This week, as part of our ABCs of Child Development series, we thought it might be helpful to list some of the most common questions we hear about kids health and development development all in one place with some tips, ideas, and links to other helpful resources.
Sensory Processing
Question 1 || My child can’t stand to have her hands messy. She has a meltdown every time she gets anything on her hands. What is going on with her?
Many children struggle with the sensation of having messy hands. Whether it’s soap, water, dirt, or glue, some kids are overly sensitive (hypersensitive) to tactile experiences. The tactile system helps us process information we receive from receptors in our skin and for some children (and even for many adults), this sensory system can be on overdrive – causing extreme reactions to touch experiences that are easily tolerated by others.
Read more about the tactile system.
Question 2 || My child is way too rough. He crashes, tackles, jumps, and pushes his way through the day. It seems like it’s just behavior, but I can tell that it’s out of his control. Why is he acting like this?
Children who are seeking out extra proprioceptive input often demonstrate “rough” behaviors. The proprioceptive system is responsible for how we grade the force of our movements and lets us know where and how our body parts are moving by processing input to our muscles and joints. Children who crash, tackle, jump, and push excessively and with 100% force are often looking for ways to provide additional stimulation to the proprioceptive system. These behaviors require them to use their muscles to push and pull and they are getting impact to all of their joints. They are looking for more proprioceptive input to keep their bodies regulated.
Read more about the proprioceptive system.
Question 3 || Every time we go out in public or into a crowded place, my child becomes so upset. She cries, covers her ears, and sometimes even tries to run away. Sometimes, she covers her ears before there’s even any noise, like if she sees a crowded place from far away. Why do these experiences bother her so much?
Some children have difficulty tolerating sound experiences that most other people don’t have any problem with. Their auditory systems are just more sensitive to sound than the rest of us. Children with hypersensitivity to sound often struggle with experiences like those described above: crowds, public places, sudden or loud noises (e.g. vacuum, hair dryer, etc.) and may have extreme reactions like meltdowns or a fight or flight response.
Read more about the auditory system.
Question 4 || My child won’t eat anything except junk food and fast food. What can I do?
Picky eating is often related to sensory processing issues because all of the body’s sensory systems play a role in eating. It can be difficult to address because the problem can range from just being a developmental phase to being a more serious sensory processing or other medical problem.
When a sensory issue is the cause of picky eating, it often has to do with oral sensory processing issues, olfactory processing issues, or tactile hypersensitivities. And there may even be other sensory systems involved too. Extremely picky eaters may limit themselves to a very small group of foods. They may even struggle with trying foods that are very similar to the ones they usually accept. For example, they may eat chicken nuggets from one fast food restaurant, but refuse nuggets from anywhere else. Other children who are picky eaters struggle with certain food textures or even with trying foods that are not a preferred color.
Read more about picky eaters.
Question 5 || What can I do if I have a child who has a really hard time falling asleep at night? He comes out of his room over and over and just can’t seem to calm himself down.
Sleep is another area of development that can is closely tied to sensory processing. Many children struggle with falling asleep or with staying asleep through the night. They may pass through phases of development during which sleep comes more or less easily. Often, kids benefit from basic sensory strategies to help them calm their bodies and minds before bed. When a child is struggling with sleep, sometimes it’s helpful to think in terms of calming a newborn baby.
Some of these same tactile, auditory, visual, and movement strategies can come in handy even with older children. Basic bedtime sensory strategies can include white noise, deep pressure, rocking/swaying and warmth.
Read more about sensory sleep tips for kids.
*If your child’s sensory behaviors are very extreme or if they significantly limit his or her participation in daily activities, it’s time to talk to your pediatrician or an occupational therapist to get some help.
Fine Motor Skills
Question 6 || Why is my child’s handwriting such a mess? We’ve worked on it at home and at school, but now it’s becoming a fight. How can I help?
Handwriting is one of the most common areas of concern I hear about from parents and teachers. Kids can have difficulty with everything from sizing and spatial awareness to handwriting speed to letter formation and construction.
Children who struggle with handwriting may be having difficulty with any one of the following skills. Click on the links to learn more:
–Visual Motor Integration
–Grasping Skills
–Hand Strength
–Fine Motor Coordination or Dexterity
-Visual Perception
-Other Learning Problems Related to Writing or Language
Question 7 || My child’s hands are so weak. She can’t seem to hold objects steady or grasp a pencil and her fingers seem almost floppy and flat. What can I do to help?
Hand strength is one of the most common problem areas I see with kids in my pediatric occupational therapy practice. Kids who struggle with hand strength may have difficulty with grasping a pencil, learning to use scissors, and managing clothing fasteners. They are also likely to struggle with handwriting and other classroom skills.
Some of the best ways to strengthen little hands are through weight bearing activities, pulling and pushing activities, and squeezing activities. Check out these fun and creative ideas for building hand strength in kids.
Self Care
Question 8 || My child is a pro at taking off all of his clothes, but really struggles with getting himself dressed. It takes us forever to get ready in the morning. What can I do?
How many times have you arrived at your destination to find a toddler in the backseat who has taken off his shoes and socks? Kids this age are asserting their independence and think it’s hilarious to strip down whenever they get the chance.
But what about learning to get dressed? The most important thing here is to practice when you’re not in a rush. A busy school/work morning when you’re trying to rush out the door is not the best time to practice dressing skills.
We like to recommend practicing at bath time or bedtime instead, when things are less hectic. Putting on soft, elastic pajamas is often easier than putting on school clothes and plush, furry slippers are great for for practicing putting on and taking off shoes! We also use Theraband and other tools to practice the motions kids need to pull clothes on and off.
Read more about teaching kids how to dress themselves.
Question 9 || Will my child ever be able to zip up her coat independently? And why can’t my kindergartener tie his shoes yet?
Clothing fasteners can definitely be tough. But being able to complete them is important for kids to be able function independently in and outside of school. Clothing fasteners require a great deal of dexterity and hand strength and grasping skills come into play too!
We like to work on “pre-fastener” skills first – fun, playful activities that target the same skills used for completing clothing fasteners. Stringing beads, lacing cards, and doing crafts with buttons are a great way to start. Then, we turn to more challenging activities like passing loose buttons through buttonholes and putting loose buttons into a container with a slit cut in the top.
Read more about helping kids learn how to complete clothing fasteners.
As for shoe tying, we tell parents not to expect this compicated skill to be mastered until the first grade. There are so many steps involved and tying shoes requires a child to demonstrate a lot of complex visual motor and fine motor skills all at once. If your child is ready to start practicing, here are some ideas for teaching kids to tie their shoes!
Gross Motor
Question 11 || My child won’t alternate his feet when going up or down the stairs. What age should I expect this to happen and how can I help him learn the skill?
Children typically begin alternating their feet on the stairs around the age of 3. They learn to go up with one foot one each step first while holding a handrail and then quickly figure out that they can use that pattern when going down the stairs too. Stair climbing combines a ton of child development skills into one big skill. If one piece is missing, it can throw the whole shabang out of whack! Alternating on the stairs requires motor planning, balance, visual perception, coordination and strength.
When I work on stair climbing with kids, we practice stepping onto and off of a small step stool or stack of books. Have your child go up with one foot leading and then step off the other side with the opposite foot first. Here are a few more ideas, including activities to get them used to climbing the stairs with other people — something that they will eventually have to do at school!
Sometimes, all it takes to help master an alternating pattern, is a little visual reminder of which foot comes next. Try this quick tip!
Question 13 || My child sits on her knees with her bottom all the way on the floor. Her legs look like a “W”. Is this position okay for her to play in?
I would answer this question with a question — is your child sitting like this ALL of the time? Or, is she moving in and out of this position consistently?
All children have the potential to begin the W-sitting habit. In this position, a child’s base of support is wider and her center of gravity is lower, allowing for increased stability through the hips and trunk. It’s a convenient position for play because she does not have to work on keeping her balance while she concentrates on her toys. This position limits active trunk rotation and weight shifting that lead to the important developmental skills of midline crossing and bilateral coordination. We are so passionate about changing this habitual sitting pattern that we dedicated an entire blog post to W-Sitting!
As a general rule of thumb, if your child is moving in and out of this position, there is nothing to worry about! All children visit the “W” at some point in their young lives. If your child has made this a habit, it is important to find out why. If there is no medical diagnosis that inhibits her from sitting in any other way, try encouraging her to play in other positions like side sitting or long sitting. Place her toys up on a higher surface so that she has to come up onto her knees to reach them. Be consistent!
