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.

 

Train your brain with jigsaw puzzles (Feva Foam)

Aug 15, 2016 by Hélène Serfontein 4 Comments

Completing a jigsaw puzzle has a number of surprising benefits. As educational toys go, this seemingly simple activity rocks. How do I buy myself 10 minutes for make up and hair when things are going pear-shaped? Give the kids some puzzles. This brightly coloured mental challenge gives a great sense of accomplishment. Keeping the number of pieces age appropriate will prevent frustration.

S&G-BrainPuzzles

What makes Feva Foam puzzles special and unique? The dense foam they are made of means that little fingers have to work a bit at inserting the pieces. Great for enhancing tactile and fine motor skills. The thicker puzzles work well on uneven surfaces, like outside on the lawn. My kids love the colourful images.
Feva Foam custom make puzzles with an image of your choice. Custom making a family photo puzzle or using an image that is meaningful to each child makes the whole experience personal and fun. Trying to find the pieces of mom and dad could be a hoot. Each of the puzzles comes in their own resealable bag/sleeve. Hallelujah! No scouring the puzzle drawer for those missing pieces.

Image via Shutterstock
Image via Shutterstock

Puzzles benefit the brain in a myriad of ways. Jigsaw puzzle building enhances short term memory. Remembering where the corner piece was, or the piece with the red dot helps train the brain.

When children build big floor puzzles together it is a helpful way to learn social skills: Teamwork, sharing, helping and taking turns.

Spatial skills: This is the ability to make sense of, change and use objects and the spaces between them. Understanding how a puzzle piece relates to the others. This skill can be viewed as a unique type of intelligence separate from other forms of intelligence, such as reasoning ability, speech, and memory skills. Completing a jigsaw puzzle provides practice in this area.

Visual skills are practiced:
Visual discrimination is the ability to spot differences in shape, form, colour, size and pattern. This is a skill necessary for reading – discriminating between different letters, words and the spacing thereof.
Figure ground: Loosely means the ability to distinguish between the object and the surrounding mess it is lying on. This ability will help find the next Lego block needed for completing the plan. Or finding that other sock in the drawer.
Visual closure: When you see part of a picture, it helps you imagine the rest. People who see half a well known brand logo should automatically know what they are looking at. This is a helpful reading fluency skill, as it aids quicker word recognition.
Good practice in visualization. This means creating a mental image of the whole picture, or imagining the completion of the task.

Image via Shutterstock
Image via Shutterstock

Jigsaw puzzles help exercise both left and right brain. Certain brain functions are more dominant in one hemisphere, even though the corpus callosum ensures interconnectedness of the hemispheres.
The left brain thinks logically and follows a sequence while the right brain is creative, emotional and non-verbal; using images rather than words. So when building a puzzle, your left brain sorts and organizes the pieces and analyzes what is needed where, while your right brain intuitively tries to complete the big picture. This working together of the two brain hemispheres on the same task establishes brain connections.

Using both sides of the brain simultaneously helps the brain to move from a Beta into an Alpha state. Beta waves are associated with logical thinking, alertness and anxiety. Whereas alpha waves are created while daydreaming or when practicing meditation or mindfulness.

Puzzle building seems to stimulate dopamine production. Dopamine is a highly complex neurotransmitter involved with attention, movement, motivation and pleasurable reward. One study showed that dopamine neurons were inhibited by aversive stimuli. Dopamine has meaning in addiction and ADHD.

“Puzzles are used for training or as an interactive tool to entertain children up to 8 years of age. Quality high density EVA foam rubber with full colour image using FEVA unique print process. The shapes can be changed to suit your requirements.” – Feva Foam

Custom make your own design.
Custom make your own design.

Feva Foam rubber products supply on order: 

15 PIECE JIGSAW PUZZLE – FFPJP01
Custom designs per puzzle. Place any personal or school photo onto the puzzle. Great for parties or events.
280 x 380 x 5mm

15 PIECE JIGSAW PUZZLE – FFPJP01
Minimum order quantity 50 units.
280 x 380 x 5mm

S&G-Puzzles

DINOSAUR JIGSAW PUZZLE – FFPJP02
Min order quantity 50 units.
290 x 200 x 5mm

Free delivery in Plettenberg Bay. For more info on these and other great products visit the Feva Foam website. With special thanks.

Equi-therapy: Therapy on horseback explained

Jun 16, 2016 by Hélène Serfontein Leave a Comment

Josie Adair is an equi-therapist. She kindly wrote this post to introduce equi-therapy to us and explain what it is about and how it works.

My name is Josie Adair, I am a South African Therapeutic Horse Riding Association qualified equi-therapist. I am in my fifth year of teaching horse riding to children and adults of various abilities, and I am in awe of the changes that I have seen in so many people through this form of therapy.

About Josie:
I was born and grew up in England, and my journey with horses began at the merry old age of 5. I rode for a few years, lost interest, got into dance classes, realised that that wasn’t for me, moved to South Africa at the age of 9 and met my instructor: Linkey Jones. That was when I fell in love with the sport all over again. I began teaching young children under Linkey’s instruction and after a year or so I found my first special needs client. She was the cutest 18 month old I’d ever seen with the curliest blonde hair; and she had cerebral palsy. She could barely hold up her own head, so she and her mum rode together. Little by little she grew stronger and stronger, and now, 3 or so years later, she walks, she runs, she sits on the horse’s back singing at the top of her lungs. And this is how I knew that I wanted to be an equi-therapist.
S&G-KidsTherapyI became more involved with the few special needs clients that we had, and met Diane, the founder of the ETHAN (Education and Training Hub for Autism Needs) project, who helped me to enroll in some short courses on neurodevelopmental disorders.
I then was asked to apply at a preschool as a teaching assistant, and my whole take on horse riding shifted once again – why just use therapeutic horse riding for children and adults with special needs and disabilities, when you can also use it for establishing school readiness and fundamental development in each and any child.
To this day my qualifications include: SATRA equi-therapist (passed with distinctions); HANDLE inst. (Holistic Approach to Neuro Development and Learning Efficiency) level one therapist; UNISA (University of South Africa) practitioners in early childhood development diploma (passed with distinctions) and EQASA (Equestrian Qualification Association of South Africa) level one and two.

The difference between therapeutic horse riding and hippotherapy:
Therapeutic Horse Riding is a form of therapy where the horse is used as a tool. The patient sits on the horse’s back, and while the horse is moving, performs exercises and games given by the equi-therapist, with a number of different apparatus and equipment. This is the means of therapy that I am qualified in.
In hippotherapy the patient is also mounted on the horse. It is conducted by a horse specialist or an equi-therapist as well as another therapist – for example this person may be an occupational therapist or a speech therapist – while the horse is moving, the therapists specialty of therapy is conducted. This is used as the movement of the horse stimulates the vestibular system and readies the senses and brain to receive information.

S&G-EquiTherapy

Why Therapeutic Horse Riding?
I love therapeutic horse riding. I enjoy my sessions just as much as my clients! First I will answer the question of why we use horses, and then we I will list some of the benefits specific to the style of therapeutic horse riding that I do.
Why horses?
Horses are incredible. That is why. But more specifically, there are a few areas that horses cannot be competed with by any other therapy.
Horses are herd animals, they communicate with each other through body language, and when a horse accepts you they communicate with you also. Although there is no way of proving this, I believe that horses have all of the emotions that people have – happiness, sadness, anger, annoyance, empathy, fear, embarrassment and the list goes on. Because of this a horse expert can see exactly what the horses are feeling. Horses have a unique ability of being able to mirror what a person is feeling. Through this, I can see the person’s emotions and feelings, without them having to tell me. This is such an amazing opportunity as a therapist, as many people don’t understand their feelings or even don’t want to tell you their feelings.

S&G-HorsebackTherapyHorses make a big impact. I have never experienced someone standing next to a horse without a big response. That response could be fear, excitement, joy; it could be internalised or shown clearly, and all of this is good.
Also, the horse’s movement is a big play into the uniqueness of this therapy. A horses movement is rhythmic and consistent, providing vestibular stimulation with these same characteristics. Rhythmic, consistent stimulation of the vestibular system calms a hyperactive person or stimulates a hypo-active person. The movement of the horses back moves a person’s hips as if they are walking, providing stimulation of these muscles, without impairment and without straining the joints. What a unique opportunity for people who have impaired gaits or are unable to walk to experience.
There is also the sensory aspect, at the stable yard and on the horse’s back there are many opportunities are sensory integration.
Lastly, horse riding is a form of exercise that puts little strain on the joints. Any form of exercise is an outlet for negative emotions and frustrations.

The benefits of therapeutic horse riding include:
· Stimulation of the vestibular system
· Increase or normalisation of muscle tone
· Increase in balance and equilibrium
· Normalisation of reflexes
· Increased trunk rotation
· Sensory integration
· Bilateral motor integration
· Improved eye muscle coordination
· Improvement of speech
· Improvement of proprioception
· Improvment of fine motor skills
· Increased hand-eye coordination
· Improvement of praxis (planning and sequencing)
· Increased laterality
· Hemispheric integration
· Emotion – building of confidence and self-image, an outlet for frustration and negative emotions

There are a few disabilities and conditions that prevent a person from being able to participate in therapeutic horse riding:
• Down’s syndrome with an atlantoaxial instability (all Down’s syndrome patient’s must have X-rays before participating in therapeutic horse riding and a doctor’s declaration that they do not have this problem)
• Arthritis in the acute stage
• Brittle bone disease
• Multiple Scleroses during the acute phase
• Severe Kyphosis and Scoliosis
• Uncontrolled epilepsy
• Unhealed pressure sores
Therapy sessions are 30 minutes long (this is the norm, all my lessons are adaptable) and are very affordable. A brief overview of the lesson shows that roughly 20 minutes are spent doing therapy the other 10 are spent actually riding the horse.
As therapeutic horse riding is fun and children learn a new skill in horse riding, the course of treatment can go on for years. However a minimum of 6 weeks is usually advised. As the person improves and grows more advanced the format of the lesson can change.

For more information don’t hesitate to contact trottingalong.therapyriding@gmail.com or take a look at my Facebook page https://www.facebook.com/trottingalongtherapy/?fref=ts

Sand & Glitter would like to thank Josie Adair for this lovely and very informative article.

Gross motor checklist

May 28, 2016 by Hélène Serfontein Leave a Comment

A lot of us wonder when our children should start doing which physical things. The sporting parents may want their little star to join in the fun, which is great. These gross motor guidelines can help keep the expectations realistic. There is a lot of variation, as few children develop in a linear way. Some children may catch a ball brilliantly, but may be slower to climb the stairs for instance. This is a guideline only. If your child has a very real struggle with all things age-appropriate, a little input may be needed.

Standing on one leg
Test both legs.
~ 3 Years: 5-6 seconds
~ 4 Years: 7-9 seconds
~ 5 Years: 10-12 seconds
~ 6 Years: 13-16 seconds
~ 7-8 Years: Longer than 20 seconds
The difference between the dominant and the non-dominant leg is greatest between 4-5 years. This difference becomes progressively smaller after that. At ages 3-4 there may be a difference of up to 5 seconds between the dominant and non-dominant legs.

Kicking a soccer ball
~ 15 Months: Ignore the request to kick, throw the ball instead
~ 18 Months: Do not kick, but rather just walk right up to and against the ball
~ 24 Months: Try to kick, walk up to the ball and start to lift leg in an effort to kick
~ 36 Months: Can kick a ball hard
~ Children younger than 7-8 may choose to kick standing on their dominant leg and kicking with their non-dominant leg. This is because their balance on the dominant leg is better.
~ Over the age of 8 most children choose to kick with their dominant leg, standing on the non-dominant one. This is because the difference in balance between the two legs are very small by then. The dominant leg becomes the stronger leg and more able to execute precision movements.

Hopping on one leg
Test both legs.
~ 3 Years: Less than 5 hops. Very difficult. Sometimes they can only manage 1 hop, and sometimes only with one leg.
~ 4 Years: 5-8 hops
~ 5 Years: 9-10 hops
~ 6 Years: 10-20 hops
~ 7 Years: More than 20 hops
Important that the child tries to hop in one place, and more on the ball (front) of the foot; not on the whole foot.

Climbing stairs (around 4-5 stairs up and down)
~ 13 Months: Crawl up 2-3 stairs
~ 15 Months: Crawl forwards up the stairs and crawl back down feet first (backwards)
~ 18 Months: Walk up the stairs when holding someone’s hand. Place both feet on the same stair. Crawl down backwards feet first or slide down on bum.
~ 21 Months: Walk up holding the banister, placing both feet on each stair. Walk down holding on to the banister, wall or mom’s hand placing both feet on each step.
~ 2 Years: Walking up and down holding on to banister, placing both feet on each stair.
~ 3 Years: Starting to alternate legs on the stairs, still holding on for support. Or, placing both feet on the same stair without support.
~ 3⅟₂ Years: Walking up with alternating legs without support.
~ 4 Years: Walking down the stairs with alternating legs without support.
~ 4-5 Years: Running up and down the stairs.

Jumping from a height and landing on both feet
~ 2-3 Years: Jump from the bottom stair and maintain balance upon landing
~ 3⅟₂-4 Years: Jump from the second stair
~ 6 Years: Jump from the third stair
~ 8 Years: Jump from the fourth stair

Catching a soccer ball
Throwing the ball straight to the child.
~ 3 Years: Catch the ball using both arms and body
~ 4⅟₂ Years: Catch the ball with both hands against the body
~ 5⅟₂ Years: Catch the ball with both hands, not against the body;
~ 5⅟₂ Years: Child bounces the ball and catches it again in both hands
~
6 Years: Child throws the ball up in the air and catches it again

Catching a tennis ball
~ 5⅟₂ Years: Catch the ball in both hands, when it bounced once
~ 7 Years: Catch the ball with one hand, no bounce

Throwing a ball
~ 15 Months: Baby lets go of objects when in the high chair or throws things on the floor (food). Baby’s eyes follow the object as it travels. Developmentally this is an important visual skill. It forms the basis for visual tracking skills for reading later on.
~ 18 Months: Throw an object while standing. This is an immature forwards pushing motion as opposed to a proper throw.
~ 3-4 Years: Adopt a definite throwing stance. Balance is still lacking.
~ 5 Years: Weight shift onto non-dominant leg. Release the ball with dominant arm in full extension (straight elbow)

Body perception
~ 18-20 Months: Know where eyes, nose, ears, feet are.

These are screening tests for gross motor proficiency. A paediatric physiotherapy or occupational therapy assessment is indicated if children continue to not meet their milestones, despite gentle parental input and encouragement.

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