Wednesday, May 24, 2017

Author Spotlight: Ileana S. McCaigue OTR/L

Ileana S. McCaigue, OTR/L is an nationally certified/ registered and licensed Occupational Therapist, author, program developer, holistic clinician and educator with 40 years of experience. Her professional career and expertise include a continuum of care. These range from the neonatal intensive care unit to pediatric concerns in the home, school and community for developmental delays, especially for strategy implementation to manage sensory-based problem behaviors.  Ileana has worked in a variety of pediatric settings that included over 20 years with Special Education students in public schools at the elementary, middle, and high school levels.

She is the author of Typical Classroom Sensory-Based Problem Behaviors & Suggested Therapeutic InterventionsAutism Sleeps™, and has written a new book entitled Taming Idiopathic Toe Walking: A Treatment Guide for Parents and Therapists.  She has also created software, the Scale of Sensory Strategies (S.O.S.S.) Tool Kit™,  for data collection regarding sensory strategies.

Ileana has taken the time to participate in a Q&A session.  It is amazing to read about her experiences as an Occupational Therapist for the past 40 years allowing her to provide a wealth of information to help children today:

Q: First tell a little bit about yourself – job experience, years on the job, etc.
I am a graduate from the Medical College of Georgia in Augusta, Georgia, with 40 years of experience as an Occupational Therapist. I have specialty certifications in Sensory Integration, as a past Certified Driver Rehabilitation Specialist and for therapeutic use of Interactive Metronome to treat processing disorders. I have served as an expert witness for several court cases involving infants and children, and am a published author in the areas of case management and life care planning, as well as energy conservation, motion economy, sleep issues for children with Autism and other Sensory Processing Disorders, interventions related to clinical and school-based pediatric practice, and most recently, on the treatment of idiopathic toe walking. I have presented inservices, seminars and workshops throughout the United States throughout my career, but since 2010, a series of seminars focused on how to develop an evidence-based sensory strategy plan to treat sensory-based problem behaviors.

I was honored at the Medical College of Georgia where I was given the Barbara S. Grant Award from the Georgia O.T. Association in October 2005 for what was stated as my dedication and lifetime of outstanding service to the field of occupational therapy. In 1977 I received the Maddak Award in the area of Physical Disability for the design of the S.K.A.T.E. (Skateboard for Kinesthetic Arm Therapeutic Exercises).
My most meaningful accomplishments include the implementation of the first Neonatal ICU Occupational Therapy program in Georgia at DeKalb Medical Center in 1979; the first Occupational Therapist to develop and implement services at Scottish Rite Childrens hospital in 1981, and the establishment of the first private practice Disabled Driver Rehabilitation program in Georgia in 1982.

I retired from the Gwinnett County Public Schools after twenty years of service in 2015, and have returned to clinical private practice after providing services in Barrow County Schools in 2015-2016. My primary area of practice is for children with Autism and other Sensory Processing Disorders, especially sleep and sensory-based behavioral concerns. I also consult as a wellness and holistic therapist, and incorporate alternative treatments as appropriate.

I immigrated into the United States in 1957 from Havana, Cuba, and became a citizen at age 7 with my parents. I am bilingual and fluent in English as well as Spanish, my native language.

Q: What made you start to write books and create software?

My first book in 1980, “Motion Economy Manual: A Handbook for Conserving Energy”, was written for and published by Northside Hospital in Atlanta, Georgia, where I was the O.T. Coordinator at the time.  My next publication was as a contributor, writing Chapter 7 of “The Handbook of Case Management and Life Care Planning,” by Dr. Roger Weed, Ph.D. Interestingly, it was Chapter 7 on the Role of Occupational Therapy in Life Care Planning which began on page 77 and was exactly 77 pages in length!

I began a private practice on the side in 1981 as a small, home-based business that developed into a brick and mortar-based clinic with a staff of 12: 7 OTs, 1 PT, 1 SLP, 1 Driver Educator for the Disabled Driver Program, an Office Manager and myself. I sold my practice in 1988 to DeKalb Medical Center, and later began working in the school in 1995.

I did not publish my first book until 2009 when I completed the “Scale of Sensory Strategies [S.O.S.S.®] Toolkit”. This was written to validate the quantity and impact of the multitude of sensory strategies that I had been using in classrooms with children with Autism. I needed a formalized data collection tool to compare and contrast the effects of sensory strategies in order to develop an effective Sensory Strategy Plan [SSP] of action that was used by teachers to manage the sensory-based problem behaviors in the classrooms I served. This was in direct response to a parent threatening litigation because of an accusation that, “Not enough sensory strategies have been used with my child!” The first printing of an SSP was for this child that included the documentation of 72 sensory strategies of which only 11 had a positive impact on managing his severe problem behaviors. There was no argument from the parent at this point, and I knew then that I had a valuable tool that should be shared with other OTs and/or PTs in my same predicament.

My next book, Typical Classroom Sensory-Based Problem Behaviors and Suggested Therapeutic Interventions was to compliment the S.O.S.S. Toolkit for suggested strategies to use to collect data.

Autism Sleeps was written after discovering that the majority (80% or more) of students with Autism on my caseload with behavior concerns were reported to not sleep steadily more than 2-4 hours a night. It was written after overcoming my own sleep disorder, Post-Traumatic Hypersomnia, that I developed after a mild head injury from a motor vehicle accident when I was hit on my driver’s door by an oncoming vehicle traveling 85mph in a 45mph zone. The strategies that helped me, as well as others researched, were included in this book.

My latest book on Taming Idiopathic Toe Walking was published after consistent success using a tool that I had initially designed 27 years prior while in private practice that worked more effectively and efficiently than those available commercially for treating toe walkers. I called my tool, Toe Tamers™, since my philosophy is that we may appease or “calm” the need for sensory input that resolves in a problem behavior, but that need may arise at any point of stress and regress in that child or individual’s life further along in life.

So, to answer your question in a nutshell, I wrote books to teach others the therapeutic tools and strategies that I used that were effective with my patients, clients and/or students throughout the course of my years of practice!

Q: What is your top tip to therapists who work in pediatrics?

Work in all areas of pediatrics before you specialize in one area if you know you want to be a “peds OT”. If you are not sure, then work in all areas of adult and pediatrics before narrowing your practice to peds. Once you have decided on the area of peds that most interests and suits you to the point that you feel you are “at home” in that environment, then visit the same setting in many areas of the country or the world to get ideas and exchange your knowledge with them. You would be surprised at how OTs are uniform in some theories of practice, but how differently they approach to treat a similar problem.

Q: What is your best advice to someone who is thinking about writing a book or creating software?

To write a book, find something you have successfully used over time that you think would be of value to another parent, therapist or educator. Then, decide if you have a passion for sharing that tool, philosophy, treatment protocol or whatever the subject may be. Envision what that publication will do and look like, and develop an outline to begin writing, including case studies to validate your clinical expertise whenever possible. Once you have completed your basic manuscript, following your outline so others can follow your train of thought, share your manuscript with trusted individuals (respected colleagues, university-based peers, other professionals in related fields, depending on subject matter, and a professional editor) to review and help you with the accuracy of your statements and the complete editing process. See if some of those professionals will allow you to print a review of your publication to enhance your credibility. Whenever possible, offer your tool or approach for a research study on which you can consult and assist with the design of the study to add further validity to your book.

Q: Do you find it hard to juggle practicing OT and creating products at the same time?

I have done both simultaneously for so long that I simply shift focus as deadlines arise or as a new idea emerges. I always have at least 2-3 new ideas “brewing” in my head that keeps me going and interested in my work as an OT and small business owner while continuing to sell and promote my completed projects. To balance my “work”, as all “good OTs should do”, I enjoy my hobbies of photography and volunteer work. I submit prints for juried shows, while serving on the local Board for the North Gwinnett Arts Association, a non-profit organization for the promotion of arts and education, and I also serve on the Board of New Directions, a day program for adults with Autism Spectrum Disorders in my local community. I have found that the busier I am, the better my time management skills are! I keep my energy levels up with use of wellness products in a “wellness home”. I also remember the quotes from Nike, “Just do it!”, and Mark Twain’s, “Age is a matter of the mind. If you don’t mind, it don’t matter!” I just keep going no matter how “young” I am getting!

Q: Do you offer seminars or workshops?

I offer and develop seminars as needed or requested on sensory-based problem behaviors which can include information from several of my publications as spring-boards. Developing Sensory Strategy Plans (I prefer this term over the label, “Sensory Diet”) using strategies in the classrooms and/or homes, treating sleep difficulties in children and/or adults, or the treatment of idiopathic toe walking. Any combination of these concerns can be addressed in a seminar.

If you would like more information on Ileana McCaigue OTR/L providing a seminar or workshop in the United States or other countries please fill out the form below or here.

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Tuesday, May 23, 2017

Bumble Bee Breathing Break – Deep Breathing Exercise

Did you know that deep breathing exercises can help to alleviate stress, reduce anxiety, strengthen the attention span and sharpen the ability to focus and learn?  In addition, deep breathing helps certain physiological responses as well such as slow the heart rate and decrease blood pressure.  Seems like an easy fix right?  Well, maybe not that easy since it takes practice and time to become mindful of your breathing and to improve your deep breathing techniques.

Give it a try with this FREE Bumble Bee Breathing Break.  Download your FREE breathing break here (a tab will open in a new window).  This is from the Breathing Breaks complete packet.

Bumble Bee Breathing and all the Breathing Breaks are a great activity to teach children to help them to tune out stress, to relax and to get the mind ready to learn.  Here are some suggested times throughout the day to try Bumble Bee Breathing with children:

  1. Before the school day begins.
  2. After recess to help calm the class.
  3. After a brain break.
  4. Following a kinesthetic lesson.
  5. After lunch.
  6. Before a test.

Give the children some time to learn how to do the bumble bee breathing.  Make sure they understand the benefits to the exercise and try and keep it serious.  Children can get silly easily so remind them to stay focused and mindful on their own breathing.

Would love to hear how it goes in your classroom, therapy room or home.  Let me know.
Breathing Breaks: This digital download is a collection of 16 deep breathing exercises and 3 tip sheets. Deep breathing exercises can help to decrease stress, reduce anxiety, remain calm, strengthen sustained attention, sharpen the ability to learn and more! This packet includes 16 full page breathing exercises and 3 tips sheets in color or black and white. In addition, the breathing exercises are provided 4 to a page to make smaller cards or booklets.  FIND OUT MORE INFORMATION.

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Monday, May 22, 2017

10 Suggestions to Reduce Pencil Pressure When Writing

When students press too hard during handwriting tasks, the hand can fatigue, paper can rip and legibility may decrease.  Recently, a reader asked for tips and suggestions to help decrease pencil pressure for when students press too hard during handwriting tasks.  Here are 10 suggestions to help children reduce pencil pressure when writing:

  1. Write on carbon paper – the child has to write softly so the marks barely go through the paper.
  2. Color using shading to demonstrate that different shades require a different amount of pressure.  Try this free Shade Wisely activity or Missing Monster freebie.
  3. Provide extra input to the hands before the students write.  Warm up by squeezing a stress ball or upper extremity weight bearing activities such as wheelbarrow walking, Proprioceptive Poems, animal walks or wall push ups.
  4. Fine tune the fingers and grip with clothespin activities.  Try the free Ninja Clothes Pin activity.  Play some visual perceptual clothes pin games. Make clothes pin silly faces.
  5. Wrap clay around pencil – if student changes the shape of the clay the student is applying too much pressure.
  6. Use a mechanical pencil – if student applies too much pressure the tip will break off.
  7. Use a slant board – when the students wrist is positioned in extension it can improve pencil control.
  8. Place student’s paper on top of a flimsy book or Styrofoam – if student presses too hard the pencil will poke through paper.
  9. Provide sample of handwritten work with correct pencil pressure.  Write one word too light, one word just right and one word too hard to represent the differences in pencil pressure.
  10. Explain to students exerting too much pressure when writing can fatigue the hand.  Have students practice writing lightly, writing just right and pressing too hard.  Can they feel the differences in their hand?

Click here to read 10 ideas to increase pencil pressure.

Handwriting Stations

Handwriting Stations: This digital download includes the materials to create a handwriting station on a tri-fold or in a folder. The station includes proper letter formation for capital and lower case letters, correct posture, pencil grip, warm up exercises, letter reversals tips and self check sheet. In addition, there are 27 worksheets for the alphabet and number practice (Handwriting without Tears® style and Zaner-Bloser® style). This download is great for classroom use, therapy sessions or to send home with a student  FIND OUT MORE INFORMATION.

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Saturday, May 20, 2017

Fidget Spinner Workout – Exercise While It Spins!

Right now, fidget spinners are everywhere.  Whether they are banned from your school or not, here is a fun way to add in some overall exercise while your spinner spins! You can download your FREE fidget spinner workout below.  Years ago, I created a fun printable with a different DIY spinning top (you can view that here).  I thought I would update it so children can use a fidget spinner to time their exercises.  The fidget spinner workout would make a great in class brain break to get the body ready to learn again.

How to Do the Fidget Spinner Exercises: Get the free download below and print.  Spin your fidget spinner. Try to do the exercises listed the entire time the fidget is spinning. Put a checkmark in box when completed. Write down some additional exercises that you want to try while the fidget is spinning.

If you need more quick aerobic exercise workout for children check out Movement Flashcards.  This digital download includes 10 aerobic exercises with flash cards templates. Students can get physical activity while reviewing material. The 10 aerobic activities include: run in place, jumping, hopping, squats, lunges, skipping, twists, cross crawls, jumping jacks and marching. Each page includes a picture image of the aerobic exercise along with a blank template to type in 18 flash cards. You choose what to work on for academic material.  FIND OUT MORE.

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Thursday, May 18, 2017

10 Activities to Get Children Ready for Prewriting Skills

The fingers, hands and shoulders require hours and hours of practicing different skills to get ready for the actual job of picking up a pencil and making marks, lines, shapes and letters on paper.  Prewriting skills include the ability to write straight lines, curved lines, zig-zags and shapes. These skills are building blocks for letter formation during handwriting tasks.  Here is a list of 10 fun activities to get children ready for prewriting skills:

  1. Play Dough – Using play dough helps strengthen the muscles in the fingers, hands and shoulders which are essential for legible handwriting.
  2. Playing in prone – By laying down on the floor on their bellies propping up on their elbows, the shoulders, arms and hands receive proprioceptive and tactile input to help children learn where their body is in space.  In addition, this position helps to strengthen the head and neck muscles.
  3. Animal Walks – Children can practice moving like different animals particularly ones where their hands are on the floor such as bear walks, seal walks and donkey kicks.
  4. Sensory Trays – Practice making marks in different sensory materials such as shaving cream, sand or flour.
  5. Lacing Activities – Lace beads onto pipe cleaners.  Try lacing shoelaces on lacing cards.  These types of activities help to fine tune the intricate fine motor skills needed for handwriting.
  6. Make shapes and letters with your body – Form the lines, shapes and letters using your body.  Check out Alphabet Movement Cards for easy visuals to get started.
  7. Move in different directions – Perform locomotor skills in straight lines, curved lines and zig zags.  Move in a circle.  This helps children develop visual spatial skills which is necessary for spacing and sizing of letters.
  8. Building blocks – Using Lego or Duplo blocks help children improve fine motor skills, muscle strength in the hands and fingers and visual spatial skills.  Brick Activities for Home and School provides patterns to create numbers, alphabet and seasonal objects using LEGO® style 2×2 and 2×4 size blocks.
  9. Fingerpaint – Let children explore making marks with their fingers.  It is easy and fun.  If the child dislikes the sensation of finger painting, offer different objects to paint with instead such as toy cars or plastic toy animal feet.
  10. Moving or placing objects along a path – The teacher can draw different lines or shapes on paper or put painter’s tape on the floor. If it is on paper, children can try putting stickers along the lines or rocks.  If is painter’s tape on the floor, children can try driving toy cars along the lines.  Draw with sidewalk chalk outdoors and children can practice riding a tricycle along the path.

When the children are ready to start with pre-writing skills here are some great resources:

Prewriting Activity Pages includes 50 black and white pictures to trace and color. This is a “just right” activity for children who are learning to write, draw and color. Each picture has dotted lines for the child to trace to practice visual motor skills. Once completed, the child can paint or color the picture. Various prewriting practice strokes are included throughout the packet such as vertical lines, horizontal lines, diagonal lines, curves, circles, squares, loops, wavy lines and more!  FIND OUT MORE.

Fading Lines and Shapes includes worksheets that gradually increase in visual motor difficulty while decreasing visual input for line and shape formation.  There are 18 worksheets for line formations ie horizontal, vertical, curves, waves, diagonals, spikes and combinations.  There are 9 worksheets for shape formations ie circle, cross, square, rectangle, X, triangle, diamond, oval and heart.  This download is great for push in therapy, therapy homework or consultation services in the classroom.  FIND OUT MORE.

Simple Lines, Shapes and Design Coloring Pages: This download is a collection of pre-writing and drawing visual motor worksheets. Practice coloring horizontal lines, vertical lines, curved lines, diagonal lines, zig zags, circles, crosses, squares, rectangles, X’s, triangles, diamonds, ovals, hearts and various combined designs. There are 40 coloring page in total. Print them full size or select print multiple pages to print half or quarter size pages. This is a great packet to encourage creativity, pre-writing strokes and coloring skills. You could use crayons, water colors or paints to complete the pictures. The dark black background helps the children to see how to stay within the shape. If mistakes are made, the errors are not as noticeable so it may help to decrease frustration in children who have difficulty coloring.  FIND OUT MORE.

Lines, Lines and More Lines

Lines, Lines and More Lines: This download is a collection of pre-writing visual motor worksheets. Practice pencil control for vertical, horizontal, diagonal and curved lines. There are 4 separate activities included: 24 task cards to practice pre-writing strokes, 5 worksheets connecting words starting with the same letter drawing different lines, 4 spin and trace the line games and 3 roll and finish the picture games.  This download is an excellent choice for: fine motor centers in the classroom, visual motor skill practice, special education classrooms and/or handwriting warm ups. FIND OUT MORE.

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Wednesday, May 17, 2017

Proprioceptive Activities for the Classroom

As pediatric therapists, we all know how beneficial proprioceptive activities are for children.  These heavy work exercises help provide students with sensory information about body awareness and positions.  They help to calm and regulate a student.  Proprioceptive activities can also help to wake up the muscles getting our bodies in an alert state to be ready to learn.

Some of the best proprioceptive exercises for children are monkey bars, jungle gyms and trampolines.  Obviously, those are not available throughout the school day so here are 10 proprioceptive activities for the classroom that students can do independently:

  1. Chair Push Ups:  Sitting with upright posture in a classroom chair, the child put his/her hands on the side of the seat.  The child lifts and holds his/her bottom up off the seat for 3-5 seconds and then slowly lowers back down into the chair.
  2. Wall Push Ups:  Put both hands on the wall with the feet a little farther than arm’s length back from the wall.   Lean your body towards the wall and back out.  Another option is to just push both hands against the wall for 5-10 seconds with arms extended.
  3. Desk Push Ups:  Place both forearms on the desk, palms facing down and flat.  Lean your body weight over your forearms lifting your bottom off the chair.  Return to a seated position.  Repeat several times.
  4. Bear Hugs:  Wrap your arms around your chest or knees and give yourself a big, firm hug.
  5. Arm Squeezes:  Use your right hand to give firm arm squeezes up your left arm starting at the wrist.  Repeat with the left hand squeezing the right arm
  6. Carry Heavy Books:  Give the child a job to organize or hand out heavy books.
  7. Wash the desks or boards:  The child can apply pressure when wiping the desks.
  8. Stack or unstack classroom chairs:   Classroom chairs are heavy therefore this is “heavy work”.
  9. Use a hand held pencil sharpener:  The act of holding and turning the pencil with one hand and holding the pencil sharpener tight with the other hand provides proprioceptive input the hands and fingers.
  10. Jumping in place:  Jumping in place, jumping jacks or marching in place helps to wake up the leg muscles and provide sensory input. This is a great activity to do before activities that require body awareness such as sitting during circle time and walking in a classroom line.

You could create a proprioception station in the classroom.  Students could perform heavy work activities prior to school work. Proprioceptive Poems can help jump start that station into action.  This digital document includes the Push Poem and Jump Poem. The poems encourage proprioceptive input with visual cues for the child to follow. Each poem comes with 5 pictures for visual cues along with a poster. The sing song text of the poem is easy for the child to remember. This is a great starter activity prior to table top tasks, fine motor skills and tactile input.  FIND OUT MORE INFORMATION.

Read more about proprioception and handwriting.


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Tuesday, May 16, 2017

10 FUN Games to Practice Self Regulation Skills (No Equipment Needed)

Self regulation skills help children to control emotions, thinking, behavior and motor actions in different situations.  Throughout the day, children need the ability to tolerate sensations, situations and form appropriate responses.  It requires that children control their impulses to stop doing something if needed and to participate in something even if the children does not want to do it.  For example, children need self regulation skills to control an impulse to move all around the auditorium during an assembly and they need to sit and watch the assembly even if they are not highly interested in the presentation.   Research indicates that self regulation in children is a predictor of academic abilities. Children with higher levels of self regulation have achieved higher scores in reading, vocabulary and math. In addition, some research has shown that the ability for young children to self regulate is associated with higher, future education levels.  The ability to self regulate is an extremely important skill that needs to be taught to children.

And guess what?  Playing games help children to practice and learn those skills!  Think about it.  Playing games help us to learn to: wait, follow rules and to tolerate losing.  Here are 10 FUN games that require no preparation or equipment to practice and learn self regulation skills:

  1. Red Light, Green Light – kids move on the green light and stop on the red light.  Don’t get caught moving on the red light.
  2. Mother May I – one child is the leader.  The rest of the children ask: “Mother May I take….” a certain amount of steps, hops, jumps or leaps to get to the leader.  The leader approves or disapproves.
  3. Freeze Dance – turn on music.  When music stops children have to freeze.
  4. Follow My Clap – The leader creates a clapping pattern.  Children have to listen and repeat.
  5. Loud or Quiet – Children have to perform an action either loud or quiet.  First pick an action i.e. stomping feet.  The leader says Loud and the children stomp feet loudly.
  6. Simon Says – Children have to perform an action only when the leader says “Simon Say do…”.  For example, if the leader says “Simon Says touch your toes” and all the children touch their toes.  If the leader says “Touch your toes”, no one should touch their toes.
  7. Body Part Mix Up – The leader will call out body parts for the children to touch.  For example, the leader calls out “knees” and the children touch their knees.  Create one rule to start.  Each time the leader says “head” touch your toes instead of your head.  This requires the children to stop and think about their actions and to not just react.  The leader calls out “knees, head, elbow”.  The children should touch their knees, TOES and elbow.  Continue practicing and adding other rules to change body parts.
  8. Follow the Leader – The leader performs different actions and the children have to follow the actions exactly.
  9. Ready, Set, Wiggle – The leader calls out Ready…Set…Wiggle and everyone wiggles their bodies.  The leader calls out Ready…Set…Watermelon.  No one should move.  Leader calls out Ready…Set…Wigs.  No one moves.  Leader calls out Ready…Set…Wiggle.  Everyone wiggles again.  You can change this to whatever wording you want.  The purpose is to have the children waiting to move until a certain word is said out loud.
  10. Color Moves – Explain to the children that they will walk around the room.  They are to move based on the color paper you are holding up.  Green paper means walk fast, yellow paper means regular pace and blue paper means slow motion walking. Whenever you hold up a red paper they stop.  Try different locomotor skills – running in place, marching, jumping, etc.

If you need more ideas to teach self regulation skills to children Self Regulation Skills Curriculum.

Self Regulation Skills Curriculum

Self- Regulation Skills Taught: This curriculum provides an effective, time-efficient structured system to provide classroom breaks, improve self-awareness and self advocacy and teach specific self-regulation skills so that kids have tools to use in their classrooms. This system will get kids moving, give them the benefits of a brain power boost [from getting their heart rate up], give them heavy work and isometrics to help them calm down, and help them learn techniques to quiet and control their bodies in order to return to their academic work.  FIND OUT MORE.

Read how to play 6 more Self Regulation Games for Children.

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