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What is Early Intervention?

Soon after birth, an infant will show off their personality and develop nonverbal communication in an effort for their basic needs to be met. These early forms of communication exhibit as brief eye gazing at objects, crying or cooing communicating needs for physical bonding; being held and possibly soothed or fussing/crying to be fed. Development continues from infancy to childhood and may not always follow the same pace for every child, however, children do grow and develop acquiring skills at typical age-appropriate milestones such as crawling, walking, saying their first words at around the same age. When children are not reaching expected milestones and are showing significantly delayed development, parents may become concerned about skill development impacting school readiness and function.

Early Intervention services are available to help an infant- child who may have trouble reaching certain developmental milestones. Early intervention means using “therapy services to enhance a child’s ability to interact with others and the environment as these everyday experiences and interactions are essential for optimal child development.”

Early Intervention includes infants and toddlers, age birth to 36 months, who have or are at-risk for developmental disabilities or delays. Early intervention supports families and caregivers to increase their child’s participation in daily activities and routines that are important to the family.

Early intervention begins with a multidisciplinary team evaluation to identify a child’s needs. Research reveals that early intervention services can considerably lessen the effects of developmental delays.

Positive early learning experiences are crucial for later success in school, the workplace, and the community. Research shows that children’s earliest experiences play a critical role in brain development.

Early Intervention may include speech-language therapy, occupational therapy, physical therapy, and education specialist services based on the needs of the child and family.

We believe Early Intervention, both therapeutically and academically, is a key part of the Educational Journey and leads to success. Monitoring a child’s development for school readiness begins at birth and is a constant process. With that in mind, we have now released a comprehensive online developmental assessment service – K-Shield Screening – created for screening children from 0- 5 ½ years of age designed for collaboration, continuity, and academic success.

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Before you make a movement

Motor planning or “praxis” is our ability to unconsciously (or consciously) plan and then carry out purposeful movements with our bodies. It relies on a number of foundational sensory and sensory motor skills, such as knowing how your body is positioned, and having good feedback from your muscles and joints about how you are moving.

Think about the last time you learned a new movement with your body. Or when you learned a new sport as a child. A lot of effort when into thinking about how you needed to move in order to be accurate in your movement. This is motor planning.

For children with coordination difficulties, poor awareness of their own body, or difficulties with planning, being able to plan out and then complete movements is an energy intensive activity. For many children, they have difficulties with even coming up with an idea of what they would like to do with their body. For example, they may want a toy form a high shelf, but have no idea of how to get it. Or their idea may be completely unworkable.

For children with movement and planning difficulties, they often require many repetitions before they master a movement. Essentially, they need to plan it out consciously every time they complete it until the movement pattern is firmly established. If we think about getting dressed for example, this requires a significant amount of sequencing, body awareness and planning of movements. Imagine now that every morning you are doing this for the very first time. The level of concentration, planning and energy used, not to mention the time required, is very significant for a child.

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Hands and fine motor skills

Fine motor skills are abilities to control and coordinate the small muscles in the hand for precise movements. The development of children’s fine motor skills are important because they are the foundation for the development of many other important skills in the future, including reading, writing, and drawing, as well as the ability to undertake everyday tasks such as tying shoelaces or holding a knife and fork. There are many components of fine motor skills including the following:

ARM AND HAND STRENGTH

Children require adequate muscle strength in their hands and arms, in order to effectively use them for fine motor tasks. – Just as a body builder needs to train in order to lift that dumbbell, children need to train their hand and arm muscles in order to build the quality of their movement, as well as their endurance levels.

GRASP

The ability to freely open and close the hand in order to grip and let go of objects when needed. – It requires coordinated finger movements and shaping of the hand to use different grasps to pick up and hold objects of different sizes and shapes. – An efficient pencil grasp requires the ability to move fingers in isolation of each other, adequate hand strength and good wrist stability.

BILATERAL COORDINATION

The ability to use both hands together in a coordinated way, such as when manipulating an object. – It develops early in a child’s life when they are observed to hold objects with two hands. – Each side of the body must be aware of what the other side is doing in order to cooperate and complete a task. It is a ‘doing/helping relationship’ –one hand does most of the task and the other helps out. – It is important for activities such as throwing and catching a ball and cutting skills.

HAND EYE COORDINATION

The ability to use the eyes and the hands together to complete a task. – The child guides hand movements with their eyes to accurately manipulate objects and place them in specific positions (i.e. Putting block on top of tower without knocking all the other blocks off) Crossing the midline – The ability to use arms, legs and eyes across the midline of the body. (MIDLINE = imaginary line drawn vertically dividing the body into two equal parts). – It is essential for activities such as handwriting and using scissors.

IN-HAND MANIPULATION

In hand manipulation is the process of moving objects that are already in the hand. It determines how effective and efficiently a child can coordinate the hand and fingers to complete fine motor tasks. – It is important for tasks such as handwriting, holding money and scissor skills.

HAND DOMINANCE

Hand dominance is the consistent favoring of one hand over the other for the skilled part of an activity. For example, the dominant hand holds and uses a pencil whilst the other hand stabilizes the paper.
Hand dominance usually starts to develop between 2-4 years, however it is common at this stage for children to swap hands. Between the ages of 4 to 6 years a clear hand preference is usually established.

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What are the seven senses?

In addition to the five best known senses – taste, touch, hearing, sight and smell, there are also two others that play an important role in a child’s development – the proprioception and vestibular systems.

TOUCH (TACTILE SYSTEM)

The tactile system refers to the awareness of touch through receptors in the skin. It consists of two levels – discrimination to tell us where the touch is on our body, and a second level to tell us whether it is a safe or dangerous touch (sometimes known as a ‘fight or flight’ response). When a child is having difficulty in processing touch sensation, their brain may misinterpret the information, and label sensations as dangerous unnecessarily, causing them to overreact to light touch. Deep pressure touch is calming to the sensory system – this is why a massage is so relaxing!

SIGHT (VISUAL SYSTEM)

The visual system interprets what we see. It is necessary to recognizing shapes, colors, letters, words, and numbers. It is also important in reading body language and other nonverbal cues during social interactions. Vision guides our movements, and we continually check out actions with our eyes to make sure we move about safely. When children are having difficulty with visual processing, they may have difficultly filtering out the unnecessary details, or may have trouble identifying important information.

HEARING (AUDITORY SYSTEM)

We use our auditory system to identify the quality, and direction of sound. It not only hears sound, it also helps us to understand speech. When a child is having problems with auditory processing, they have difficulty with identifying the important information, and blocking out the background noises. They may be very sensitive to loud noises, or easily distracted by small noises (like the sound of the ceiling fan). Children with auditory processing difficulties will often struggle to focus in busy environments, and may need to be told instructions over and over.

TASTE AND SMELL (GUSTATORY AND OLFACTORY SYSTEM)

Taste and smell are senses very closely linked and work as one integrated system. The sense of smell is one of the oldest and most vital parts of the brain. The two senses together allow us to identify foods that we enjoy, and also tell us what is safe to eat. If a child’s sense of smell or taste is not working properly, they may identify foods as unsafe or dangerous, and refuse to eat. Smell is also directly linked to our emotional brain – we can use smells to access feeling of calm, alertness or pleasure within the brain.

MOVEMENT (VESTIBULAR SYSTEM)

The vestibular system contributes to our balance and our sense of where our body is in space. It provides the most input about movement in the body, and works with the auditory and visual system to give accurate information to the brain about the direction the body is moving. It is important for the development of balance, coordination, eye control, attention, and even some aspects of language development. If a child is not processing vestibular information effectively, they will have difficulty with balance and coordination, and will rely on visual information to give them feedback about their body. Movement input received by the vestibular system is generally alerting and can impact the nervous system for 6-8 hours.

BODY AWARENESS (PROPRIOCEPTION SYSTEM)

Proprioception or Kinesthetic System refers to the perception of sensation of the muscles and joints enabling the brain to know where each part of the body is and how it is moving. Proprioception was developed by the nervous system as a means to keep track of and control the different parts of the body, using feedback from the movement of joints and muscles. It allows us to know where the edges of our body are – how far away we are from a wall, or how much pressure we are exerting on a pencil. Children with significant proprioceptive needs and decreased awareness of their bodies’ movements often seek out activities that provide them with increased awareness, such as grasping objects very tightly, or jumping onto pillows or furniture. They have difficulty knowing where their body is, in order to move it effectively. Proprioceptive input lasts around 2 hours – it provides both calming sensations to overactive children, and alerting information to under stimulated children.

SENSORIMOTOR ISSUES ARE INVOLVED IN:

• ADD/ADHD
• Autism
• Tactile Defensiveness
• Speech/Language Disabilities
• Reading/Decoding Phonemes
• Dyslexia
• Writing (Dysgraphia)
• Visual Processing Disorder
• Motor Planning (Motor apraxia and sequencing)
• Emotional/ Behavioral Disorders
• Down’s Syndrome and other genetic disorders
• Cerebral Palsy

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Do I Need an OT?

Children develop at different rates and some variation is typical, however a child may benefit from OT support if showing:

Difficulty with self care tasks beyond what is expected for their age. This includes:

• Toileting (awareness, coordination, completing all the steps)
• Dressing including buttons and zips
• Washing hands, brushing teeth
• Extreme discomfort with haircutting and fingernail trims
• Difficulties using cutlery
• Limited food preferences
• Decreased willingness to try new foods

Specific sensory needs such as:

• Putting hands over ears / startling with loud noises
• Tantrums in the shopping centre
• Anxious about going new places
• Avoiding light touch
• Seeking movement or crashing
• Avoiding certain fabrics (eg: tags in clothes)
• Smelling or licking / chewing nonfood items
• Increased light sensitivity

Difficulties with school:

• Attention and concentration
• Unable to sit still
• Poor reading
• Poor handwriting or fine motor skills
• Letter reversals
• Decreased coordination or clumsiness
• Difficulty learning new movement activities

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Learn The Signs. Act Early. Developmental Milestones.

How your child plays, learns, speaks, and acts offers important clues about your child’s development. Developmental milestones are things most children can do by a certain age.

Check the milestones your child has reached by the end of each age specified below. Talk with your child’s doctor at every visit about the milestones your child has reached and what to expect next.

The American Academy of Pediatrics recommends that children be screened for general development using standardized, validated tools at 9, 18, and 24 or 30 months and for autism at 18 and 24 months or whenever a parent or provider has a concern.

If you are concerned, act early: tell your child’s doctor if you notice any signs of possible developmental delay and ask him about your child’s developmental screening.


*This is a not a substitute for standardized, validated developmental screening tools. Learn the Signs / Act Early materials were adapted from CDC website and are free of copyright restrictions.