based activities your child may do in occupational therapy include, but are not limited to:


  • Swinging
  • Crashing into foam pads
  • Jumping on trampoline
  • Deep pressure
  • Joint compressions
  • Spinning

School

School is probably the most obvious use of a child’s mind. We do see children in the school setting to assist with improved independence with school tasks. Occupational therapy can work with students on attention to task and ability to verbalize when help is needed. We frequently assist students with developing legible handwriting through activities and encouragement. We allow our students to develop their own minds by fostering a positive environment and giving positive and constructive feedback. The students that we see in school are assisted with improving reading comprehension and confidence with reading aloud and answering questions in class. We also teach valuable time management skills for completing school assignments. Our students often benefit from brain breaks at school. This is when a child is able to give their brain a break and move their bodies in order to improve their attention and focus in the classroom. Below are some YouTube videos that provide great brain break and sensory work for children: 



Mindfulness

Mindfulness is a word we use to describe a child’s ability to be aware of something. Yoga is a great way to encourage mindfulness in a child. Doing yoga allows a child to become familiar with their own body and relax from their anxieties. Practicing yoga and mindfulness on occupational therapy allows a child to develop their own plan for mindfulness and to be more aware of their feelings and identify ways to cope. There are many great benefits and resources for yoga:


  • Superman Pose: Stand with legs wider than hips, with arms up reaching high into the sky.
  • Triangle Pose: Feet spread wide, left arm swings down to touch right foot and raises back up to the sky. Repeat this with both arms several times. Remember to breathe!
  • Flamingo Pose: Raise one leg and rest it on the side of the other. Bring both hands up and 
together. Stretch your body up, balance, and breathe. 


Sequencing

Sequencing occurs when we break down an activity into smaller tasks, in order. Sequencing is addressed by OT and ST. A child needs the ability to sequence in order to perform activities of daily living, chores, school work, and simply moving around day to day. Occupational therapy assists with teaching the mind to sequence by practicing ADL tasks and teaching sequencing through games and brain activities. Speech therapy addresses sequencing by looking at the way a child understands a task and its proper order. 

Speech often uses “First ___” and “Last ____” or “First...then...” vocabulary to explain and understand sequencing with children.

Speech Therapy

Speech therapy grows a child’s mind by increasing a child’s ability to communicate and understand communication. Learning how to speak and say various letters is very much brain work. It is through speech therapy that these things are addressed and improved upon. Speech Pathologists work with children on expanding their communicative brains and understanding how or why they do, hear, and say certain things. Speech therapists work on growing a child’s mind through their ability to receive and express effective communication.

Physical Therapy

Physical therapy addresses gross motor skills, core strength, and stability among other things. How a child moves when running, jumping, etc. is gross motor. Learning these movements help a child not only become more independent, but also less accident prone and more agile. Growing a child’s mind through physical therapy gives them the brain power to motor plan and move their bodies as needed every day. Allowing a child to learn proper balance and core control gives them the freedom to use their minds to learn new information and enjoy new tasks rather than thinking about how to move their bodies.

How to get help

If you think your child would benefit from therapy services, you can:

  • Complete our Patient referral form HERE.
  • Contact our office for further information: (270) 688-8449 or contact@theratreepeds.com
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