There are many areas and important milestones to development, and the more you look into this online it can become confusing.  

Through my practice and experience as an Occupational Therapist I use the Central Nervous System Pyramid of learning (William & Shellenberger, 1-4) model to support child development areas. This has helped me to know what to first focus on in therapy in order to achieve a family’s goals.













I wanted to share these areas and ideas through my private practice.

The areas of development includes;

1. Sensory Systems
2. Body movements
3. Visual Processing
4. Academic Learning and Daily self-care activities

 
Our sensory systems include our 8 body sensations, 5 external senses (touch, taste, smell, vision, hearing) and 3 internal sensations (proprioception, vestibular, interoception).

Body movements include posture, core strength, upper body strength, ability to use two hands, motor planning, reflexes and awareness of two sides of our body.  This developmental area includes all the sensory systems which help our young learners to retain what they have learnt and to perform the motor output with their bodies and muscles.

Visual Processing incorporates eye hand coordination, posture adjustments, ability to sit, visual perception skills (how far away is something), and the ability to focus.

Academic learning, then can come into play when these developmental areas are working together and the young learner can function. Including to brush teeth, get dressed and toileting, the need to break down a tasks step by step (sequencing), and problem solve how to use the bodies muscles to complete a task. This level also includes behaviour adjustments and social -emotional learning.

I hope to further break down these areas to support families with strategies to use daily for their child’s development.

If you have any concerns or questions, please do not hesitate to contact for more information and ideas on how to help your child in these developmental areas.

https://www.facebook.com/Connecting-Together-Occupational-Therapist-1599431303464275/
https://www.connecting-together.co.nz/
https://www.connecting-together.co.nz/blog-page/sensory-processing-summary

Melissa Walker-Tate
Occupational Therapist
Connecting Together.

There is a lot of research out there for sensory processing.
 Sensory Processing is the way in which our 8 Senses are processed in our bodies
 to help us effectively use our body within the environment 

8 Senses?

We all know our 5 senses, but do you know;
Proprioceptive- Awareness of the movement and position of our bodies
Vestibular- Position of the body that controls balance and eye movements
Interception- A fairly new internal sensation, to understand and feel what is going on inside your body, e.g the need to go toilet, or that you feel hungry.

How do I know my child struggles with sensory processing?

Challenges focusing and holding attention
Demonstrates inappropriate behaviour in multiple environments
Showing a lot of energy
Showing to be underactive and easily tired
Difficulty learning and retaining learnt skills
Dislikes participating in group activities
Dislikes large crowds and groups of people
Challenges with social skills and peer interactions
Shows heightened anxiety in a range of areas.

What can I do?

Observe and take notes of your child's daily sensory behaviours, e.g are they seeking, or avoiding certain sensations
Seek support from an Occupational Therapist
Provide more sensory based play in your daily routine

If you have any questions about your child or a child you may work with around their sensory processing needs, please do not hesitate to give me a call 02102915235 or email connectingtogether2017@outlook.co.nz

Kind Regards,

Melissa Walker-Tate
Occupational Therapist
Connecting Together.

Social interactions are about relating to others and engaging with them, it is an important component of human instinct.

Children learn social interactions through playing and interacting with peers and adults. Play provides children with opportunities to learn and practise new cognitive and social skills in a fun, safe and supportive environment.

Using play allows the child to feel a sense of motivation, achievement, challenge and working other body tasks, such as cognitive, fine motor skills, speech and observing.

Autism (ASD)
Some children with Autism usually have challenges with social interactions and engaging with others, children may not join in with others who are not playing by the rules, do not share or are unable to communicate with others.

Some suggest that children with Autism may be less likely to engage with others in play and social opportunities due to,

• They may not be motivated in the same way as others (interacting may not be a motivating factor)
• They may struggle with how to play with objects, new toys, new people, and the environment all at once.

Although the reason for why there may be a challenge is not concrete it is definite that children with Autism do want to interact with others. I have worked with many children with a diagnosis of ASD that would really like to play with others and be likes by their peers.

There is also evidence to support that children with ASD can learn social interaction strategies and be able to engage in play activities.

 Like their peers, siblings and classmates that develop skills in a developmental sequence, it may not be at time same time however it is important that play mirrors this. Some children may need coaching to support them playing with others.

To develop social interactions a professional, teacher or therapist may look into your child’s play stage, interests, activities they enjoy, social opportunities, and individual skills for each opportunity.
Social interactions and social skills is offered at Connecting Together, if you have any concerns for your child’s play, and social interactions at home, day-care or school please reach out and contact Connecting Together for support.
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Poroporoaki hoki inaianei,
 
Melissa Walker-Tate (Occupational Therapist).
Connecting Together Ltd.

A diagnosis is termed the identification of an illness, through examining the symptoms.

It is a common question parents come across, even at times when you did not expect it. However, it has these days become more common, as there is now more awareness of particular mental health diagnosis than there used to be. Assessing your child when challenges occur is really important.

Some challenges that may cause a parent concern and possibly consider a mental health assessment for their child may include;

• Behaviour concerns
• Challenges with social interactions
• Limited to no speaking
• Low muscle tone
• Poor coordination in play activities
• Challenges with coping with changes
• Difficulties in trying new activities
• Anxiety meltdowns
• Your child not reaching milestones, such as crawling, walking, talking, eating
• Challenges understanding emotions in themselves or others.

It can be overwhelming considering if your child needs a mental health assessment, and can even be a battle with your values, partner, families and teachers/schools. It is highly recommended to have a support person to assist with these thoughts or concerns you may have. It is important to note how long you have had these concerns for, and most importantly to reach out to see if any other adult in your child’s life has had the same concerns, such as parent, caregiver, teacher, daycare teacher, or friends.

Often parents compare their child to another child’s development, and then begin to feel that something is wrong, or that they have not done everything they can as a parent. This is important to unpack and seek support about to investigate these concerns and know that you have done everything you can do. Parents should know it is never to late to start with therapy, strategies or seeking support for you child or family.

What to know?  
In thinking about taking your child for an assessment you should consider what the goal of the assessment is. Such as, ‘Is it around understanding your child’s needs’, ‘Finding the best way to support them’, ‘funding support’, and/or  ‘knowing how to best work with your child’. A diagnostic assessment can often help us to understand why, what, and how to support your child.

It is important to prepare information around your child and the family before going for an assessment. Information they will ask parents/caregiver or guardians can include:

• Family genetics
• Family History
• Childs birth and labour
• Childs development, including any trauma, illnesses or accidents
• Siblings information
• School- friends of your child, does your child experience bullying
• Substance use
• Fine and Gross Motor skills, social skills, self-care tasks, independence, sensory processing and academic achievement/IQ of your child.

Assessment
If you are considering an assessment, and you have support around this decision; it is recommended that families seek a professional opinion.
To begin the process you visit your General Practitioner (GP) who will refer you to the Public mental health system (District health board), if that is what you want.
You can also look into private mental health assessment options, however this often comes at a high cost.

Who can assess my child?
Using the Diagnostic Statistic Manual 5 (DSM-5) there are a number of professionals that are able to clinically assess your child that is within their scope of practice, these include

• Psychiatrist
• Paediatrician
• Psychologists
• Authorised autism specialists
• Attention Deficit Hyperactivity Disorder ADHD association
• Autism ASD associations
• Mental health services

If diagnosis and mental health is not something you agree to do for your child, this is also okay. There are several support services that can provide therapy for your concerns, and that work on goal setting with families to achieve what you want to work on.

Connecting Together offers screening for mental health diagnosis such as Autism, Attention Deficit Hyperactivity Disorder (ADHD), anxiety, sensory processing and more. This can provide an indication of whether there may be an underlying diagnosis however it does not clinically diagnosis, as this is not within the scope of an Occupational Therapist to clinically diagnosis. With this indication you could then carry out an assessment if you decide, or you could begin therapy for your child and family.

Connecting Together creates goals with the child and family , working through these in therapy sessions, reviewing the goal progress every 3 months, providing strategies to family and schools, and supports you in the process with any questions that come up along the way.

Please contact me on connectingtogether2017@outlook.co.nz, leave a message if you feel your family or child could benefit from this service, any questions or enquiries you may have, and lastly a contact number I can access you easily on.  
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Poroporoaki hoki inaianei,
 
Melissa Walker-Tate (Occupational Therapist).
Connecting Together Ltd.

Occupational Therapists focus on achieving functional independence through therapeutic interventions, including activities someone wants, needs and has to do in their daily life. Children gain functional independence through there development and play; however it is not always easy to consider all areas/milestones your child needs to reach.
A Paediatric Occupational Therapist helps to address evaluate and provide support in the development of children.

What can occupational therapy offer Paediatric patients?
Occupational therapy helps and supports children to develop the underlying skills needed for a child’s learning and performing specific tasks, while also focusing on addressing social and behavioural skills.

Occupational Therapy helps children to develop the basic sensory awareness and strategies to regulate themselves in their developmental stage of life, focusing on learning healthy behaviours.
Occupational Therapists ensure to work with the whole family, caregivers, and teachers involved in the child’s daily life; as this has shown to be most evidence based and provides the most effective change.

Occupational Therapist`s work to educate, coach, share, reinforce and provide specific skills and changes to the person, routine, environment and performance of the challenging functional skill.

Occupational Therapy can provide therapy and intervention for the following:

• Body awareness in space, and deep muscular pressure (proprioceptive sense)
• coordination between the two sides of the body (crossing the midline)
• Fine motor control (Small hand muscle movements)
• Motor planning (preparation and sequencing of movements)
• Motor movements and coordination
• Gross motor coordination (Balance, strength, core strength and posture)
• Ocular motor skills
• Visual perceptual skills (visual memory, depth perception, visual tracking)
• Self-regulation (sensory, emotional and behavioural)
• Sensory modulation (reaction to stimulus)
• Self-cares (daily activities, showering, toileting, eating, sleeping)

When would a child need Occupational Therapy?
When you feel concerned for your child’s functioning and development it is best to seek support as early as possible. See my previous Blog Post about Early intervention for why this is so important. If you feel your child is not functioning at an age appropriate level in any aspects of their life, an Occupational Therapist can provide strategies, assessment and intervention as required.

If you are concerned about any of the following for your child consider talking to an Occupational Therapist for support in:

• Poor coordination
• Decreased balance (“clumsiness”)
• Delayed motor skill development
• Low muscle tone or strength
• Difficulty with handwriting
• Difficulty or avoidance engaging in fine motor tasks, e.g. puzzles, playdough
• Challenges in learning new skills
• Difficulties recalling information
• Struggles to remember and follow through on instructions given to them
• Difficulty completing tasks that seem easily attained by peers
• Behavioural or social skill challenges
• Difficulty maintaining attention
• Decreased self-esteem and self-concept
• Decreased visual skills including visual perceptual skills and ocular motor skills
• Difficulties with feeding, is a picky eater or a messy eater
• Challenges performing self-care tasks, e.g. toileting, eating or sleeping.

If you feel your child needs support in these areas, or you would like to discuss if your child is functioning age appropriately then please contact Connecting Together, mobile 02102915235 or email connectingtogether2017@outlook.co.nz  

Poroporoaki hoki inaianei,
 
Melissa Walker-Tate (Occupational Therapist).
Connecting Together Ltd.

Firstly, Core Strengthening is related to the muscles in the core, centre of the body that relate to posture, centre of gravity and movement. The muscles in action when using your core include, abdominal muscles, back muscles, and pelvis.
These muscles matter greatly to us, as we depend on these in a lot of daily activities that at times we do not realise.

Why do children have low muscle strength or weak core muscles?
Through my experience it is becoming clear that a lot more children are showing low muscle tone and strength in their core. This shows through children having difficulty in seated table top activities, such as handwriting, eating dinner at the table and even through playing games seated in the floor.
This can be due to a range of reasons and is important to think about:

• Developmental delays
• Low physically activity during the day time, relating to increase in use of technology and screen-time
• Muscular growth difficulties
• Nutritional deficiency

Strategies to increase Core Strength:
As many challenges which can occur in our developing children there are strategies in which you can add to their daily routine to increase Core Strength

• Add activities to your existing routine, such as while your child engages in dressing can they perform a few core strength exercises. Adding exercises to your routine ensures you do it daily, remember and also to try not to add something extra for you to do daily.
• Ensure your child is calm and has regular breathing patterns before doing these exercises.

Exercises

• Bridging- Lying on your back, with knees bent and feet flat to the floor, have them push up through their heels to raise their bottom. How long can they hold this for? Can you do it with them to motivate them? Engage the whole family for motivation and encouragement. Change it – Add a teddy between your child’s knees to squeeze, move soft toys through the bridge under your child (Don`t squish the ‘teddy’!).
• Superman- Lying on their tummy, and try to lift their arms, upper chest and head up from the floor. This increases back muscles. Change it- Can they lift their legs too? Can they hold a ball/teddy in their hands and lift it up? Engage them in reaching for stickers or post it notes from the lower wall to have them reach upwards!
• Therapy Ball-

1) Have your child lye on their tummy on the therapy ball and pull themselves along the ground, keeping their feet on the ball. Change it- Add an object, goal or spot for them to get to, increase this over time. This works on abdominal and pelvic muscles.
2) Have your child lye on their back on the therapy ball adult, hold their hands and see if they can push from their legs. Change it- See if they can balance themselves on the ball and reach up for your hands.
 
Enjoy practicing and working on Core Strengthening exercises with your children or children you care for. If you have any queries or comments please contact Connecting Together, also look into out coordination package offering therapy across a range of gross motor skills, balance, aiming, throwing, core strength and catching.
 www.facebook.com/Connecting-Together-1599431303464275/

Question- Would anyone like to share exercises or strategies for increasing core strength in children?
 
Poroporoaki hoki inaianei,
 
Melissa Walker-Tate (Occupational Therapist).
Connecting Together Ltd.

At times change can be challenging for our young children, this includes moving from kindergarden into primary school, beginning a new school year with a new teacher and moving from school into intermediate.

It can challenge our children’s emotions, functional skills and at times cause anxiety. This can be understood even as adults when moving jobs or beginning a new job we too can feel anxious.
Children’s confidence and resilience in coping with change is supported mostly by their secure relationships around them, that help to foster the sense of safety in the change to come. These relationships include parents, therapists, friends, family and the school staff (teachers).
 
In my experience an important aspect of what helps our children cope with these changes, comes down to Preparation.  
There are many ways to prepare your child and every child will be different as to what works, however there are some standard strategies which include:

• Two to three weeks before school is due to start, begin talking to your child, saying in a few weeks you will be going to school. Talk them through what time they will wake up, how they will get ready for school in the morning, how they will get to school, and who will pick them up from school. This helps with expectations, knowing what it to come and feeling safety in how they will get to and from school.
• Visit the school. If the school offers transition to school days take these up. But also visit the school as many times as you can before it starts, play on the playground, and point out the classroom if known.
• Take photos of the toilets, school hall, office, classroom, drinking fountains, and playground.
• Show your child the photos when they ask about school, when you talk about school and anytime you feel would help.
• Create a visual book with the photos, with writing. Saying things like you will go to school, this is your teacher, this is the classroom you will be in, here is where you play at break times, here is the toilet, and here is where you eat lunch. This will help to reduce anxiety around new environments, and also to prepare them for what is to come.
• Routine; begin to get the routine at home the same as it will be during school time, such as when they will wake up, eat breakfast, pack a bag, put shoes on, visit the school in the morning if possible, afternoon tea, dinner time, and getting ready for bed routine. Doing this as early as you can before school starts will help your child adjust to the routine and it not be as overwhelming when adding the change of going to school.
• Support and encourage your child to like school, talk about their interests and that they can learn more about these at school, such as if they like dinosaur you could motivate them in speaking about science or history. If they enjoy reading or drawing talk about art classes etc.

Here is a useful website from Australia which has some great story templates you could create and read to your child to help with preparation https://www.ecia.org.au/Transition-to-School#226781-downloadable-resources

If you have any questions about these recommendations above please do not hesitate to ask.
If your child and family would like support in transitioning to school Connecting Together can support this, helping to make resources, helping to reduce anxiety, and helping your child cope with change.www.facebook.com/pg/Connecting-Together-1599431303464275/about/?ref=page_internal

Thank you for reading,
Poroporoaki hoki inaianei,
 
Melissa Walker-Tate (Occupational Therapist).
Connecting Together Ltd.

What is it?
Early Intervention, is supporting a child’s development as early as possible when suspecting, or knowing of developmental delays.
Early intervention can provide the strategies and treatment needed to shift a child’s development in order to help them function in daily tasks and activities.
Developmental delays can often occur in more than one area of a child’s development and milestones.

Some common areas of delay include,

• Cognitive (thinking and problem solving)
• Walking
• Social skills and interactions (Play)
• Talking- Communication and speech
• Fine Motor skills
• Muscular growth
• Independence
• Coordination
• Developing attention

Why does it matter?
It is important to take notice of developmental delay s as early as possible, as these can be possible underlying signs and symptoms of an existing medical condition, such as Global Developmental delay (GDD), Autism Spectrum Disorder (ASD), cerebral palsy, or genetic disorders.

What can I do?
There is plenty of research out there which can be overwhelming and at times leave you feeling uncertain at what to do regarding supporting your child’s development; however if unsure it is best to get support from a health profession to support development, such as an Occupational Therapist (Functioning/Therapy), Speech therapist (talking/swallowing/communication) or a Physiotherapist (Muscular/movement).
Below includes a range of health professionals that can support and provide intervention planning for your child,

• General Practitioner (GP)
• Pediatrician
• Audiologist
• Occupational therapist
• Speech pathologist
• Psychologist
• Psychiatrist
• Social worker
• Therapists, e.g. speech-language, physio
• Special education teachers and support workers

 
Strategies

• Take notes in a notebook around your child’s milestones, if your child does not show to walk around 15 months of age or speak their first word by 18 months, seek support.
• Play with your child every day, interactive play can assist movement, communication and cognitive thinking.
• Talk to your child as often as you can, this promotes speech, listening, interactions, social skills, cognitive thinking and independence.
• Praise and encourage your child to do tasks, especially new ones. This will promote independence.
• Allow your child time to complete tasks, at times we can expect them to complete a task such as packing away or moving from an activity when this can take a lot of cognitive processing.
• Using a range of verbal, and visual prompts in an activity. Visuals are a great way for your child to learn language, learn a task, and to follow instructions/routine.
• Use simple, small step instructions for your child to follow.
• Seek support from a health professional (as mentioned above) to help create an individualized therapy plan; supporting with small achievable goals for areas of developmental concern. 

If anyone would like support in creating an individualized therapy plan for your child please contact me at Connecting Together, we can meet for a free consultation to discuss any queries and questions you may have. Your child does not need to have a diagnosis to receive therapy/intervention support, therefore if you feel there is an area you would like strategies, support, ideas, activities or guidance in please contact me connectingtogether2017@outlook.co.nz or mobile 02102915235.
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Melissa Walker-Tate (Occupational Therapist)
Connecting Together Ltd.

Connecting Together is a relatively new Community Service/Private Practice providing care, intervention, therapy and guidance to children and families.
Connecting Together came to be through understanding gaps which currently exist in our health care system.

My name is Melissa Walker-Tate, I am a Registered Occupational Therapist who has vast experience working with children in mental health and disabilities.
This is my first time writing a blog post, so please feel free to leave me some feedback and comments.

• Through my experience working in the health care system it is clear there are services and programs our children need for their development and transition into primary school, that is not currently being offered in the Franklin Community.

 

• In learning how much our community is growing this is important to consider for our growing children.
• Therefore with my experience and also my empathy to help others; I hope to offer this and help families at an affordable cost.

 

• Firstly, I hope to successfully provide social skills for children.
• Secondly, I hope to provide therapy working on goals for children and families struggling with day to day needs in our community. Therapy includes fine motor (hand skills and strength), sensory processing, gross motor skills (coordination), and self-care skills (daily living/routine needs).

 

• I feel most confident and competent working with children who may be experiencing emotional, behavioural, sensory, social and attentional challenges in their daily lives.
• I have a large interest and experience in Sensory Processing (SPD) and Autism Spectrum Disorders (ASD).
• I have been fortunate enough to attend a range of training`s in my line of work, including the Dr Tony Attwood trainings on Understanding Autism, basic sign language, Sue Larkeys Workshops, Positive Behavioural Therapy Training and much much more.

 
Please contact me on connectingtogether2017@outlook.co.nz, leave a message if you feel your family or child could benefit from this service, any questions or enquiries you may have, and lastly a contact number I can access you easily on; that way I can get in touch and let you know of upcoming events, group therapies and child therapy package deals.  
www.facebook.com/Connecting-Together-1599431303464275/

Poroporoaki hoki inaianei,
 
Melissa Walker-Tate (Occupational Therapist).
Connecting Together Ltd.