The Disorder Is Sensory; the Diagnosis, Elusive

Taken from the New York Times

DENVER — Almost every parent of young children has heard an anguished cry or two (or 200) something like:
Kevin Moloney for The New York Times

“This shirt is scratchy, this shirt is scratchy, get it off!”
“This oatmeal smells like poison, it’s poisonous!”
“My feet are hot, my feet are hot, my feet are boiling!”
Such bizarre, seemingly overblown reactions to everyday sensations can end in tears, parents know, or escalate into the sort of tantrum that brings neighbors to the door asking whether everything’s all right.
Usually, it is. The world for young children is still raw, an acid bath of strange sights, smells and sounds, and it can take time to get used to it.
Yet for decades some therapists have argued that there are youngsters who do not adjust at all, or at least not normally. They remain oversensitive, continually recoiling from the world, or undersensitive, banging into things, duck-walking through the day as if not entirely aware of their surroundings.
The problem, these therapists say, is in the brain, which is not properly integrating the onslaught of information coming through the senses, often causing anxiety, tantrums and problems in the classroom. Such difficulties, while common in children with developmental disorders like autism, also occur on their own in many otherwise healthy youngsters, they say.
No one has a standard diagnostic test for these sensory integration problems, nor any idea of what might be happening in the brain. Indeed, a diagnosis of such problems is not yet generally accepted. Nor is there evidence to guide treatment, which makes many doctors, if they have heard of sensory problems at all, skeptical of the diagnosis.
Yet in some urban and suburban school districts across the county, talk of sensory integration has become part of the special-needs vernacular, along with attention deficit disorder and developmental delays. Though reliable figures for diagnosis rates are not available, the number of parent groups devoted to sensory problems has more than tripled in the last few years, to 55 nationwide.
And now this subculture wants membership in mainstream medicine. This year, for the first time, therapists and researchers petitioned the American Psychiatric Association to include “sensory processing disorder” in its influential guidebook of disorders, the Diagnostic and Statistical Manual. Official recognition would bring desperately needed research, they say, as well as more complete coverage for treatment, which can run to more than $10,000 a year.
But many psychiatrists, pediatricians, family doctors and school officials fear that if validated, sensory processing disorder could become rampant — a vague diagnosis that could stick insurers and strapped school districts with enormous bills for unproven therapies. The decision is not expected for three or four years, but the controversy is well under way.
“There’s a real resistance to recognizing this, and you can see why, because you’re introducing a whole new vocabulary,” said Dr. Randi Hagerman, a developmental-behavioral pediatrician who is medical director of the MIND Institute at the University of California, Davis. Dr. Hagerman added, “Many of the behavioral difficulties that are being labeled today as anxiety or A.D.H.D., for instance, may be due to sensory disorders, and that forces you to rethink the treatments,” as well as diagnoses. Everyone seems to agree that sensory problems are real and disabling in children with diagnoses like autism or Fragile X Syndrome, a genetic disorder that causes social difficulties and learning delays.
Most youngsters with these diagnoses react strongly to certain sounds, textures or other sensations — or appear unusually numb to sensory stimulation. They may gag at the mere whiff of common smells, or cry out when touched. They may spin or flap their arms as if seeking stimulation (or, in some cases, to relieve pain). Children with attention deficit disorders, too, frequently appear to have unusual sensitivities.
A common treatment for sensory symptoms is occupational therapy. For these children the therapy typically involves activities and games, guided by a therapist, intended to make the youngsters more comfortable as they engage the sensations that disturb them — or more alert to those they usually do not notice.
It was a California occupational therapist and psychologist named A. Jean Ayres who, in a widely read 1972 book, first argued that sensory problems were more than symptoms of other disorders. They were the primary cause of many motor and behavioral problems, she argued, and far more common than doctors recognized.

Fore more on this article http://www.nytimes.com/2007/06/05/health/psychology/05sens.html?fta=y
Taken from the New York Times

By BENEDICT CAREY
Published: December 17, 2008
The book is at least three years away from publication, but it is already stirring bitter debates over a new set of possible psychiatric disorders.

Brendan Smialowski for The New York Times
Dr. Darrel A. Regier is co-chairman of a panel compiling the latest Diagnostic and Statistical Manual of Mental Disorders.
Multimedia
Graphic
A Growing List of Mental Ills


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Is compulsive shopping a mental problem? Do children who continually recoil from sights and sounds suffer from sensory problems — or just need extra attention? Should a fetish be considered a mental disorder, as many now are?
Panels of psychiatrists are hashing out just such questions, and their answers — to be published in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders — will have consequences for insurance reimbursement, research and individuals’ psychological identity for years to come.
The process has become such a contentious social and scientific exercise that for the first time the book’s publisher, the American Psychiatric Association, has required its contributors to sign a nondisclosure agreement.
The debate is particularly intense because the manual is both a medical guidebook and a cultural institution. It helps doctors make a diagnosis and provides insurance companies with diagnostic codes without which the insurers will not reimburse patients’ claims for treatment.
The manual — known by its initials and edition number, DSM-V — often organizes symptoms under an evocative name. Labels like obsessive-compulsive disorder have connotations in the wider culture and for an individual’s self-perception.
“This is not cardiology or nephrology, where the basic diseases are well known,” said Edward Shorter, a leading historian of psychiatry whose latest book, “Before Prozac,” is critical of the manual. “In psychiatry no one knows the causes of anything, so classification can be driven by all sorts of factors” — political, social and financial.
“What you have in the end,” Mr. Shorter said, “is this process of sorting the deck of symptoms into syndromes, and the outcome all depends on how the cards fall.”
Psychiatrists involved in preparing the new manual contend that it is too early to say for sure which cards will be added and which dropped.
The current edition of the manual, which was published in 2000, describes 283 disorders — about triple the number in the first edition, published in 1952.
The scientists updating the manual have been meeting in small groups focusing on categories like mood disorders and substance abuse — poring over the latest scientific studies to clarify what qualifies as a disorder and what might distinguish one disorder from another. They have much more work to do, members say, before providing recommendations to a 28-member panel that will gather in closed meetings to make the final editorial changes.
Experts say that some of the most crucial debates are likely to include gender identity, diagnoses of illness involving children, and addictions like shopping and eating.
“Many of these are going to involve huge fights, I expect,” said Dr. Michael First, a professor of psychiatry at Columbia who edited the fourth edition of the manual but is not involved in the fifth.
One example, Dr. First said, is binge eating, now in the manual’s appendix as a tentative category.
“A lot of people want that included in the manual,” Dr. First said, “and there’s some research out there, some evidence that drugs are helpful. But binge eating is also a normal behavior, and you run the risk of labeling up to 30 percent of people with a disorder they don’t really have.”
The debate over gender identity, characterized in the manual as “strong and persistent cross-gender identification,” is already burning hot among transgender people. Soon after the psychiatric association named the group of researchers working on sexual and gender identity, advocates circulated online petitions objecting to two members whose work they considered demeaning.
Transgender people are themselves divided about their place in the manual. Some transgender men and women want nothing to do with psychiatry and demand that the diagnosis be dropped. Others prefer that it remain, in some form, because a doctor’s written diagnosis is needed to obtain insurance coverage for treatment or surgery.
“The language needs to be reformed, at a minimum,” said Mara Keisling, executive director of the National Center for Transgender Equity. “Right now, the manual implies that you cannot be a happy transgender person, that you have to be a social wreck.”
Dr. Jack Drescher, a New York psychoanalyst and member of the sexual disorders work group, said that, in some ways, the gender identity debate echoed efforts to remove homosexuality from the manual in the 1970s
For the rest of this article visit: http://www.nytimes.com/2008/12/18/health/18psych.html?_r=2&ei=5070&emc=eta1

Great Stocking Stuffers

1. Sensory balls
2. Tangles
3. Jitter Critters
4. Zoo sticks and spiney balls
5. Bug tongs
6. Accordion pipes
7. Tornado Spinners
8. Strecthgetti

Holiday Toys

What are some different and exciting toys that you can buy for the holidays?

Look at our catalog and you will fiund plenty to choose from. Here are a few top picks:

String Along http://shoponline.pfot.com/cgi-sys/cgiwrap/pfot/sc/productsearch.cgi?storeid=*1270fdb65ed10b6f9c5027

Super Skipper http://shoponline.pfot.com/cgi-sys/cgiwrap/pfot/sc/productsearch.cgi?storeid=*1270fdb65ed10b6f9c5027&search_field=super+skipper

Wok N Roll http://shoponline.pfot.com/cgi-sys/cgiwrap/pfot/sc/productsearch.cgi

Check out our website for more...

Handwriting and OT

Importance of Legible Handwriting
How important is good handwriting? Although keyboarding may serve as a compensatory tool for illegible handwriting in some children, handwriting is still necessary for most assignments, homework, and tests, including standardized tests (high school achievement and college preparatory). The importance of good, clear handwriting is further emphasized by the inclusion of a mandatory written component on the SAT.1 Thus, legible handwriting continues to be an important skill for children to develop in elementary school to attain proficiency in schoolwork. Children who experience difficulty mastering handwriting may avoid writing and develop a mind-set that they cannot write, which will contribute to decreased development of composition skills. Overall, handwriting instruction in the elementary classroom will contribute to students being able to focus more on ideas and composition, and not so much on the mechanics of writing in producing assignments.2
The Role of OT in Handwriting Instruction
One important area of occupation for children is education. Because written communication is required to meet educational goals, learning to write legibly is a critical skill. Problems with handwriting performance can interfere with the ability to succeed in educational activities and are among the most common reasons for referrals of school-age children to occupational therapy.3
According to Benbow,4 children generally fall into one of three classification groups in response to handwriting instruction. Group A children learn to write well regardless of the methods used in teaching. Group C children are unable to learn handwriting, no matter what interventions are used in teaching. Group B children fall between the two extremes and will learn to write legibly with good teaching strategies. Appropriate intervention or compensatory strategies should enable most children in groups A and B to learn to write legibly. For Group C children, compensatory strategies must be considered to allow for functional written communication.
The occupational therapist typically looks at the child's occupational performance in the classroom and designs interventions to improve performance skills, which may include developing legible handwriting. Taken from www.aota.org

Autism and OT

Occupational Therapy from www.autismspeaks.org

Occupational Therapy can benefit a person with autism by attempting to improve the quality of life for the individual. The aim is to maintain, improve, or introduce skills that allow an individual to participate as independently as possible in meaningful life activities. Coping skills, fine motor skills, play skills, self help skills, and socialization are all targeted areas to be addressed. Through occupational therapy methods, a person with autism can be aided both at home and within the school setting by teaching activities including dressing, feeding, toilet training, grooming, social skills, fine motor and visual skills that assist in writing and scissor use, gross motor coordination to help the individual ride a bike or walk properly, and visual perceptual skills needed for reading and writing. Occupational therapy is usually part of a collaborative effort of medical and educational professionals, as well as parents and other family members. Through such collaboration a person with autism can move towards the appropriate social, play and learning skills needed to function successfully in everyday life.
What Makes a Good Toy?

Toys are the tools children use in play. Every plaything should measure up to this tall task. Below are some points to consider when purchasing toys for the little ones in your life.Is it Safe? A good toy should pass the drop test and a lot more. Be it wood, metal, plastic, or fabric, the basic material should be durable and well-finished. Avoid toys with sharp edges and long cords. Abide by any age-specific safety warnings, such as small parts which may present choking hazards for children under three years old.

Is it Age Appropriate?

The play activity should developmentally suit the child's age. Check the toy maker's recommendations and believe in the "+" sign. Ages 3+ does not mean your 4-year-old has outgrown it. If in doubt, consult with the toy experts. ASTRA specialty retailers are very astute when it comes to matching activities to specific ages.

Does it Engage the Child?

A good toy should encourage open-ended play, invite exploration, and engage a child's interest beyond a short sitting. Toys should be hands-on tools – not watch-me players. A child should be able to power a plaything – even a battery-operated toy – with his or her own ideas and imagination.

Does it Expand the Child?

A good toy with play value benefits the child at a particular stage by introducing and reinforcing age specific skills. A great toy grows with the child, helping her or him advance from one developmental stage to the next.

Does it Add to the Toy Box?

A child needs a variety of toys and different types of play activities. When selecting a new toy, consider one that adds balance to your child's busy play.

Is it Fun?

Most of all, a good toy is fun to play with. Dull and boring, regardless of benefit, have no place in a good toy box.

Taken from www.ASTRA.org

Backpack Awareness Day

This was taken from the American Occupational Therapy Association

National School Backpack Awareness Day is September 17, and occupational therapy practitioners across the United States are gearing up to help students “Pack It Light, Wear It Right!” But occupational therapists work every day in virtually every school district, providing services ranging from behavioral help to proper posture for computer use.

National School Backpack Awareness Day focuses on just one area of occupational therapy expertise—ergonomics—but occupational therapy in schools is much more. Occupational therapists and occupational therapy assistants help children, youth, and families with a broad range of health and wellness issues that affect the ability to participate in and enjoy everyday activities. In schools, they help students develop the skills they need to learn, play, and interact with others.

Visit www.aota.org for more information on backpack awareness.

Backpack Awareness Day

The American Occupational Therapy Association has published ten tips to avoid backpack-related health problems:
Never let a child carry more than 15% of his or her body weight. This means a child who weighs 100 pounds shouldn't wear a backpack heavier than 15 pounds.
Load heaviest items closest to the child's back and arrange books and materials to prevent them from sliding.
Always wear both shoulder straps. Wearing only one strap can cause a child to lean to one side, curving the spine and causing pain or discomfort.
Select a pack with well-padded shoulder straps. Too much pressure on shoulders and necks can cause pain and tingling.
Adjust the shoulder straps so that the pack fits snugly to the child's back. The bottom of the pack should rest in the curve of the lower back, never more than four inches below the child's waistline.
Use the waist belt, if the backpack has one, to help distribute the pack's weight more evenly.
Check what your child carries to school and brings home to make sure the items are necessary to the day's activities.
If the backpack is too heavy, consider using a book bag on wheels if your child's school allows it.
Choose the right size pack for your child's back as well as one with enough room for necessary school items.
If a student is experiencing back pain or neck soreness, consult your physician or occupational therapist.

Treatment for SPD

From Kid Foundation- another great resource
Treatment for Sensory Processing Disorder is a fun, play-based intervention that takes place in a sensory-rich environment. Private clinics and practices, hospital outpatient departments, and university occupational therapy programs are typical places where treatment for SPD or for sensory issues in disorders such as ADHD and Autism may be found. Children are most commonly treated for SPD with occupational therapy (OT) that may be supplemented with listening therapy (LT) or other complementary therapies. Sometimes other professionals such as physical therapists, speech/language therapists, teachers, and/or others who have advanced training in using a sensory integration approach may be involved in treatment.
The most effective treatment for SPD is research-based. Although a great deal remains to be discovered about the disorder, scientists at SPD Foundation and elsewhere already have learned that some intervention strategies are more effective than others. Treatment from a research-based clinic or clinician ensures that these strategies will be put to work for your child or for you.
Effective treatment for SPD also is family-centered. In family-centered care, parents and therapists become partners who assume different but essential roles during treatment. Parents identify priorities and act as the experts on their child. The child's therapists have expertise in therapeutic technique and measure progress toward the family's priorities. Together, the family and the therapist collaborate to develop the best possible program that reflects the family's culture, needs, and values. Treatment from a family-centered clinic or clinician who uses quantifiable outcome measures improves the likelihood that you will benefit and be satisfied with the therapeutic program you choose for your child or yourself.

Sensory Ideas for Home

From www.kidfoundation.com a great resource for sensory questions

Incorporating Sensory Input into Daily Activities
Bath time: Scrub with washcloth or bath brush, try a variety of soaps and lotions for bathing, play on the wall with shaving cream or bathing foam, rub body with lotion after bath time (deep massage), sprinkle powder onto body and brush or rub into skin.
Meal preparation or baking: Let your child mix ingredients, especially the thick ones that will really work those muscles. Let child mix and roll dough and push flat. Allow child to help you carry pots and pans, bowls of water or ingredients (with supervision, of course). Let your child tenderize meat with the meat mallet.
Grocery shopping: Have your child push the heavy cart (as long as the weight is within their capability). Let your child help carry heavy groceries and help put them away.
Mealtime: Encourage eating of chewy foods and drinking out of a straw. Try having your child sit on an air cushion to allow some movement. A weighted lap blanket may be helpful as well.
Household chores: Allow the child to help with the vacuuming or moving the furniture. Let the child help carry the laundry basket or the detergent. Let the child help with digging for gardening or landscaping.
Play time: Reading books in a rocking chair or bean-bag chair may be beneficial. You can help your child make up obstacle courses in the house or yard using crawling, jumping, hopping, skipping, rolling, etc. Listen to soft music. Play the sandwich game (child lies in between two pillows and pretends to be the sandwich, while you provide pressure to the top pillow to the child’s desired amount). Ask them "harder or softer?" as you push on the pillow. Some children will like much more pressure than you would expect. You can also go for a neighborhood walk with a wagon and have your child pull it (make it semi-heavy by loading it with something the child would like to pull around). You can do the same with a baby-doll carriage. Swimming in a pool is a wonderful activity if you have that available, as are horseback riding and bowling. Mini or full-size trampolines are excellent for providing sensory input as well. Make sure the child is using them safely. Sandboxes, or big containers of beans or popcorn kernels can be fun play-boxes. too, if you add small cars, shovels, cups, etc.
Errands and appointments: Before visiting the dentist or hairdresser try deep massage to the head or scalp (if tolerated), or try having your child wear a weighted hat. Try chewy foods or vibration to the mouth with an electric toothbrush. Let your child wear a heavy backpack (weighted to their liking with books and with the straps padded as needed). Be sure to give the child ample warning before any changes in routine or any unscheduled trips or errands. Many children with SPD need predictability.
Other General Guidelines for the Home
Keep routines and possessions organized.
Be consistent with rules and consequences.
Keep an activity schedule or calendar posted.
Create specific routines for troublesome times of day (bedtime or getting ready for school).
Discuss upcoming anticipated changes in routine at a point in time that is beneficial for your child. You will have to experiment with how early the child "needs to know."
Try to indirectly use your child’s sensory preferences for fun rewards to help you handle behavior. For example, having your child work towards an extra trip to go bowling or horseback riding may be helpful. However, try not to restrict movement activities when your child is being disciplined. For example, taking away recess time or playground time for not sitting at the table appropriately during dinner may not be the most effective way to deal with these issues. Your child may need that movement time, and by removing it, his or her behavior may actually become more difficult later.

Summer Time Word Search

Summer Time
G Y A Z N C H O B C X V E H O K K G G A
T E B Z S T A N J B R M V B C X K S V B
A W D E Y Y A A R K R A L P J A U Z D V
V L R W C P S E Q K H X B J P R E P N F
F N T Q Q J D C H T B Z B B F H Q B A N
S D N E I R F O M O Y V G I I H O E L A
N Y T O W H A B O W P R N Y F N E T J Y
E L S A I L B O A T A G U S D R G A P X
F V X Z F N H Q U G V E G D T Y K K X X
P A A D O I L T A G G C Z I E D W K H X
F I Q S K Z D C A N W D P Y K H X U F S
F E F V T S F K Q P D V U A O E M G I C
Y I Q V M Q A U I G E S V F V Z H D S N
B A I D W V Q H N T G K N A X K W E H E
O P P G N P G Q Q P M M O K J Y C N I E
Q G T W T N I H C N E I O W J F O S N D
A J E F B I D A U Y H E E T D C A U G S
W U G M R G D G J O P E A N N D M N P R
H L T J B S B C Y W N I A U B E E G B C
P J F U N R R Y J A Y S J R N I W K S Q

Find: BEACH CRABBING FISHING
FRIENDS FUN HOT OCEAN
SAILBOAT SAND SUN SURFING

What is Sensory Integration??

Sensory integration theory proposes that sensory integration is a neurobiological process that organizes sensation from one’s own body and from the environment and makes it possible to use the body effectively within the environment. The spatial and temporal aspects of inputs from different sensory modalities are interpreted, associated, and unified. Sensory integration is information processing…Praxis and perception are both end products of sensory integration… Practic ability includes knowing what to do as well as how to do it. Practic skill is fundamental to purposeful activity”(Ayres, 1986 p. 9). The effectiveness of organism-environment transaction in promoting human development is partially dependent up on the inherent plasticity of the central nervous system. The brain, especially the young brain, is naturally malleable; structure and function become more firm and set with age. The formative capacity allows person-environment interaction to promote and enhance neurointegrative efficiency. A deficiency in the individual’s ability to engage effectively in this transaction at critical periods interferes with optimal brain development and consequent overall ability. Identifying the deficient areas at a young age and addressing them therapeutically can enhance the individual’s opportunity for normal development (Ayres, 1986 p.10). Definition taken from www.siglobalnetwork.org

Zoo Sticks, Rookie Sticks, Tongs

Zoo Sticks, Rookie Sticks, Tweezers and Tongs!
Whether you have zoo sticks, rookie sticks, tweezers or tongs you can do all of these activities. First, what’s the difference between these tools??
Zoo Sticks have an animal on top with long legs to make the tongs. Rookie sticks are long and thin with an “M” shaped top. Each of these are actually children’s chopsticks. Tweezers are available in various types and are going to be smaller with a pointier tip. Some are resistive, some squeeze to open, others squeeze to close. Tongs tend to be larger and thicker with a flat surface, so easier than tweezers or zoo/rookie sticks.
You can use these tools to pick up almost any small object: spiny balls, critter balls, cotton balls, pieces of scrunched paper, pop beads, M&M’s, beads, etc. The child can hold a small container (film canister, or paper towel tube with one end closed up) in the other hand to put the small objects into. Now you’re also working on bilateral hand use and crossing midline!
Other Uses:
Pick up and place pegs in a pegboard, while copying a pattern or making a design.
Use to move pieces during traditional board games.
When playing with putty; roll out the putty into a snake and use tool to pinch into an inch worm, or pick up small pieces of putty.
Have a rice/bean bucket or sand table? Use tongs to pick out hidden buttons/cotton balls/small plastic toys/beads or anything you’d like!
Make your own tongs!! With two Popsicle sticks, a rubber band, and a small piece of paper rolled into a ball! Place the ball on one end of the Popsicle stick and the rubber band around this side. You have a pair of tongs that you can change the position and resistance of.

Play Ideas for Home

Let’s re-visit: Houshold Items!
We have decided to focus on activities for the summer that you can do at home. Most families do not have swings and trampolines at home but that doesn’t mean you can’t have a sensory gym in your house. Some fun ideas with items around the house are:
1. Couch Cushions or Pillows
Take the cushions off the couch, pile them up on the floor and have your child jump on them as if it were a trampoline or crash mat. You can sing the ABC’s, or count while they jump.
Turn the cushions into an obstacle course- lay two on the floor to jump over, then one to hop around, and three in a row to walk across.
Pretend the cushions are stepping stones- lay them on the floor making a path, walk across “the river”. You can place objects on the floor for them to squat down and pick up along the way. It is a great way to work on balance.
Use cushions to provide some deep pressure- sandwich your child between two cushions and give a little squeeze. Pretend they’re a hot dog and the pillows are the bun or use a blanket and roll them up inside to make “kids in a blanket”.
2. Laundry
Have your child push/ carry the full laundry basket to and from the machine/dryer
Once the laundry is finished they can help match and fold each item. This is a great visual perceptual task.
3. Old magazines and newspapers
Before you throw them in the recycle bin, let your kids cut them up. They can help you cut coupons, cut out items with a theme and make a collage (some example themes are “things they like”, “Summertime” “Things that smell good”) , or just cut away until you have confetti!
Use the paper to play a basketball game- crumple and shoot to a can or laundry basket; add in some writing and math practice and keep score.
4. Egg Cartons
An egg carton is a great sorting dish. Color each space a different color and ask your kids to find one of their toys that match and place it in.
Or you can label them with letters (you need 2 cartons for the whole alphabet. You can cut letters out of the newspaper or magazines and have your kids match them to the appropriate cup. Or if you have magnetic letters, they will fit also. Make it difficult and have them find something around the house or just the kitchen that starts with each letter.
It also makes a great paint palette, so pour some paint and make a masterpiece! You can also go on a hunt for large rocks in a park or shells at the beach. Wash them off, they can paint them! (Remember Pet Rocks!)

How to Find Us

Mailing Address:PFOT P.O. Box 174 Morganville, N.J. 07751
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Who Are We?

PFOT, while still a small company, continues to grow and work hard to meet your needs. It was conceived and established in 1989 by us, Michelle Tobias and Ilene Goldkopf, and yes we are Occupational Therapists. Our initial goal was, and still is, to assist Occupational Therapists and others, concerned with the development of children, find the unique materials needed to provide effective, appropriate, motivating and fun, pediatric therapy and learning. That's why the catalog is arranged into catagories pertinent to develpment. This makes classroom, home programs and gift giving recommendations easier for you.
As therapists, we have over 35 years of combined experience in pediatrics & developmental disabilities. We are both Board Certified Pediatric OT's and are certified to administer the SIPT. We are coauthors of the book "OT GOALS (Goals & Objectives Associated with Learning)" published by Therapy Skillbuilders, Inc. We are also contributing authors to the book "Hand Function in the child: Foundations for Re-mediation" published by Mosby, Inc. and continually have projects underway.
We both continue to work full time as Occupational Therapists, servicing public schools in Central New Jersey, as well as private clients in our clinic. We are also pleased to be included in the new AOTA Pediatric Resource Guide. If you have any therapy-related questions, we'll try to help answer them or lead you to a resource for the info.
Hope this helps in understanding us and our catalogue a little better - but please keep writing and calling, we enjoy hearing from you!
Ilene and Michelle