Seamless Clothing for Your Sensitive Kid…


I love living in a state that has four seasons. I love the beach in the summer, skiing in the winter, and pumpkin lattes in the fall.

One thing I’ve noticed over the years as a therapist is that not everyone loves the change of seasons. Children with sensory processing difficulties, in particular, have a hard time adjusting to the changes.  I’ve explained to many parents over the years that their little guy with sensory processing problems doesn’t see, hear, or feel things the way we do.  Holiday lights and decorations may be too much, Halloween costumes may be too itchy or uncomfortable,  and the flowers blooming in the springtime can really affect a child’s allergies and overall behavior.

When the seasons change, I inevitably see a rise in children’s “bad days”, with parents complaining of cranky kids or tantrumming.

As an OT, I’ve worked with many parents who struggle with clothing and dressing issues with their child with sensory processing issues.  Moms are frustrated because their little one will only wear dresses  or refuses to wear underwear.  Dads complain that their child tantrums about tee-shirts and socks.  Over the years, I’ve made behavior charts, and recommended tag-less shirts and under armor.  Every child responds differently to different interventions.  One line of products that I am excited about is the SmartKnitKIDS line.

As the weather begins to get cooler, clothing will change from short sleeves to long and from light to heavy.  While this seems like no big deal to many of us, it can be very upsetting for a child with sensory processing issues.  Options that I’ve tried for students in school include compression vests, weighted vests, or weighted lap pads.  However, there are options for home, too.  Some kids don’t want to “look different” or have anything “special” for their sensory processing difficulties.  That’s what I love about the SmartKnitKIDS line.   SmartKnitKIDS offers invisible options for  underneath the clothes.  I learned about this line of products at a conference and was immediately impressed by the variety of products and the quality of the materials.   As I looked through the different options, students kept popping into my head. “This would be perfect for Grace, these socks might be good for Tommy” etc.  I know from experience that parents will try anything if it will make their child comfortable.  I left that conference ready to recommend this line of products to a bunch of parents that struggle with the morning routine, dressing, and a very limited number of clothing options.

Children with sensory processing issues often find comfort in constant firm pressure.  The Compresso-T is super soft and looks like a regular undershirt.  There are no seams and its material is designed to stay dry and cool.  The Compresso-T provides the same input as a compression vest, which can help a child with sensory processing issues feel calm and self-regulated.  And it’s invisible to the eye, so sensitive or anxious kids can get the input they need without feeling the social worry of being different.  It comes in a Bralette, too, which is perfect for tweens or young women who find the discomfort or a typical bra unbearable.

seamless bra smartknits

Socks have been the detriment to many of my parents’ morning routine.  Getting the heel in the right spot, managing seams, etc.  Socks are often the root cause of a child’s (and therefore the parents and the rest of the family’s) meltdown in the morning.  SmartKnitsKIDS seamless socks have absolutely no seam anywhere, and they are designed not bunch up or fall down.  A lot of my little ones with sensitive feet get uncomfortable if/when the socks starts to fall down.  The SmartKnitKIDS Seamless socks are made of stretchy corespun and lycra yarns,which result in a form-fitting design that “hug” little feet and help eliminate wrinkling and bunching.  My research into the design taught me that the socks are spun from the tip out, like a caterpillar spins his cocoon.  Because socks fit snugly, they won’t slip off those wiggliest toes.


SmartKnit kids socks

Years ago, I had one adorable little girl on my caseload who was very uncomfortable wearing underwear.   Her mom and dad were awesome about trying to accommodate her, trying to desensitize her, allowing her to wear long dresses whenever possible.  However, we wanted her to be able to wear pants and underwear on gym day, her soccer uniform, and more than two pairs of leggings.  Underwear problems were often the cause of this beautiful family struggling to get out of the house in the morning, with this sensitive little girl and her mom fighting tears over the upsetting situation.  Seamless Undies would be a perfect thing to suggest for a kid like this!  No seams, soft stretchy material, and no elastic to bother sensitive kids.


Seamless Undies, compression underwear, sensory processing dysfunction


I’m excited to announce a Give-Away from SmartKnitKIDS!

*This post sponsored by SmartKnitKIDS. All opinions expressed are mine and mine alone. For more information, read my disclaimer.


Miss Jaime OT

~Have A Seamless Day!


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Long Island Links: Therapeutic Horseback Riding and Hippotherapy

One of my favorite things about Occupational Therapy is that there are no limits to how you can help a patient achieve their goals.  It depends on what the patient wants to achieve and what they are interested in.  You can use activities like gardening, scrapbooking or crocheting to work on motor skills. You can use yoga, dance, or karate to work on strength and coordination.  The list goes on.  One of the coolest ways to help a patient achieve their goals is on horseback.

There are a number of places right here in Long Island that offer Hippotherapy and Therapeutic Riding.  When I learned that a PT friend of mine does therapeutic riding lessons on the side, I just had to go see what it was all about.  And of course, I loved it!

Hippotherapy vs. Therapeutic Riding

So here is what I learned:

Hippotherapy is different than “therapeutic riding”.  The American Hippotherapy Association defines Hippotherapy as  a physical,  occupational, or speech and language therapy treatment strategy using a horse.   A horse is incorporated into the treatment to “engage the sensori-motor and neuromotor systems to create a functional change in their patient” (

So basically, a therapist takes their treatment goals and uses the movements of a horse (rather than a swing, scooter, etc.) to facilitate the achievement of that goal.  From an OT’s perspective, let’s say I wanted to work on visual perceptual skills, teaching left and right and reaching across midline.  I could set up puzzle pieces on both sides of my patient (and the horse) and have them reach across midline following my directions to get a piece from the left or right and then walk the horse forward to where the puzzle is to insert the piece.  A physical therapist might use this same activity to work on postural control, balance or trunk rotation.  A speech therapist might use it to facilitate language in a patient.

Movement and vestibular input can be very calming and organizing. I have seen children who are almost non-verbal sing and say new words after swinging on a swing for a few movements.  The movements of a horse can have the same effect.


According to the American Hippotherapy Association (AHA), there are only about 7 certified Hippotherapists in the Long Island Area. A board certified Hippotherapist has earned the letters HPCS after their name, which stands for Hippotherapy Clinical Specialist.  Hippotherapists can be licensed physical therapists, occupational therapists, or speech and language pathologists who have been practicing their profession for at least three years.  They must have 100 hours of Hippotherapy practice within the three years prior to application. Application fees apply, and a multiple-choice examination must be passed.

“Hippotherapy is not a horseback riding lesson. It is therapy prescribed by a physician and delivered by a team that includes a licensed, credentialed therapist (occupational therapist, physical therapist, or speech-language pathologist), a professional horse handler, and a specially screened and trained therapy horse. There is direct hands-on participation by the therapist at all times. The horse‘s movement is essential to assist in meeting therapy goals.” (Apel, 2007). 

Therapeutic Riding:

There are also many PATH certified therapeutic riding instructors all through the Long Island area.  The “PATH” organization stands for Professional Association Therapeutic Horsemanship.  PATH offers three levels of certification for therapeutic riding instructors: Registered, Advanced and Master. The requirements for each level include skills in Equine Management, Horsemanship, Instruction, Teaching Methodology, and Disabilities.  Instructors who are “PATH” certified have completed online coursework, self-study exams, and 25 mentored hours with a PATH Intl. Certified Riding Professional instruction as well as an on-site workshop and certification.  (

“Therapeutic riding is recreational horseback riding lessons adapted to individuals with disabilities. It is completed by a professional horseback riding instructor in conjunction with volunteers.” (Apel, 2007)  “Recreational riding is used to enhance the quality of life through physical and emotional stimulation while the client learns horsemanship skills.” (Meyer, 2006).

Observing Therapeutic Horseback Riding

I observed two therapeutic riding lessons at MyShine in Old Bethpage, Long Island

One of the things that struck me right away was the staff to child ratio.  There were three staff members assisting the child and even more watching from outside the rail.   I was so honored to meet a teenager named Caroline and her mom.  She is diagnosed with Autism and Seizure Disorder.   Her mom brings her every week for her half-hour lesson and watches from the rail as Caroline mounts the horse with help, walks around the course, and practices making the horse stop, go, and turn. My friend Stephanie (PT) taught the session.  I could see how Caroline had to use the muscles in her legs to give the “signals” and the muscles in her arms to manage the reins and make the turns.  The staff worked with her on spatial concepts very naturally, with directions such as “go between the cones”, “turn around” and “make a left”, which was Caroline’s favorite.  Caroline seemed happy and proud to be on the horse, even though she’s been doing it for years.  She had trouble focusing and following the directions at times, but the staff was amazing about redirecting her.  They had such a great rapport; it was easy to see.  Caroline went up into the woods on a trail with the staff, which was relaxing even to me who followed on foot.  The environment of being outside on a beautiful sunny day, walking on a trail through the trees was very peaceful after a crazy day. I can totally understand how this activity can reduce stress and anxiety for anyone!


Stephanie’s mom, Mary, taught the next session.  I had the opportunity to meet with a teenager named Gina and her dad.   Gina is a fifteen-year-old who has been attending either hippotherapy or therapeutic riding since she was 3 years old.  She is diagnosed with Smith-Lemli-Opitz Syndrome (SLO).  Gina is non-ambulatory and has very high tone in her legs, so she rides without a saddle.  Stephanie told me that the tone of her legs improves when she rides.  Gina has decreased strength throughout her body, so riding is a great workout for her.  Stephanie explained to me that hippotherapy is usually done bareback, while therapeutic riding is usually with a saddle. However,  Mary uses a bareback pad with Gina even though it’s therapeutic riding because that is what Gina needs.   Mary and the staff supported Gina from all sides as she went up on the trail.  One of my favorite moments was when one of the staff members put on a Justin Beiber video on their phone for her.  The way her eyes lit up and the burst of giggles that came out of her mouth was so endearing. What a typical teenage girl!   It was interesting to see how the staff placed Gina’s legs so that she was sitting “traditional style” with her legs on either side of the horse, then with both legs on one side in a “side-sitting” position, then backwards, then side-sitting on the other side, and finally back to facing front.  Stephanie explained that this is called “around the world”, and it is Gina’s favorite thing to do.


Gina’s mom told me that she learned about hippotherapy from Gina’s Early Intervention PT. It was difficult to find a program for her at such a young age, but Gina’s mom was very motivated by the research and documentation she found. Her first session on a horse was at the age of 3.  It was with an experienced rider and the instructor sat in the horse with Gina and they rode together.  Gina’s mom reported that Gina finds it very relaxing and when she was young she would often fall asleep (thumb in mouth) and out like a light on the horse. Over the years, Gina has participated in both hippotherapy and therapeutic riding with a PT, and an OT.  They reported that they saw the biggest changes when they started at MY Shine.  She began holding the reins (not mouthing her hands or her shirt) and becoming thoroughly engaged!  Gina’s mom also reported that they see increased trunk control, better posture, maintaining contractors in her legs (which is preventing surgery), and decreased mouthing her hands (which is a constant challenge). Overall, Gina is a happy girl when she is on a horse!


 The benefits of horseback riding

There are many benefits to horseback riding for people of all ages; both with and without disabilities.  Horseback riding can help to improve speech and language, sensory processing, and muscle tone and strength.  It addresses balance, motor coordination, and reflexes.  Horseback riding can be used to address cognitive and mental health goals as well.  There is a lot of research about how animals can facilitate progress in children and adults with physical, cognitive, social, psychiatric, and developmental disabilities.  Articles report increased socialization, improved mood, decreased anxiety, and improved communication (both verbal and non-verbal) when animals or pets are incorporated into a patient’s therapy or care (Rosetti & King, 2010).

 Hippotherapy and Therapeutic Riding Resources

“American Hippotherapy Association, Inc.” American Hippotherapy Association Inc. N.p., n.d. Web. 20 June 2015. <>.

Apel, L. (2007, 06). Hippotherapy and therapeutic riding highlight! The Exceptional Parent, 37, 28-34. Retrieved from

Meyer, G. E. (2006). Special needs, special horses: A guide to the benefits of therapeutic riding. Physical Therapy, 86(4), 596-598. Retrieved from
Rossetti, Jeanette,EdD., R.N., & King, Camille, MS,R.N., P.M.H.C.N.S.-B.C. (2010). Use of animal-assisted therapy with psychiatric patients. Journal of Psychosocial Nursing & Mental Health Services, 48(11), 44-48. doi:

 Long Island facilities that offer Hippotherapy or Therapeutic Riding:

HorseAbility Center for Equine Facilitated Programs

Horse Riding School
223 Store Hill Rd
Old Westbury, NY 11568

*HorseAbility offers both Hippotherapy and Therapeutic Riding, as well as many other equine assisted activities.  Click the link for more information.

Great Strides Long Island, Inc. 

Saddle Rock Ranch
41 Coram-Swezeytown Road
Middle Island, NY  11953

*Great Strides believes in the benefits of equine assisted activities for everyone – children, adults, and veterans of all abilities.  Great Strides is currently running a recreational therapeutic riding program using PATH certified instructors.  They also offer programs to veterans free of charge.  Click the link for more information.

Pal-O-Mine Equestrian, Inc. 

829 Old Nichols Road
Islandia, NY 11749

* Pal-O-Mine offers hippotherapy, therapeutic riding and other equine assisted activities.  Click the link for more information.

SPeech IN Motion

Speech Language Pathology in Motion has been offering Hippotherapy as a speech therapy treatment strategy for over 5 years. They are the only place on long island set up as a therapy practice.

Locations in Islandia and Hauppauge, NY
ph: (631) 479-3393 Ext. 3
fax: (631) 479-3358
alt: (516) 395-8610


Center for Therapeutic Riding of the East End  (Ctreeny)

Wolffer Estate Stables
41 Narrow Lane East
Sagaponack, NY 11962


*Ctreeny offers therapeutic riding lessons from “PATH” certified instructors.  They do not accept insurance, but they do offer scholarships.  Riders start with core balancing riding at age 3 and there is no limit on older ages.   Riders must have good sitting balance and our restrictions are listed on our new rider paperwork.

IRIE Therapeutic Horseback Riding

Union Standardbred Farm
937 Reeves Ave.
(631) 871-1916

Disclaimer: Part of my goal in developing this blog is to offer resources to families in my community of Long Island, NY. Miss Jaime OT is not employed by or associated with the above organizations.  These organizations were contacted for permission to be included on this blog post.  If you have information about another resource in Long Island that should be added, please let me know.

For more information about Hippotherapy, click here.

For more information about “PATH” click here.


Happy Riding!


~Miss Jaime, O.T.


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Coping With Sensory Processing Dysfunction (SPD): A Young Woman’s Personal Story of Survival

Foreword from Miss Jaime, O.T. :

A few months ago, I came across a post in a Facebook support group that really moved me.  It was written by a young woman who has Sensory Processing Dysfunction (SPD).  She praised and encouraged the stressed out, besides-themselves-with-worry parents who often use the forum to ask questions, vent frustrations, and just seek support for their sensory kid.  I’m sure she didn’t realize what a comfort she would be offering these parents when she wrote it.

She just wanted to tell them that they were doing a great job and that her parents had been the ones to help her to with coping with SPD.  The responses from the parents; however, were amazing.  They seemed to cling to the hope that they were doing the right thing for their child and that their child would be okay despite the day to day struggles that they were dealing with.  As I read the comments that started pouring in for this woman, I was struck by the fact that these parents were so grateful.  They were grateful for the praise and the support from a young woman who had been through all of these day to day struggles and survived.

Not just survived but prevailed.  I reached out to Abby to ask her to write a guest post for my website.  What she has written is one of the most moving and inspiring stories I’ve ever read. For a young woman of 17 years, she is wise beyond her years.  Her story is a touching tribute to what it really feels like to have Sensory Processing Dysfunction.  Thank you, Abby for sharing this personal story.

Disclaimer:  This post is a personal story written by a young woman with Sensory Processing Dysfunction.  This is not meant to imply that you or your child will experience these struggles. Sensory Processing Dysfunction affects people in many different ways.  Please contact your physician for more information or go to to learn more

Guest post from Abigail Ralstin:

Coping with Sensory Processing Dysfunction: The Struggle from Childhood

It’s no secret that adolescence is a difficult time for most people, and the same is true for myself. My story is not meant to invoke pity or awe, I am nothing extraordinary and I know that. I have had a life much better than some, and much worse than others. My experiences have shaped me into the young woman I have become, and I wouldn’t change them for anything, despite having nearly not made it out of a few hardships. Most anyone who knows me knows I’m not like the people around me in a few particular ways. My entire life I’ve been called the drama queen, and it’s true. I’m passionate to a fault, I feel incredibly too much, and sometimes I have to hide from the world in order to feel okay again. I’m sure my quirks are somewhat just part of my personality, but what very few people know about me is that at times I genuinely cannot control my emotions or reactions. It’s not just an “Abby thing,” as my friends would put it. It’s a medical condition not many know of.


Coping with Sensory Processing Dysfunction

The first time I heard the words “Sensory Integration Dysfunction” I must have been six years old, or thereabouts. It was always just something I’d been diagnosed with as a child, I paid no mind to it, never connected my little quirks with an actual diagnosis. My parents, however, understood that wearing my socks inside out or my abnormally intense tantrums weren’t just who I was, it was this obscure disorder I had. From an early age they knew I was different. I’m sure they knew I’d struggle more than an average child, and I did. I don’t remember my childhood as vividly as they do, for obvious reasons, but I remember being affected by Sensory Processing Disorder; then called Sensory Integration Dysfunction. I used to be late to school because I would throw fits over my shoes feeling too tight, or my undergarments feeling itchy, as embarrassing as that is. I spent my childhood as a relatively happy child when at home, despite the itchy socks. School, however, was never good for me. Academically I suppose I’ve always been above average, not to toot my own horn, but socially school was always a necessary evil. Throughout elementary school, I was bullied, for various reasons, but one, in particular, I remember relating directly with SPD. As a child, up until I was about ten or so, I never wore jeans. I always wore skirts or dresses, specifically because jeans set my nerves on edge for whatever reason. Tight clothing, in general, was never my friend as a child. Anyway, apparently my never wearing jeans bothered some of the kids I went to school with and suddenly I was the new form of entertainment. It wasn’t all bad, I had a few friends here and there, but they always seemed to be very abusive friends. Never respectful or just nice, it always seemed that I had done something wrong. Little did they know, I honest to God could not help the things they found so odd about me.

Coping with Sensory Processing Dysfunction



Coping with Sensory Processing Dysfunction in High School…

Fast-forward a few years and a lot of awkward, puberty related incidents, and I was finally entering high school. Freshman and sophomore year were probably the most difficult years of my short life, and not for the normal, teenage reasons. Along with being diagnosed with depression and anxiety, as well as the SPD, I was faced with entering an entirely new territory. Genius that I am, I also chose this time to come out to my friends and family, and consequently the entirety of the town, apparently. Small towns, huh? Right, so; incoming freshman, queer kid, depressed, anxious, and scared out of my wits. Great way to start high school. Long story short, it didn’t go well.

(Please let it be known that I am not bringing attention to these details for any personal gain or to get anyone’s pity. I’m sure it may seem that none of this can relate to SPD at times, but I promise it will make sense in the end. These events in my life, the choices I made, are not something I am proud of. However, I believe they are necessary aspects of my story, which is why I’ve included them. Additionally, the next section may be a trigger for anyone who has dealt with addiction, depression, anxiety, or self- harm.)

Need help understanding your teenager with sensory processing issues?

Coping with Sensory Processing Dysfunction

As stressed and alone that I felt, I started a very bad habit. I turned to self-harm as a form of escape, per se. I fully believe that my struggle with this habit, addiction really, is directly related to Sensory Processing Disorder. That’s not to say that all kids with SPD are going to turn to something like this, of course not. I suppose it was just my incredibly unhealthy way of coping with my senses, both mental and physical, being entirely too stimulated. Unfortunately, after some time, the depression and self-harm led to multiple suicide attempts. I won’t get into the details, because they’re not something I’d like to relive, nor something I believe anyone would like to hear. What I will say is that even the most recent suicide attempt relates to my diagnosis.

The effects of SPD are not only physical but emotional as well. For me, the emotional aspect probably affects me most seriously. When I love, I love so much it’s almost too much. When my heart breaks, it can seem like the end of the world if I don’t regulate what I’m feeling. At this point in my life, I did not know how to control my emotions, what I was feeling the night I made the decision to end my life was very real and very intense. My entire life my emotions have always seemed too much as if they were a burden. I have felt many emotions very intensely, but I can honestly say the night I made this decision was the worst instance in which I have ever been overcome with emotion. If you don’t struggle personally with SPD, or maybe you aren’t affected by the emotional aspect, imagine the worst emotional pain you have ever felt. Now, imagine sitting in a dark room with that emotion for hours letting it eat away at you. Now, imagine that multiplied by ten. That’s what I was feeling that night. Thankfully, I was found and taken to a hospital before my heart stopped.

Coping with Sensory Processing Dysfunction – Two years later…

Two years after my last suicide attempt and a week spent in an inpatient facility, I am the healthiest and happiest I have ever been. Thanks to multiple forms of therapy and an incredible support system, I am two years self-harm free. I’ve learned to control my emotions, more or less, and I now know how to handle it when my SPD acts up. As weird as it is, I never actually made a conscious connection to SPD and my previous hardships until very recently. A few months ago, I took to the internet and decided to search SPD and it’s the connection to the diagnoses I had as well as my struggle with self-harm. The internet isn’t the best resource obviously, but after a lot of research, I found multiple connections to so many of the things I’ve struggled with. I found articles about how SPD can truly affect my emotions, how it can be connected to self-harm through stimulation, how many other people with SPD also struggle with depression. I can’t begin to explain how excited I was, I’ll admit to even shedding a few tears. It was like after so long of feeling misunderstood and wrong, it all made sense. Maybe all the things people thought were just “Abby things” were things I really couldn’t help. After all of this self-discovery though, I realized there was something else missing. It came to mind that I had never once talked to another person with Sensory Processing Disorder, which kind of sucked, honestly.

So, I took to the internet again. More specifically, facebook, and I found a group for people with Sensory Processing Disorder. Reading through the posts was a feeling like no other, seeing other people dealing with the same things I thought were just quirks was incredible. So, I decided to make a post praising and encouraging all the parents on the page trying their best to help children going through a lot of the stuff I did. The response was extraordinary, my mom and I read through the wonderful comments with tears in our eyes. I think the most important thing I’ve learned throughout this crazy journey, though, is this: no matter what you’re going through, no matter how alone you feel, and no matter how much you feel like giving up there is always someone out there who understands and wants to help you. I spent so many years thinking there was something wrong with me and feeling like it would never get better, I can’t tell you how many times I’ve wished I just couldn’t feel anymore.


Now, though, I know who I am. I know that SPD is a part of me and it always will be, and even if it feels like a burden sometimes, it’s part of what makes me unique. I may feel too intensely, but that makes me passionate, it makes anyone who receives my love incredibly lucky. I may seem too much to handle to the wrong people, but to the right people I am so important. I may not be able to wear those shoes I liked or that dress I wanted because they don’t feel right on my body, but there are other shoes and dresses. For every burden it seems that comes with this diagnosis there is always a gain, and I hope that if anything comes from my life, it’s that I’m remembered as someone who could always find an upside in the face of adversity. Most of all, I hope whoever is reading this can realize how incredibly special they are. This disorder is not an easy one to face. I’m sure there are many more obstacles to come my way, but I am better because of the challenges I’ve faced and I promise you that you will be too.

sensory processing disorder, SPD, sensory issues, sensory teens, MissJaimeOT, Miss Jaime OT

About Abigail Ralstin:

Coping with SPD, SPD and Suicide

Abigail Ralstin is a 17 year old student in Indiana. She has grown up with SPD and continues to educate herself on her diagnosis as often as possible. Abigail will start her senior year of high school in the fall and hopes to attend Ball State University in the fall of 2016. She plans to study Zoology and hopes to work at a wildlife rehabilitation center in the future. Along with her studies, Abigail plans to continue to write about her own experiences as she moves forward in her life. Abigail owes much of her success in overcoming her hardships to her wonderful parents, Tammy and Danny, and an incredible support system through her friends and family.

For More Information:

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Sensory Processing 101 is a vital resource for parents, therapists, and teachers who work with children with Sensory Difficulties.

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Using Aerial Yoga for Kids with ADHD, ASD, and everything else!

As I’ve mentioned before, I love yoga.  Recently, I had the opportunity to observe an Aerial Yoga class for children.  After that, I just had to try an adult class myself.  I kind of had an idea of what to expect, but the class totally exceeded my expectations.   I practice yoga and I use it with my Occupational Therapy students all the time.  I think yoga is such a wonderful way to work on strength, balance, and coordination.  It also helps to quiet the mind and increase focus.   Aerial Yoga has all the benefits of traditional yoga, as well as the added benefits of sensory input.  Traditional yoga provides sensory input, too, but in a different way.  I am writing this blog post about my experience as an OT in both observing and participating in an Aerial Yoga class.  I recommend that you also read the post “Aerial Yoga from an OT’s perspective”  by the owner of the facility, who is able to give her perspective as a Occupational Therapist specializing in the treatment of Sensory Processing Disorders.   I’ve attached the link for you at the bottom of the page.

You may be wondering exactly what Aerial Yoga is.  Have you ever seen Pink do one of her performances where she sings as she hangs from the ceiling and twists, swings, and flips herself around?   Picture that! Ok , ok. I didn’t hang or twist like a rock star… but the theory is there.  And I felt like a rock star!

Lycra “hammocks” are suspended from two hooks in the ceiling.  The height can be adjusted based on the size of the person who will be using it.   The stretchy  material hangs in a “u” shape.  The material is super stretchy but also very strong, so it can support a child or adult size body midair. The instructor and staff members measured each person to make sure their hammock was the right height.   Aerial Yoga focuses on strength, balance, and coordination through different poses with the Hammock.  The children’s class that I observed was at Sensational Development in Massapequa.  There were 8 students, a Yoga Instructor and three staff members assisting the kids.  The therapists at Sensational Development are trained in Yogapeutics.    For more info on Yogapeutics, please check out the link at the bottom of the page.


Even the room itself was cool!  The lights were dimmed and soft music was playing in the background.  The floor looked exactly like a hardwood floor, but when I looked closer I realized it was made up of foam mats!  The kids ranged in ages from about five to sixteen.  The students seemed familiar with the yoga instructor’s verbal cues and were able to follow the directions.  The music really helped to provide a calm and relaxing aura. Later, when I would get into the complex inverted positions myself, I was able to feel my body become “un–calm”.  My heart would be racing from physically exerting myself as well as whatever else I was feeling from being upside down. Somehow, the instructor Linda, knew how I was feeling too.  After the “stimulating” poses, she would go back to a relaxing, calm pose.  She called it “chill-axing”.  I loved it. She really knew how to get our bodies back to right “state”.  Not too high, and not too low: Just right. The class consisted of children of all different levels of ability or “disability”. There were children on the spectrum, children with impulsivity and hyperactivity, and children with low tone.  The instructor, Linda, had an awesome way of providing the kids with the cues and descriptions to follow her instructions.   I was amazed at how the kids were able to follow up to ten step directions to perform the different moves she was showing them.  I was also surprised at how well the staff was able to manage all of the kids.  They were all different ages and abilities!  The owner told me later that the parents have to sign up their children for the class in advance so she can make arrangements to have the appropriate staff members present based on which kids were attending.   That made sense.  No wonder everything ran so smoothly.  They had it down to a science.

Aerial yoga is one of those wonderful activities that works on a bunch of goals at once.  Here are just a few of the areas that I saw being addressed:

Attention and focus – as I watched the children adjust their bodies according to Linda’s instructions I noticed that each child had a different way of listening and attending to her words. Some of the children stopped moving and watched her quietly and others kept bouncing as though they were on a trampoline. Each child was able to control their bodies and their positions to what felt comfortable for them. In the classroom, there are children who cannot sit still and listen. But just because they aren’t sitting still and just because they aren’t looking at the teacher doesn’t mean they aren’t listening and they aren’t learning. Some children need to move more than others. And some children need to move all the time. This class was the perfect example of showing that you can still listen when you’re moving around. All of the children followed Linda’s instructions. Occasionally one of the kids would try a different move than what Linda was explaining. The staff just gently went over and redirected them to stay on task and with the class. Some children needed more direction and more physical assistance than others.  So the children who needed less assistance were able to “play” in their hammocks until everyone was ready. This worked out great for everyone.  In the school setting we sometimes talk about a child’s need for self-regulation in the classroom.  What we really mean is that we want the child to be able to keep their own body awake and alert without being hyper or “wild”.  The point is that every child’s body and sensory system is different and their needs can be met in different ways.  It doesn’t mean that they have to sit still.


Strength– the kids used their core (abs and back) muscles throughout the session to arrange their bodies according to Linda’s instructions.  When I had the chance to try the poses myself, I really felt the muscles in my back and abs working to keep myself in the right position. I also felt the strength in my arms and legs during every pose. When we did the upside down poses, we had to use our arms to pull ourselves back up.  You know in the action movies when someone is hanging from a bridge or a train or something and they miraculously pull themselves back up? Yeah.  That was me!  One thing I didn’t expect was the amount of fine motor coordination and dexterity that was incorporated into the aerial yoga class.  Linda often had us re-orient our swing, to make sure it wasn’t all bunched up, so that our bodies would end up in the correct positions. She used cute expressions like “make a bikini bottom”  to help the kids understand what she wanted. The kids learned to use their fingers to bunch up the material the appropriate number of times according to Linda’s request.  It kind of reminded me of scrunching up a sock or a pair of stockings before you put them on. It takes a lot of small movements in your fingers and hands to get that material all bunched up. We had to do it over and over again, so those muscles got a great workout. What an awesome way to hide fine motor strengthening in a gross motor activity.


Motor planning – as I mentioned before, following Linda’s instructions required a lot of listening and watching her physically demonstrate the movements. She made it look so easy!  It was much harder to get my body to do what she just did. Motor planning is the ability to cognitively plan out how you’re going to move your body to complete an activity. We take motor planning for granted, but it can be really hard for some people.  The  entire one-hour session was filled with motor planning challenges.  Any new movement can be tricky if you’ve never done it before.  The staff was awesome about making sure that each child in the children’s class as well as every adult in the adult class was able to complete the movements either with or without assistance from staff.  

Tactile and proprioceptive input – As the children stretched and pushed their bodies against the Lycra Hammock, they were receiving tactile and proprioceptive input throughout their entire bodies.  Our largest organ is our skin. So when you engage in an activity that stimulates your entire body, the receptors in your skin are sending a ton of feedback to your brain. This can be calming or alerting; it depends on the child as well as the setting of the activity. Proprioceptive input is also known as deep pressure.  Inside that Lycra swing, your whole body is pressing against that material. And the material is pressing back as you hang against gravity, providing proprioceptive input throughout the entire class.  When I had the chance to do it myself, I was surprised at how my perceptions of the input changed throughout the hour-long class. There were times when I was calm and relaxed and there were times where I felt a little nervous or anxious. The sensations and my emotions changed in different poses.



Vestibular input – Hanging from the ceiling with nothing holding you but a large stretchy sock (hammock) can be a little unnerving. Most adults rarely go on rides. I am no exception to this. In fact, I’ve been on a roller coaster twice since the eighth grade. The reason for this is that most rides make me feel sick. Even swinging on a playground swing too high or for too long can make me a little nauseous, so I wasn’t sure what to expect from Aerial Yoga. The instructors told me that it’s normal to feel a little lightheaded or dizzy after class. For the most part I was totally fine. Vestibular input can be extremely calming or alerting to a person’s sensory system. Many children actively seek out vestibular input by swinging, rocking, or hanging upside down. They simply know what their body needs. Then, there are other children whose bodies need vestibular input, but it makes them uncomfortable. Some children avoid having their feet off the ground at all. This is called gravitational insecurity and it can really interfere with typical childhood play.  I thought it was amazing how aerial yoga, with one piece of equipment, could provide so many different kinds of sensory input. How awesome!

Self Esteem and Confidence -There was one student, a teen-age girl, who was the sibling of one of the kids in the class.  She was very quiet, but she was great at the poses; maybe even the most comfortable and skilled in the class. The staff told me that she attends the class every week with her sister, who is on the spectrum.  This is one of her “extra-curricular” activities, such as taking dance or gymnastics.  When I commented on how good she was, the staff told me that she progresses each week, learning new and more difficult poses. They tailor certain things to meet her need for a challenge, since she is capable of more than some of the other children.  The best part was that the staff reported that this girl had really transformed since coming to aerial yoga.  She has become more confident, more self-assured, and more outgoing.  How cool is that?


For a more detailed description of how Aerial Yoga can impact a child’s sensory system, you should read this post by Sara, an Occupational Therapist specializing in the treatment of Sensory Processing Disorders, and one of the owners of the facility where I took the class. Click here for the link.


So, are you willing to try an Aerial Yoga Class? Want to see if your child likes it?  Sensational Development is offering a deal with this blog post; “Buy five classes, get one free”.  Mention “Miss Jaime, O.T.” to get the deal.









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Ask An OT: “What pencil grip should I use for my child?”

Question from Dena Rich in  Albany, NYdena(1)


“Hi Miss Jaime!  Love, love your articles!!!! My daughter Emilia still struggles with her pencil grip (using whole hand instead of proper 2 fingers). I’m having trouble finding a pencil gripper. Do I have to go to a parent teacher store? Love the tweezer separating sprinkles idea. Do u think this will be too hard for her?  She turns five in March. “

Hi Dena!  Thanks for the compliment!  You don’t need to go to a teacher store; you can buy anything online!

Children who are four are often still developing a comfortable pencil grip.  It can be hard for children to develop separation of the two sides of the hand, but a pencil grip can help.  I usually try not to use a grip until I’m sure that the child is physically having difficulty.

That means that I have taught them many times where their fingers should go and where the pencil should sit in their hands.  When I ask them to hold the pencil correctly, they try to and they know what I mean.  The problem is that due to weak strength and endurance, they can’t maintain a proper grasp.  So then, I use a pencil grip.  My favorite “go-to” grip for preschoolers is called “the pencil grip”.  I like it because it’s “fatter” towards the back which helps kids to open up their web space.  This is the area between the thumb and the index finger.    There are specific spots for each finger, but even if they hold it wrong, it’s still ok.   Here is what it looks like.

Another good one that I like for kids Emilia’s age is the “writing claw”.  This one can be a little tricky to learn how to use, but once a child gets the hang of it, it’s great.  There are spots for the thumb, index and middle fingers.


Pencil grips can be uncomfortable for children at first.  That’s ok, it’s uncomfortable because the child is now using the correct muscles, and they aren’t used to doing this work.  Keep encouraging them and use it consistently.  It will pay off!   Also, you can help your child to “tuck in” the ring and pinky finger by having them hold a pom pom or a cotton ball in those fingers.  It helps to keep the pinky side of the hand separate from the thumb part.

Another way to make it easier for your child is to play games and work with toys that require separation of the two sides of their hands.  Classic games like  Bed Bugs, Lite Brite, Operation, etc. are examples of toys that encourage this.

Good Luck, Dena!  Keep us posted!


  ~Miss Jaime

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Ask An OT: How to desensitize a child’s skin…


Ask Miss Jaime OT!

~from Theresa Allender in Seattle, Washington:

How to  Desensitize Skin…

“My four year old has a super sensitive body. She is uncomfortable with kisses and hugs, she will only wear certain clothes because of how they feel, she is the same about shoes, it’s uncomfortable for her to have her head washed, etc. I was wondering if I could desensitize her to make her more comfortable in her skin.

Also, is this hypersensitive body related to her inability to hear others around her sometimes? For example it seems like she is blocking people out on purpose but she is genuinely startled to be tapped on the shoulder or yelled at for not responding.”


Thanks for writing in Theresa!  It sounds like your daughter has tactile and auditory hypersensitivity.  Sensory processing difficulties are very difficult to pinpoint without an assessment.  Even with an assessment, many children’s sensory issues change from morning to night, day to day, or season to season. What bothers them one day may not bother them the next.  Your daughter sounds pretty consistent, which may be helpful in figuring out how to help her.   In terms of “desensitizing” her, you could try massage.  A friend of mine is a Massage Therapist and she happens to work with children.  She says that gentle massage every night after a bath would really help the desensitization process.    You know what your daughter can tolerate, but start slow and gentle with some lotion.  She said that one very important thing is to decrease the time significantly for a child.  Start with five to ten minutes if she can tolerate it and then try to increase it.  But even 20 to 30 minutes total is a great accomplishment and will help to start the desensitization process.  You could try some lavender or pleasant smelling lotion if you think she would like it. If not, go plain.  If you already do this, systematically make your massage a little longer.  Then you can try pressing more firmly, etc.  If she has very sensitive spots, avoid them.  After you brush her hair, you could gently massage her scalp while you talk to her.   If the massage becomes ok, you can “step it up” by using a soft washcloth for the massage, or follow up the lotion with a “drying” massage with a towel or soft cloth.

Pediatric massage can help improve sleep, reduce anxiety, and improve aversion to touch.  It’s also great for improving the parent/child bond.

As for the second part of your question, children who are hypersensitive to auditory stimuli may appear not to hear you because they don’t hear you.  Children who have auditory hypersensitivity will hear every little thing around them, which may limit them from hearing something closer.  Leaves blowing outside, the sirens blowing two blocks away, or the hum of the air conditioner are competing with the voice of Mom.  All of these background noises can be hard for a child with auditory hypersensitivity to “tune out”.  This means that these background noises may be equal or more pronounced than closer noises like mom calling her name.   So it makes it hard for her to respond at times.  Often children learn how to self-modulate so that they can “tune out” the background stuff.  If it’s really impacting her, you could consider a “Therapeutic Listening” program.   You would need to find a therapist who is certified in it, but it seems pretty cool.  Check out this link for more info:

or you could look at this You Tube Video to get an idea of what it’s all about: 

Thanks for taking the time to “Ask an OT”!  If my readers have any other advice for Theresa & her beautiful daughter Maya, please comment!

Thanks for stopping by!

Thanks for stopping by!

~  Miss Jaime, OT

If you have a question for Miss Jaime, O.T., please leave a comment on this page or go to “About Me” and leave your question.   Thanks!

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The “Real” Reasons Your Kid Can’t Tie Yet!


There is so much going on in the news in regards to education these days.  The Common Core Craze has changed the way teachers teach and Kindergarten is the new second grade.  That said, there are many things that teachers are teaching that are not remotely on our politicians radar.  Manners, character, and self care skills are just a few.  However, the list is endless.

Anyway, learning how to tie your own shoes is a rite of passage that turns your child into a “big girl” or a “big boy”.  Think back to when you were little and you learned how to tie.  I would bet that your parents or older sibling taught you how to tie.  It takes practice and a certain amount of motivation.  Both the adult and the child need to be motivated in order for the child to learn the skill.  The adult is usually motivated to get the child to tie for themselves so A) they aren’t tripping on their laces and B) so there is one less thing for the grown up to do.  The child is usually motivated to tie because they are excited to be a “big kid”.

When are children ready to tie?

Some children are ready to tie before they even start kindergarten.  Many are ready to learn in their kindergarten year.  Keep in mind this means children who are four and a half and five years old.  It always concerns me when I see a third grader in the halls with untied shoes and when I ask them to tie their shoes for safety, they end up telling me that no one ever showed them how.  It’s easy to buy slip on shoes and Velcro, but kids still need to learn how to tie.  I think sometimes it simply slips parents minds that they need to teach this skill, just like zipping, wiping and washing hands in the bathroom and using a fork and spoon.  Life is hectic and busy, but before you know it you have a ten year old who can’t tie.  Uh-oh!

Of course, some children have motor or learning difficulties that interfere with their ability to easily acquire this skill.  When this is the case, an Occupational Therapist may be the one who ends up teaching them, which is totally appropriate.  If you have a child that receives OT and you are concerned about their ability to perform self care skills, definitely let the OT know.  You may think that the OT should automatically know this or look at this, but the truth is that school based OTs are really supposed to work on skills that directly impact a child’s education.  Not just handwriting (MYTH!) but copying from the board, visual processing, motor coordination, using two hands to manipulate school tools and many other things that affect a child’s ability to learn the curriculum.

I’ve had parents ask me to work on riding a bike, because their child can’t ride with the family or the kids in the neighborhood.  That stinks! An OT will absolutely know how to teach a child to ride a bike, because it’s all about balance, coordination and motor planning.  However, riding a bike has nothing to do with school.  I always feel bad when I explain this to a parent.  I can work on motor planning, coordination and balance, but bicycles are on the other side of the line.

Untied shoes can be a safety issue for a child with special needs.  Shoe-tying is a self care skill and that is school appropriate. So children who have motor or learning difficulties may end up learning how to tie at school.   Everyone else will (hopefully) learn at home.  I think I’ve taught at least a hundred kids to tie over the years.  And I’ve found that there are a few simple reasons why it’s so hard for some kids to tie.

Postural stability

Children who are low tone or have weak core muscles have a very hard time holding their trunk upright and managing the steps to tie. Even children who are simply young have trouble with this.  It’s just too many things to conquer.  You may notice that your child will use one hand to kind of hold themselves up.  This obviously interferes with the ability to tie because they need to manage both laces.

The easiest way to fix this problem is to have the child sit with their back against a wall or something flat.  Try to get them to put their bottom all the way to the back of the wall. Kids often round their backs and scoot their bottoms forward, which provides less support.


Notice how she is propped against the cabinet and her left leg is tucked out of the way


So now the child is seated with their back against a wall.  What next?  Have you ever tried to do that thing where you tap your head and rub your belly at the same time?  This takes a lot of motor planning and the ability to do different things with different body parts at the same time.  Tough Stuff.  So the next tricky thing is getting the child’s body in a position that makes it easy to manage reaching their feet.   We already took care of their trunk by propping it against the wall.  Now we need to get their legs in a good position.  Decide what shoe you want to tie.  Then tuck the other leg underneath and out of the way.  Bend the knee of the tying foot up towards the chin.  The hard part here will be getting the knee to stay there.  I sometimes tell my kids that they should rest their chin on that knee.  It helps keep it in place.  For kids who are a little chunky, the knee usually falls to the side.  This also happens to kids who are low tone.  The only problem with this is that now, the bow will be on the Inside of the foot, instead of the Middle of the foot on top of the tongue.  Although this isn’t the biggest problem in the world, it’s harder to tie because the laces aren’t the same length anymore. Also, the laces will probably dangle on the inside of the foot, making it more likely that the child will trip on them or step on them. So get that knee under the chin.


Having the child place the chin on the knee keeps the leg and the bow nice and straight.

Bilateral Coordination

Some children still don’t have great bilateral coordination at the age of 5. Bilateral coordination is the ability to use two sides of your body at once. Sometimes it is hard for a child to keep their first hand holding the loop while the second hand does the next step.  I always tell the child “you have to hold onto the bunny, or he will hop away!”  As I said before, sometimes a child will take that hand away and lean on it, using it as a support.  That goes back to the postural control and positioning.  It can be hard to tell why they are taking that first hand away (difficulty with using two hands at once?  or the need to hold themselves up?) but if you get them against a wall in the right position, you may eliminate that urge to take the hand off the loop and put it behind them.

 The Laces

Length -Children’s laces should be the right length, of course.  But  very often they aren’t.  At least they aren’t the right length for a kid who is learning how to tie.  The  laces should be long enough to give the child some leeway as they are learning.  But they can’t be too long or it becomes a big mess AND they will trip on them even after they are tied.  So what is the perfect lace length?  It depends on the size of the shoe, but I recommend that the  laces should be between 11-13 inches long from the tongue (after the shoes are laced).  The Dollar Tree sells packs of laces for a dollar in all different sizes.  If your laces are too short or too long, you really should get a new pair of laces.  It makes a world of difference.  For some reason, kids want to hold the first loop or “bunny ear” with their whole fist, instead of pinching it with their two fingers.  If the laces are too short, they disappear in that little hand.  You need laces that are long enough to work with.

Texture – Now this may seem ridiculous, but it’s really true.  Some of the new funky sneakers come with cool laces that are just too silky!  They are usually round, too.   I prefer the plain old flat cotton laces. They tie easily and they stay tied.  The silky ones tie, but because of their round shape and silky texture, they come united right away.  Little kids usually don’t have great hand strength to tie the final bow super tight.  Those silky laces are like Houdini.  Out of that knot in a few minutes.

Visual Attention 

For some children, half the battle is getting their eyes to look at what they are doing.  For children with very poor visual attention, I recommend teaching one step at a time.  I find that children who are motivated and feeling successful do much better with keeping their eyes on what they are doing. By teaching only step one over and over a few times, the child learns it and then feels successful.  Feeling like something is achievable or within their reach makes it more enticing and may help with the visual focus a bit.

Visual Perception

Some OT catalogs sell toys, books, and other gadgets with laces that are two colors.  This is great for kids whop rely heavily on visual feedback.  I really prefer to teach kids to tie on their foot though.  Otherwise you end up teaching them twice.


Just one of the many tools out there with different colored laces….

If your child has difficulty with left/right or spatial concepts such as over/under, it may help to use different colored laces.  Buy two colors that are the same length.  Then cut them both in half and tie them back together with the opposite color.  Lace the shoe so the knot is at the bottom in between the first two holes.  Now when you are helping your child you can say, “the pink lace” rather than left, right, this one, that one, etc.  It just takes away one more obstacle.

Sequencing and Motor Planning

Sometimes the real problem is remembering the steps.  I like to use a story or a poem to help the child because it helps them to remember what happens next.  I prefer to use the one loop method but you can teach it however you like.  There are so many different versions of how to teach it but if you get their body in a good supported position with the other leg out of the way, you are halfway there.

I use the bunny and the snake story. First you make the letter X.  I teach the child to make the X on the shoe, not in the air, because it is more work to hold the two laces up and manipulate them than to leave them down.  Then I help the child find the lace on top.  (This is where the two colors come in handy).  The lace that is on top goes underneath and into the middle. If you tied it correctly, it should look like a piece of twisty macaroni.


Now the child has to make a loop.  This is the bunny, who sits on “macaroni hill”.   I always talk to kids about how bunnies hop on the ground, so it’s important that he doesn’t look like a flying balloon. “Bunnies don’t fly!” Don’t forget to give the bunny a nice long tail.  The other lace is the snake.  Depending on the child, you can make the snake mean and hungry (you can guess the end) or nice.  I like to have a snake in the story because I can tell the child that the end of the lace (the plastic part) is the snake’s face.  This helps them remember that they need to work with the snake’s belly, not his face, in the middle of the story.  “He might bite you!  Don’t touch his face.  Be Careful!”

The snake decides to sneak up behind the bunny.  This part of the story helps a child to remember where the lace needs to go.  “You would never walk in front of the bunny if you were trying to be sneaky…”  Then the snake loops around and hides his face in the forest.  This is the hard part for a lot of kids.  They keep wanting to pick up the end of the lace. “Watch out!  He’ll bite you.  Not his face, grab his belly!”

The snake pushes his belly through the hole that he made when he walked around.  I tell the child  to “pinch the snakes belly”.  The other hand hops to the top of the bunny ear and then both hands pull.  You can have the snake hug the bunny and invite him to lunch (awww) or eat the bunny for lunch (ewww).  You will know what your child will like and remember.

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It doesn’t matter what story or method you use.  But having a story with steps that help a child to sequence and motor plan their movements  really helps.

I really hope these insights will help you to help your child to tie!  Please comment and tell us if you have any other good tips! Good Luck!

Thanks for stopping by!

Thanks for stopping by!

~Miss Jaime, OT


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