Expert Advice

Expert Advice, Tips & Affirmations from Pediatric Therapists
  • Summertime Safety

    Summertime is a great opportunity for children to
    explore and challenge their growing bodies to reach new heights, but it is also
    a time when safety is of great importance. June is National Safety Month and the greatest concern parents have in the
    summertime is heat exposure. There are numerous articles that discuss hot car
    and water safety as well as the need for sunscreen and insect repellant when
    temperatures rise.  Many parents,
    however, are not aware that high temperatures and humidity indirectly can lead
    to accidents, the number one cause of childhood injury. According to a 2000
    journal article in the American Academy of Pediatrics, “exercising
    children do not adapt as effectively as adults when exposed to a high climatic
    heat stress. This may affect their performance and well-being, as well as
    increase the risk for heat-related illness.”

    With very hot weather and humidity, the body’s natural
    cooling system can fail and lead to issues like muscle cramps, exhaustion, and
    dehydration. Because children tend to ignore symptoms when they are having fun,
    they need reminders from caretakers to prevent injuries and accidents that can
    occur when their bodies are not functioning normally and are inclined to take
    more risks.

    In addition, time spent with water play and on outdoor
    equipment such as slides, swings, and obstacles courses can also affect the child’s
    vestibular system. This is located in the inner ear and provides a sense of
    balance and spatial orientation. With excessive movement or excessive water in
    the ear canals, this system can cause dizziness, loss of balance, and

    What can you do to help?

    Step 1. Identify
    Symptoms. These can include: irritability, headaches, increased thirst or
    sweating, weakness, nausea/vomiting, dizziness, frequent falls, or cool/clammy

    Step 2.  Provide Reminders. These can include: rest, removal
    of excess clothing, drinking water or sports drinks, and seeking cooler areas
    in shady or indoor, air-conditioned areas.

    Remember to consult with your child’s physician if
    symptoms appear to last for long periods of time. You can also see an
    occupational therapist if symptoms of an abnormal vestibular system appear
    regularly. I hope you find these tips helpful. 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
    about Playapy’s publications, visit
    or email

    Continue reading
  • Why Writing Capital Letters 1st is Key

    Learning to write
    is a milestone in the childhood experience of almost all typically developing
    children. Still, it is achieved with great effort and struggle for many. Countless
    products sold in stores often complicate the task for parents by combining
    uppercase and lowercase letters and encouraging the printing of 112 letters in
    an alphabetical yet developmentally arbitrary fashion. This can be overwhelming
    for a small child, decrease their confidence, and create poor habits. Hence,
    specialists often teach uppercase letters prior to introducing lowercase. It
    may seem counter-intuitive to learn capitals first when mostly lowercase
    letters are used in writing. There, however, are several important reasons why
    this particular method is beneficial to a child in terms of ease and

    Here are 5 helpful reasons why learning to write capital letters first is the key to success:

    1.     All uppercase letters start at the top.
    Lowercase letters vary and have different starting points.

    2.     All uppercase letters are the same height.
    Lowercase letters vary and have different heights with some tall and some

    3.     All uppercase letters use the same space.
    Lowercase letters vary with some letters ascending to the top line and some descending
    below the base line.

    4.     Uppercase letters are easier to recognize.
    Children have more exposure to capital letters in their environments on street
    signs, billboards, buildings, etc.

    5.     Uppercase letters encourage top to bottom
    and left to right eye and hand coordination fundamental for reading in addition
    to writing.

    It is also important to note it is not necessary to learn to write letters in alphabetical order.  Many handwriting programs are available with instructions to teach letters in groups according to how they are formed or in developmental stages. This helps a child to practice similar letters together and quickly become more successful.  Remember to consider if a child has the foundational skills of copying and connecting simple lines to form basic shapes before teaching letters. If your child is struggling with handwriting, consult with your doctor about seeing an occupational therapist for an evaluation or consultation. 

    I hope you find this tip helpful. 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
    about Playapy’s publications, visit
    or email

    Continue reading

    is the time of year when occupational therapists (OT’s) gets their time to
    shine in the national spotlight… and it is needed. The average person is not
    familiar with OT’s unless he/she or a family member has had a personal experience.
    It is even more unlikely that there is a true understanding of what an
    occupational therapist (OT) does when disability or disease it not involved. Below is a common scenario
    of what happens an OT is brought to light and introduced to a family with a
    young child.

    Johnny’s preschool teacher tells mom that
    she thinks he is having trouble holding a crayon and maybe needs to see a
    specialist. Mom does some research, learns about OT’s, and gets a doctor
    prescription. The OT completes an evaluation, which includes observing Johnny’s
    skills and conducting tests to see how he compares to children his age. The
    report written includes the results noting a delay, recommends therapy once a
    week for 30 minutes, and lists treatment strategies and measurable goals.
    Johnny sees the OT and participates in what looks like playtime. He completes
    exercises to build his strength in his hands as well as his large body muscles
    like walking around “like a bear.” He plays with toys that require him to push,
    pull, snap, or build using his hands differently or more efficiently. He colors
    with a special pencil grip to keep his fingers in place and decrease stress on
    the tiny joints of his young fingers. His OT creates a program for his parents
    to help him at home and measures his progress and creates more challenging
    activities for him until he is able to perform skills appropriate for his age
    level. Johnny’s becomes more independent at school and his confidence improves.

    can focus on many skill areas including dressing and feeding skills. Often a
    child that has trouble holding a crayon properly often also has difficulty
    holding other utensils and may require additional assistance with tasks like
    buttoning a shirt or tying shoelaces. An OT can assist with these life skills
    as well. If your child is struggling with daily activities common for his or
    her age, consult with your pediatrician about seeing an occupational therapist
    for an evaluation. I hope you find this tip 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, visit or email

    Continue reading
  • Fidgeting May Be Beneficial for Children

    Did you know that fidgeting may actually be beneficial for kids? While fidgeting is mostly viewed negatively as restless movements including tapping a foot or fiddling with fingers, hair, clothing, or objects, it can also be purposeful and helpful.

    Some parents battle with their child to stop these restless behaviors, and sometimes it is necessary because the child may be harming him or herself. Yet, the fight to end fidgeting may be a battle better left unfought. Research conducted in the UK in 2005 by psychologists found that children that were allowed to fidget with their hands performed better in memory and learning tests. Researchers concluded that teachers should actually encourage fidgeting in class. This supports what pediatric occupational therapists have long recommended to teachers when suggesting fidget toys as tools for improved learning.

    Fidget toys provide sensory stimulation including tactile input and movement for a child’s hands. Together they help to improve focus and attention and can also facilitate language production and thinking overall. The improvement is attributed to how fidgeting can reduce stress or can arouse the body to function at an optimal level of performance. Without a fidget toy, a child could actually find it more difficult to maintain attention to a task, keep still in a seated position, or have difficulty formulating thoughts. Some examples of fidget toys can include small toy figurines, koosh balls, a pencil, or Tangle toys (pictured above).  Allowing a child to use a fidget toy may provide the needed stimulation for the brain and decrease negative behaviors like nail biting or picking at skin.

    A parent should consider having his or her child evaluated for an underlying cause of fidgetiness or poor focus in the classroom when the child’s progress is negatively affected or his or her behavior becomes a disruption to peers. A parent should also consider a professional opinion despite their own experience with fidgeting when they were younger. Parents sometimes feel that if they had the same issue as a child and survived without additional services that their child should be able to as well. However, schools are now more open to adapting environments for children and understand the benefit of addressing such behaviors from a developmental perspective.

    I hope you find this tip helpful. 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

    Continue reading
  • Do Girls Need Therapy As Much as Boys?

    In July 2014 an ad campaign by Always called #LikeAGirl became a movement bringing light to how discriminatory phrases in our culture often puts girls at a disadvantage. As a therapist, I have noted that the majority of my caseload has always been boys. Typically if I do have a female patient, she has a more complicated medical history. I have often pondered whether this disparity was more due to genetics or gender disadvantage. So why do boys receive therapy more than girls?

    It is true that more boys than girls are diagnosed with developmental disorders including autism, attention-deficit/hyperactivity disorder (ADHD), and speech delays. This is due in part to girls developing language, social, and emotional skills faster than boys. A young female brain is actually known to have more activity, fibers, and white matter compared to the brain of a young boy. However, a 2014 DNA study published in the American Journal of Human Genetics revealed that girls seem to tolerate more genetic mutations than boys do before showing symptoms of autism and are therefore more resilient. Yet, when they are diagnosed, they tend to demonstrate symptoms that are more severe including in cases of ADHD and intellectual disability.

    Interestingly, a 2005 study published in the Journal of the American Academy of Child and Adolescent Psychiatry looked at gender differences in ADHD and showed that females demonstrated more internalizing disorders such as separation anxiety verses the externalizing disorders common to males like oppositional defiant and conduct disorders. Taking both studies into consideration, I feel it is possible that girls may display different, less disruptive symptoms and hence fly under the radar. Perhaps the emotional maturity of young girls verses boys allows for more internal sign that are overlooked by parents and educators? Maybe it is not that girls tolerate mutations more than boys but that adults are less tolerant of the behavior displayed by boys? The debate is not likely to end anytime soon; but, in the meantime, let’s consider that acting like a girl may cause girls to be under-diagnosed.

    Symptoms of ADHD in girls include dreaminess, forgetfulness, or messiness that may lead to difficulty with completing school assignments, expression of anxiety in social situations, and feelings of inadequacy with school work. If observed, consider consulting with your primary care physician about seeking an evaluation with a pediatric occupational therapist. I hope you find this helpful. 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

    Continue reading
1 9 10 11 12 13 14
Recent Posts
Newsletter Signup