DIY Cardboard Box Carwash

My son (once again) said, “Maybe go to the carwash today.”

OT mom said, “Instead, let’s play car wash!”

DIY CardboardCarwash Toy

My son’s current obsession is anything carwash. Just about everyday, he asks if we can go to the carwash when we are out running errands. His love for playing carwash inspired my latest activity idea: a fun, DIY crawl through car wash!

The kids can play with this several ways: by actually pretending they are the “cars” or using it to wash their big toy cars and trucks by pushing them through. It has proven to be extremely entertaining for their busy minds, and in addition to the great imagination and pretend play engagement it promotes, there are additional hidden benefits as well.

Super Fun & Easy

Crawling through the tunnel gives my kids a dose of proprioceptive input, which can do wonders for regulating the sensory system. Click here to learn more about proprioceptive input.

By weight bearing on extended arms during crawling, it also provides strengthening for the shoulders, arms, core, and even the muscles of the hands. Putting weight through open hands strengthens the arches in the hands- which will be important for the development of handwriting and other fine motor skills.

While pushing cars through the car wash tunnel, you may notice a child using one hand on the ground to stabilize, and the other hand to push the car through. This promotes dissociation of the two sides of the body and allows for practice with crossing midline and bilateral coordination skills. 

DIY

My son didn’t play with the car wash the same way the whole time this evening. He tried to wash his wagon, his truck, and he pretended to be the car. By moving his body (and toys) through the makeshift car wash, he had the opportunity to work on his motor planning  and praxis skills. The development of such skills relies on using novelty in movement sequences.

But the list goes on… we made our car wash “scrubbers,” as my son calls them, brightly colored and slightly different fabrics, so my daughter enjoyed the tactile discrimination aspect of playing with the wash. We added an “open” and “closed” sign for fun (and it stayed open all evening).  I was pleasantly surprised with my kids’ ability to take turns moving through the car wash and sharing their space- a thing I think most siblings have trouble with.

The bonus was that I didn’t spend a penny on this project- I used scrap fabric and a leftover moving box. It feels good to save money and reuse old items.

So here’s how I made it:

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I  started with an extra large moving box, with one end taped. Using a utility knife, I cut off the flaps from one side. (Please use caution with the utility knife).

Next, cut out a door for each side. Above the door, cut small holes about 1/2 an inch above the doorway.  I didn’t measure initially, I just eyeballed the size based on the size of my kids and their toys. It turned out to be  about 14 inches wide and just over 17 inches high.

DIY carwash

I used fabric strips to make the “scrubbers” (I had some leftover from another project or you could use scrap clothes, etc). I didn’t measure these initially, but they were about 2-3 inches in width by about 19 inches long.

Once you have your fabric strips, cut a small hole from about 1/2 inch from the end and feed that through a hole in the box. To secure, feed the opposite end of the fabric through the hole and pull snug. Continue until all the holes have scrubbers.

Since kids don’t seem to mind if things aren’t measured perfectly, it was a pretty quick project to complete.

DIY Carwash open

Just for fun I used some scrap cardboard and sticky-back velcro to make an “Open/Close” sign for the carwash. You could easily do this with markers or paint. It’s as easy as that!

If you decide to try this easy, beneficial DIY activity, please remember to keep your kids supervised for this activity!  I’d love to hear how your kids liked it!

DIY-1

*Disclaimer

Please use supervision with this activity, as young children or children with motor skills difficulties may get tangled up in the fabric strips.

The information presented in the blog is intended for information purposes only. Please consult your physician with any medical concerns and/or for medical advice. The information presented is not intended to be used in place of individualized therapy services, please contact your health care team for skilled therapy if you think it is necessary. Please supervise your children (or friends, spouses, etc)  if you decide to try any of the activities or ideas presented as the author or this blog does not claim liability for possible injury or negative consequences related to the activities and ideas presented here.

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Go Outside! (Reasons Why and Ideas for What to do While You’re Outdoors)

OT Mom says, “Let’s go outside!”

Dr. Dad says, “Let’s go outside!”

Finally, something we can agree on. When it comes to spending time outdoors, we are completely on the same page. Not only do we both enjoy it, we know there are countless benefits to outdoor time.

There is a growing base of evidence that identifies both physical and mental health benefits to spending time outdoors and in natural settings.

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In a 2015 Environmental Health Perspectives article,  Nate Seltenrich summarizes some of the benefits, “… research has shown that outdoor exercise in nature can enhance emotional well-being and amplify the benefits of physical exercise. And for kids in particular, being in or near green spaces has been found to be associated with better test scores, improved self-discipline and cognition, and reduced behavioral problems and symptoms of attention-deficit/hyperactivity disorder (ADHD).” You can find the original article, including the sources from the research here.

There’s even a movement for health professionals to prescribe time outdoors. Such “park prescription” programs aim to promote knowledge and information about the benefits of spending time in nature and community green spaces with the overall goal for increased individual and community health. The National ParkRx Initiative  is a great resource with more information about the health benefits that parks and green spaces can offer as well as resources for agencies that want to or currently participate in a park prescription programs.

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The best part about spending time in nature is it’s generally FREE. And whether it’s spending time in your backyard, a nature preserve, an urban green space, or any other park, there’s likely going to be benefits.

Now that you know some of the numerous mental and physical health benefits of nature, here’s some fun ideas to try if you don’t quite know what to do with your kids (or yourself) once you’re out enjoying the fresh air.

Walk, Jog, or Run

Try a stroll on a beach, a jog through the woods, or a race across a park, depending on your fitness level, abilities, and interests. My kids love playing simple, classic games like “chase” and tag. It gets us all moving and the fresh air is reinvigorating.

While you’re at it, don’t be afraid to splash in some puddles, jump in a pile of leaves, or lay down in the snow to make a snow angel, depending on the season.

Outside health collecting

Look for Something

I have fond memories of collecting rocks as a child and my kids just started to show interest in it too. However, currently they prefer to look for worms. Adults may enjoy bird or butterfly watching. Every spring our family looks for edible mushrooms in the woods (I only suggest this if you are certain you know which are edible as many are poisonous and even deadly). Kids and adults alike may enjoy looking for things like wild blueberries, or collecting colorful leaves in the fall.

You can even try a scavenger hunt. Here’s an example of a general one:

Nature Scavenger Hunt

Please feel free to download the pdf if you’d like to give it a try: Nature Scavenger Hunt

Create Something (out of nature or for nature)

Draw in the dirt, build a sand castle, stack up some rocks, or plant a garden. An activity I love is making bird feeders with my kids and putting them out in the trees in our yard.

Create with nature

Use Some Equipment

Ride a bike, kick a ball, head down a slide, or go kayaking.  While a lot of equipment may cost money, you can keep it simple and utilize public parks with things like swings and slides for your kids or invest in a football to play catch.

We invested in a bean bag toss (corn hole) game that even gets the adults wanting to play outside.

Visit Some Animals

Many communities have outdoor green spaces that have an abundance of wildlife. Ideas would include checking your area for places like fish hatcheries, and nature preserves.  You can keep an eye out for free events such as free fishing days for kids and farm days/petting zoos.

EnjoyNature

Just Enjoy It

Look around and take all the beauty in. Look at the clouds and day dream. Stop and smell the flowers.

As a mom, I’m so happy to have read much of the research to motivate me to get my kids outside as much as possible. As a healthcare worker, I am excited to spread some knowledge and try to incorporate more nature into practice as well.

Still, not quite motivated to head outside? Maybe getting outside will give you the mental and physical energy you’re looking for. In yet another study, spending time in nature was found to be correlated with improvements vitality. So now that you’ve read this, turn off your device and (weather permitting) head outside.

go outside

*Disclaimer: The information presented in the blog is intended for information purposes only. Please consult your physician with any medical concerns and/or for medical advice. The information presented is not intended to be used in place of individualized therapy services, please contact your health care team for skilled therapy if you think it is necessary. Please supervise your children (or friends, spouses, etc)  if you decide to try any of the activities or ideas presented as the author or this blog does not claim liability for possible injury or negative consequences related to the activities and ideas presented here.  Please use common sense and safety when engaging in outdoor activities (for example check weather conditions, supervise children, and take precautions such as sunscreen, etc).

References:

n.a (2016) About the Initiative. ParkRx.org/community-of-practice retrieved 4/24/2017

Ryan, A., Weinstein, N. & Bernstein, J (et al) (2010). Vitalizing effects of being outdoors and in nature. Journal of Environmental Psychology. 30: 159-168

Seltenrich, N (2015). Just what the doctor ordered: using parks to improve children’s health. Environ Health Perspect 123: A254-A259; http//dx.doi.org/10.1289/ehp.123-A254

 

 

 

Messy Play Hacks

OT Mom says, “Let’s use some [insert something super messy; e.g. paint, slime, sand] today!”

Dr. Dad doesn’t say anything but omits a low guttural sound of disapproval. He doesn’t love it when we make a mess. He does, however, help when we do it anyway.

Respect all life.

Messy play activities are excellent for allowing young children to explore their world. Not only does do messy play activities provide an opportunity to develop a variety of senses, they have the potential to promote skills such as fine motor coordination, pre-writing skills, tactile discrimination, and bilateral coordination to name a few.

That being said, we don’t always have the time, energy, or patience for all out messy activities. Last summer we even had our house for sale, and trying to keep it clean with a messy toddler boy and a food-throwing baby was quite the challenge. While attempting to keep our house close to “show” ready, I figured out some hacks to make messy activities possible. I’ve thrown in some bonus ideas to make the most of messy play opportunities.

Take it Outside

If the weather is nice, take the kids outside to make a mess. When we think of painting, we usually don’t think to do it outside, but why not? A little paint splattered into the grass is no biggie. I use a drop cloth on the back lawn and let them go at it. If it’s especially warm, you can  have some water ready outside for easy clean up.

You can also use mother nature’s readily available messy supplies. Kids love digging in the dirt, playing in rocks, or stomping in mud puddles. We recently planted some seedlings and got dirt everywhere, and it just took a quick sweep to clean it up.

The bonus:  Being outside is associated with a lot of perks in itself, such as associations with many positive mental health benefits.

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Take it to the Tub

There are so many fun, messy sensory activities you can do in the bathtub! You can use what’s available commercially (foam soap, bubbles, bath crayons, bath paint) or go a little bit outside of the box.

We use actual kid paint in the bath tub sometimes when we are doing art projects, just because it makes clean up much easier.

The bonus: Using the vertical sides of the bathtub wall also promotes some great motor skills when doing things like doodling with bath crayons.  Writing on the vertical surface of the tub wall allows for wrist extension and promotes proper grasp patterns children need for good handwriting skills.

Box It Up

Speaking of thinking outside of the box, you can do messy play IN a box to help keep it contained. This is a great idea for things like markers, paint, and crayons that you don’t want a toddler getting all over the walls.

The bonus: Kids love to play in boxes and they are inexpensive (it’s also another opportunity to utilize a vertical surface).

COFFEE

Catch It in a Sheet

I love letting my kids cook and bake with me, but let’s face it, toddlers are NOT good at keeping all the ingredients in the bowl. When we bake, I usually will put a sheet or a picnic blanket on the floor and let the kids help mix the ingredients on top of that. While it doesn’t catch every speck of flour, it does help keep the mess contained.

I also use a drop cloth under the area that my kids play with play dough.

The bonus: Kids can help lay out the sheet and make sure it’s smooth. When the activity is done, they can help to fold it up in a way that the mess won’t fall out and help shake it out outside.

Try Some Good Ol’ H20

The absolute easiest idea is to simply use water. Young kids can “paint” with water on construction paper (you can let it dry and reuse it several times). When my older son paints with watercolors (what I believe to be the easiest paint to clean up), my daughter (who is a bit younger) is perfectly happy with just water.

OTMOMSAYS.COM-5

 

There are also watercolor paint books that have just a touch of paint at the top of each page and “magic” water activity books that are low to no mess.

I’ve even taken it up a step with the water messy play by putting a couple thick towels on my kitchen floor to let my daughter use kitchen items and water for pretend play. She likes to pour and stir the water in kitchen pots and bowls with real utensils. She scoops and pours a little water with measuring cups. Sure some of the water spills, but it’s super easy to clean up. Just about a cup of water (and of course supervision) and she is happily entertained and engaged in a great activity.

The bonus: Using water for pretend play encourages creativity and promotes development of social-emotional skills.

Zip It Up

This one isn’t messy at all. It is however, a fun tactile activity that little ones love.  You can use a zip lock bag filled with something squishy (I use hair gel) and add things such as glitter, water beads, or small toys (without sharp or pointy edges).  I’d also recommend taping the bag shut and always supervising kids closely with this activity, in case the bag does happen to get ripped open and since if not used correctly a suffocation and choking hazard. When my son was a baby, I’d tape it to his high chair tray for a fun, easy activity to do while I prepped dinner. If you’re really brave, you can have a young helper assist in making the bags.

Copy of Zip it up

The bonus: Visual perception/discrimination games can be incorporated into the play. Some ideas include: have the child point to all the blue items, identify alphabet beads, squish all the purple water beads to the same side. This activity also provides an opportunity to practice finger isolation to poke at the sensory bag for fine motor development.

Make It Edible

We all have to eat and a lot of young kids are already making a mess, so another option for messy play is to stick them in the high chair or at the table and paint with yogurt, jam, avocados, sauce (whatever you have on hand). This way, if they are in a stage where they’re putting anything (or everything) in their mouth- it’s a good thing!

The bonus: Try to incorporate practice using utensils for fine motor development and promotion of self-help skills. Even if your child doesn’t use a child spoon accurately yet, it’s great to still allow for some practice and exploration of the item.

halfway

Plan Ahead

This may seem obvious, but I’ve learned the hard way. Having your clean up materials at arms length is half the battle. If your doing some kind of wet messy play (e.g. paint, goop, food, etc) have some wet wash clothes or baby wipes nearby. If it’s some kind of dry mess (e.g. rice, sand, etc) have a broom or vacuum ready to go. This way, once the activity is over, the mess can be minimized before it spreads and takes over your house.

The bonus: Having the kids help you gather the needed items allows them to be involved in the routine and can serve as a learning opportunity. Concepts such as before, during, and after can be explained and the preparation, action, then clean up can help kids with transitions between activities.

Clean Up Together

Let’s face it, sometimes messy play (no matter how you plan it or what precautions you take) makes a BIG mess. That’s ok, because there are many great skills to be gained in the clean-up process.

The bonus: During the clean up process, kids get a sense of participation in the family routines, motor skills may be developed, and more sensory input is included, such as proprioception.

Add or Remove Clothing

Either way is a good way to go- Using a smock or an old shirt designated for painting, or allowing for some shirtless messy play, you get a reduction of ruined cloths and:

The bonus: practicing self care dressing (and undressing) skills.

Messy Play-2

Use Everyday Stuff

Messy play can simply be fun, cheap, creative play. There are so many activities you can do using the items you have in your house at any given time. In the kitchen, have the kids explore produce:  pumpkin guts, squishing (and eating bananas), dried rice for a sensory bin, playing in flour, or dried dried noodles. You can head outside to stomp in the mud, dig for worms, or jump in leaves. The options are endless, just look around!

The bonus: by looking at an everyday item in a different way, imaginations can soar.

I hope your next mess is a good one! Let me know how it goes 🙂

*Disclaimer: The information presented in the blog is intended for information purposes only. Please consult your physician with any medical concerns and/or for medical advice. The information presented is not intended to be used in place of individualized therapy services, please contact your health care team for skilled therapy if you think it is necessary. Please supervise your children (or friends, spouses, etc)  if you decide to try any of the activities or ideas presented as the author or this blog does not claim liability for possible injury or negative consequences related to the activities and ideas presented here.

Taking Care of your Mental Health: Ideas for a Happier Today

It hadn’t even been a terrible day, but I felt like I was about to burst. After close to two hours of what seemed like non-stop crying and whining, my head hurt and I had had enough. My husband had just returned home work and I sent the kids to their play room with him so I could cool down. He raised his eyebrows and looked at me.

Then Dr. Dad said, “Take a deep breath, calm down, there’s no reason to be so frustrated.”

OT Mom replied, “I know, but I’m stressed out and I need a minute.”

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Whether you are a parent, a student, someone with a full time job, or something else entirely, I am guessing you have had one of those moments before. Feelings of stress, anxiety, depression, and even anger are something we all experience at some point in life. Unfortunately for some, those feelings surface more intensity or more frequently.

According to the National Institute of Mental Health, in 2015 it was estimated that 43.4 million American Adults (17.9% of the U.S. adult U.S. population) were living with a mental illness at some point during that year. That’s nearly 1 in 5. Moreover, these numbers do not take in account substance use disorders (such as drug or alcohol addition).

If you think you’re mental health is in a bad place, it’s important to seek proper medical treatment from a trained professional. Furthermore, if you have concerns about the mental health of a loved one, it should be taken seriously, as the statistics show how prevalent these conditions are. Early identification and treatment are important to ensuring optimal mental health outcomes.

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Even for people without a diagnosed mental health disorder, life can be seem overwhelming, stressful, and exhausting at times.

“It’s natural to have ups and downs. its not natural if your persistently down for more than 6 months,” -Kalub Fedak, M.D.

For a lot of us, keeping our mental health in balance on a day to day basis is a work in progress. So after a little reading, a little thinking, and a few long conversations with Dr. Dad and some stressed out friends, I’ve compiled some strategies for a potentially happier today.

Get Moving

In addition to all the physical health benefits of exercise, “the overwhelming evidence present in the literature today suggests that exercise ensures successful brain functioning”  (Deslandes, Morae, Ferreira et al., 2009).   Physical exercise releases several neurotransmitters, including serotonin and dopamine.4  Serotonin impacts alertness, plays a role in pain control, and low levels of serotonin are linked to depression and even suicidal behavior.5   Many of us have also heard of the “runner’s high” that from increased endorphins which are released during high intensity exercise.

  “The mind affects the body and the body affects the mind” -Kalub Fedak, M.D.

In addition to the neurologic changes that comes with exercise, physical changes that result (such as increased strength, endurance, and overall better health) can result in changes in self-esteem and impact overall wellness.

Get Outside

Being in natural environments may help with coping, recovering from stress and promoting recovery from mental fatigue. Simply observing nature has been identified to correlate with positive impacts on concentration and productivity.6 Wherever you live, try to make time to get outdoors. You can visit a park or a nature preserve, take a scenic route to or from work, or even start your own garden.

Better Yet, Get Moving Outside

There is evidence to suggest that positive changes in both mood and self-esteem can occur after just 5 minutes of green exercise. Who doesn’t have 5 minutes? The study also found that the biggest changes in mood were following either light or vigorous exercise, but improvements were identified for all intensities of green exercise2. I think this is pretty exciting, since we all have different physical capabilities, and this suggests that even an easy stroll at lunch time can make your day a bit brighter.

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Drop the Guilt, Just Say “No.”

It’s important to have a balance in your life and sometimes that means limiting your obligations. Sometimes saying “no” to requests is just fine, and feelings of guilt shouldn’t be attached to it. There are always going to be fundraisers, parties, events, extra work, invitations to do more. For a lot of us, it’s hard to say, “no,” even when it’s taxing us to take on more. It’s ok to decline these obligations, especially if it’s going to increase your feelings of stress.  Balance is essential for a happy life, so don’t feel guilty if sometimes the answer is “no.”

Ask for Help

This can be hard for many people, and I’ve struggled with it myself. Sometimes I want to be the super mom. I want to be the mom that doesn’t just do it all, but does it with a smile on my face and all on my own. This is just not realistic. It’s important to not be afraid to use the support people we have in our lives. Sometime just having someone to talk to when you’re feeling down helps. Or if you have too much going on, you can ask for something specific. If your struggling to find someone in your life to talk to, perhaps trying a support group could help.

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Reshape Your Thinking

There’s a reason cognitive behavioral therapy (CBT) is well-known. It works. In a study that looked at multiple stress interventions for the workplace, cognitive behavioral interventions were found to have the largest impact on stress reduction7.  If you think negative or irrational thoughts are causing a disruption in your daily life, seek the help of a licensed health professional for individualized treatment.

I will leave the specifics of CBT to the experts and just share some ideas that could improve the optimism in your thinking.

  •  Try not to dwell on the negatives. Many of us are familiar with the scenario of replaying an event that happened where we wished we would have said something differently than we did.  Next time you’re worrying about something in the past, focus on the something good you did that day. It’s ok to acknowledge the feelings of regret, but try not to dwell on them. Today is a new day.
  •  Don’t focus on all or nothing. There are shades of gray in most aspects of life, so striving for perfection could set you up for disaster. It’s great to set goals to work towards, but even if the end result doesn’t come out how you had hoped, it doesn’t  necessarily mean you have failed. Partially met goals counts too.
  •  Turn off the negative waterfall. A lot of times when we are in a bad mood, all the negatives seem to get bolder, louder, and splashing down on us like a waterfall. Take a minute and focus on something good. A lot of times we blow bad things out of proportion when we are in a bad mood.
  • Acknowledge what you are thinking and know that it’s not a permanent state. It’s ok to be sad, mad, or anxious at times. Sometimes these feelings are good motivators for us. What matters is what you do in response to those feelings.

Have a Moment of Mindfulness

“Mindfulness is the practice of being happy in the present moment. Mindfulness means being aware of what’s going on in an accepting way, opening ourselves to our experience.”  -Thomas Bien, Ph.D.  from The Buddha’s Way of Happiness (p. 31)

I’m rather new to the practice of mindfulness, but I’ve found it personally helpful on a daily basis. We live in an extremely fast-paced world and sometimes we forget to stop and really experience the moment we are living. Taking a moment to be mindfulness can be liberating, as it can help you become more aware of your feelings, sensations, and the world around you.

“When we practice living mindfully and happily, we don’t create an inner war.”

-Thomas Bien, Ph.D.  from The Buddha’s Way of Happiness (p. 91)

I’ve actually started using a bit of mindfulness with my three-year-old when he is mid-tantrum. I will usually give him a hug and ask him if he can feel my arms hugging him, if he can feel his heart beating, and if he can feel the air going into him as he breaths. Whether it’s the act of being mindful or the fact that being mindful of himself distracts him from his whatever the moment’s tantrum was about, it seems to help. A lot.

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Engage in a hobby

Leisure pursuits are correlated with both psychosocial and physical benefits and are important to maintaining a happy and balanced life. Whether you have a current leisure activity or want to start a new one, there’s evidence that engaging in nonobligatory, enjoyable activities may lead to an increased sense of self worth, increased coping skills, and a release of feelings of hostility and aggression8. Even if time is limited, a little bit of leisure is important.

Smile and Laugh

There’s science behind the our laughter. When we laugh, our hormones related to both stress and “feeling good” are altered.  Laughter leads to a decrease in those stress hormones and an increase in endorphins that make us feel happy8

. What makes you laugh? Maybe try looking at a picture you think is hilarious. Watch a funny movie. Talk to your favorite funny family member or friend. I know I always feel better when I talk with my Dad (who has a whacky sense of humor). Whatever gets you smiling and laughing, go for it. I bet you will feel at least a little relieved.

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Use your Senses to Relax

Sensory strategies can do wonders for effecting mood. You probably already know what types of things calm and relax you and what irritates or stresses you out. Try turning down the lights, turning on enjoyable music and lighting a pleasant smelling candle to relax. Deep pressure input and warm tactile sensations (like a warm bath) are calming, as is slow, linear movement like rocking. Try keeping a list of what helps your to relieve your stress in your environment to so can utilize those things or change your environment as needed.

Write It All Down

I used to work at a school for kids with severe and challenging behaviors where both students and staff wore a “safety plan” everyday. The safety plans consisted of a list of personalized coping strategies that could be used as needed. When we are angry, stressed, anxious or otherwise upset, we often have trouble accessing our coping strategies because our emotions are interfering. While you might not want to wear  a badge on your chest with what works best for you, I encourage you to take note of what does seem to work best for your personal situation and coping style. I actually have a few things noted on a list in my phone (because who doesn’t keep their phone nearby most of the time in this day and age).

Talk to Your Doctor

If you are finding yourself unhappy more than not, it’s probably time to talk to your doctor. There is no shame in bringing up personal mental health concerns to a professional. Mental health is just as important as physical health, and mental illness has real, neurological implications. “Chronic depression alters neural synapses, as does uncontrolled pain,” Kalub Fedak, M.D. explains. It can hurt just as much to have a mental health condition as a physical health condition. Let’s all get past the stigma and take care of ourselves and each other.

If you feel like hurting yourself or someone else, seek assistance immediately. Call 911, contact your nearest  emergency services, or call the National Suicide Prevention Lifeline at 1-800-273-8255.

*Disclaimer: The information presented in the blog is intended for information purposes only. Please consult your physician with any medical concerns and/or for medical advice. The information presented is not intended to be used in place of individualized therapy services, please contact your health care team for skilled therapy if you think it is necessary. Please supervise your children (or friends, spouses, etc)  if you decide to try any of the activities or ideas presented as the author or this blog does not claim liability for possible injury or negative consequences related to the activities and ideas presented here.

References:

1. Any Mental Illness (AMI) Among US Adults, (n.d.) Retrieved April 9, 2017, from https://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-us-adults.shtml

2. Barton, J., & Pretty, J. (2010). What is the best dose of nature and green exercise for improving mental health? A multi-study analysis. Environmental Science & Technology, 44(10), 3947-3955. doi:http://dx.doi.org/10.1021/es903183r

3. Bien, Thomas (2010) The Buddha’s Way of Happiness. New Harbinger Publications, Inc, Oakland, CA

4. Deslandes, A., Moraes, H., Ferreira, C., Veiga, H., Silveira, H., Mouta, R., . . . Laks, J. (2009). Exercise and mental health: Many reasons to move. Neuropsychobiology, 59(4), 191-198. doi:http://dx.doi.org/10.1159/000223730

5. Lundy-Ekman, L. (2007). Neuroscience: Fundamentals for Rehabilitation (3rd). Saunders Elsevier, St. Louis, Missouri

6. Maller, C., Townsend, M., Pryor, A., Brown, P., & Leger, L. S. (2006). Healthy nature healthy people: ‘contact with nature’ as an upstream health promotion intervention for populations. Health Promotion International, 21(1), 45-54. Retrieved from https://search.proquest.com/docview/200046096?accountid=143111

7. Richardson, K. M., & Rothstein, H. R. (2008). Effects of occupational stress management intervention programs: A meta-analysis. Journal of Occupational Health Psychology, 13(1), 69-93. doi:http://dx.doi.org/10.1037/1076-8998.13.1.69

8. Southam, Marti (2006). Leisure Occupations. In McHugh Pendleton, H. & Schultz-Krohn, W. (Eds). Pedretti’s Occupational Therapy: Practice Skills for Physical Dysfunction (6th) (pp. 337-339). Mosby Elsevier, St. Louis, Missouri

Non-Candy, Skill Promoting Easter Gift Ideas

Dr. Dad says, “Let’s not go overboard with the Easter candy this year.”

OT Mom says, “Great idea, I have some better alternatives in mind.”

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While my husband is not a pediatrician, according to recent research, he’s right on the money when it comes to limiting excess sugar in our kids’ diets.  In a recent scientific statement published by the American Heart Association (2016), too much sugar is linked to risk factors for heart disease such as elevated blood pressure and an increased risk of obesity.

They recommend that kids over 2 years old consume no more than six teaspoons (25 grams) of added sugar per day and that children under 2 years avoid it altogether. With so many sugary snacks marketed to kids, these recommendations are surely good to keep in mind this Easter.  For more nutritional guidelines for kids, broken down by age group, check out MayoClinic.org Nutrition for Kids Information.

So this Easter, instead of filling those baskets and eggs with sugar, why not go for goodies that  promote developmental skills? In addition to the sugar being a nutrition downfall, in our house some of it ends up getting thrown out anyway, so it turns into a waste of money as well.

That being said, here are my favorite alternatives to candy and a little bit about why they can be much more beneficial than sugary snacks:

ART INSPIRED

Art supplies

This list could be almost endless, but engaging in art projects has a ton of benefits for the development of skills such as fine motor, visual motor/hand-eye coordination, bilateral coordination, visual perceptual, and in-hand manipulation skills. The items you could choose from are almost as endless as the benefits. A few ideas to get you started include: child-safe scissors, sidewalk chalk, stickers, markers, paint, crayons, glue and accessories to glue (feathers, noodles, cut out shapes/pictures, pom poms, etc).

There are also a lot of little craft sets available that come with everything you need or you can compile your own. A favorite project of my son’s is  painting wooden ornaments with watercolors. Another idea could be a small notepad with a set of stickers and markers.

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Bubbles

From traditional bubble wands to the newer whacky, bubble blowers, you can’t go wrong with bubbles. This activity is great for visual tracking skills, oral motor skills, and visual motor skills to name a few.

Self care items

As a child I often got a toothbrush in my stocking from Santa. I think the Easter Bunny could do something similar. Getting something like a toothbrush, comb, or even  a special pair of socks may encourage your little one to practice the self care skill related to that item with more motivation.

Books

In my opinion, you can never have too many books. Reading with your children not only promotes literary and language skills, but is a great time to bond with them. Try to pick out books specific to your child’s age.

Play Dough

If we didn’t already have tons of this stuff, it’d be right at the top of my list. Play dough is so much fun and can help with hand strengthening, proprioceptive input for the hands, tactile exploration, bilateral coordination, and more. There are tons of homemade recipes you can find online if you don’t want the store bought stuff.

Blocks and/or Legos

Blocks are great for learning spacial relationships and promoting motor skills. Building with blocks encourages problem solving, creativity, and self esteem.   Legos add the need for hand strength and provide some sensory input (proprioception) into the little joints of the hand.

Balls

So many motor skills are at work when throwing, catching, kicking, or bouncing a ball. From small to large and everything in-between, balls are always a great gift.

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Fidget/Sensory Toys

Anything with fun textures are especially great for young kids or kids with sensory needs. Restless hands benefit from exploring different textures, so things like rubbery squeeze toys, bumpy balls, crinkly textures, fabrics and the like could work. Sensory items that are geared for the visual sense are great too, such as sensory bottles.

Bug Gathering Equipment

It’s spring, so let’s get the kids outside! I think a butterfly net and an insect viewer are perfect spring time outside toys. This encourages outdoor exploration, problem solving, and motor planning.

Gardening Tools

Not really up for the bugs? How about some gardening instead. Kid sized spades, gardening gloves, and watering cans can make a great spring themed basket.

Seeds

In addition to the gardening tools, what about some seeds? Perhaps the Easter Bunny could leave some carrot seeds for your kids to plant for him!

Sand Toys

If you don’t have sand toys, now’s a good time to get some. Playing in the sand at the beach or in a sandbox is such a fun tactile sensory experience, and adding tools such as shovels, buckets, rollers, and sand molds add motor development into the mix.

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Kites

Kites are the best reason to hope for a windy day. They’re fun to watch in the sky, but can take a lot of skill to get into the air and maintain their momentum. Both of my children are very young, so I get the kite started for them then hand it over. Older kids can have the chance to practice to do it with minimal or no help.

Finger Puppets

Not only are finger puppets fun, they promote finger isolation, bilateral coordination, body awareness, tactile (touch) discrimination, and imaginative play.

Musical Instruments

From motor skills, to language development, and an overall fun sensory experience, musical instruments are wonderful. Take your choice from maracas, drums, recorders or kazoos (for an oral motor bonus), bells, xylophones, etc. Jam on, little people!

Flashlights

Not only do kids love flashlights, they can be used in a way that promote visual tracking, visual memory, and visual motor skills. Try using flashlights for games such as watching you make a pattern on the wall with the light and then having them copy it with their own flashlight.

Tweezers and Tongs

Using tweezers can help with hand muscle strengthening, coordination, development of the arches of your hand, and allows kids to learn to use effective grasp patterns that promote differentiating the two sides of their hand (an important skill for fine motor development).

Non-Candy

Yoga/movement cards

Activities such as yoga provide some powerful prorioceptive input that do amazing things for our kids, you can read more about proprioception here.

Card games

Games are great for teaching turn taking, problem solving, and attention skills.

Squirt toys

Water play is an easy,  but not terribly messy activity that gets kids up, moving, and using their hands. Squeezing the variety of squirt toys available these days can strengthen little hands, while engaging in the sensory experience of it.

Pretend Play Toys

This is a broad category, but pretend play is an important skill that helps children in multiple areas of develop. Pretend play promotes thinking skills, creativity, social-emotional development, and cognitive flexibility. Toys such as cooking sets, cleaning sets, doll houses, etc. are all good choices.

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Healthy Treats

Instead of jelly beans in ALL the easter eggs, I think we’re going to have raisins in some. Or you could try fresh fruit instead of fruit flavored candy. Perhaps the Easter Bunny will leave a few of his carrots behind as well. Toddlers are notoriously picky eaters, but maybe if there’s a special healthy treat left by the Bunny, himself, the kids might try it! It’s worth a shot. I’m hoping my son will regain his appreciation of carrots.

Now the hard part is deciding which ones to go for!  I think I might need a couple bigger baskets. Do you have some more ideas? I’d love to hear them 🙂

References:

Vos, M. B., Kaar, J. L., Welsh, J. A., Van Horn, L.,V., Feig, D. I., Anderson, C. A. M., . . . and Council, o. H. (2016). Added sugars and cardiovascular disease risk in children: A scientific statement from the american heart association. Circulation, Retrieved from https://search.proquest.com/docview/1859733288?accountid=143111

*Disclaimer: The information presented in the blog is intended for information purposes only. Please consult your physician with any medical concerns and/or for medical advice. The information presented is not intended to be used in place of individualized therapy services, please contact your health care team for skilled therapy if you think it is necessary. Please supervise your children (or friends, spouses, etc)  if you decide to try any of the activities or ideas presented as the author or this blog does not claim liability for possible injury or negative consequences related to the activities and ideas presented here.

Little Helping Hands in the Kitchen bring BIG Benefits

Dr. Dad says, “I’m hungry!”

OT Mom says, “Have the kids help you make a snack.”

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While it sometimes takes a few minutes longer to have kids help make meals and snacks, it’s very beneficial in more than one way, and the best part is that kids love to help. Even the smallest of hands can help with kitchen tasks like ripping up lettuce for salads or helping gather kitchen tools.  There’s evidence that involving kids in meal preparation of healthy foods can lead to good dietary habits and increase the amount of healthy foods they eat1. Since we all have to eat, why not let your kids help prepare what’s going into their bodies?

In addition to learning about healthy, wholesome foods and instilling good habits, food preparation has these following benefits as well:

An opportunity to work on motor skills

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There are tons of hands on tasks that challenge hand strength and coordination when working in the kitchen. Here’s just a few examples to try (but the list could be endless): 

  • Bilateral coordination is needed to complete tasks such as to stabilize a bowl with one hand while stirring with the other.
  •  Strength and bilateral coordination is needed to open food containers, bag, boxes, etc.
  • Proximal stability, strength, and hand eye coordination is needed to use kitchen tools such as hand held mixers, which also give a nice dose of proprioceptive input.
  • Fine motor coordination skills are needed when manipulating smaller ingredients and small kitchen tools such as measuring spoons.

Sensory exploration

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Not only do we get to taste the food, we see the different colors of the food, we can feel the textures with our hands and mouths, smell the aromas of the ingredients and hear the sounds of chopping, sizzling, and manipulating of the food.

When I’m cooking certain things that the kids can’t help with, such as using the hot stove top, I let my kids explore some of the ingredients prior to cooking them. If I’m sautéing vegetables, I let the kids feel the raw zucchini and smell it. Prior to making guacamole, I let my daughter play with the avocados. It’s also fun to show your kids how something looks before it’s cooked and compare how it transforms, such as hard noodles that turn to soft, sticky spaghetti.

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This leads to learning

When we talk about the foods and the process of cooking, kids can learn new vocabulary and it can open discussions about other things. For older kids, you could branch out and talk about where the food came from, such as:  Was it local or imported? Did it grow in the ground or from a tree?

When following a recipe, you are reading together, and using math to measure and count out ingredients. Research has even identified that frequent family meals have correlations with improved intellectual development including vocabulary and reading skills2. Another important skill they learn is SAFETY. You can teach your kids about hot and cold and how avoid getting burned. You can talk about sharp knives and how kitchen appliances work so that they know what to do to avoid getting hurt.

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Self Esteem

Cooking has the wonderful outcome of instant gratification of something yummy (usually). To know they helped make something that tastes good and nourishes them can really give kids a sense of pride. I see people posting pictures of the meals they’ve cooked up on social media to show off their culinary skills, and our kids feel that same pride when they help makes something yummy.

Fun!

Spending time as a family is just fun. It gives you a chance to be silly with your kids, try new foods, make a mess (then clean it up together), learn and grow together.

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Still not quite convinced? Here’s a few tips that I’ve found helpful when cooking with messy, busy toddlers:

  • Bring it to their level- This can be up or down. My son likes to do the classic maneuver of bringing a kitchen chair to stand on to help me cook at the counter level. My daughter, however, would not be safe doing this, so sometimes we cook on the floor or on a toddler size table. My kids love helping me make pizza and we usually do this on the little table. When we bake, I will put a big sheet on the floor and put the mixing bowls on that. It doesn’t completely eliminate the mess, but it reduces it dramatically and everyone can help mix the ingredients.
  • Clean up is important too- my dogs like to help with this (especially when we are making pizza and the cheese is flying all over), and young kids like to help with light clean up tasks. It’s also a great teaching opportunity. My son like to use the vacuum (a hand held minivac is great too) and my daughter likes to sweep and wipe.
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  • A tiny amount for tiny hands- when my youngest is being a little rambunctious (as one-year-olds tend to do) and she can’t quite help with a recipe requiring more precise measurements, I give her her own bowl with just a little of what we are making, or even with just a little water.  This way, if she spills it, it’s not a big deal and she feels involved in the process. Some kids are even satisfied with just banging around with the pots, pans, wooden utensils, and/or measuring cups and engaging in some parallel pretend play while you cook.
  • Non-food meal tasks- in addition to preparing the food, kids can help with the smaller tasks that go along with meal time, such as setting the table, gathering the ingredients from the pantry, helping with the grocery shopping list, and even putting the clean dishes away (besides the hazardous ones, of course). Sorting silverware is a great job for preschool aged children.

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Now for the fun part… here are just two of our EASIES but YUMMY recipes (if you like these let me know so I can post more in the future):

Easiest Guacamole Ever

Easiest Guacamole Ever

Ingredients: avocados, 2 TBSP of your favorite salsa per avocado, 1 tsp lemon juice per avocado, salt/pepper to taste.

Directions: Mash up your avocados, combine with all other ingredients, stir, enjoy! We usually don’t even measure the ingredients, we just pour a little salsa in, but my son like using the measuring spoon too. My favorite salsa to use in this recipe is a HOT habanero lime salsa.

buttermilkpancakes

Fool Proof Pizza Sauce

Ingredients:

  • 1 can tomato paste (6 oz) and equal parts warm water
  • 2 TBSP Honey
  • 1/2 Tsp dried Basil
  • 1/2 Tsp dried Oregano
  • 1/2 tsp dried Marjoram
  • 1/2 tsp garlic salt
  • 3/4 onion powder
  • 1/8 Tsp dash of black pepper
  • A dash crushed cayenne pepper to taste (optional- my family loves spice so we use a generous dash)

Directions: Just combine all ingredients and use on your favorite pizza crust with whatever toppings you love.

This recipe is super forgiving (that’s why I call it “fool proof”). My son usually measures the the herbs so sometimes there’s different amounts. We’ve made this without the onion powder and used some Mrs. Dash instead, and it came out tasting good. We’ve also used fresh garlic in it as well. It’s a good base to start with and play around with. I hope you like it as well as we do!

A quick note on picky eaters- it takes most kids many exposures to a new food before they will like it, so just because your little one didn’t like something a few times, keep introducing the food and try pairing it with a preferred food item.

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References

1. Chu, Y. L., PhD., Storey, Kate E,PhD., R.D., & Veugelers, P. J., PhD. (2014). Involvement in meal preparation at home is associated with better diet quality among canadian children. Journal of Nutrition Education and Behavior, 46(4), 304. Retrieved from https://search.proquest.com/docview/1539994846?accountid=143111

2. Fruh, S. M., Fulkerson, J. A., Mulekar, M. S., Kendrick, L. A. J., & Clanton, C. (2011). The surprising benefits of the family meal. The Journal for Nurse Practitioners, 7(1), 18-22. doi:http://dx.doi.org/10.1016/j.nurpra.2010.04.017

*Disclaimer: The information presented in the blog is intended for information and entertainment purposes only. Please consult your physician with any medical concerns and/or for medical advice. The information presented is not intended to be used in place of individualized therapy services, please contact your health care team for skilled therapy if you think it is necessary. Please supervise your children (or friends, spouses, etc)  if you decide to try any of the activities or ideas presented as the author or this blog does not claim liability for possible injury or negative consequences related to the activities and ideas presented here.

Beyond the Five Senses: Input Vestibular

Dr. Dad says, “I’ll rock the baby tonight.”

OT Mom says, “Well then, good night to the both of you.”

Like many parents, he often falls asleep while rocking her, but why? Not only are our babies warm and snuggly, (and most of us are usually at least a little short on sleep), there’s more going on. It’s the rocking. The slow, linear movement of rocking has a direct calming effect on both of them, thanks to their vestibular systems.

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Many of us are familiar with the five senses we learned about as kids, but there are several additional senses that have a ton of impact on just about everything we do. In a post a couple weeks ago, I provided some information about the proprioceptive system. Another super important system (that works very closely with the proprioceptive system) is the vestibular system.

So what is the vestibular sense? It’s the sense of where your head is positioned relative to gravity and your awareness of head movements. It works closely with our visual and proprioceptive systems to allow for us to maintain balance. The receptors for this sense are located in the inner ear and include three semicircular canals filled with fluid and hairs, and two organ sacs filled with gel, hairs, and little rock-like things called otoconia8. I will spare you the physiological details, but pretty much the hairs move in response to movement, movement momentums, and the position of your head in space.

When I hear the someone say, they’re “losing their marbles,” I really hope they don’t mean their otoconia. There is actually a disorder known as Benign Paroxysmal Positional Vertigo (BPPV) where those silly otoconia are displaced into one of the semi-circular canals causing symptoms like vertigo, nausea, and poor balance8.

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Dr. dad tells his patients that “they’ve got rocks loose in their heads,” and they laugh.

When we engage in motion that is slow, rhythmic, and linear, it has a calming effect on our nervous system4. That’s why things like rocking babies or swaying with them slowly, puts them to sleep (and sometimes makes the moms and dads tired too). The vestibular system also contributes to the drowsiness we get in the car. It’s the constant linear motion that creates a calming effect.  When used in a different way, this system can be very alerting. When movement is fast, irregular (such as sudden starts and stops), or changing directions and intensities, it stimulates our nervous system and heightens our awareness and alertness4,16.

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But what about car sickness? I blame Dr. Dad’s bad driving. Just kidding (kind of). Actually, car sickness is due to the visual and vestibular systems getting contradictory information8– that’s why it’s more common for people when they try to read in the car. If you’re focused on something in front of you, and your visual system is not getting input of the movement of driving down the street, but your inner ear is, it’s a disconnect and your nervous systems says, “somethings not quite right here, let’s vomit.”  Well, hopefully you’re not to the point of vomiting, but you get my drift. That’s also why when you are in the front seat, especially the driver, you’re less prone to car sickness as you’re more aware (I hope especially if you are the driver) of the movements of the car and yourself.

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This nausea can also happen if you are sitting still but you’re getting visual input telling your brain that you are moving, such as in some 3D experiences  or movies with a shaky camera. I have a distinct memory of my sister listening to, rather than watching, the end of one such shaky camera horror movie with her face over an empty popcorn bowl. The visual to vestibular disconnect made her that unable to watch.

Usually, however, for most of us the vestibular system functions well with our other senses to do amazing things.  In our brain, vestibular information meets up in a central hub that also receives information about proprioception (relating to joint movements and positions), vision, tactile (touch), and auditory information. This allows for:

  • control of our head movements
  • stabilization and control our eye movements (even when our heads are moving)
  • maintaining and adjusting body posture and influencing our body’s muscle tone
  • development of self regulation and sensory awareness
  • engagement in bilateral integration (using both sides of the body efficiently, such as both hands together to complete a task).
  • auditory language development2,4,8,9,10

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As you can see, the vestibular system is linked to many, many areas of the brain and has a wide spread influence over brain organization and functioning. There’s also some research suggesting that vestibular input can influence stress reduction13emotional behavior6,12 and mood11,16. In some settings, vestibular input has been shown to promote academic participation and achievement15.

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For the kids of the world, it’s so important to provide them with opportunities to develop and strengthen this system. There’s evidence that an environment rich with vestibular-proprioceptive opportunities has powerful effects on development14. It baffles me to see school districts cutting back on recess, PE and related activities.  In this day and age of technology, our kids still need to MOVE!

Seize the

So, now that we know a little about this incredible sensory system, let’s use this knowledge to brainstorm some fun vestibular activities that could promote good things today!

-In your house, equipment free– to provide stimulating input you can spin, dance roll, climb exercise, run with lots of stop and go’s (think red light/green light).

-Play outside-  swings, slides, bike riding (always wear a helmet), wagon rides, scooter boards, push cars, sledding, skiing, running, playing team sports, and the list could go on and on.

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– Try similar things inside- my kids love pushing each other in a cardboard box and spinning each other on our swivel chairs and office chairs for increased stimulation; try rhythmic, slow rocking for a calming effect.

– Tai Chi- While I have not tried this personally, there is more and more evidence that engaging in Tai Chi can improve balance, well-being, strength, and potentially decreases falls for older individuals1,7.

– Dance-  Try slow dancing to relax, or dance fast and wild to wake up. There’s research on the benefits of dance for older adults too, with improvements found in both cognitive and sensorimotor performance5.

Wear your baby– instead of just rocking your baby, you can use a baby wrap, carrier, or baby backpack to attach your baby to you while you grocery shop, clean your house, or go for a walk. I’ve even taking my kids morel mushroom hunting using them. Not only does your child get the wonderful movement, I think it’s also great for bonding and allowing them to be involved in your daily activities.

– Ride a horse- there’s a whole branch of therapy known as hippotherapy where horses are utilized as a treatment tool for OTs, PTs, and SLPs. Riding a horse provides vestibular and proprioceptive input and can promote improvements in balance, strength, coordination, mobility, balance, sensory motor function, postural control, attention, mobility, and communication3.

-If you’re prone to motion sickness, don’t read in the car. In fact try to pay attention ahead out the window to reinforce the connect between your visual and vestibular systems so that you don’t get the negative effect from a disconnect.

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It is important to remember that each individual has different thresholds for sensory input for each individual sensory system. For example, my kids have pretty high thresholds for vestibular input, as they love to spin, go on slides, and move constantly. They love spinning each other in our gliding chairs, and often my son wants to spin me while I’m sitting with my daughter. I always end up limiting the repetitions as my threshold for rotary movement is low. I get nauseous easily and am prone to motion sickness on boats and in cars. You can also think about  our individual differences when considering how people differ in regards to roller coasters. Some people love the thrill of the motion and tolerate spinning upside down, while others you will find wanting to puke in the corner after just the thought of it.

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Additionally, there is also something known as gravitation insecurity, which makes some children very fearful and anxious in situations where their feet leave the ground6.  I mentioned a lot about the autonomic effects that can come with waking up this system, so please use caution. If you do any of these activities on a regular basis or decide to try a new one, be aware of a few warning signs that you’re overdoing it: pallor, nausea, changes in heart rate and breathing, palpitations, anxiety. Please take things slow and do what works for you. Always contact a doctor or certified therapist to address individual issues.

*Disclaimer: The information presented in the blog is intended for information and entertainment purposes only. Please consult your physician with any medical concerns and/or for medical advice. The information presented is not intended to be used in place of individualized therapy services, please contact your health care team for skilled therapy if you think it is necessary. Please supervise your children (or friends, spouses, etc)  if you decide to try any of the activities or ideas presented as the author or this blog does not claim liability for possible injury or negative consequences related to the activities and ideas presented here.

Resources

1. Adler, P. A., & Roberts, B. L. (2006). The use of tai chi to improve health in older adults. Orthopaedic Nursing, 25(2), 122-6. Retrieved from https://search.proquest.com/docview/195963159?accountid=143111

2. An, S. L. (2015). The effects of vestibular stimulation on a child with hypotonic cerebral palsy. Journal of Physical Therapy Science, 27(4), 1279-1282. doi:http://dx.doi.org/10.1589/jpts.27.1279

3. Bender, M., & McKenzie, S. (2008, Winter). Hippotherapy. Palaestra, 24, 43-44. Retrieved from https://search.proquest.com/docview/213181696?accountid=143111

4. Kramer, P. & Hinojosa, J. (2010) Frames of Reference for Pediatric Occupational Therapy (3rd). Lippincott Williams & Wilkins, Philadelphia, PA

5. Kshtriya, S., Barnstaple, R., Rabinovich, D., Desouza, J. F., & X. (2015). Dance and aging: A critical review of findings in neuroscience. American Journal of Dance Therapy, 37(2), 81-112. doi:http://dx.doi.org/10.1007/s10465-015-9196-7

6. Lane, Shelly J, PHD,O.T.R./L., F.A.O.T.A., Lynn, J. Z., & Reynolds, Stacey,P.H.D., O.T.R./L. (2010). Sensory modulation: A neuroscience and behavioral overview. OT Practice, 15(21), CE1-CE8. Retrieved from https://search.proquest.com/docview/807980071?accountid=143111

7. Leung, D. P. K., M.Sc, Chan, C. K. L., M.Sc, Tsang, H. W. H., PhD., Tsang, W. W. N., PhD., & Jones, A. Y. M., PhD. (2011). Tai chi as an intervention to improve balance and reduce falls in older adults: A systematic and meta-analytical review. Alternative Therapies in Health and Medicine, 17(1), 40-8. Retrieved from https://search.proquest.com/docview/851708686?accountid=143111

8. Lundy-Ekman, L. (2007). Neuroscience: Fundamentals for Rehabilitation (3rd). Saunders Elsevier, St. Louis, Missouri

9. Mauer, D. M. (1999). Issues and applications of sensory integration theory and treatment with children with language disorders. Language, Speech & Hearing Services in Schools, 30(4), 383. Retrieved from https://search.proquest.com/docview/232585154?accountid=143111

10. McHugh Pendleton, H. & Schultz-Krohn, W. (2006). Pedretti’s Occupational Therapy: Practice Skills for Physical Dysfunction (6th). Mosby Elsevier, St. Louis, Missouri

11. Mehta, Z., & Stakiw, D. B. (2004). Childhood vestibular disorders: A tutorial. Communication Disorders Quarterly, 26(1), 5-16,56-57. Retrieved from https://search.proquest.com/docview/213789303?accountid=143111

12. Rajagopalan, A., Jinu, K. V., Sailesh, K. S., Mishra, S., Reddy, U. K., & Mukkadan, J. K. (2017). Understanding the links between vestibular and limbic systems regulating emotions. Journal of Natural Science, Biology, and Medicine, 8(1), 11-15. doi:http://dx.doi.org/10.4103/0976-9668.198350

13. Sailesh, K. S., & Mukkadan, J. K. (2015). Controlled vestibular stimulation, standardization of A physiological method to release stress in college students. Indian Journal of Physiology and Pharmacology, 59(4), 436-441. Retrieved from https://search.proquest.com/docview/1812437841?accountid=143111

14. Schaaf, Roseann C, PHD,O.T.R./L., F.A.O.T.A., & Lane, Shelly J, PHD,O.T.R./L., F.A.O.T.A. (2009). Neuroscience foundations of vestibular, proprioceptive, and tactile sensory strategies. OT Practice, 14(22), CE1-CE8. Retrieved from https://search.proquest.com/docview/232422301?accountid=143111

15. Watling, R., & Hauer, S. (2015). Effectiveness of ayres sensory integration® and sensory-based interventions for people with autism spectrum disorder: A systematic review. The American Journal of Occupational Therapy, 69(5), 1-8A. Retrieved from https://search.proquest.com/docview/1711617297?accountid=143111

16. Winter, L., Wollmer, M. A., Laurens, J., Straumann, D., & Kruger, T. H. C. (2013). Cox’s chair revisited: Can spinning alter mood states? Frontiers in Psychiatry, 4, 132. doi:http://dx.doi.org/10.3389/fpsyt.2013.00132