Sand and Glitter

One mom's understanding of childhood development

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My child needs glasses. Now what?

Jan 31, 2017 by Hélène Serfontein Leave a Comment

It is a shock to find out that one’s small child can’t see properly. I somehow thought because they are still small their eyes should be very good. Well, actually I didn’t give it much thought at all. Until it happened.

The trouble is, children don’t know what things should look like. Or, if their vision deteriorated gradually, they forget. So they DO NOT COMPLAIN of bad eyesight. They might blink a lot. (Which, incidentally, also might point to a vitamin A deficiency or uptake problem). They may sit too close to the TV. They may develop a squint. They may become less attentive of their environment. They may stop paying attention in school. Their art work may not be the best – which sometimes it isn’t in any case. They may seem bored or unmotivated. In children depression can look like boredom. And it surely is depressing when one can’t see. They may seem anxious and unsure. They may suddenly fall down a lot or become car sick. And parents may very well overlook all these subtleties. Teachers too.

So well done if you realized your child has a vision problem. That was some great parenting right there! And if you are looking around for more help, even better. This is the list I wish I had. If someone could sit me down in the very beginning and say, “Listen, here’s what you do:…,” we would have had a much easier time. But when everything turns out ok, luckily we tend to forget a lot of those pesky little details. Remember that the whole body is one unit. Vision is a function of every single part of a child. This will hopefully demonstrate that. So here is my two cents’ worth:

Image courtesy Shutterstock
Image courtesy Shutterstock

STEP 1: Have your child’s eyes tested. Find the best ophthalmologist or optometrist by reputation. It is very very difficult to get a child into their ideal glasses prescription. And they may refuse to wear it, because of the big change it creates. Work with the professionals to find the prescription that your child can tolerate initially. It can be adapted once they get used to it.

STEP 2: While you are waiting for your eye appointment, start looking at frames. The optometrist’s is a good place to go. They should be small enough so the lenses don’t have to be too thick. And very sturdy for playing and rough housing in. Get your kid excited about these glasses – even though you are still struggling with the idea.

STEP 3: Get support. Yes, it helps to see you are not alone. And to ask all those many many questions. Two wonderfully useful Facebook groups are: Little Four Eyes and: Vision Therapy Parents Unite. Vision therapy is an option in some countries.

STEP 4: Have a developmental occupational therapy assessment. If your child could not see properly for however long, they are sure to need a little bit of developmental input. The occupational therapist will look at things like vestibular and proprioception or tactile issues. They will also test for gross and fine motor delays. These skills are the foundation for school skills later on. Visual-motor perception and motor planning is greatly affected by faulty vision.

STEP 5: Young children with vision problems often have retained primitive reflexes. These reflexes create movement patterns in babies before they do conscious, controlled movements. When the higher postural reflexes start taking over as babies mature, the primitive reflexes disappear. They may reappear as a result of physical stress (like lack of vision). Or they may have been retained because of lack of tummy time and movement opportunities as a baby. To check, look at a photo of your smiling child. If they have wide, staring eyes even when smiling, they may have a raging retained Moro reflex. Some paediatric physiotherapists, occupational therapists and behavioural optometrists address these reflexes and help integrate them. It is a long term process that requires dedication and daily effort, but it pays off big time. Retained reflexes interfere with vision development, gross and fine motor skills, hand-eye coordination and general school performance.

STEP 6: Inform your child’s teacher. Getting glasses is a transition. This child might have a hard time adjusting and coping. Kindness and gentle encouragement is needed. Keep the expectations at a minimum for a while and everyone will be happy.

STEP 7: This one should actually be the cornerstone of every step. Lots of love for this brave child. Patience, love, acceptance. Your child is going to be facing hard changes. Lots of challenges. They need you on their team. Loving them, cheering for every little step forward, carrying them sometimes. Your job as a parent is to know when your child needs a break.

STEP 8: Limit screen time. Too much screen time interferes with developmental movement opportunities of body and eyes.

STEP 9: Get moving, get active, get outside. Studies have shown outdoor activity has a positive impact on vision development. Work those core muscles. Head control and core stability has an effect on eye convergence. Very important for children with amblyopia (lazy eye). Ball sports are lovely and fun for improving eye tracking.

STEP 10: Nutrition. Certain foods can boost vision development. Zinc and Vitamin A deficiencies especially impact vision development negatively.

“Sucking on Sour Candies, Pickles or Lemon Pieces. Sour tastes help bring facial muscles and eyes into a more focused (aimed inward) state, called convergence. Sucking helps to bring the facial muscles, including eye muscles, into a convergent posture…After sucking on a sour food or piece of candy, encourage the child to attempt a near-vision task that was difficult for him previously, and see what happens!” – Quote courtesy of the book Eyegames: Easy and fun visual exercises by Lois Hickman and Rebecca E. Hutchins.

STEP 11: Sagging arches in the feet may affect vision development. Arch support is directly linked to eye convergence. The lumbrical muscles in the feet are responsible for arch support. They work in synergy with all the postural muscles. For children older than five with flat feet orthotics can be investigated. The physiotherapist can recommend a good orthotist to custom make these. Lumbrical exercises for feet are easy. It has been suggested that toe walking may improve the arch support in flat feet. Invest in good shoes that keep little feet more optimally aligned.

STEP 12: Reawaken the senses. You know how some people feel like they don’t hear/connect well without their glasses on? Same goes double for children. Not being able to see well does not sharpen the other senses. Rather it dulls them. With muted senses a child’s world becomes small. And they do less of the very activities that would have helped them. Practicing mindfulness on nature walks is a lovely way to help a child with visual neglect to reconnect. This could be a walk around the garden. Smells in particular raise a child’s level of awareness. Probably because the olfactory and limbic system, where emotions are seated, are enmeshed. Vestibular input helps restore proper eye movements, so running, rolling, swinging.

Enjoy this special time of rediscovering sight with your child.

 

A weighted vest for the low tone child

May 26, 2016 by Hélène Serfontein 2 Comments

What does low tone mean?
The best explanation is by means of analogy. Imagine purchasing a mechanical arm that could wash dishes. The arm would need to be attached near the sink. Would you attach it to the curtain/drapes? Not likely. The arm might end up swinging the dishes through the window. No. The arm would need to be attached to the very sturdy wall. This is true for all movement. Arms and legs need a stable background of attachment where movement forces can be generated. Precise and coordinated movement need to come from a strong central support. Low tone implies that postural muscles are somewhat too floppy for good support. The origins of low tone based postural instability often have to do with a lack of healthy and varied movement opportunities as a baby.

How do I know if my child has low muscle tone?
The low tone child has a very real struggle to remain upright in various positions. They adopt compensatory strategies early on. Children with inadequate muscle tone display poor postural control. In other words, they slouch.
Low tone children may present with some of these characteristics:
– They fatigue easily or lose concentration
– Poor perseverance in gross motor activities
– Improper body awareness feedback
– Avoid or struggle with chewy foods
– Poor posture in sitting and standing
– Impaired balance
– Lacking in confidence or assertiveness
– A preference for indoor activities

A child with low muscle tone may use compensations such as the following to sit perfectly upright:
– Hand support on the surface with locked elbow(s)

S&G-HandSupport
– Hooking feet around chair legs for support

S&G-FeetSupport
– ‘Fixing’ shoulders by shrugging them up for fine motor tasks such as cutting or writing
– ‘Locking’ the pelvis into an anterior tilt by arching the low back

S&G-AnteriorTilt
– Leaning to one side – bearing weight only on one buttock

S&G-SittingCompensation
– Pushing the chin forward so the head ‘locks’ into compressed position on the neck, sometimes with mouth open

S&G-NeckLock
– Creating a wide base: Sitting with legs bent to one side or in reverse w-position.

S&G-WideBase

S&G-WSitting
– Folding themselves into a chair. Low tone children may appear very bendy.

S&G-LowTone

 

Why is this important to know? How would my child be affected if she had low muscle tone?
Low tone children struggle in school. Poor central trunk and head control has many implications.
Good head-on-neck control is necessary for:
– Efficient speech
– Directing the gaze, eye contact, reading skills
– Hand-eye coordination, drawing and writing skills
– Direction and redirection of attention
– Concentrating on tasks
A raised fixed shoulder girdle interferes with normal breathing. Diaphragmatic breathing is impaired in this position, affecting breath control during speech. Impaired diaphragm movement also affects core muscle activation – causing the low tone and core instability situation to perpetuate itself.
Muscle imbalance creates malalignment of spine and joints. Malalignment leads to strain and pain.
If a child has trouble maintaining postural muscle control, the head is not properly aligned for good eye tracking movements on a page. Reading gets harder to do.
Proximal stability (good shoulder control) is needed for coordinated and effective distal movement (hand grip and movements). Writing takes more effort.
The ability to sit still is an active process of maintaining reciprocal balance between muscle groups. It is compromised in low tone kids. Paying attention becomes more difficult.
Social interaction is affected by attention and eye contact.
Sports participation is affected by balance, posture and coordination.

Having to work at maintaining an upright position leads to fatigue and impaired concentration. Postural control and balance should be automatic and ingrained long before school age, allowing kids to deal with the tasks at hand.

Low tone with poor postural control create anxiety and feelings of inadequacy in children who fail to perform to their academic, social and sports ability as a result. The social and school pressures on children are very real.

Why would a weighted vest help?
Deep pressure is very calming. Wearing the vest is like being enveloped in one long continuous hug. Kids love it. A weighted vest has a snug fit with pockets designed to house little weights. It creates a downwards pressure on the joints of the spine, which stimulates extension responses.

Deep pressure is useful for down-regulation of heightened sensory states. Wearing a weighted vest enhances proprioceptive and sensory feedback. This increases body awareness, tactile integration with improved posture and balance. Automatic balance reactions develop with sufficient postural control.

Wearing a weighted vest should be part of a sensory diet as prescribed by an occupational therapist. Always have a paediatric physiotherapy or occupational therapy assessment for any suspected developmental challenge.

Supplier information available upon request.

The Magic Mat and its little secret…

Feb 1, 2016 by Hélène Serfontein Leave a Comment

The Magic Mat is a magical adventure of movement. This is such a fun activity – with huge developmental benefits. It is a truly holistic approach to physical and emotional development through movement, sound and breathing.

image“The magical tool of the book and animated DVD, (view trailer) demonstrates fun, physical stretching and relaxation techniques that develop happy, relaxed, loving and healthy children where kids get to discover their higher selves and learn to feel love, compassion and gratitude.”

The beauty of Magic Mat is this:
– The whole experience creates a wonderful mixture of movement, stretch, mobility and postural awareness combined with breathing.
– Through touch and specific movements, children develop body awareness and spatial awareness. This is part of proprioception development.
– By using very strong visual imagery and association with animals and colours, children can become aware of emotions and how they can manifest in the body.
– Children learn to celebrate different emotions and how to ‘clear out’ upsetting emotions.
– The movements incorporate easy balances and basic midline crossing techniques.
– Some of the movements are neurodevelopmental movements.
– The sequence of movement has a great combination of flexion and extension movements.
– Improvement in self-awareness, self-esteem and confidence can be brought about with regular visits to the Mat.
– The relaxation techniques, mindfulness and breathing relieve anxiety.
– It introduces mindfulness techniques in a way that little ones can easily manage. This holistic approach brings the child’s awareness to listening, thinking, breath and emotional awareness. Mind-body connections are emphasized in these easy steps.

The parent and child guides in the beginning of the book give simple, concise and clear instructions for use.

The Magic Mat is a book of 44 pages with a complimentary 26 minute length animated DVD.
It is suitable for 5-12 year olds, however younger children can participate. My 4 year old loved it, even though she couldn’t do all the movements. At age 6, my son already had an appreciation for the mindfulness exercises and emotional aspects of Magic Mat.

Website where it can be viewed/purchased: http://magicmatsecret.com/

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