Expert Advice

Expert Advice, Tips & Affirmations from Pediatric Therapists
  • April is Autism Awareness Month


    Recent reported estimates in the news have stated as many as 1 in every 68 children in the United States has autism, a developmental disorder that appears in the first 3 years of life, and affects the brain’s normal development of social and communication skills.  The numbers and methods of obtaining these new estimates are subject to debate, but what is clear is that the increase in cases in going up and up year after year.  Some of this is attributed to the increase in awareness of symptoms, which may be leading to inaccurate diagnosing from parents and doctors.  However, the increase in awareness can also help to get children services needed to improve developmental skills despite having the correct diagnosis.   There are screenings available that include checklists to help in this process.  The Modified Checklist for Autism in Toddlers, Revised with Follow-Up is a 2-stage parent-report screening tool to assess risk for Autism Spectrum Disorder (ASD). The M-CHAT-R/F is an autism screening tool designed to identify children 16 to 30 months of age who should receive a more thorough assessment for possible early signs of ASD or developmental delay.  The M-CHAT-R/F is intended to be administered by a trained health care professional, so if you answer the questions at home, please discuss your results with your doctor regardless of the results.  You can view and complete the checklist at no cost on  

    If your child is having difficulty with language and social skills or play, learning, and self-care skills, you should consult with your doctor about having a speech therapist or occupational therapist conduct an evaluation and create a treatment plan if deemed necessary.  Have a playful day!

    Amy Baez, OTR/L, The Smart Play Curator

    Amy Baez is a pediatric occupational therapist, award-winning handwriting author, and founder of Playapy. For more information, visit or email

    Celebrating Autism Awareness Month with a reblog of this 2014 blog post. 

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  • Does Your Child Have (Sensory) Issues?


    As the number of
    children diagnosed in the United States increases each year, so does the
    public’s awareness of autism and its symptoms. Sensory processing problems,
    also referred to as “sensory issues,” are one of the most common symptoms of
    autism. They, however, can be experienced in children without the other
    criteria required for an autism diagnosis, which include communication
    difficulties, social challenges, and repetitive behaviors.

    processing is defined as the way the nervous system receives information from
    the senses and interprets it into motor and behavioral responses. Sensory
    issues occur when the body has a response that is considered to be outside of
    the normal range. For example, a child may be overly sensitive to light and may
    not be able to tolerate brightly lit supermarket. This may cause the child to
    act out or have “issues.” When a child has responses that seriously affect or
    interfere with everyday life, a diagnosis such as Sensory Processing Disorder may
    be given.

    Everybody knows the
    five senses of sight, smell, sound, taste, and touch. Yet, sensory input also
    can be received from the sense of balance and spatial orientation in movement
    (vestibular sense) and the sense of position and strength needed in movement
    (proprioceptive sense). When a child is hyper-responsive, that means he or she
    demonstrates a low or hyposensitivity. When a child is hypo-responsive, that
    means he or she demonstrates a high or hypersensitivity.

    Examples of hyposensitivity

    Touches people or things excessively or when
    not appropriate

    Craves movement and/or has difficulty
    remaining still

    May harm others by not recognizing his or
    her own strength

    Does not respond to requests or name being

    Examples of hypersensitivity

    Easily distracted or annoyed by background

    Avoids or is fearful of playground
    equipment like swings or monkey bars

    Walks on tiptoes or is hesitant to walk on
    sand or grass

    Very particular about clothing or food textures

    therapists (OTs) specialize in helping children regulate the sensory system
    through sensory integration therapy. If your child has disruptive sensory
    issues, consider consulting with your pediatrician about prescribing an evaluation
    with an OT who can create and implement a plan specific to your child. I hope
    you find this information helpful. Have a playful day!

    Amy Baez, OTR/L, The Smart Play

    Amy Baez is a pediatric occupational
    therapist, award-winning handwriting author, and founder of Playapy. For more
    information about Playapy services and products, visit or email

    Continue reading
  • Good Night, Sleep Right!


    The phrase “sleep
    like a baby” seems like an oxymoron to most parents of newborns. Yet many
    people are not aware of how often sleep disturbances affect the home life for
    parents of children much older as well. With National Sleep Awareness Week
    taking place March 6-13th, I would like to shed some light on the
    issue of sleep concerns related to children. Sleep issues can cause a host of
    problems for children involving their mood, behavior, memory, concentration,
    safety, and reaction time. Hence, not only can home life be disrupted but
    school as well. 

    Signs of sleep
    problems that should be brought to a doctor’s attention include:

    Snoring or irregular breathing while

    Difficulty falling or staying asleep

    Difficulty staying awake during the day

    Unusual nightmares or sleep walking

    Unexplained poor performance during
    waking hours


    Parents can help
    their child in many ways. Here are some commonly known and smart suggestions:

    Establish a regular and consistent bed
    time and stick to it.

    Create a relaxing routine that is similar
    to a spa experience.

    Adjust the lighting, noise level, and
    temperature of the room for comfort.

    Turn and keep off electronics an hour
    before bedtime.

    Avoid caffeine six hours before sleeping
    and big meals close to bedtime.

    Put your child to bed before falling asleep
    and don’t get into the bed.

    I hope you find
    these tips helpful. If your child regularly struggles with sleep, consider
    consulting with your pediatrician or an occupational therapist to develop a
    plan for your home specific to your child. There are many alternative options
    including sleep apps, specialty pillows, and books that may be worth the cost
    if you can gain sleep for you and your child. Have a playful day!

    Amy Baez, OTR/L, The Smart Play

    Amy Baez is a pediatric occupational
    therapist, award-winning handwriting author, and founder of Playapy. For more
    information about Playapy services and products, visit or email

    Continue reading
  • A Passion for Play

    February is the
    time of year for professing your true love, and I am not too shy to admit that
    one of my greatest passions is play. As a pediatric occupational therapist, I
    spend many hours of my week at play with children. The trunk of my car is full
    of games, toys, and equipment like balls and cushions. I design activities to
    foster skills in children that have developmental delays or disorders that make
    learning and living more challenging for them. Surprisingly, I often have to remind
    parents and teachers that play is actually a child’s occupation. It is through
    play that they learn, use their imaginations, problem solve, enhance their
    muscular coordination and strength, regulate their emotions, and develop their
    sensory systems to understand the world around them. 

    My passion for
    play is a direct result of witnessing the negative effects of schools
    decreasing recess time for young children. Hence, I have become an advocate for
    more playtime in schools. In recent years, societies have moved away from play
    by placing more concern on risk aversion, separating from nature, and
    succumbing to elements of modern living like increased technology. In addition,
    the implementation of policies like No
    Child Left Behind
    has placed more emphasis on testing and assessment
    scores. This has forced schools to find more time in the day for instruction,
    which has led to reducing unstructured play opportunities and free time for
    children. Research, however, shows unfortunate consequences have developed from
    trying to improve education in this way. In fact Boston University psychologist
    and author, Peter Gray, has studied the link between a sharp rise in mental
    disorders and the decline of free play over the last 50 years.

    As more therapists and educators
    become passionate about play advocacy, more attention is brought to this
    important issue. Subsequently there are more positive stories in the
    news including a 1st grade teacher in Texas who recently
    experimented with adding more recess time during the day. Over the course of
    five months, she reported her students were more focused, more attentive, less
    fidgety, and less likely to have discipline issues. I can only hope that more
    schools rethink their recess policies and return to providing more time for
    students to rest and reset their minds.

    I hope you find
    this insightful. If your child struggles with a lack of play opportunities in
    school, consider consulting with an occupational therapist to develop a plan
    for your home. Have a playful day!

    Amy Baez, OTR/L, The Smart Play

    Amy Baez is a pediatric occupational
    therapist, award-winning handwriting author, and founder of Playapy. For more
    information about Playapy services and products, visit or email

    Continue reading
  • Keeping Cursive Current


    As the creator of
    a handwriting program, people outside of my profession often ask me if I think
    handwriting will soon be a thing of the past due to the advancement of
    technology. They usually reconsider when I remind them of all the daily
    activities we don’t think of that require handwriting like writing checks,
    filling out applications, signing contracts, etc. What fascinates them,
    however, is hearing all the benefits particularly when it comes to cursive
    handwriting. Since many schools have stopped requiring the instruction of
    cursive, it has become a lost art to many. So much so that National Handwriting
    , January 23rd, was created to promote the skill and help to keep
    it current.

    The benefits of
    handwriting extend beyond the obvious improvements in fine motor skills, hand
    strength, and hand dexterity. Research shows that handwriting verses tracing or
    typing of letters is important for the early recruitment in letter processing
    of three brain regions known to support successful reading. Therefore, handwriting
    may facilitate reading acquisition in young children.1 In fact,
    research has shown children that learn to write letters from memory
    automatically and quickly may increase the probability that they will become
    skilled writers in terms of composition.2
    This is because there is better access to thoughts and information
    when handwriting flows more naturally. Cursive has been known to be a faster and
    more efficient method for handwriting, but research also shows that it is better
    for learning as well. A 2014 study compared the notes taken by college students
    with one group writing in cursive and the other group typing. The students that
    used longhand demonstrated better understanding and retention of their notes
    despite writing less than the typing students whom recorded more words
    verbatim.3 Lastly, cursive
    handwriting stimulates brain synapses and synchronicity between the left and
    right hemispheres, something absent from printing or typing.

    The many benefits
    of cursive handwriting create a strong argument in support of its continued
    instruction in schools. Keeping it current is not only helpful to children and
    adults as readers and writers but as learners overall. Maintain a cursive
    practice and reap the rewards.

    I hope you find
    this helpful. If your child struggles with handwriting tasks, talk to your
    pediatrician about consulting with an occupational therapist. Have a playful

    Amy Baez, OTR/L, The Smart Play

    Amy Baez is a pediatric occupational
    therapist, award-winning handwriting author, and founder of Playapy. For more
    information about Playapy services and products, visit or email


    James, K. and Engelhardt, L. (2012). The effects of
    handwriting experience on functional brain development in pre-literate
    children. Trends in Neuroscience and education. 1 (1), 32-42.

    2 Berninger, V.W., et al.
    (1997). Treatment of handwriting problems in beginning writers: Transfer from
    handwriting to composition. Journal of
    Educational Psychology
    , 89, 652-666.

    P.A., and Oppenheimer, D. M. (2104). The pen is mightier than the keyboard:
    Advantages of longhand over laptop note taking. Psychological Science. 23
    April. DOI: 10.1177/0956797614524581.

    Continue reading
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