By: Easterseals DuPage & Fox Valley Occupational Therapy Department

“Summer is a great time to explore a large variety of playful sensory input types for children. From messy play and crafts to outdoor activities, children and families can immerse themselves in expanding their touch, sound, sight and movement-based sensory options,” shares Andrea Sagel, MS, OTR/L, Director of Occupational and Developmental Therapy.

One of the best summer activities is around water play! Here are some ideas of both indoor and outdoor sensory play using the theme of water.

SPLASH INTO SUMMER WITH NEW ACTIVITIES!

Simple activities in the bathtub or going to a splash pad or playground can provide fun opportunities to play while improving a child’s visual processing, hand strength and more!

Water Play!

Walking or running in water increases resistance and helps with awareness.

Crawling on hands and knees in water increases a child’s muscle mobility and strength.

Bath Time Fun!

Suggested items to put together into a bag to play with in the tub/pool to develop hand strength and coordination as well as visual motor skills.

• Use sponges or washcloths to fill- up with water and squeeze them out.

• Fill mist or squeeze bottle up with water and watch the mist appear.
  
• An eye dropper is a great tool to squeeze picking up water and releasing it into another container. 

• Use squirt toys such as traditional water guns or super soakers!

• Traditional squirt guns which need a thumb and index finger to use with a squeezing motion.  These develop palm strength.

Messy Boats: Sticky, Yummy Toddler Play!

Let your toddler explore the world around them and learn about their senses with messy activities! Read more about this messy boats activity involving gelatin along with a great clean-up strategy from from Busy Toddler here!

Hand-Eye Coordination Activities

These activities enhance motor skills which helps movement in eyes, hands, and feet while performing different tasks. Some of these activities at the playground can involve many different input types, such as visual processing and hand eye-coordination.

Velcro Ball and Mitt Sets!

Simply pulling balls off mitts helps with eye-hand coordination and upper-body strength!

Playground Fun!

Hang on a bar for a count of 3 and increase as your child is able!

On a swing: name a body part, i.e., arms or legs, and have them bring that part forward for you to tickle, push, etc.

ARGH!

Walk the Plank Activity from “Tools to Grow”!

Make a simple balance beam or wood beam 4 inches wide. Walk backwards, forward, and even sideways! Test your balance skills or time how long before you fall off. Set goals and accomplish them.

Find more of these activities’ day by day in the “Tools to Grow” website! The site has daily activities for caregivers to do with kids each day for the summer targeting different areas of cous like visual motor skills. (Level 1 is for Preschool- 1st grade and Level 2 is for 2nd grade – 4th grade.)

Floor is Lava Hopscotch Activity!

To provide a child with increased proprioceptive input, motor planning, tactile processing, and handwriting: try Hopscotch or drawing a “floor is lava” course with chalk. This can be done on the driveway or on the sidewalk. Families can use a hose or spray bottle to spray away the chalk when done!

Photo Credit: http://www.hopscotchin.com

For more summer sensory ideas, or ways to adapt these activities to your child’s needs and goals, ask an occupational therapist at Easterseals DuPage & Fox Valley. For more information about our occupational therapy services, visit our website.

Enjoy your summer!

By Katelyn Bentel, MSW, LSW          
Social Worker at Easterseals DuPage & Fox Valley

Mental health is at the core of human interaction and is the foundation from which individuals navigate their world. Mental health can be difficult to understand because it does not manifest in the same way across the human population—let alone in an individual on a day-to-day basis. We all respond differently!

In healthy individuals, the upstairs brain (prefrontal cortex) is fully developed by the age of 25. This part of the brain is responsible for executive functioning skills (e.g., decision-making/impulse control, problem-solving, working memory, attention, emotional regulation, etc.). With this, adults possess an ability to discern emotions and process their own mental distress through self-reflection, which can potentially lead to them seeking out additional support—if deemed necessary.

Children instinctually operate from their downstairs brain (cerebellum, brainstem, and limbic system); responsible for basic, life-sustaining processes (e.g., breathing) and the fight-flight-freeze response in moments of perceived stress/danger. Their ability to identify, understand, and control their emotions is limited due to an underdeveloped upstairs brain, making it difficult to monitor and communicate struggles with their own mental health, thus, emphasizing the need for extra support.

Signs that your child may need additional support:

• Aggression/increased fighting
• Increased emotional sensitivity
• Frequent temper tantrums/uncharacteristic mood swings
• Stomachaches, headaches, physical complaints
• Loss of interest in previously enjoyed activities/self-isolation
• Inattentiveness
• Difficulty separating from caregivers
• Noticeable change in appetite
• Noticeable decrease in sleep quality
• Lack of self-confidence

These signs can temporarily appear during a child’s typical developmental process as they learn to adjust to inevitable stressors in their environment. However, these signs can also evolve into maladaptive coping skills—negatively impacting the child’s overall mental health. It is important to take notice of the presence of these signs, their frequency, duration, and impact on the child’s ability to function daily.

Understanding why your child is responding this way

Sometimes a child’s response to stress is misinterpreted as “bad behaviors.” A healthier and more sensitive way to interpret these responses is to reframe “bad behaviors” as communication in an attempt to express an unmet need.

For example, a child may be acting in ways that appear “attention-seeking” (e.g., whining/crying, temper tantrums, wanting help with simple tasks, etc.) when, in reality, they are having difficulty communicating that they are trying to seek out connection.

How to respond with Connection:

• Nurturance
  · Respect and acknowledge child’s feelings
  · Talk and act so child feels seen and safe
  · Be Gentle
  · Offer affection (verbal or physical)
  · Encourage!
  · Allow for mistakes
  · Be consistent with developmentally appropriate rules and expectations
  
• Validation of emotion
  · Respect and acknowledge child’s feelings
  
• Shared quality time with caregiver
  · “Special Time,” just you and child
  · Include child in your activities
  · PLAY!

Another example of a misinterpretation is when a child is viewed as “manipulative” while, in reality, the child could be acting in ways that give them some semblance of control. Children are reliant on their caregivers to have their needs met. This has the potential to come with the repercussion of the child feeling as though they have lost their voice when (well-intentioned) decisions are made on their behalf by caregivers.

This lost voice may make a child feel uneasy, urging them to act in maladaptive ways as a coping mechanism to satisfy that lack of a sense of control. A simple way to instill a child’s sense of control is by offering the child options to choose from to complete the caregiver’s desired task/end goal. These examples are not to be confused as excuses for a child’s behavior or to invalidate a caregiver’s frustration, but rather, to serve as a potential explanation and encourage caregivers to pause and be curious about the why behind these actions. (Chart 2)

Seeking Additional Support

Seeking additional mental health support from a professional is a great use of resources if these dysfunctional responses/signs become a consistent presence in a child’s everyday life. Everyone can benefit from support. For instance, if an individual is recovering from a weakened ankle from a sports injury, it is common to receive physical therapy to rebuild that muscle. We should do the same for someone struggling with emotions/adapting to stressors.

There is no better time to create a strong foundation for mental health and foster resilience than during childhood. The Mental Health & Family Support Team at Easterseals DuPage & Fox Valley provides a safe and inclusive space for children and their families to receive support. Learn more about our mental health services here.

By: Kristin Roemer, MS, OTR/L

The Importance of Vision

As a first grader, I got my first pair of eyeglasses at age 7. My school had an acuity screening, which showed that I could not see clearly from a certain distance. Getting glasses made seeing the board and all the materials within my classroom so much sharper and brighter. While many of us are familiar with the big “E” chart and understand the need for glasses for an acuity problem, we may not think as much about the other aspects of a person’s functional vision and how that impacts their participation in daily routines.

The Vision Clinic screening at Easterseals involves consultation with a developmental optometrist and an occupational therapist to screen for visual concerns and to discuss how these may be impacting a child’s participation in the classroom or at home. First and foremost, the developmental optometrist assesses the overall health of the eye structures and the need for a prescription. Two more areas, visual efficiency skills and visual processing skills, round out what makes up our vision.

Visual Efficiency Skills

Visual efficiency skills consist of three categories:

1. Oculomotor skills (or “eye tracking”):

• Fixation – the ability to maintain one’s gaze on a single image
• Smooth pursuits – the ability to keep one’s gaze on a moving image
• Saccades – quick movements between different visual targets

2. Accommodation (or “eye focusing”):

• The ability to sustain focus for an extended length of time
• The ability to change focus from far to near and back again

3. Binocularity: (also called eye teaming or coordination)

• Convergence and divergence: the ability of the eyes to move closer or farther and to keep a single image, not see double

Visual Efficiency Examples

If you think about your child sitting at their desk at school, each of these areas are put into play for them to be successful. Your child must use smooth pursuits to follow their teacher around the room and to follow along while reading. They must fixate and complete saccadic movements to look from one part of the board to another, such as when comparing two math equations. When they shift their gaze from up at the board back down to their desk, they are converging and diverging their eyes.

Keeping the information that they are looking at crisp and clear without “spacing out” and letting words get blurry involves their focusing system. When something about any of these systems is off, it can cause great difficulty in completing schoolwork. Even if a child is able to successfully hold each of these things together to complete a quick acuity screen, it may not show the bigger picture of how these skills have an impact on a full day in school or at home.

Visual Processing Skills

Visual processing skills refer to the brain’s ability to interpret visual information in different ways. These skills include:

• Visual discrimination – the ability to recognize details/differences among similar objects
• Form constancy – the ability to recognize an object in different contexts or in different sizes/colors/orientation
• Visual closure – the ability to visualize the whole picture when given a partial picture
• Visual figure-ground – the ability to perceive and locate an object in a busy visual field
• Visual-spatial relationships – the ability to perceive the position of objects in relation to each other and to oneself
• Visual memory – the ability to remember for immediate recall certain characteristics of an object
• Visual sequential memory – the ability to remember forms/characters in the correct order

Visual Processing Examples

Let’s imagine your child, now at home, is helping out with their chores and getting ready to get out the door. A child with a visual discrimination concern will have trouble matching up socks when they’re helping to sort laundry. When you ask your child to grab their homework off the messy kitchen counter, they may have difficulty locating it if they have poor figure ground skills. A child with form constancy problems may have trouble recognizing letters or words in different fonts or in different contexts, such as reading off a cereal box or from their assignment notebook. Let’s say you’ve asked your child with a visual closure problem to find their shoe, but they are unable to find it because it is partially obscured by a coat strewn halfway over it.

Maybe you show your middle schooler a neighbor’s address and ask them to drop off a letter down the street, but your child has difficulty with visual sequential memory and can’t remember the order of the house number. Your child, who is consistently clumsy, knocking over cups of water when reaching for the ketchup at the dinner table, may be having problems with visual-spatial relationships and be unable to adequately judge the distance between items. A child with visual memory difficulties may have poor reading comprehension, which can make for a frustrating situation when following a recipe or gathering up items from a list.

Vision Clinic Details and What to Expect

Who knew so much went into the way you take in information visually?! The occupational therapists on our team understand that the different sensory systems in our body affect how we navigate the environment and participate in various parts of daily life. If your OT feels that a developmental optometrist should be consulted to screen your child’s visual skills, they will first complete some screening activities themselves to grossly assess your child’s visual efficiency skills. If appropriate, they will also conduct some standardized assessments to get a baseline number for different visual processing skills. This information, along with identifying functional activities that may be difficult, is shared with the developmental optometrist before the clinic so the doctor can get a broader picture of how things have been going.

Our Vision Clinic typically takes place on the last Wednesday of the month. If possible, your child’s treating therapist will be present and able to share from her perspective how vision has impacted participation in therapy sessions based on what she has observed and in conversation with you. If s/he is not able to attend, she will touch base ahead of time with the OT running the clinic, who will then be able to share information and ask questions during the clinic. Information gathered from the screening will be shared informally with the treating therapist as well as a full report scanned into your child’s chart and emailed out for your records. In any case, if further consultation is needed with the optometrist, our therapists are able to contact their office and discuss strategies or action plans in more detail.

Recommendations and Additional Steps

Recommendations from the clinic may vary – the developmental optometrist may identify a few areas that need particular attention over the next few months. You will receive a list of activities to try at home, as well as toys and games that help promote visual development, and your therapist will also incorporate different activities into their therapy session. Sometimes, addressing these areas at home and in OT is all that a child needs to improve their visual skills adequately.

Other times, it may be recommended to go into the optometrist’s office for a more thorough evaluation. Some problems can be fixed with a pair of glasses (either performance lenses during tabletop tasks, glasses to address near or farsightedness, or specialty glasses with prisms), while others may require more intensive work in vision therapy. If this is the case, you will receive a packet of recommended providers in the area along with information about the typical vision therapy focus and progression. It is recommended that all children see an optometrist yearly to monitor vision development, regardless of suspected problems.

How to Get Started

If you feel that much of this information resonates for your child, ask your treating therapist about attending the Vision Clinic at Easterseals DuPage & Fox Valley. You can also contact our Clinic Coordinator, Christy Stringini, at 630-261-6216 or cstringini@eastersealsdfvr.org to facilitate this process. We look forward to *seeing* you!

By: Kelly Nesbitt, MOT, OTR/L  

What is executive functioning?

Executive functioning refers to organizing, problem-solving, working memory, sequencing and efficient execution of ideas to complete a task. Executive functioning is a complex process involving good sustained attention, organization of ideas, inhibiting impulses, time management, and problem-solving (Calderon, 2011).

General functioning would be tough without these skills in everyday life. There are many strategies that Occupational Therapists can help a child improve their executive functioning skills to better participate in their daily routines, which will be discussed below.

When do kids need to use executive functioning skills?

As an OT, I look at executive functioning specific to how kids can execute their daily “occupations,” such as getting dressed, packing up their backpacks, completing their self-care routines, or completing a craft.  Almost all tasks kids do during the day involve some executive functioning skills. For instance, when they encounter a problem, they must come up with a new idea, organize how to execute a plan, gather supplies needed, and adjust their plan if something new arises. Take the example of getting dressed in the morning, for example. When you tell your 7-year-old child, “Go get dressed before school,” your child must… 

1. Be regulated enough in their body to understand and process the verbal directions given to them. Do they know what “go get dressed before school” means?
2. Have an idea of what they want to wear- Do they need shorts? Leggings? Jeans? Once they realize it’s cold outside, do they know the necessary steps to take?
3. Visualize what supplies they need on a cold day: socks, shoes, underwear, a shirt and pants. They need to know where to go in the house to find all these supplies.
4. Once they have this “list” of what they need, they need to gather these materials. Your child must be able to draw on their memory to know where do I find my clothes? My dresser? My closet?
5. Then find all these articles of clothing in their room, keeping in mind everything they need and staying focused on this task (sustained attention) and getting it done in a reasonable amount of time before mom calls them to get in the car for school.
6. If they find every article of clothing but realize that they cannot find their jeans, do they have a strategy to solve this issue? Can they ask Mom? Can they look in the laundry room if mom or dad has washed their jeans and it just hasn’t been put away yet?
7. Once your child finds out that their jeans were just in their brother’s room, can they then sequence the steps accurately of dressing in their school clothes? (take off PJs, pull on their underwear, then pants, then their shirt)
8. Be able to evaluate to see if the task was completed correctly. Did they forget a sock? Did they miss a step? Did they complete the task on time?

Needless to say, a lot of brain power actually goes into what seemingly is a simple task to most adults.  

How do I know if my child has executive functioning difficulties?

A diagnosis like attention deficit hyperactivity disorder (ADHD) or autism can certainly be a factor, but there are many neurological, mental health and behavioral disorders that can affect a child’s executive functioning skills. An Occupational Therapist, Speech Pathologist or Social Worker, can help you determine if their difficulties are from executive functioning difficulties or if there are other sensory, postural, mental health, and/or motor planning issues underlying. Some signs that executive functioning may be hard for your child include (but are not limited to)…. 

• You have to constantly prompt kids to get dressed in the morning or walk them step-by-step through daily routines that you know they know how to do 
• Your child consistently forgets their homework assignments at home, or their binder is so disorganized that they cannot find what they need in it 
• Your child consistently forgets to do chores (not just avoiding them) or does them incompletely (when you know they understand what to do)  
• They get distracted easily. You ask your child to do something, and you consistently find them doing something completely different (watching tv, playing with a different toy) 
• Homework tasks are really hard (especially around 2^nd grade, where the workload increases) 
• Teachers have described them as “disorganized” or “getting distracted in class.” 

Strategies to help: 

Environmental setup: 

• Keep the environment at home decluttered (as much as possible). Have designated spaces where toys belong that are denoted with labels (for kids that read) or pictures (for children who are not yet reading). I recommend taking literal pictures on your phone of what goes in the bin and printing it out so that your child makes the connection of what actual items go in that bin.  

• For homework completion, you can have two bins at the table where the child does their homework, labeled “to do” and “done.” You can put all the papers the child must complete in the to-do bin, and as the child finishes each, they can move them to the “done” bin. Sometimes this concrete step helps a child’s brain visualize what is left to complete and what is already complete.

Visual schedules: 

• Have a visual schedule of activities you want your child to complete. This schedule has small pictures that go in see-through sleeves. Once an activity is completed, the child can take the picture out of the sleeve and put it in a pouch at the bottom. Again, I’d recommend you take pictures of the child’s literal tasks/them doing the tasks to help improve comprehension of what the picture represents.  

Timers: 

Count “ups”/ Clocks– For children who both do and do not know how to tell time, I recommend using a clock to help them manage time. If you have an analog clock with a glass or plastic face, use Expo markers to draw pie segments on the clock face of what task you want the child to do.  

For this example, if you need to be out the door by 3 o’clock, tell the child that they need to get dressed while the big hand is in the orange area. Children who can read can have more complex segments delineated on the clock for multi-steps.  

Countdowns/timers: 

Time Timer clocks count DOWN how much time is left, which can be helpful for children when it’s almost time to transition away from the TV or leave for school in the morning.  

Executive Functioning Support

If you feel like your child is struggling consistently with executive functioning tasks, an Occupational Therapist can specifically look at these skills in an OT evaluation.  Our skilled therapy team works across ages and diagnoses and can help create a personalized plan to help your child.

To learn more about services at Easterseals DuPage & Fox Valley, call us at 630.282.2022 or email info@eastersealsdfvr.org.

References: 

Executive function in children: Why it matters and how to help – Harvard Health by Johanna Calderon, PhD 2011  

By: Kelly Nesbitt MOT, OTR/L & Certified DIR Floortime Therapist

DIR Floortime is a multidisciplinary, developmental treatment approach that has profoundly shaped my clinical practice as an Occupational Therapist. I have personally seen a variety of children thrive with this approach. I have been lucky enough to learn all about DIR Floortime at Easterseals. While DIR is a very complex model, I wanted to have an overview of this model that parents can refer to and start off on their journey of learning and growing with their child.

Author’s Note: I use both identity-affirming language “autistic children” and person-first language “children with autism” throughout this post, as these are two schools of thought within the autism advocacy community regarding how to refer to someone with this diagnosis. Generally, I use the language that feels most respectful to each individual family and child. As I am not someone with autism, I don’t have the lived experience to make a judgment on which school of thought is “right.”

Dr. Stanley Greenspan and Dr. Serena Wieder explain their model, DIR Floortime ®

What is DIR Floortime?

DIR, which stands for Developmental Individual Differences Relationship Model, is the theoretical framework that works to promote the relationship between the child and parent, looking at the unique individual differences (sensory processing, motor, neurology, developmental, cognitive, and social-emotional skills) of the child and using playful, child-led strategies to support engagement and development.

All these Individual differences and the Relationship you have with your child all help catapult your child forward Developmentally. Floortime is the practice or application of DIR theory in which you literally “get down on the floor” with the child and “get into their world,” exploring their interests through affective, playful engagement in order to help them grow. The most important part of DIR Floortime is the “R,” which stands for “Relationship;” your relationship with your child drives all the development and meaning they derive from the world. DIR Floortime is, at its core, a parent coaching model.

Growing research is showing that this developmental, multidisciplinary approach is an effective treatment option for working with children with Autism Spectrum Disorders. Multiple randomized-controlled studies have been published since 2011 identifying statistically significant improvement in children with autism who used Floortime versus traditional behavioral approaches.

How Therapists Are Involved

Your therapist will help coach you on how to use your child’s strengths and interests to accomplish your child’s goals. It aims to empower parents, who are the “experts” in their child, to trust their instincts, follow their child’s lead, and fundamentally look at the child’s capacities in a strengths-based approach. Essentially, this model looks at and bases treatment decisions around all the wonderful things a child can do and what strengths they already possess.

What I love about DIR Floortime:

It Respects the Parent’s and Child’s Knowledge

As an OT, I hold the core assumption that every parent and child is trying their best based on their mental, emotional, and physical capacities at that moment. This model coincides with that belief on a profound level. Since DIR Floortime is a strengths-based model that presumes competence of both the parent and child, this approach really helps me go into a session with an empathetic heart and help you use “what is going well” with your child and expand from there.

Because this approach is centered upon relationships, it’s incredibly important that all families feel comfortable with their therapist as a cheerleader and coach and are able to be vulnerable in sessions. Parenting is incredibly complex, hard, and rewarding, and your therapist rides all those ups and downs with you, not as an “expert” in DIR, but as someone who is in your and your child’s corner. Even if a session is really hard, there is always something positive that can be found together, and growth can occur from there.

It is Neurodiversity-Affirming

I also love DIR Floortime, as it is neurodiversity-affirming. Neurodiversity-affirming practice refers to celebrating the unique diversity of neurological functioning that makes humans beautifully complex. It honors the interests and experiences of the neurodiverse child (children with Autism, ADHD, sensory processing differences, OCD, anxiety, and more). This approach assumes that children “don’t need to be fixed or cured,” just supported where they are developmentally and accepting their uniqueness; We see the child as inherently good the way they are. This model doesn’t see, as some may say, “unusual interests” in Autism but rather sees a child with a passion that can teach us more about something we may have never thought twice about.

It Encourages Interests and Doesn’t Label

I remember hearing an adult with Autism explain how when he was little, he always saw profound beauty in light reflecting off droplets of rain or in suncatchers on windows. He described how he would flap his hands in excitement as the droplets slid down the window or light danced through the glass and onto the floor, his body unable to contain the excitement at witnessing something so wondrous.

I wonder if, as a child, this boy may have been described as having an “unusual interest” in windows and “stereotyped behaviors” rather than someone with a unique sensory system and neurology who is having a joy-filled sensory experience. I have also heard of some Autistic advocates reporting that it must be sad that “neurotypical” people don’t get to experience the profound joy of stimming and seeing the beauty that surrounds us in everyday experiences.

I think this is a wonderful way to look at neurodiversity- what can these children show us about experiencing the world with a newfound sense of wonder and excitement. How can we reframe pathologizing neurodiverse children and instead amplify their voices and experiences to learn something exciting and new?

DIR Floortime looks at a child as a human being, not a diagnosis or label, who has great ideas that should be honored.

DIR Therapy at Easterseals

Lucky for us all, Easterseals has many certified DIR Floortime Therapists in the Occupational Therapy, Social Work, and Speech Therapy departments! You can request a therapist who has this specialization. However, if one is not currently available at the time your child needs therapy, don’t worry! Easterseals has an environment of constant collaboration and clinical supervision, so a non-certified Floortime therapist can still provide a strengths-based, child-led approach with mentorship and consultation from a certified DIR Floortime therapist.

Easterseals provides an environment that celebrates neurodiverse children’s experiences and, through the DIR Floortime model, allows parents to help their children gain skills and grow!

If you are interested in getting started with DIR therapy for your child at Easterseals, we have many qualified therapists to guide you through the process!

Learn more here to get started.

Where can I learn more? DIR Resources

Websites:

Profectum Parent Toolbox (this is a wealth of videos, webinars, worksheets, and educational materials to help walk parents through all aspects of this model. Available in English and Spanish)

Profectum.org and ICDL.org are the two large organizations of DIR Floortime. Both websites have a wealth of information and training opportunities for professionals and parents.

ABA vs. DIR Floortime? This is a look at these two different approaches to help you decide which is a better fit for your family

 DIR Floortime Quick Fact Sheet   (This link is a list of clinical research and evidence supporting this model)

Affect Autism Podcast What is it? – Affect Autism: We chose play, joy every day (this is one of my favorite podcasts about DIR Floortime, exploring a range of topics within this model)

Books about DIR Floortime and Related approaches:

• Brain-Body Parenting by Mona Delahooke PhD (2022)
• Beyond Behaviors by Mona Delahooke PhD (2019)
• Visual/Spatial Portals to Thinking Feeling and Movement by Serena Wieder PhD and Harry Wachs O.D. (2012)
• Engaging Autism by Stanley Greenspan, M.D. and Serena Wieder, PhD (2007)
• The First Idea: How Symbols, Language and Intelligence Evolved from Our Primate Ancestors to Modern Humans by Stanley L. Greenspan, M.D. and Stuart G. Shanker, D. Phil (2004)
• The Secure Child by Stanley Greenspan, M.D. (2001)
• The Irreducible Needs of Children by T. Berry Brazelton, M.D. and Stanley L. Greenspan, M.D. (2000)
• Building Health Minds by Stanley Greenspan, M.D. (1999)