5 Ways To Help Parents Manage Screen Time During Quarantine

Being stuck in quarantine has resulted in a huge spike in video games, movies, and video watching for all of us.  

Trying to limit screen time is especially hard now when parents are facing so much stress.  But the negative effects of too much screen time hasn’t changed.

  • insomnia
  • obesity
  • aggression
  • mood swings
  • decreased socialization
  • vision problems

Therapists and educators can provide the education and support needed to make healthy choices. Merely asking parents to set limits on screen time may not be enough.  Let’s get those kiddos off the screens!

What’s Too Much? 

Here are the American Academy of Pediatrics (AAP)’s specific recommendations (pulled straight from www.aap.org). “Screen use” refers to any content viewed on TV, video games, devices (tablets and smartphones), and computers. 

  • For children younger than 18 months, avoid use of screen media other than video-chatting. 
  • Parents of children 18 to 24 months of age who want to introduce digital media should choose high-quality programming, and watch it with their children to help them understand what they’re seeing.
  • For children ages 2 to 5 years, limit screen use to 1 hour per day of high-quality programs. Parents should co-view media with children to help them understand what they are seeing and apply it to the world around them.
  • For children ages 6 and older, place consistent limits on the time spent using media, and the types of media, and make sure media does not take the place of adequate sleep, physical activity and other behaviors essential to health

 KEY TAKEAWAY: No children under the age of 6 should be viewing a lot of digital content alone. This is hard because so many parents use digital devices when they need to keep their children busy so they can work, cook dinner, etc.

5 ways to help parents reduce the harm of screen time

1. Make Recommendations for High-Quality Apps/Programs 

  • Not all apps labeled “educational” are created equal.
  • The AAP specifically mentions Sesame Workshop and PBS kids as examples of “high quality” apps.
  • Commonsensemedia.org is a great resource for searching apps, TV shows, and games by age range. They review Youtube channels to help parents decide whether the content is age-appropriate.
  • Khan Kids is a great one! It’s free and provides a HUGE number of different activities. It’s very language-rich and teaches lots of different skills.

2. When using apps, make movement a priority

Young children need to move as much as possible.  There are many apps that encourage fine and gross motor skill development. If they have to be on a screen, let’s get them moving.

  • Dexteria Jr. ($3.99 in the app store) is fun for practicing fine motor and pre-writing skills. This is one of the very few apps that has a pincer grasp activity.
  • There are great letter practice apps available but make sure that children have developed basic prewriting skills. Check out this post for the best handwriting apps. Have children use a stylus to promote fine motor skills for writing. 
  • Some apps help encourage gross motor activity and exploration of the environment too. Seedling Scavenger Bingo is free and allows you to do pre-made scavenger hunts or create your own!  Youtube also has great kids yoga apps and dance videos. 

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3. Recommend Tools to Set Screen Time Limits and Manage App use

  • Apple products come with built-in features for managing screen time.  Guided Access  (found in the accessibility settings) allows parents to set time limits, block off controls or parts of a screen (ex. Volume button), and set the device so that the child can’t leave the app they are in. On Android devices, this is called “Screen Pinning”. See how to do it here
  •  Turn down the screen brightness to reduce over-stimulation which can lead to meltdowns.
  • Decrease the blue light to help your child sleep better. 

4. Find Out WHEN Devices Are Being Used 

  • Screen time tends to increase when parents are busy. They need an entertained child so they can cook dinner, clean, or just use the bathroom in peace. Parents often use a device to keep children calm during unpreferred activities (ex. children with feeding difficulties that watch a preferred video during mealtimes).
  • Devices are also frequently used during transitions, car rides, the grocery store, waiting for appointments, etc.
  • Once you know when screens are coming out, you can problem solve and prioritize. Try to find alternatives to keep them busy. Keep small pocketbook toys on hand instead.

5. Help Parents Problem Solve

All children are different.  To help families problem-solve alternatives to screens use, consider this:

  • What are their favorite activities on the device? If a child is looking for visual stimulation maybe they can get that from a sensory bottle, sensory bag or i-spy. Children that always want to watch certain characters might be equally entertained by books or toys from the show. Kids that like racing games might be equally entertained by a remote control car, hot wheels, etc.
  • Are screens used to help the child calm down? If so, try to find some other easy “unwinding” activities their child likes (ex. sensory bins, listening to music)
  • Help establish routines that incorporate movement. Play outside, do age-appropriate chores, help prepare a snack, help clean up, etc.
  • Help parents identify calming activities to do before getting ready for bed (ex. Crashing on piles of pillows, making a “burrito” with a blanket, rocking in a rocking chair, etc.) so that children are not going into the nighttime routine overstimulated
  • Use tools like visual schedules and timers to help children understand when different activities take place, how long they last, and what’s coming up next. This can help reduce arguments.

Start The Conversation

Despite all of its wonderful capabilities, technology has the ability to cause some problems for small, growing minds.

But it doesn’t have to be that way. Talk about the potential harm of too much screen time. Make sure to report the benefits of play, movement, social interaction, and routine to the developing brain.

Ask questions and let parents know that even small changes are good. Model limited use of screens in your classrooms and therapy practice. 

 

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Teletherapy for school-based practitioners

 

When the COVID-19 pandemic hit, I was flooded with questions from therapists who were suddenly thrust into the world of OT telehealth, also known as teletherapy.  Personally, I had never done it, but I’ve always been interested in learning more about telehealth for school-based practitioners. I had the pleasure of interviewing two school-based occupational therapy practitioners, who happily shared their telehealth tips, tricks, and strategies.

Interview with Lesley Geyer, MA, OTR/L & Kendra Cooper, OTR/L

Getting Started in PT and OT TeletheALTH

What is your number 1 tip for therapists that are new to teletherapy?
  • Don’t expect perfection. We are not in ideal times.
  • Do your best and provide lots of consultation.
  • Find a friend to do a practice session with.
What do therapists need to be concerned about with licensure and state telehealth regulations?
  • You need to be familiar with your particular state’s licensure act and what it says about telehealth. Also, check to see if your state has any telehealth statutes.
  • Keep in mind, OT uses “telehealth” but other disciplines use different terminology.
  • Be sure the student is located in the state where you hold a license during all sessions.
  • Notify your malpractice insurance carrier that you are providing services via telehealth

TelEHEALTH & PRIVACY

When it comes to teletherapy, a huge point of concern is privacy for students. How can therapists who are suddenly thrust into teletherapy comply with privacy rules and regulations? What programs do you recommend for teletherapy?
  • You want to use a program that is HIPAA/FERPA compliant (Zoom and Go to Meeting have versions that are).
  • Skype and Facetime are not.
  • Both student and therapist should be using secure servers. Public servers are not safe options.
  • Both student and therapist should also be in a private room.
Are group sessions allowed in teletherapy? Does that violate FERPA?
  • We do group sessions frequently. Our students are in virtual classes with other students. We explain the group process to parents ahead of time to be sure they are OK with it. We use only first names.
  • You can provide an Informed Consent form for parents to sign. Check your school’s policy and state laws and regulations to assure compliance.

What exactly is considered Telehealth?

Many therapists are providing families with videos or packets of activities. Does teletherapy have to be LIVE in order for it to be considered teletherapy?
  • Teletherapy can be live or Store and Forward where a video is recorded and accessed by the client/family at a later time. It must be a video.   If it’s just packets, we consider it to be a Home Exercise Program. 

Effective planning of teletherapy sessions

What is the best way to plan for our teletherapy sessions and not overwhelm the student’s guardians with (handouts, worksheets, activities, education, etc) with everything else going on?
  • Platforms such as Smart Notebook/Smart Exchange and virtual whiteboards are very helpful, online programs such as Go Noodle have many videos that can be used to base a session around
Do you have any time-saving strategies? Tips to cut back on the planning or the paperwork?
  • You should continue with the same documentation you were required to do when you saw the child on-site.
  • Continue data collection for goals but use caregivers/learning coaches to report and assist with data collection.
  • For time-saving prep short videos, save favorites/websites in Word docs for quick access, save individual or category type of Smart Folders. You can begin an activity and begin again where you last left off in the program.
  • Send handouts such as handwriting worksheets or sensory online links in separate emails so that the family/you have quick access during a session to print out/review resources.
  • Daily computer cleans are simple and can improve your computer’s usage and ensure efficiency.
How do you recommend that therapists send or share videos with families? Large files are too big, should they post the videos? Use a cloud drive?
  • Youtube can be used but be careful not to include any confidential information. You can post a video and make it “unlisted”. When you share the link, parents can view the video, but it’s not public. Screen Caster is a wonderful free easy to use the option to create a video to share.

TELETHERAPY FOR Challenging students

Many therapists are finding their OT and PT treatment sessions very challenging with students who have lower cognitive levels and are non-verbal. Also the students that have decreased attention, are defiant, or have limited mobility. How would a teletherapy session look different than a direct treatment session?
  • Sometimes you have to use more of a consultative model with students and guide the caregiver through therapeutic activities.
  • Work with the caregiver to set-up behavior intervention plans and arrange for rewards for good behavior and work completion.
  • Use what the student has in their own environment as motivators e.g. toys, pets, parent-approved videos, animated rewards, at home reward system
Do you have suggestions for OT or PT treatment activities for these types of students?
  • Not all students are appropriate for PT and OT telehealth sessions and need on-site therapy. At this point, this is not possible.
  • For students where you are determining their functioning level, ensure caregiver presence for safety and be prepared to stop a session if you have any safety concerns.
  • Use Smart Notebook simple tasks like matching activities, clicking with a mouse on large targets or using a student’s on-site toys. Use multimedia items online to aid engagement in the task: interactive programs, annotation tools
What about hands-on treatment or cues? Do you instruct the parent in techniques? How involved is the parent? Or how involved CAN the parent be?
  • It depends on the age and level of the student.
  • For younger children and those with more intense needs, the parent attends the session with the child and assists as directed by the OT.
  • Older students may do their sessions without a parent/learning coach present.
  • There is often lots of parent instruction and consultation that occurs. This includes verbal cues, demonstration of the task first with the parent, and education for Hand Over Hand and fading cueing/assist

OT Telehealth for gross motor skills

What about gross motor activities? Do you do them along with the student? Show pictures of what you want them to do, etc.?
  • Often we model first, then observe and have a learning coach there to help with any hands-on assist that might be needed. They could be done with a child following your lead and doing them together.
  • A wide-angle webcam can be helpful. Videos can be a wonderful addition, music, and activities that work well in small spaces vs. a large gym.
  • Consider using bodyweight exercises and animal walks. Yoga, stop/freeze games, and obstacle courses with at-home items.  Use a visual model with reps and dance videos. Take precautions prior to beginning any gross motor tasks. Have the caregiver move the computer/webcam around the work area to ensure it’s safe, well lit and free of clutter.

TEleTherapy and handwriting

Writing over teletherapy is so different. What are your top tips for addressing handwriting via teletherapy?
  • A separate webcam really helps with this. You can also practice ahead with pulling your screen partway down to show tabletop and then have the caregiver do this to view handwriting work if there is not a webcam available.
  • Also, provide more handwriting space on the table  by pushing the computer back. Often students require a visual model on their own paper vs looking on the screen.
  • Email paper types ahead so you and the student have the exact same page. A plastic sheet protector works very well to allow dry erase marker usage and then can be used repeatedly.
For regular therapy, most therapists provide reward time at the end of their sessions. It helps our students get through challenging tasks and is also motivating. What is something fun and rewarding we can offer to our students at the end of our teletherapy sessions?
  • Allow time to play on a favorite toy or App, parent-approved virtual game/video, or use of virtual reward stickers.
  • Bring your or their pet in to see/share. Work with the family to develop a plan for a reward for good work during a session (a tangible treat the parent supplies)
What are your go-to treatment Ideas for kids who have very limited (if any) tools to use at home for treatment such as scissors, markers, shaving cream, etc.?
  • Bubble wrap, carrying and lifting heavy objects, moving furniture, and animal walks for proprioceptive input.
  • We do a lot of with self-regulation using programs like the Alert Program and Zones of Regulation, maximize online virtual games, trivia, videos.
  • Use supplies in the home consider “home care” types of modalities such as cooking, gardening, making homemade play dough, art and craft projects.
  • See what games or toys the student has, board games can be wonderful, using sports equipment such as child bowling sets, marbles, hula hoops, and ball based games.

 

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 Is there any special tech equipment that can help make sessions easier?
  • If your internet connection isn’t great, use an ethernet cable to attach directly to the modem for improved internet connection speed & reliability when using various meeting platforms & programs.
  • Separate webcams (moveable, multi direction for practitioner/student) are a huge help and there are a variety of stand devices you can use with them.
  • A headset improves computer audio output/input, reduces ambient noise
  • A mouse and touch pad help for therapist demonstration
  • Webcam mount: optional aid for webcam for handwriting or table top work, match to your webcam base and set up needs
  • External document camera: optional aid to enhance video for handwriting and closer work
 What do you find to be the most common obstacles for telehealth?

We did a study:

  • Technology
  • Attendance
  • Family communication
  • Dealing with attention problems
  • Dealing with negative behavior
  • Communicating with student
  • Addressing motor and sensory needs
  • Completing evaluations

occupational therapy evaluations and telehealth

Can you complete evaluations virtually?

Yes, but you need to use mainly checklist type tools and questionnaires. The DAY-C, SFA, SP and SPM are easy to use. You may use the Beery VMI but you need to mail booklets to families and they need to mail them back to you. You can use other tools and mention in your report that the tool was used in a non-standardized manner due to the session being virtual.

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Ten Best Apps for Handwriting with Kids

As I walked into school the other day, a friend of mine grabbed me in a panic and said “Should my four-year-old really be practicing a page of letters every night?! This is the only time I get to spend with her and I’m forcing her to write a whole page of D’s! This stinks!”

No, as an OT, I don’t believe that a four-year-old should be practicing a page of letters for twenty minutes a night.  It’s too much for those little hands.

But – an educator who spends two days a week in kindergarten, I have to say, this is where the curriculum is going. Developmentally, preschoolers are still preschoolers, but kindergarten curriculum expectations have increased tremendously.  Little kids are expected to be able to write upon entering kindergarten.  Preschools are bowing to the pressure and teaching what used to be the kindergarten curriculum.

I felt empathetic towards my friend who just wants to play with her little girl at night, rather than drilling her to finish a worksheet.  But here’s what I told her.

Think about it differently.  You have the chance to make sure she learns all her letters correctly before she starts Kindergarten.  There will be other children in her class who don’t know their letters, and the teacher won’t be able to really sit with them one on one to make sure they get it.  Many teachers teach one letter a day in two forms (capital and uppercase), so the kids don’t really develop the motor memory.  It’s difficult for kids to learn it and to write comfortably at this rushed pace.   If a child learns their letters correctly it is so much easier for them to write neatly.  It becomes automatic.”

 

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keyboarding skills

Is my child ready to learn how to keyboard?

Keyboarding skills are often considered just important (or more) than handwriting.  But when are children developmentally ready?

keyboarding skills

Developmental Progression of Keyboarding Skills

Have you ever gone to a restaurant and spotted an entire family on their phone or tablet? Technology is everywhere, and there is no getting away from it. I’m sure you’ve read those articles about the importance of limiting technology and screen time, but what about the importance of teaching technology in a developmentally appropriate way?

When are kids ready to learn how to type? 

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SNAPTYPE PRO

The App That Will Make You a Hero To Your Dysgraphic Students

Students who struggle with getting their thoughts on paper and HATE writing  will LOVE this game-changing app called SnapType Pro.


With two weeks left of school, the middle school was HOT and sticky.  The smell of sweaty teenagers who just didn’t want to be in school permeated through the hallways.  As I sat across from the teenager who “HATES writing”, I could see his face growing red.

The tears were building up.

And he still had one more essay to finish.

Having to concentrate on a final exam is just torture for anyone, but it’s even worse for a child with a disability.   

Thank goodness I found a way to help this poor child. 

square-hero-2

Does this sound familiar? 

If you know someone who is dysgraphic, you’re familiar with the symptoms.

  • Messy handwriting
  • Difficulty putting thoughts down on paper
  • Physically slow when writing
  • Difficulty with spelling
  • Organizing words and sentences is a challenge

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inventing snaptype

How To Bring Your OT App Invention To Life

*This post contains affiliate links

INVENTING SNAPTYPE

Amberlynn Slavin, a college student in an Occupational Therapy program, came up with this amazing idea and then brought it to fruition.   I find myself brimming with ideas, but I’ve still never invented anything!  Amberlynn was kind enough to answer a few questions about the process of inventing and developing an app.

Here are the questions that I had for Amberlynn….

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Bluebee Pal

Bluebee Pals – for children who love to learn, play, and interact!

 

What should a parent do when their child isn’t interested in reading?

What if they aren’t prepared for kindergarten?

Will they ever learn their letters?

I just found the perfect solution to the disinterested child. A Bluebee Pal.

As an OT and a newly certified Assistive Technology provider, I am always looking for fun ways to incorporate interactive technology into to my sessions.  I often recommend educational apps and games to parents to help with follow through at home. Let’s face it: Kids love technology.    It’s important for them to still manipulate and play with toys, games, and puzzles, but a tablet or cell phone can be used in any location to work on almost any goal.

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