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Slippery Slopes: The Great Tobogganing Debate

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

Growing up as a kid in the era of “go outside and find something to do”, I always tobogganed in the winter.  We lived on the top of the escarpment with some great hills behind us.  I would venture out with my GT Snow Racer, and usually my dogs, and would find some great runs.  The combination of speed, fresh air and exercise made for a fun afternoon.

While we didn’t have social media at the time, the news would tell stories of people hurt tobogganing.  I remember one story in particular of a young Reverend who died tobogganing at the Burlington Golf and Country Club when he hit a tree.  I believe he was tobogganing at night with some kids in his congregation.  Other stories of broken bones, head injury and the like would circulate, but with all things slightly dangerous, these stories didn’t seem to change the fact that kids would still venture out to toboggan as a favorite Canadian past-time.

This winter has brought considerable debate regarding the tobogganing ban in Hamilton and other cities across Canada.  Many are outraged that enjoying this fun winter activity could come with a hefty fine.   As my own kids approach the age where the little “bunny hills” near our house are no long “fun enough”, and I consider the work I do in Brain Injury, I do find myself re-evaluating this pastime.

So let’s review the dangers: experts state that tobogganing is considered the 4th riskiest sport for catastrophic brain and spine injuries, behind diving, snowmobiling and parachuting.    A 2008 Ontario study showed that the instance of long term disability or permanent injury was 38 of 100 000 people with a death rate of 2.4.  (http://news.nationalpost.com/2015/01/05/national-post-editorial-board-the-freedom-to-toboggan/).  There are different types of toboggans that need different positions – from head first to feet first, lying to sitting, some take more than one person, and all go at varying speeds.  The risks are real and will depend on many factors including the hill and its surroundings, the number of people also sharing the space, the type of sled, the position, age, experience, and size of the rider.

So how can we balance these risks with the acknowledged fact that tobogganing is a fun, enjoyable, and a great form of winter exercise?  Here are some tips:

1.       Supervision.  The risks of injury with tobogganing will increase, not decrease, as kids get older.  The older they are, the more likely they are to make poor decisions, to go fast, to try and be “cool” around friends, or to forgo the use of safety equipment.  Supervising your child (at any age) while they partake in this activity is recommended so you can act as their “second brain” and can provide them with cuing and guidance away from poor decisions.

2.       Wear a Helmet.  Like skating and skiing, choose a CSA approved helmet that fits properly.  You don’t have to hit a tree to sustain a head injury – even just banging heads with another person, impacting the ground, or coming to a very sudden stop can cause the brain to be rattled.  A helmet adds protection and reduces the risks.

3.       Choose a “safe” location.  Consider that some locations are now illegal for tobogganing and so do your research before you arrive.  Find a hill that is not too crowded, that has lots of open space and plenty of room to stop at the bottom that is away from trees, roads or other hazards.  Ramps and obstacles, while fun, increase the dangers so teach your kid to avoid these.

4.       Use a proper sled.  Find a toboggan that allows for steering and stopping and requires your child to sit upright, feet forward, where they have a clear line of sight and can easily bail if things are going amiss.

5.       Feet first.  Teach your child to toboggan with their feet, never their head, leading their body down the hill.  A broken leg, while still a serious injury, is less life threatening than massive head or neck trauma.  Much like going down a slide, teach them the safest technique.

6.       When in doubt… bail out.  Tell your kids to forgo the sled and bail to the side if they are going too fast, are approaching a person or obstacles, or if they are losing control.  Just like all the training we give our kids – we need to teach them that if they are going to fail or fall, do it properly and safely.

My family has a secret spot for tobogganing.  It is a private golf course that we have permission to use.  The slopes are wide open with varying runs to choose from.  The trees surrounding the hills provide shelter from the wind without creating unsafe obstacles.   No one else is ever there.  We bring our dogs who enjoying running the hills with our girls.  Everyone comes home exhausted.  We were there last weekend and noticed that some other kids have also been using the hills.  But these kids seemed to have snowboards and had made a trail up into the forest with jumps and turns.  I walked those trails with my kids and we talked about how unsafe they were.  Too steep, too narrow, too many trees and a massive jump at the end.  It was refreshing for me to realize that my girls understood the safety risks involved and that I was there to help them make better decisions about what hills to descend.  While they were sledding I baked in some winter sun, threw snowballs to my dogs, helped my girls bring their sleds up the hills, and even took in a few runs.  We had a great time and followed it up with some hot chocolate.   That is how we enjoy our winter and I hope that in lieu of a ban or fines that cities can find a way to facilitate safe participation in this winter pastime, recognizing the value this brings to our culture as a country that spends a few months of the year in the cold and snow.

How do you feel about the tobogganing ban?  Will you and your family continue to hit the slopes for the remainder of the winter and moving forward?  If you do, please be safe!

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Raise a Reader

Today in Canada it is Family Literacy Day.  This day is celebrated across the nation in schools, daycares and youth organizations as a day to empower kids to read.  Reading is an important activity at any age as it stimulates our brains and leads to lifelong learning.  Here are some suggestions on now to instill the love for reading in your kids:

1.       Start early:  The earlier the better!  Reading aloud to young children, sharing board books and conversations with your child will help to develop their speech and language skills.

2.       Start a “Reading Routine:”  creating a routine of reading books together before bedtime is a great way to ensure daily reading and will help ease bedtime struggles.

3.       Variety is key:  it’s important to provide a variety of reading resources for children.  But books can be expensive!  Take part in book swaps, visit used book sales and of course your local library and allow your kids to choose books that interest them.

4.       Create a Special Space:  once old enough to read on their own, reading provides a great way to allow children to function independently and have time to themselves.  Help your child find or create a space that is their special go-to reading area.  Ensure they have comfortable seating and proper lighting for the best reading experience.

5.       Be A Reading Role Model:  kids learn from others, especially their parents.  When your children see you reading, they will be more inclined to want to read themselves.

6.       Power Down:  in this digital age it is important to set limits on how much tech time kids are allowed.  By powering down video games, tablets, tvs and iphones kids will have more time to curl up with a good book!

The following infographic from Scholastic’s 5th Annual Reading Report shows the some of the factors that lead to regular reading in kids.  Check it out and raise a reader today!

scholastic

 

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Concussion Curriculum Gets Thumbs Up

The Halton District School Board was recently featured in the New York Times for the great work it has done to implement a new component to its curriculum on Concussion Awareness. This new curriculum teaching about traumatic brain injuries has been rolled out to 9th graders and they are beginning to teach certain components to grades 3 and 6 as well.

This new component of their education is thought to be the first of its kind across North America and the Halton Board is hoping it will become a template that many other boards will adopt.

Check out more about this valuable new programming in the following from the New York Times.

The New York Times:  Canadian District Goes to School on Concussions

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OT Approved Christmas Gifts

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

If you’re a keen and organized shopper, I’m sure you have the majority of your holiday gifts already purchased, and if you’re anything like my Mother had everything done and wrapped in August! However, if you’re anything like my husband, you are waiting until the 24th to think about Christmas.

Although Santa and his Elves are hard at work building the toys your children put on their Christmas wish list, there may be a few items you still need to purchase.

We consulted our talented team of Pediatric Occupational Therapists and are happy to provide you with some fun but functional gift inspiration. These are gifts that are educational and stimulate child development:

1. BOOKS: Although technically not toys, books make an excellent gift. Fostering a love of reading in children from an early age is essential in development of language and literacy skills, while building creativity and imagination. And so many types of books exist! Beyond regular books, pop-up books, and interactive books, there are even books where you can record your voice, or the voice of a loved one into the story so that person is “reading” to your child. This is great for those people in your life who are out of town and are not able to “read” bedtime stories in person.

2. TOYS THAT MAKE THEM THINK: Look for puzzles, games, shaper sorters, science kits and more. Problem solving through play is fantastic for the mind and will help them become independent problem solvers in life. But be prepared to explore and learn with them. Interactive parent-child time through new learning is also essential to development!

3. TOYS THAT GET THEM MOVING: We’re living in the sedentary age of technology where obesity is on the rise. Try some active toys like a skipping rope, scooter, ride on toy, a bike or winter sports gear like skates, skis or snowshoes. But with all riding toys, include the helmet too! Keeping kids active is extremely important for both their physical and mental health!

4. TOYS THAT BRING OUT THEIR CREATIVE SIDE: Fostering creativity in kids at an early age is important for their development. Looks for gifts that will encourage them to be creative like art kits, dress up clothes or crafts and supplies.

5. AN EXPERIENCE THEY WON’T FORGET: Too many toys to choose from? Why not treat the children to an experience instead. Consider tickets to a sporting event, a play, or musical or a child-appropriate concert. Special events like these create fantastic memories and can strengthen family bonds.

We hope you find some gift inspiration from our tips and with you very Happy Holidays!

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Picky Eaters: Making Mealtime Manageable

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

As a mother of four kids, meal times can be stressful. While I raised in the era of “finish everything on your plate”, I realized early that this is not an approach that would work for my family. I think the first time I tried the “eat everything approach” it went something like this:

ME: “Abby, you can eat everything on your plate, or you can go to bed”.

ABBY: “Well, that’s a goodnight” as she pushed her plate away and went to bed at 5pm.

Okay, mission failed. But this and other experiments with Abby over time made me realize that she has some texture sensitivities and what I will call “visual food distortions” that absolutely impact her eating. She cannot manage the texture of most meat (unless greasy) and won’t eat anything that looks like a dog’s breakfast (most casseroles, soups and even lasagna included). She likes some pasta shapes but not others, and most days refuses her favorite omelette because it is…not cooked enough, cooked too much, too golden brown, not flipped properly…yes, some days I think Abby survives on air.

However, while I don’t have the time, patience, or cooking knowledge to cater to the specific food preferences of each of my children, I have developed ways to ensure they are getting their nutrition while making meals slightly different. For example, I can still make pasta, sandwiches, and even meat and vegetables while remembering that within these meals each child is more likely to eat what I have prepared if I make some concessions. Some don’t want sauce so I prepare an extra vegetable, some won’t have cheese so I put yogurt on the side, and some need gravy to manage the texture of their potatoes while others leave them plain. The point is that I know the importance of nutrition, and recognize that if I am willing to be flexible, creative, and marginally accommodating, meal time is more enjoyable for us all.

In keeping with the National Child Day on November 20, I wanted to focus on this important parenting topic of picky eating. With the help of pediatric Occupational Therapist Jana Maich, we wanted to provide education and tools for parents on this important topic as follows:

The act of eating is an important part of the daily routine for both children and adults. In addition to being critical for healthy growth and development, eating is also a social activity and often an important part of the family routine. While it is normal for kids to have certain food preferences and dislikes, having a child who is a picky eater can be very concerning for parents, especially when this “pickiness” leads to food refusal, tantrums, or other behaviours. For these families, preparing meals, enjoying dinner as a family, or going out to eat can be unenjoyable due to the very specific preferences of their picky eaters.

There are varying degrees of severity when it comes to picky eating, ranging from an avoidance of certain textures (e.g. not liking “mushy” foods like bananas) to refusal of entire food groups. In addition to working with a pediatrician and nutritionist, occupational therapists can help to address this common issue. In this blog post I will talk about some of the strategies occupational therapists use to help expand a child’s food repertoire and make mealtime enjoyable again.

First and foremost, remove the pressure! A child should never be forced to eat anything. Forcing a child to consume a certain food item reinforces a negative association with meal time and with food. All meal time experiences should be kept positive to allow for the development of a positive association with food. Keep meal time playful and fun with no coercion or pressure to consume anything. Role model exploration of new foods and talk about foods as you eat them (e.g. “wow this apple is so crunchy and sweet!”) A positive meal time environment creates the necessary foundation for food exploration.

Allow your child to explore new foods on his or her own terms. You know the expression “never play with your food?” Ignore it! Exploring the sensory properties of food is a critical component to becoming comfortable with eating. In fact, a children’s comfort with food follows a sequential progression of sensory acceptance. Broadly, this continuum goes as follows: accepting/tolerating the food on their plate, exploring the food with a utensil (e.g. touching with a fork but not with their hand), smelling the food, touching the food with their hand (or allowing you to touch them with the food), bringing the food to their lips, tasting the food, putting the new food item in their mouth (they may spit it out at this point… that is ok!), chewing the food, and finally swallowing a bite. It can take multiple exposures at each level before a child feels ready to move on to the next step. An occupational therapist can help determine where your child is on this sequence and develop fun, play-based activities to move your child along the continuum.

Set a consistent meal-time routine. A predictable routine prior to and during meals can help ease anxiety about mealtime and positively prepare your child for a meal. For example, set a timer prior to the meal where your child will wash their hands, help set the table, and sit down. Make the routine work for you and your family. Involve your child as much as possible in the preparation and serving of meals as this helps increase exposure and comfort with food.

Introduce changes slowly. Start with your child’s preferred foods and gradually make changes to those. For example, if your child likes pizza try adding a small amount of a vegetable to the sauce. When considering what new food items to try, think about keeping the properties of the new food similar to a preferred food. For example, if your child loves peas, try green beans as they are similar in colour and texture. If presenting something new, don’t overwhelm your child with a large portion of a new or non-preferred food – ensure to always have a preferred food on the plate with the new, non-preferred food to make it less overwhelming. Remember – even if your child doesn’t eat it, the fact that it is on the plate counts as EXPOSURE and is a step in the right direction. If tolerated by your child, try and present a new food with a preferred food at all meals to increase exposure and encourage exploration of new foods.

Most importantly, check your expectations. Expanding a child’s food repertoire is a slow process, as the thought of new foods can actually be very overwhelming and scary for some children. Take it day by day, keep it positive, and take pride in small victories while making sure your child feels proud too!

We hope you find this post helpful!  For more insightful parenting tips check out some of our past articles on Children’s Health.

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Getting Physical with Education

Great news! Physical education is not just happening in the gymnasium anymore and gone are the days of children being expected to sit quietly all day in the classroom. Instead, it is now recognized that each student learns differently and for those with attention deficit disorders and learning disabilities, classrooms need to accommodate unique styles of learning. In today’s classroom, children are spending more time collaborating, exploring, moving around the room, creating student driven discussions and having frequent breaks for stretching and physical activity. The following form the New York Times discusses how adding physical elements to the classroom can help spark creativity and support a better learning environment for all kids, but especially those with ADHD.

The New York Times Well Blog:  Put the Physical in Education

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Sensory Overload! Understanding Sensory Sensitivity in Kids

Guest Blogger Jana Maich, Occupational Therapist

In my previous blog, “Busy Bodies, Is It Sensory Seeking,” I wrote about the sensory seeking child. To quickly re-cap, sensory seekers are always on the move, searching for sensory input in order to meet their high sensory thresholds. On the other end of the spectrum is the sensory defensive child. Unlike sensory seekers who have high thresholds for sensory input, sensory sensitive children have very low sensory thresholds. Due to these low thresholds, they experience sensory input much more intensely or notice sensory input much more often than their peers. This means that sensory input that may not bother you and I (for example the feel of jeans, brushing our teeth, or the sound of an alarm going off) may be very aversive, distracting, threatening, or even painful for that child.

Sensory sensitive children can respond to their low sensory thresholds in couple of ways. For some children, they may actively avoid sensory input in an attempt to avoid meeting their threshold. They may set strict rituals and routines to avoid unfamiliar sensory input which can be seen as threatening, engage in disruptive behaviours, or escape the situation in an attempt to avoid feeling the pain or discomfort caused by some sensations.

Other children may demonstrate less active attempts to avoid sensory input. Although these children do not actively avoid the situation, they are constantly bombarded with sensory input as they notice it much more than others. They may appear distracted, hyperactive, or have difficulty focusing as their attention is constantly being diverted to a new sensory stimulus in the environment.

Sensory sensitivity is not to be confused with normal selectivity of children. For example, it is not uncommon for a child to dislike going to the dentist or to cover their ears in a noisy environment. Ask yourself: How much is the sensitivity negatively impacting my child’s daily routine and functioning? Is my child unwilling or unable to participate in daily routines and activities due to avoidance or sensitivity to sensory information?

As mentioned in the last blog, if you are concerned that sensory sensitivity may be a problem for your child, an occupational therapy assessment can help determine the underlying causes and potential solutions. Therapy sessions for sensory sensitivity may focus on specific exercises and techniques designed to desensitize your child and support increased tolerance for sensory input. Additionally, occupational therapists can offer simple strategies and/or modifications to daily routines that enable your child to better accept difficult sensations (e.g. hair washing, eating certain foods, or tooth brushing). Strategies can also be recommended to improve your child’s ability to filter out extraneous sensations in order to promote increased attention and focus. As always, all strategies would be tailored to meet your child’s specific needs, modeled, and modified as needed.

If you are concerned that your child may be experiencing sensory sensitivity, and you would like some support and guidance to understand or reduce those behaviors, try occupational therapy.

References
Dunn, W. (2002). Infant/Toddler Sensory Profile: User’s Manual. San Antonio: The Psychological Corporation.

Dunn, W. (1997). The impact of sensory processing abilities on the daily lives of young children and their families: a conceptual model. Infants and Young Children, 9(4), 23-35

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A Healthy Breakfast– Start The Day Off Right

Breakfast is the most important meal of the day – especially for children considering their physical and cognitive development and need to attend to school activities all day. Studies show, among other things, that eating a healthy breakfast promotes concentration, however, it is known that more than 40% of Canadian children skip this important meal regularly. The morning rush can be quite chaotic, so check out these great easy breakfast recipes that kids can eat on the go.

Parenting:  15 On-the-Go Breakfast Recipes

The month of September celebrates “Breakfast for Learning,” a Canadian charity that for over 20 years has helped to nourish school-aged children by providing breakfast, snack and lunch programs in schools. Be sure to check out their great work and help support Breakfast for Learning across Canada.

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Busy Bodies: Is it Sensory Seeking?

Guest Blogger Jana Maich, Occupational Therapist

In my experience as an occupational therapist working with children, sensory related concerns are some of the most common issues brought to me by parents. Sensory processing is complex, however, often there are simple home-based strategies that can be very helpful in meeting your child’s sensory needs. One of the most troubling sensory related concerns for parents is when their child is a “sensory seeker,” meaning they seem to be constantly looking for additional sensory input. In this blog post, I will be explaining what it means to be a “sensory seeker” and will provide information on how occupational therapists can help you to meet the needs of your child in order to keep him or her in a more regulated state throughout their day.

Sensory seekers are constantly “on the go” as they are attempting to obtain the sensory input that their bodies crave. They may run, crash, jump, mouth items, bounce, flip, spin, etc. to keep their bodies moving. This type of child has what we call a high sensory threshold (1). This means that in order to feel “regulated” and in an optimal state for attention and focus, they require much more intense sensory experiences than others. As a result, they are constantly on the lookout for such opportunities.

Occupational therapy works with children who struggle with sensory seeking by first identifying the types of sensory experiences your child is seeking, and second by helping to create more opportunities for sensory input throughout your child’s daily routines. When needed sensory input is provided naturally, these children are able to remain in a more regulated state, reducing the behavior.

If you are concerned that sensory seeking may be a problem for your child, an occupational therapy assessment can help to outline the behaviors, causes, and possible solutions. Our treatment would then involve specific activities and strategies tailored to your child’s needs. Additionally, these strategies will be modeled, monitored, and adjusted as needed during treatment sessions to help reduce them over time.

There are many activities that occupational therapists can suggest to support you in meeting the unique needs of your child. Everyday activities such as household chores, park visits, games and activities can be designed in ways that help provide needed sensory input. An occupational therapist will ensure to make the activities FUN and a part of the daily routine. The ultimate goal is to integrate activities that are enjoyable for your child naturally into their day, making “therapy” not seem so “therapy” and to ultimately benefit your child and other members in the family impacted by the behavior.

If you are concerned that your child is sensory seeking, and you would like some support and guidance to understand or reduce the behaviors, try occupational therapy.

1) Dunn, W. (1997). The impact of sensory processing abilities on the daily lives of young children and their families: a conceptual model. Infants and Young Children, 9(4), 23-35

2) Ayres, A.J. (2005). Sensory integration and the child. Understanding hidden sensory challenges. Los Angeles, CA: Western Psychological Service.

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Back To School: 1st Day Jitters and Separation Anxiety

Starting or returning to school after summer is can be both exciting, but also anxiety provoking for many kids. Some will slip back into routine quite easily, however, some will struggle with separation anxiety. This can be extremely stressful for both kids and parents, but with proper preparation and planning the first day transition can be an easier one. The following from Parenting magazine provides 16 tips and tricks to help you and your child prepare.

Parenting:  16 Ways to Prep For School Separation Anxiety