November 2017 ‐Blog
What is play?
I have noticed that when I ask parents to play with their children while they are receiving CST, it goes in one of two directions. They either quiz them or give them an electronic device. I do not consider either of these play. To me play is when we pretend with their toys and engage the child’s imagination. When forts are made out of blankets, when a hairbrush becomes the microphone for the made up dance routine, when a meal is cooked and ate using imaginary pots and pans.
In my office, when I place blocks (you know the ones, with letters, numbers, and colors on them) in front of a child more often than not the parent is asking the child: What color is this? What letter is this? Let’s count the blocks. Pass me the blue blocks. I rarely see the blocks stacked up — promoting fine motor control, and then knocked down – promoting giggling to no end. I have never seen a parent turn the blocks into a train and choo—choo them across the table. I started to wonder when this trend of constant teaching our children versus playing with our children occurred.
Many of the parents I know confessed that they can play with their kids for about 20 minutes before they, the parents, get bored or distracted. Most stated they chose to play computer games with their older children because that is what interests their children. Studies have stated that 9 out of 10 children said computer games were something they would rather play on their own, while three—quarters said they would prefer to spend time with their parents enjoying board games or playing outdoors together.
This led me to question, if as adults, we even know how to play with our children. The dictionary defines play as engaging in an activity for enjoyment and recreation rather than a serious or practical purpose. Yet, as a physical therapist I am aware play is more than that. Play is the way that children develop their musculoskeletal system, their sensory system, their visual perceptual system, and all of these influence the way they think.
Studies show that parent—child pretend and physical play is linked with the child’s competence, gross motor skills, peer group leadership, cognitive development, helps children learn how to regulate their emotions better, and can lower their stress chemicals. We already know how the hormone, oxytocin, plays a major role in parent-infant bonding and other social and emotional behaviors. Oxytocin levels increase when mothers engage in affectionate play with their infant and when fathers engage in stimulatory play with their infants. When parents play with children, oxytocin, that love hormone, is released in them.
I urge you as parents to get back to the basics. Add some free play with your kids. When they run around, try to catch them. Introduce pretend play, let the child develop the theme. If you feel you must be teaching your child something, use stuffed animals or puppets to act out real—life situations that can teach problem solving or social skills. Let the puppet demonstrate the wrong way to handle a situation. Then, along with input from the child, act out a better way.
As a therapist, you have the ability to model this play to your parents. After all this is how they develop social and self— control skill sets. It’s time for us to get back into their world, to be silly along with them and have fun.
Sorry, I have to end my rant now, because my kids ages 19 and 21, would like to play a board game and they have invited me to play!
September 2017 ‐Blog
How can Craniosacral Therapy help with autism?
To be honest, autism or sensory processing disorder is the whole reason I started doing craniosacral therapy. Having a child that is on the spectrum and having to deal with various aspects of autism, I was looking for the best way I could help my child. After chasing my tail for years trying to figure out why he was the way he was, we finally gave up and decided that he was the way he was, and we just need to accept that and move forward. With craniosacral therapy, I felt as if I was finally treating the source of the problem versus treating symptoms of a problem. My personal experience was multifaceted. I think because there are numerous reasons a person is autistic, there are numerous, so called cures for autism. I also believe that under every autistic person is an anxiety disorder and/or a sensory processing disorder. So even if autism is "cured", you are still left behind with a child that has many other issues. Therefore, how craniosacral therapy can help you differs for every person. For us personally, each session had different outcomes. We initially noticed a decrease in his OCD personality traits. We noticed less anxiety and less tension in his body. We noticed that he was requesting hugs versus not allowing us to touch him. Not all of these things happened immediately after a session, some things evolved over time and some things were a work in progress. I am not sure there is one set answer on how craniosacral therapy can help with autism. Most people with autism or sensory processing disorder have problems with tight fascia in some area of their body and when you release that tight fascia, depending on where the fascia is depends on what type of results you will have. For instance, if you release the tight fascia surrounding the amygdala, an area where fear is kept, the child tends to be less fearful. Therefore, a CS therapist will follow the tissue where ever the child guides them to work and this will be where you get to see the differences occur.
July 2017 ‐Blog
What is Craniosacral Therapy?
This is probably one of the toughest questions to answer because every time you try to answer you can see the person’s face start to gloss over as they have no idea what you’re saying. I must admit, at times, I’m not even sure what I’m saying. I think the best answer that I’ve ever heard is when another person said " Do you know how a chiropractor adjusts your bones to make you feel better, well a craniosacral therapist adjusts the soft tissue in your body to make you feel better. "
Of course, it is way more technical than that, but I guess the bottom line is, if you’re interested in the technical version, you can look that up under What is Craniosacral Therapy? on my website.
Let’s get back to that adjusting the soft tissue part of it, a friend of mine compared it to a piece of thread in a woven blanket. If you pull one thread the entire blanket changes shape. If you pull one thread hard enough and long enough you end up changing the original form of the blanket. It’s like that in your body, if you engage the soft tissue long and hard enough in one area, it moves and reshapes the entire body. A craniosacral therapist will help you relax the soft tissue, thereby smoothing the blanket back out, allowing the body to self—correct, thereby allowing the person to feel better.
So, this blog took me in a direction I had no idea I was going to go in. With that said, I am going to now re-write some of my website.Back to top of page
May 2017 ‐Blog
Why the SICS (Sensory Integration for CS Therapists) class is for everyone
Let’s first start with some definitions;
Sensory Integration is the ability to feel, understand and organize sensory information from the body and environment. Information is received through the sensory systems ‐ which include vision, touch, smell, taste, and hearing, as well as knowing about gravity, position of body parts and movement.
Sensory Integrative Dysfunction is when a person is unable to feel, understand and organize sensory information. The person will not respond in an ordinary way to ordinary sensations.
A person can be Oversensitive ‐ This is the person who is sensitive to external stimuli. Some of these behaviors are labeled: picky or spoiled child, behavior problem ‐ when really it’s their sensory system that is hyper-sensitive.
A person can be under‐sensitive or have Sensory Deprivation ‐these are your sensory seekers ‐ They are on the go, looking for input ‐ they are the people who are running into objects, hitting themselves or others, they need lots of input ‐ like spicy, chewy foods.
Or a person can be sensory scrambled ‐ this is most of us. We are over‐sensitive in some areas and under‐sensitive in other areas. We are the people who can be dysregulated but in a calm, alert state.
And this can happen in one or all of the senses:
For example I am over-sensitive for smell. I had a teacher in 3rd grade who some days had coffee breath or orange juice breath and she would come up right next to my ear and talk and I could not hear anything she said because it was all I could do not to vomit due to the smell. I tried to never ask questions in the morning for fear she would talk to me and I would smell her breath. The anticipation alone was overwhelming. As you can imagine, I did not learn much that year, and you can also see how this can be interpreted as a behavioral problem.
I also did not realize I had anxiety issues until I had a son on the spectrum. When I was a child I had learned to manage my anxiety by running. This constant proprioceptive input provided to my body grounded me and calmed my senses. When I stopped running in college ‐ I became unglued and I had no idea why. Suddenly, if I was around more than 3‐4 people at a time I became so anxiety ridden I could not function normally. On the outside I looked just fine, only I knew I was suffering. I slept a lot trying to gather enough energy to attend the next function. What I finally learned was I had less anxiety when I was around less people. And if I did attend a social event I needed several days to sleep it off and recuperate. I learned to avoid situations that exhausted me.
From the above we can see that a Sensory Processing Disorder (SPD) affects more than just kids‐ it really affects all of us. Some of us have just learned different coping skills then others. Avoidance and isolation being a coping skill. In 2007, the Palm Beach Post ran an article that stating that one out of 10 children will be diagnosed with SPD. I personally 10 /10 people have SPD. Some of us have just learned to compensate around our issues in a more socially acceptable manner than others.
How does this relate to the SICS class? In the SICS class we go through each sense and allow the therapist to experience what it feels like to be over-sensitive or under-sensitive. We learn how to tell if a person is in a state of high arousal or has increased anxiety. We then use SI techniques to bringing the person back into a " neutral " place. One they are in a neutral place we use CST to find and release any other restrictions we find that might be impeding the way sensory input is interpreted. We are not teaching student how to be sensory integration therapists. We are teaching students how to recognize if a person is over or under responsive to sensory stimulation and then giving them some solutions to help address the sensory system so that they can tolerate a CST session.
I hope this helps with your understanding of this class and I also hope to see more people who are treating adults in this class!Back to top of page
April 2017 ‐Blog
Since April is Autism awareness month – I thought I would tell a little of my story.
I have a son who was born on the autistic spectrum. Being a physical therapist who had specialized in sensory processing disorders (SPD) and was SIPT certified, I found myself in the position of either being in denial, or over therapizing him. When he was three, someone told me he would benefit from CST. So, off I went to take yet another class, on a new modality. This was back in the day when in CST 1 we were told to absolutely not treat children, and I listened. So, my son was taken elsewhere for treatment. He was getting so many different modalities of treatment, who knew what the key element was. All we knew was that he was making progress and had not gotten kicked out of Kindergarten, my goal for him that year. When I finally took the Peds class, he was a participant in the class. He spent the entire session under a table with his sister and two therapists. After the class, someone gave him a lollypop. After a few minutes we realized he was actually sucking on the lollypop. A skill he had never done previously. You can imagine how breastfeeding went, or not. The second day he was sitting on the table and talking with the therapists. The only way I could treat him was when he was asleep, we were just too connected.
When he was in the second grade, things came to a critical point. My mom could no longer pry him out of the bathtub and get him ready for school. So, I quit working full time and started my private practice working school hours. We stopped all therapy, except me treating him occasionally with CST, while he slept. He had introduced me to both my passion, CST, and to a faith in God.
He has taught me more lessons then you can ever imagine. He has taught me about being neutral. Neutral with my thoughts, touch, intention, observations, and judgements. A hallmark of any good CST practitioner. He has taught me that as I continued taking classes, TA’ing, and getting treatment for myself, and as I worked on our pregnancy, his birth, and my challenges with him, he could shift with me. Something we talk about in the CCPB1 classes. How children can mirror and hold onto their mom’s patterns. This is why we teach that you cannot just work on a child, you must work on the family. Meeting them all where they are at. He has taught me that sometimes you just have to challenge yourself, so I became an instructor for UI. He has taught me that we are all sensory challenged, it’s just how you respond and interpret those challenges that matter. People tell me I should write a book about raising and living with a child with SPD. I cannot. He would never understand. He thinks his childhood was normal, he believes he is normal, and he is. I am, however, an instructor for the Sensory Integration and Craniosacral (SICS) class. In this class we talk about each sense, what happens when we misunderstand the information to or from that sense, and we then then experience that it would be like to receive this misinformation and how our body reacts to this misinformation. We learn how to tell when a person is over or under sensitive to stimulation from the senses and how to accommodate our treatment session so a client can tolerate CST. We learn that if a child is a moving target, we are not meeting them where they are. He has taught me that CST can change a person’s life for the better.
Where is my son now? We still have our challenges and he misunderstood the college application, so he is spending his first year in Paris, France as a freshman in college.Back to top of page
May I see another type of practitioner while I see you?
I have been asked many times if I tell my new clients that while they are seeing me they should not see other disciplines. For instance a chiropractor, massage therapist, osteopath, Acupuncturist, etc.. My answer is: Why would I discourage anyone from getting the help they need. Craniosacral Therapy is not the end all or cure all, and for some people may not be a benefit at all. Then I am asked – well how do you know if what you are doing is what is fixing the client or if it from the other discipline? This question, for me has a multifaceted answer. Let’s start at the beginning. I believe there is room for everyone and on any given day the body may respond better to one technique versus the other. My job is to follow the inner wisdom and offer the body what it needs and wants in that time and space. I like to think I am facilitating healing, but this comes back to CST 1 – and being neutral. We must be neutral in our touch as well as our intention. And this to me means letting go of outcomes. I do not know what healing looks like for any individual. I trust that their inner physician knows what they need for their own healing. And I trust that this occurs with any and all practitioners that they come in contact with. Since I no longer have any attachment to outcomes, and I do not “fix” anyone, my patients are invited to do all they can to promote their own heling. If this involves other modalities, so be it.
I also refuse to participate in the blame game. The patient saw me last so the pain must be from something I did. I know I am coming from that place of neutral, following the tissue and inner wisdom and to be honest, the fact that the patient left my office, means the patient was the last person to do something to their body.
I have had several practitioners tell their patients not to see me for two months while they begin treatment with them so they can see the results of their own session. If this is what works for them, I can live with this. I personally don’t care who helps a person as long as they are getting help. I will also say that the above practitioners are now a referral base for me as they can tell when their clients have seen me in between their appointments with them.
I know we all want to help people, that is why we are in this profession, but at some point you will come to realize not only can less be more but by letting go of your intention to “fix” someone, amazing things will happen.Back to top of page
January 2017 - Blog
Is My Child Developmentally Delayed?
Since the back to sleep program started in 1997 I have seen more normal kids referred to physical therapy for developmental delays that simply do not exist. The truth of the matter is we as parents are no longer doing our job of raising our children, we have left that to the positional toys and whatever new device is available.
Lets look at a common scenario: Chloe — at 13 months old was referred to PT for not pulling to stand. "She just sits there" according to her mother. She loves to stand and walk boasted her father as he picks up Chloe — holds her under the arms and she walks for the therapist. As we delve into Chloe’s background it is revealed that she has never received any floor time because: "Well... we have hardwood floors and I did not want her to get hurt. She never really liked her belly and just cried when ever I placed her there so I always picked her up or placed her in her bobby so she could sit or her exersaucer for standing. She was so much happier in those positions. She just wants to see everything we are doing."
During the evaluation it is noted that Chloe cannot turn her body to pick up a toy placed next to her. If she reaches in any direction and begins to tip over her father immediately places her back into sitting and gives her the toy she was reaching for. "She has a hard time playing by herself and requires constant attention so she won’t fall over. I thought as she got older she would be more independent" Chloe’s mother states, "but I can’t leave her alone for a moment. And if I leave the room she bursts into screams and cries until I come back. The doctors can find anything wrong with her. They are running blood tests to see if it is a genetic problem."
This may sound extreme to you but by the time I left the medical based practice I was evaluating a new child a week for this non-specific gross motor delay. So you ask, What is wrong with Chloe? — nothing — Remember the saying we live what we learn — What has Chloe learned? By placing Chloe in a boppy pillow to sit, she has learned to sit. By placing Chloe in an exersaucer, she has learned to stand. And to get what she wants, she has learned to cry. What Chloe has not learned is how to get from one position to another. Something that can only be learned through trial and error. When my generation was growing up we were all put on our belly to sleep. We could net see what was going on so we had two options – we rolled over or we pushed up on our hands, raised our heads and looked around. Remember for children it is a visual world. Vision is the dominant sense until we are 7 years old.
The kids of this generation are already on their back, so they have no need to roll over to see what is going on. And when placed on their bellies — of course they cry — it is a new and scary position to them. They cannot see mom or dad so they cry. Instead of teaching them how to bear weight on their hands and pick up their heads to see, we pick them up. Instead of getting down on the floor to play with them, we place them in a position convient for us — sitting. When we were on the floor crying, our mom’s politely said: "sorry dear, I need to finish the lunch dishes before dad gets home so we can use them for dinner" or "you’ll just have to figure it out for yourself, I have to have dinner on the table when your dad gets home." Today's parents run and pick up their child so the crying will stop. As a child, I have learned cry — they pick me up. As a mom — I got nothing done today, because the baby would not let me put her down. So, I call my husband and tell him we need "take out" for dinner because I was busy with the baby all day, or we have to eat on paper plates because I could not get to the dishes, because every time I tried the baby cried. Another senerio is that as a parent I got it all done because the infant was in her exersaucer all day.
Your baby is not crying because of pain, she is crying for cause and effect. She knows if she cries you will pick her up.
And she also knows she can out last you. So, incorporate belly time into the day on several occasions. And when she cries —
walk to the door and back before you go to her
—get down and help her to see you, by positioning her arms in the right place for weight bearing.
—play roll over with her, back and forth, and every time leave her on her belly a little longer.
And every time she cries wait another 15 seconds, until she is finally on her belly for 15 minutes at a time.
A child must like being on their belly if they are going to learn to crawl. And yes, every child needs to learn to crawl, of course unless you do not mind the consequences. Sort of like that flat head thing. If you are going for a misshapen head then by all means leave you child on one spot of her head for 15- 20 hours a day.
Studies have linked decreased motor coordination, poor reading skills, and difficulty in handwriting to children who have skipped the crawling phase. Crawling is the primary way in which we establish the proximal stability our shoulders need to complete tasks as we grow older. Once we move into standing and walking, we are no longer placing weight on our hands and through the shoulders to give them the strength they need to allow us to have mobility in our wrists and fingers. With all the new positional devices available for infants, we are depriving them of their ability to learn to move their bodies independently. This is causing a delay in motor planning, motor coordination, and motor skill development. Floor time, especially belly time is vital to the learning process for all children.
At birth the pelvis is largely cartilage. Because the hip cartilage is malleable, how a child lies in the crib has a great effect on the development of this lower structure. If a baby only lies on his back the legs tend to be splayed out and this in turn will limit pelvic ossification as well as delay the development of soft tissue tone to pull the legs together. This can lead to poor motor coordination as the child grows older. Crawling helps to stretch and strengthen the tissues surrounding the hip.
This leads me back to my original question. Is my Child Developmental Delayed? I do not know, you decided, and if you are unsure have a physical therapist do a complete assessment.Back to top of page
Babies Cry for Communication
When my son was a baby I cannot tell you how many times I was approached in a store because my child was crying. I received more bad advice from unwelcomed sourses then I care to remember. He must be hungry, wet, or my favorite "tired". No, my son was born on the spectrum. He cried more then the average child. He cried, as all babies do, because that was his form of communication. It was my job as his mother to interpret that cry. Sometimes I succeeded quickly and sometimes I failed miserabley.
What I did not realize was that he became overwhelmed easily — the lights were to bright, it was to loud, his clothes were itchy. In hindsight I wish I had known about these sensory issues when he was a baby. I, however, did not. I did my best to calm him while completing my errands. Much to the dismay of anyone in our path.
What I learned then was there are many ways to calm a baby. As a new parent I was told — you will learn your baby has a different cry for different needs. One cry will mean he is wet, one cry will mean he is hungry. I can tell you all the cry's sounded the same — loud and in distress. As a parent I could not tell the difference between the cries so I had to run down my checklist, is my baby safe? tired? hungry? full diaper? hot?. Then it was a matter of redirection versus feeding into the problem by increasing my anxiety and frantically trying to calm my baby.
What I now know is that a baby can also cry from sensory overload — just too much stimulation — too much or too fast rocking and what calms one baby may not calm another baby. Being in the NICU I have learned to read a babies cues. Most infants will give you warning before they start to cry.
These cues include:
- Irregular breathing
- Facial grimace
- Color changes
- Limits have been reached
- Needs a change
- Needs consoling
- Variable sensitivity to stimuli
I have since learned to differenciate between a development cry versus a stressful cry.
Developmental cry — breathy, helpless, intermittent - baby is breathing between crys
Stressful cry —high—pitched (hyperphonated) cry
After flying in an airplane with an infant on the spectrum - my motto became "If the worst thing that has happended in your day is that my crying baby bothered you. You live very blessed life". Because belive me I have bigger concerns in my world than someone elses crying baby. I now honor any baby that crys - because that cry is a CRY FOR COMMUNICATION. And just like adults, sometimes a baby just needs to be heard.
- Hold baby quietly — no talking, no looking at, and no movement
- Use soft, low lighting
- Provide one or toys for baby to look at
- Keep sound level down
- Provide soft music
- Provide environmental sounds — vacuum cleaner, clock, fan
- Talk softly, sing, or hum
- Keep temperature in room steady
- Handle baby with firm, gentle support
- Swaddle baby
- Try warm bath
- Massage baby
- Rock baby with slow rhythmic movement
- Walk with baby
- Use swing
- Drive in car
- Limit perfumes and bad smells
- Use pacifier
- Have baby suck on hands
- Carry baby in front or sling carrier
- Firmly pat baby on the back or shoulders
- Position baby in a flexed up position