By: Laura Donatello, PT, DPT

Update: With a stay-at-home order for all of Illinois in effect, I know parents and caregivers could use some ideas for energetic children more than ever. I updated my previous blog with some new ideas.

I know it is hard to balance the need for work and for child care at the same time, so just know you are doing your best!

Push-Pull Activities

This total body strengthening activity targets shoulder stability as a child pushes an object at or below shoulder height with straight arms, core to change direction, and lower extremities to power forward.

Push/Pull Activity Ideas:

1. Hide some of your child’s favorite toys in a large open room. Have your child push a laundry basket around the room, and fill up the cart with toys. You can place toys at various heights, encouraging your child to stand on their toes, climb a couch cushion, or squat down to retrieve a toy. Pay attention to the type of flooring in the room. When using a plastic laundry basket, carpet will generally be more challenging to push against, and hardwood/tile will be easier.
2. Have a race to see how fast he/she can push the basket to the end of the hall to retrieve a toy, and back. Races can be against siblings or parents, or be in the form of a relay race.
3. Tie a string to the basket to make this a pulling activity.

Obstacle Course

The possibilities are endless with obstacle courses. You can encourage your child to help create, set up, and clean up the course. Maybe incorporate your child’s favorite play scheme; he/she has to navigate the course to place a puzzle piece in the puzzle, feed their favorite doll, or animal. You can add multiple activities together, or just focus on a few. There are many gross motor skills that can be incorporated such as walking, jumping, balancing on one foot, and hopping.

Obstacle Course Ideas

1. Lay out couch cushions on the floor for your child to step on, jump over, or climb through. Maybe even jump from cushion to cushion.
2. Navigate a hopscotch course made out of tape on the floor. This can be modified into many different patterns such as a few boxes in a row, column, diagonal, or in a traditional hopscotch pattern. Your child can walk, jump, or hop from square to square.
3. Crawl or squat under a string tied across two chairs.
4. Walk on a bubble wrap road, walk across a taped line, or both!
5. Crumple up old newspapers and grab a laundry basket to play newspaper basketball. For a balance challenge, have your child stand on a cushion or one leg to make a basket.
6. Cut a pool noodle into 26 pieces, put a letter of the alphabet on each piece and grab some string. Kids can practice putting words together, squat to pick up a piece, and go up on their toes to thread the noodle through the string.

Color Under the Table

Color Under the Table

Tape a piece of paper or coloring book to the underside of a kid’s table. Your child can color up from laying on the floor to work on strengthening their shoulder and trunk muscles!

Exercise Dice

Create a six-sided dice out of cardboard and tape. On each side draw or print out a picture of a different activity such as clapping, jumping jacks, running in place, jumping, heel raises, and dancing. You can also create another dice with numbers on each side to determine how many times or seconds to complete an activity for.

Online Resources

1. Cosmic Kids Yoga is a website, app, and free YouTube channel where a narrator demonstrates popular yoga poses in the form of stories. Kids can follow along with the instructor on the screen as they narrate their favorite stories or movies in the form of yoga poses. You can access a free 2 week trial if you download the app, or type in “Cosmic Kids Yoga” into the YouTube search bar to access free videos!

• Go Noodle is another great free online resource to get kids moving! The website is full of videos including dance parties, yoga sessions, and games. The resources span a variety of ages, abilities, interests, and can be interactive to include siblings.  Access Go Noodle for Families website through the link.

10 Popular Toys on Amazon Under $20

Here are some of my favorite entertaining, therapeutic toys used with a variety of ages.

1. Beads are a great multi use toy you can take practically anywhere with your imagination.
2. Bubbles are another perfect activity to incorporate into obstacle courses, pop in a variety of positions such as sitting or standing, or work on blowing them to control your breath. “Fubbles” are a personal favorite because they don’t spill.
3. Paint in a Bag is a great sensory activity. Grab your favorite paint colors and squeeze them into a zip lock bag. Tape the bag to a table or the floor and watch your child be entertained with pushing the colors around.
4. Spinning Toy is a fun way to work on gross motor and fine motor to spin the gears around the pipe.
5. Pop Tubes are a fun, noise making, resistance toy your child can practice pulling in a variety of positions.
6. Zoom Ball is a partner game to propel the ball along the string by moving your arms. It’s a great shoulder exercise even adults can feel the burn from!
7. Squigz are little suckers that stick to a variety of surfaces. They’re great for sticking on mirrors and pulling off against resistance. The company Fat Brain Toys also makes Whirly Squigz that spin.
8. Get ready to make cookies with the Melissa and Doug Slice and Bake Cookie Set. This pretend play set is the perfect toy for obstacle courses. The cookies come on a Velcro tray making this toy the perfect resistance activity. The frosting also Velcros to the cookie. Hide the cookies in an obstacle course or navigate over couch cushions to put the cookie on the tray.
9. Top Bright Bird Feeding Game is a great fine motor activity. Play this game laying down on your side to use different muscles to feed the bird!
10. Spike the Fine Motor Hedgehog is another great fine motor toy to pull his spikes out and push them back in.

Whatever activity you choose, be sure to have fun with it!

For more information on Easterseals DuPage & Fox Valley services, visit eastersealsdfvr.org.

By: Laura Van Zandt, MS, OTR/L & Pediatric Nutrition Therapist Cindy Baranoski MS, RDN, LDN

In January 2019 a groundbreaking article was published in the Journal of Pediatric Gastroenterology and Nutrition describing children challenged with feeding problems and their care. Pediatric Feeding Disorders (PFD) is the term the expert team of authors define as “impaired oral intake that is not age-appropriate, and is associated with medical, nutrition, feeding skill, and/or psycho-social dysfunction.” It goes on to establish the basis for creation and implementation of a medical diagnosis code that would support children identified as having problems in any of these four areas, which are impaired by or impairing a child’s ability to eat a diet that is expected for age.

It concludes with the primary need for children to be identified early, and receive interdisciplinary evaluations and interventions, as opposed to seeing one practitioner alone to try and help all areas. Interdisciplinary thinking, evaluations, and treatment have been the core practice of Easterseals DuPage & Fox Valley’s Feeding Clinic the past 20 years, since its inception in 2000.

What Brings You Here

From the moment we are born, feeding and eating is something that is supposed to come naturally to everyone. When a baby is born, we feel an overwhelming sense of love and a strong desire to watch over, protect, and nourish to grow. When it’s time for feeding, our bodies are already preparing the necessary tools to breakdown and process what is provided. Feeding involves more than just our mouths. At play are the sights (color, shape, size), feelings (warm, hot, cold, crunchy, chewy, soft, sticky), smells (sweet, stinky), sounds (loud, quiet), and most especially, the way our body works. From how our muscles work together to align our trunk in sitting, allowing our arms to reach, grasp, and explore, to coordination of suck, swallow, and breathe, and manipulating the food in our mouths, everything sets the foundation for a good relationship with mealtimes and foods. Our past and current experiences all shape our belief around feeding and nutrition. Your body must work all together to receive and process nourishment.

For some children, however, this process isn’t easy and doesn’t always come naturally. Many children struggle to coordinate their bodies to eat or drink, have GI systems that don’t process the foods well leading to constipation, diarrhea, vomiting, GE reflux, which leads to poor growth, frustrations, fear, and worry. For children with respiratory conditions, poor coordination of breathing, overall weakness, eating a meal like other children their age is nearly impossible. Yet, they still need what other children need – nourishment, socialization, variety, scheduled mealtimes, and interaction with foods. For these children, who may be fed through a tube, eating may not be the primary mode of nourishment, but all the other factors play into what promotes development, health, and good growth.

As a parent, nothing is more important than watching your child grow and thrive, and nothing is more heart wrenching than watching them struggle. When a child doesn’t eat, parents feel blame and guilt. We ask ourselves why? Did I do this? What could have I done differently? We try a host of different strategies. We Google and seek advice from family, friends, and medical providers. We fall back to what we know, which may or may not work.

Who We Are

Our Feeding Clinic at Easterseals DuPage & Fox Valley consists of a team of individuals who have a passion for helping kids with feeding, mealtimes, tolerance, health, and growth. Our team assesses the many different reasons why a child might be struggling. We are not just looking at their ‘behavior’, but dig deeper and aim to understand the core source of the behavior and what it is communicating. Eating is so much more than bringing food to the mouth, chewing, and swallowing.

Our Clinic consists of a pediatric gastroenterologist/integrative medical practitioner, registered dietitian nutritionist, speech and language pathologist, occupational therapist, and parent liaison. The team has over 230+ years of combined expertise, and have gone on for extensive training in many areas, such as NeuroDevelopmental Therapy (NDT), Sequential Oral Sensory (SOS) Approach, DIR/Floortime, Respiratory and Rib Cage Development, Homeopathy, and Chinese medicine.

As a team, we review your child’s birth and developmental history prior to the appointment, with a thorough analysis of the diet record you submit. We ask you to let us know your expectations of the evaluation when filling out the paperwork, both online and written forms. Our goal is to meet these expectations. During the actual meeting we are looking and listening for red flags that clue us into issues driving the challenges your child is having. A list of possible reasons why your child might be seen by our feeding clinic is found in Table 1.

Table 1

What Happens, What We Do, and What’s Next

During the interdisciplinary evaluation, the full team meets with the family. Engaging with and helping your child feel comfortable in the room, the speech and language pathologist and occupational therapist are also listening while beginning to perform a physical assessment.

Medical & Nutrition

First the team reviews and establishes your child’s medical health and overall nutrition status. Many medical complications from birth can impact a child. Undiagnosed medical and gastrointestinal (GI) problems often come to light in clinic.

Think of your child’s health like the foundation to your house. If your foundation is weak, then the floors above it will compensate for weakness. If your child is struggling from constipation, diarrhea, motility, gagging, GE reflux, then most likely they are subconsciously learning to connect food to feeling poorly. Additionally understanding your child’s nutrition, assists the team in understanding what might be contributing to what is not medical, allowing the team to make appropriate recommendations to ensure for growth and health. Analysis of current nutrition includes what is expected for your child, balance, timing of meals/snacks, calories, protein, fluid, hydration, vitamins/minerals, route of nutrition and growth. An understanding of both medical health and nutrition status, allows for changes from the foundation first and foremost.

Speech and Language Pathology & Occupational Therapy

Observing how your child interacts and engages during the evaluation can help the speech and language pathologist as well as occupational therapist, before they move on to assess the physical portion of eating and drinking. Our goal, no matter where your child is in their journey with food and feeding, is to have a positive relationship during the process. While observing your child, both therapists are also looking at their underlying motor skills and evaluating if any postural supports might be beneficial. Mary Massery, a well-known physical therapist, has said “breathing always wins”, and she is not wrong. Breathing dominates. Where your body is in space and stability is its second priority. Swallowing and feeding behavior must continually adapt to changing respiratory and postural systems.

When your child sits down with the therapists, it is about getting a better sense of your child’s oral motor skills from the speech and language pathologist. The occupational therapist is observing potential underlying sensory processing difficulties and relationship issues with food. Anxiety around meals and feeding can increase adrenaline which suppresses our desire to eat. Assisting with overall regulation is important for comfort at mealtimes.

Social Services

The emotion with feeding and nutrition difficulties can be overwhelming for both the parents and child. Many times, a child’s survival from birth and medical health is the primary focus, as it should be. When a child becomes more stable, a parent can start to see beyond the medical fears and begin to focus on other things such as independent feeding. With this new focus, the emotions, fear, concerns, and hope are still there. Whether your child is struggling to be an oral eater or being fed by tube, the emotions can be immobilizing. Our parent liaison is a vital team member in our clinic, helping every parent know they are not alone. She provides support, empathy and connections to any resources.

By the end of the evaluation, the team confers together within the same space as your family, and immediate and long-term recommendations are made. Often, these recommendations focus on gut health, breathing, positioning, or establishing improved nutrition, before working on some of the more therapeutic needs such as oral motor skills or sensory processing/relationship interactions. Sometimes recommendations are made to work on several key things simultaneously to help your child be more clinically stable, or a single recommendation that may be central to all other concerns identified. Returning to our 90 minute clinic for a follow up visit, may be one of the recommendations made.

Final Thoughts

Wherever you are at in your child’s journey, there are many aspects to feeding disorders in the pediatric population. Therefore identifying and addressing all of them is a priority that should not be overlooked. Easterseals DuPage & Fox Valley’s Feeding Clinic has been and continues to view your child and his care from this interdisciplinary “Pediatric Feeding Disorders” approach, involving a skilled and expert team of professionals. Nutrition issues is an area that brings an enormous amount of stress and anxiety to a child and caregivers. Our team is uniquely qualified and experienced to assist children at all levels of feeding, instilling hope and helping them be their very best.

Each child is unique, and each intervention is tailored to fit your child and family. While you research options you have, consider the following –

• Aim to help your child feel their best. They need to feel well – this is key for success in any area.
• Ensure your child is receiving sound nutrition, regardless of what they are currently receiving. There are many ways around getting your child good nutrition.
• Assess their positioning with mealtimes and feeding to be sure they are fully supported. Positioning is key. Seated on a firm surface with feet flat on the floor or chair rail, with head and shoulders aligned over hips, equal weight bearing, is the most optimal positioning. Allow her arms to rest on her tray or table with shoulders down.
• Ensure a regular schedule. Regardless if your child is orally fed or through a tube, a mealtime plan is essential, and helps your child learn hunger and fullness, allows their bodies to sustain through the day, can improve their overall tolerance, and should have a positive beginning and end.
• Patience – feeding therapy is a journey with bumps and curves along the road. Share your compassion and empathy. Learning to eat and mealtimes, after a rough beginning, might involve reshaping many memories. You might have to start over to build trust. Remember even the tortoise finished the race with the hare.
• Expose, expose, expose and don’t limit opportunities for exposure. Have fun and play with food. Model appropriate food reactions – don’t “yuck someone else’s yum.” Continue to find way to present food to your child even if he/she is not ready to taste them. You can read books together about food, visit different grocery stores and markets, and find ways to get them involved in mealtime preparation without eating.

To learn more on our Nutritional Feeding Clinic visit our website at: https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/specialized-clinics/feeding-clinic.html. And contact our Intake Coordinator at 630.261.6287 or mscholtes@eastersealsdfvr.org to ask questions or schedule an appointment for a feeding evaluation. 

By: Kelly Nesbitt, MOT, OTR/L, Occupational Therapist

As the winter creeps up, my client families have been worried about their children not getting “their energy out.” It is a time when recess is moving from outdoors to indoors and fun trips to the park are being replaced with play at home. Not to mention with the sun setting after 4:30 PM, parents are a little weary of having kids play outside in the dark. 

So how do we make sure that our kids get the needed movement, play, and sensory input when the days are too short and invariably too cold to go outside? 

Besides indoor sensory activities that you can do at home (see previous post on Indoor Toddler Activities), here are a collection of indoor sensory parks in the Chicagoland area. These gyms have indoor swings, equipment, and sensory play that can help support your child in the winter months (or year round) when playing outside may not be possible.

These recommendations are based upon input from other therapists, clients, and online research. Sites have not been individually inspected on-site by the author.

We Rock the Spectrum

OT Overview

• What is it?: A “gym for all kids” that  “is committed to providing a safe, nurturing, and fun environment to foster learning, exploration and safe sensory experiences.” We Rock the Spectrum is owned by a speech pathologist whose mission is to provide a safe space for all children to play and explore. We Rock the Spectrum is a large gym facility that hosts both open play times, respite care, birthday parties, and classes. We Rock the Spectrum is specifically designed for children with special needs, especially those on the Autism Spectrum! Open for children in infancy to 13 years old. All children must be accompanied by an adult and wear socks. 
• Why an OT likes it: We Rock the Spectrum has a handy graphic of all their pieces of equipment and what sensory input they provide! 

General Information

• Where: 553 East Dundee Road Palatine, IL
• Hours: Open gym typically runs 10am-7pm during weekdays, but hours may vary, please check website for details. 
• Amenities: This gym has a lot of the same swings and equipment seen in therapy gyms- There is a zip line, swings, crash pit, weighted blankets, trampoline, tunnel, platform swing, hammock swing, monkey bars, and bolster swing. 
• Pricing: There are drop in prices as well as memberships. $14/child, $12/siblings for open play. You can get membership cards (5 visits for $60, 12 visits for $120, etc.) See website for full conditions and price listings. Unlimited monthly packages are available too.
• Contact: 
  • Website: https://www.werockthespectrumchicagopalatine.com/
  • Phone: 847-496-5674

ColorWheel Playhouse

OT Overview

• What is it?: Owned by parents of a child with Autism Spectrum Disorder, ColorWheel Playhouse aims to be “a place where kids with all ranges of abilities could come together and find joy and smiles on our Color Wheel of happiness.” ColorWheel playhouse is a facility that has a large gym, can host classes and birthday parties. Classes include a variety of topics such as bully prevention, CPR, karate demonstrations, fire safety, and much more. This facility is specifically designed for children with special needs! 
• Why an OT likes it: ColorWheel Playhouse has various different areas in which your child can choose what kind of input they are needing; there is an “Action Room,” designed to get your child the heavy work (push, pull, carry, climb, etc.) types of input to their muscles and joints that has a calming effect. There are various types of swings so your child can get the needed vestibular input (movement input from swinging back and forth, spinning, and jumping). Also there are arts and crafts/sensory bins available if your child needs a quiet moment to themselves. I also enjoy that the owners have a child with Autism, so the staff understands a child on the Spectrum and all potential needs and challenges. If birthday parties are challenging for a child, ColorWheel Playhouse offers themed birthday party packages at their facility. 

General Information

• Where: Sandpiper Plaza, 2000 Army Trail Road, Hanover Park, IL
• Hours: Open play hours: Tuesday through Saturday 10am-6pm, Closed Sunday and Monday.
• Amenities: This facility has a rock wall, ball pit, monkey bars, log swings, rope climbing wall, cacoon swing, trampoline, zip line, an arts and crafts table, and sensory bins.
• Pricing: Open gym: $10/child, $9/addition child. Punch cards and monthly memberships are available as well; See website for full conditions and price listings.
• Contact: 
  • Website: https://www.colorwheelplayhouse.com/
  • Phone: 847-284-9625

Ball Factory

OT Overview

• What is it?: Ball Factory is an indoor gym that has specified areas for babies, toddlers, and young kids to explore and play. Children up to 12 years old are permitted to play with their parents present. Ball Factory aims to make play comfortable for all ages, they have equipment and toys suited for babies to 12 year old kids, as well as comfortable seating for parents and senior discounts available for when grandma and grandpa want to visit! There is even a cafe inside where you can grab a bite. This facility is designed for all children, of all ages and abilities. 
• Why an OT likes it: I personally love the variety of equipment available at this facility- everything from ball bits, climbing structures, to push toys. I would recommend this facility for my clients that cannot get enough pretend play with cars and other vehicles, since there are kid-sized vehicles to drive around (and get vestibular and heavy work input as they pedal and push their cars around). I also love that this facility encourages family members not to just sit on the sidelines and watch their children play- but to get in on the action! Adults are allowed in all the play areas and there are comfortable seating options so that moms, dads, grandmas, and grandpas can play with their children, then rest and recharge. After all, a place with fun equipment is great, but made into an amazing experience for a child when their loved ones join in play with them. 

General Information

• Where: (there are 2 sites!)
  • Naperville: 864 S Route 59
  • Mount Prospect: 1042 S Elmhurst Road
• Hours: Sunday-Thursday 10am-7pm, Friday-Saturday 10am-9pm
• Amenities: Ball Factory has many fun areas for your child to explore that is age and abilities appropriate:The “Imagination Playground” has large soft blocks for children to play with, the “Tot Area” has padded equipment, cushioned toys, balls, and a small play structure with large, soft, Lego blocks. Based upon pictures from the website, there does not appear to be any indoor swings. However, there is a “Pedal Tractor Area” with pedal tractors with loaders, trailers, tractors, and fire trucks. There is also a pretend play gas station for all of the vehicles to refuel! Other pieces of equipment include a ball pit, maze, multi-story playground, ball blasting area (soft balls shot out of air-cannons), baby slides, interactive play floor, and super slides!
• Pricing:  
  • Children over 12 months (Monday-Friday) are $12.95, Weekends are $15.95. Children 6-12 months (Monday-Friday) are $10, weekends are $12. 
  • Children under 6 months are free. 
  • The Ball Factory also offers 5 visit passes that are $55. 
  • They also have fun discounts such as “PJ Play” in which children cost $8 for the last hour of the day and “Happy Hour Play”, in which children are $10 after 3pm  (Monday-Thursday).See website for full conditions and price listings.
• Contact:
  • Website: https://www.ballfactoryfun.com/
  • Phone: Naperville (630-640-2020), Mount Prospect (224) 244-9580 

Urban Air Trampoline and Adventure Park (Naperville)

OT Overview

• What is it?: This massive facility has all kinds of activities such as go-karts, “Wipe Out” styled obstacles, ropes course, etc. This facility offers Open Play hours where you can explore the building’s fun activities- such as an indoor trampoline park and climbing gym. There are so many activities available for open gym play as well as special events such as birthday parties. This facility is not specifically tailored to children with special needs, but may be suitable for these children with adult supervision and support. 
• Why an OT likes it: This facility would be perfect for some of my clients who love coming to OT to get intense crashing, pushing, pulling, and are “thrill seekers!” Some of my clients are obsessed with Wipeout and American Ninja Warrior- and Urban Air looks like a place where those “adrenaline junkies” could pretend they are competing in American Ninja Warrior themselves. 
• Special Note: Some activities at Urban Air may be a little more intense than the previously mentioned indoor playgrounds. I think this facility would best suit children who are more independent in their play and need just supervisory support to engage in novel gross motor activities. While these activities certainly do offer opportunities for heavy work and vestibular input (especially trampoline course, ropes course, zip line, climbing structures, rock walls, etc.), children with motor delays and/or are sensitive to intense movement input may have difficulty engaging in all of the activities offered. That being said, there are so many activities at this facility, that you are bound to find something for kids of all abilities to be able to participate in.  Please see the website for pictures to make your own assessment if these activities would be fun for your child. Consult your child’s Occupational Therapist if you are unsure if they would enjoy a certain activity. 

General Information

• Where: (3 Illinois Locations)
  • 1955 Glacier Park Avenue, Naperville, IL
  • 67 Ludwig Drive, Fairview Heights, IL
  • 19800 South La Grange Road, Mokena, IL
• Hours: (Varies by location, please see website for site specific hours)
  • Naperville Open Play hours:
    • Sunday-Wednesday (10am-8pm)
    • Thursday (No Open Play hours)
    • Friday and Saturday (10am-11pm)
• Amenities: Urban Air definitely offers the widest variety of obstacle courses (rope wall, Wipe Out course, tubes playground, dodgeball, warrior course, ropes course, strapped-in zip line), bumper cars, go-karts, trampolines, and much more!  There is a Kids Under 7 area with little-kid appropriate trampolines. 
• Pricing: Endless Play Memberships are available as well as birthday party prices. See website for full conditions and price listings.
• Contact
  • Website: https://www.urbanairtrampolinepark.com/locations/illinois/naperville 
  • Phone: (331) 472-8799

I hope these ideas will help jump-start your planning for outings for the winter months! If you have any questions or concerns about any of the aforementioned facilities, please contact the facility. Also, ask your child’s Occupational Therapist about what types of activities would be most beneficial.

For more information on occupational therapy at Easterseals DuPage & Fox Valley, visit http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/occupational-therapy.html. 

By: Cindy Baranoski MS, RDN, LDN
Manager of Nutritional Therapy

Maybe you heard about this in the news last week, or maybe not. Either way, trying to make sense of what we should be offering our children to drink is always a dilemma. From the moment a baby is born, the question becomes, breast milk or formula. Breast milk being the optimal choice, but that’s not always possible, so formula is available.

Children less than 12 months of age should never be offered a bottle of straight up milk, but after 1 year, it is the go to drink recommended by everyone. Juice is often offered, but it is not the same as eating the fruit or vegetable. And sometimes in infancy, prune juice is given to help with stools, but that’s not a rule. Many children do not like milk, once done with breast milk or formula, and parents begin to offer anything to help ensure their child is hydrated.

Bring in the new options available for children to drink and it can be confusing to know what is best to offer. For example, plant based milks are all the rage now for many reasons, including allergies, family preferences, cultural reasons, and last resorts for a picky eater. They are flavored, unflavored, sweetened, and unsweetened. And the selection continues to grow, including rice, almond, coconut, soy, oat, hemp, split pea, cashew, and blends to name only a few. Though these may seem like a great alternative to cows milk, each one of them can be found fortified, unfortified, with added protein, or original version. Most plant milks are going to be lacking in protein, fat, and potentially key vitamins and minerals found in cow’s milk.  Diet modifications can be made to help ensure what is lacking in a plant milk can be found in other sources in the diet. But if cow’s milk cannot is not the choice for whatever reason, plant milks with diet modification can work.

Juices have changed as well, with many companies offering non sugar sweetened fruit and/or vegetable juices. Some companies offering cold pressed and fruit/vegetable smoothies with additives, such as greens, protein and vitamins. Use of sweeteners such as grape juice or artificial sweeteners replace sugar and high fructose corn syrup. Juice is not the best option for anyone to be consuming regularly, or in quantity, when the food brings so much more nutrition to the diet that has yet to be identified or quantified.

And then there is water, but not just tap water, but bottled water, flavored water, sweetened waters, artificially sweetened waters, vitamin boost waters, and sparkling waters. As a general guideline, plain old regular water with nothing added or changed, is the best choice.

To help, the Academy of Nutrition and Dietetics, The American Academy of Pediatric Dentistry, the American Academy of Pediatrics and the American Heart association have made some updated recommendations.

Finally, whenever something is happening out of the ordinary with any child, and there is a struggle or question of fluids, seek the advice of a Registered Dietitian Nutritionist to help guide what would be best. Looking at the child as a whole, their full diet, development, family choices, help with recommendations being made for fluids. This will ensure children receive optimal fluids, contributing to best growth and development.

For more information visit: eastersealsdfvr.org/nutrition or contact our Intake Coordinator at 630.261.6216.

By: Kelly Nesbitt, MOT, OTR/L, Occupational Therapist

When a child with sensory processing disorder goes on vacation, it may be difficult for their bodies to go into that “relax and restore” mode. Children with sensory processing disorders are constantly “battling” with their environment in many of the following ways:

• Every sound is too loud and hurts their ears
• Smells are abrasive and can cause them to gag or vomit
• New tactile sensations send them into a panic
• Changes in their normal routine can make them extremely anxious
• New sights and movement in their environment can startle them

The following are some tips that may help support a child with sensory issues during a summer vacation so they may have a relaxing experience.

Visual Schedules

If your child benefits from knowing what to expect in the day, it may be useful to set up a visual schedule revolving around your vacation. This can include the steps you will need to complete going through the airport. (Travelers Aid Chicago has resources to make a visual schedule specific to O’Hare airport).

Some children may also just benefit from going over what to expect on their vacation. You can help them prepare by saying, “We are going to the airport and this is what to expect…”  or “We will be on vacation for 4 days. During those days we can do these activities…”

Long Car Rides

Children that are constantly on the move may find it extremely difficult to sit still during long car rides to their vacation destination. Often times kids who are always “on the go” benefit from heavy work activities that involve pushing, pulling, and carrying. These activities give input to the joints and muscles which can be very regulating. Here are a few heavy work ideas specifically for car rides: 

• Squigs on the windows: I suggest this for children who need something to keep their hands busy with push and pull component to get heavy work. These small plastic suction cups stick perfectly to car windows and to each other. Children can build and make a picture with them on the windows 
• Pop Tubes: These toys also provide an opportunity for children to push and pull when you are cooped up in the car.
• Animal walk breaks at rest stops: Just as you need to get out and stretch your legs during a long ride, your child with sensory difficulties will need this break too! At rest stops, take advantage of the opportunity to move by doing silly activities that promote heavy work: walking like a bear, jumping like a kangaroo, playing on a playground if the rest stop has one. 

What to Pack

Here’s a list of sensory supports that may help your child while you are on vacation. Make sure to consult your occupational therapist about which items may be most beneficial for your child.

• Noise cancelling headphones: Some children benefit from wearing headphones if they are easily overwhelmed by the loud noises of crowds. Noise canceling headphones can range anywhere from $20 to upwards of $200. These might be handy for kids that would get overwhelmed by crowds, traveling on an airplane, or seeing a firework show on the 4^th of July. 
• Comfort item: Bringing a stuffed animal or blanket that your child finds soothing may be beneficial for when they become anxious or overwhelmed while on vacation. You could even add soothing aromatherapy scents such as vanilla, lavender, or chamomile to these comfort items for an extra sensory “treat.” (Always make sure your child tolerates and likes the scent prior to adding it to their comfort item. If the smell is too bothersome to them, they may not want to be around it anymore!) 
• Weighted blanket or stuffed animal:  Some children with sensory processing difficulties find compression comforting. A weighted blanket or stuffed animal may provide some calming input and tell their body to relax. Weighted items are now available at most stores or online. Click here to read more about the benefits of weighted blankets.
• Fidgets:  These are small items that kids can fiddle with in their hands to keep them busy and focused when they may feel overwhelmed. Fidgets can be bracelets, putty, pop tubes, etc. 
• Identification bracelets: Sometimes when a child is overwhelmed, they may run away from the group. Because of this, it may be a good idea to make a bracelet with your phone number on it so that you can be reached in case of an emergency. Options include beads with numbers on them, temporary tattoos that you can specially order with your phone number on it. There are even cute “Disney-themed” buttons and tattoos with emergency contact information that you can specially order. Here are some examples of number bracelets and  temporary tattoos or you can design your own ID bracelet. 

The Benefit of Breaks

Children are working very hard to stay regulated and calm when they are being bombarded with all this new sensory input that comes with a vacation. They may just need a little break. It is absolutely okay to take some time in your hotel room or find a quiet spot for your child to regroup. Sometimes just a quiet room with a preferred toy or sensory tool is just the break that your child needs in order to enjoy the rest of their vacation.  

You can help your child create a “calm down corner” in your hotel room or wherever you are staying. This spot does not need to be complicated – it can be a little corner of the room with pillows, blankets, and some of the items previously listed in “What to Pack.”

This can be their special area in which they can retreat to take a break if they become overwhelmed and enjoy a moment away from whatever input is overwhelming them.

This is not a punitive space to send them to when they are behaving badly or being uncooperative. This is a calm space that you can offer them a break in or they can elect to go to when needed. Just as you may go sit by the pool after a busy day on vacation to relax and recharge, your child with sensory processing difficulties may need their own unique space to do the same.

Unexpected Meltdowns

Children with sensory processing difficulties can have meltdowns when they get too overwhelmed by the sensory input in their surroundings and/or if they become too fatigued. As well prepared as you may be, you can’t anticipate or prepare for every meltdown.

If your child has a meltdown while on vacation, first try to figure out what elicited the meltdown and remove them from the input that is too overwhelming for them. It may be helpful to go through all 5 senses: Was there a smell, sound, touch, sight, taste that they experienced that caused them to react? Were they in a loud, busy crowd for too long? Did the plan change too suddenly and without warning?  

Once you have removed them from whatever caused the meltdown (as best as you can), give them input to help calm them down. For some children, they like compression from big hugs or weighted blankets. Other children need to put on their noise cancelling headphones and have some quiet time. 

Sometimes children with sensory processing difficulties can meltdown because they are so tired from holding themselves together for so long in a new environment. As a clinician, I have an understanding of the experience, and know it must be exhausting to be bothered by what most people consider “normal” input, such as the sounds of people talking, the feel of your clothes on your body, or the smell of the pool on vacation.

It’s important for parents to understand that their child with a sensory processing disorder is expending a lot of energy processing input from their surroundings. They may need more patience and understanding when they are having a tough time with changes outside their normal routine. It may be helpful for parents to help children label when they are becoming agitated, by saying “It looks like you are not comfortable right now, can we take a break?”  

Summer vacation should be an opportunity for everyone in your family to rest and recharge. If you need help brainstorming what activities/preparations would be best for your child this summer, consult your occupational therapist for more insight into your child’s unique sensory needs.  

Read our previous blog on How to Plan a Sensory Friendly and Accessible Vacation

For more information about Easterseals DuPage & Fox Valley and our Occupational Therapy services, visit: https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/occupational-therapy.html .