We value the importance of ongoing education and training and are commitied to providing evidenced based programs and best practices based on up-to-date research, knowledge and skills.
Treatment may use one or more of the following approaches:
DIR Floortime Approach
The clinicians at OT4KIDs use Floortime strategies to foster development in the areas of emotional thinking, social engagement, attachment, social problem-solving and play.
Floortime is an individualized, strength-based, child-led approach that centers around observing, listening and joining the children at their developmental level. Using play and positive experience-based social interactions, the children are progressed through their personal developmental ladder. Parent engagement and participation are key, as parents are their child's most important and consistent relationship. The clinicians work together with the parents to foster transference of skills to the home and community by demonstrating and modeling interactions that are motivating and challenging and capitalize on their child's natural interests, while at the same time honouring individual differences.
- Regulation and Attention
- Social Engagement and Attachment
- Social Problem-Solving
- Pretend and Imaginative Play
- Emotional thinking
Dynamic Core for Kids
Handwriting Without Tears Program
At OT4KIDs, we use Handwriting Without Tears (HWT) strategies and tools to develop printing and cursive writing skills. HWT uses a multisensory approach, while accounting for the developmental stage, learning style and interests of each individual child. It also targets self-esteem, pencil grip, posture and fine-motor skills required for learning and success within the school environment.
HWT includes various pre-printing and printing activities like games, songs and kinesthetic tools, while emphasizing and reinforcing consistent stroke patterns, letter formation and literacy. It incorporates hands-on playful learning approaches to appeal children, as they prepare for school success. The instructional method can easily be taught to parents and be adapted and applied at home to allow for greater transference of skills.
- Strength and posture
- Fine motor skills
- Letter formation, spacing and alignment
- Printing and cursive
Interoception is the sensory system that provides information about how the body feels on the inside. This information enables us to identify hunger, satiation, pain, nausea, arousal and exertion, in addition to offering greater insight into emotional states. For example, noticing a belly growl prompts the realization of hunger which leads to seeking food for satiation. Interoception helps us understand how we feel (interoceptive awareness)
Interoceptive awareness is crucial for effective self-regulation. It is a foundational skill required for successful engagement in various activities of daily living, like toilet training, sleep hygiene, mealtime, dressing, motor games and play, social participation and academic success.
Using Kelly Mahler’s Interoception curriculum, our clinicians help the child notice and label internal body signals, connect these cues to emotions, and use this knowledge to apply strategies to promote regulation, including body state regulation and emotional regulation. It is based on mindfulness principles which use movement, heavy work and alerting activities, sensory play, and communication prompts. The strategies are developmentally appropriate, can be easily modified to meet individual needs, and can be paired with other regulating strategies like The Zones of Regulation program.
- Self-Awareness and Regulation
- Problem Solving
- Attachment and attunement
- Social Intuition
- Perspective taking
- Flexible thinking
- Motor imitation
Safe and Sound Protocol
The Safe and Sound Protocol (SSP) is a music based program used to promote regulation, social engagement and resiliency. It focuses on the porosity of the human voice to help calm the child’s nervous system, reduce auditory sensitivities and foster improvement in one’s ability to listen, connect and socialize with others.
The SSP is based on the Polyvagal Theory proposed by Dr. Stephen Porges, which has documented parallels between dysregulation of the autonomic nervous system (ANS) — the system that controls the fight-flight-freeze system. The theory proposes that the system functions like a platform that can facilitate or inhibit various types of behavior from spontaneous social interactions to aggressive/oppositional behaviors to shutdown (freeze responses). Essentially, our ability to listen depends on our ANS state. If we cannot regulate our physiological state, we cannot listen, socialize and connect with others.
The music is specifically designed to manipulate the muscles of the middle ear, so that the muscles are strong and flexible. This improves the child's ability to attune to the higher frequency sounds of the human voice which are calming and less so on the lower frequency sounds of threat and danger (e.g. background noise). By focusing on the porosity of the human voice, the SSP music via stimulation of the Vagus nerve, helps to shift the child’s ANS state from a heightened, defensive state to a calm, responsive and socially engaged state.
- Regulation and Attention
- Auditory processing (listening)
- Social awareness and social engagement
- Social Problem-Solving
- Emotional expression
Sensory Processing/Sensory Integration Theory
Social Thinking Programs
SOS Feeding Approach
The clinicians at OT4KIDs use the Sequential Oral Sensory (SOS) approach to feeding strategies to promote healthy relationship with feeding and to increase the child’s ability to participate in feeding with increased ease and comfort.
The SOS Feeding approach encompasses a multi-disciplinary type of feeding therapy that utilizes a systematic approach to address both the sensory processing and the oral motor skills, grounded in the abilities and capacities of feeding needed to eat a wide variety of food groups and textures.
The SOS Approach focuses on increasing a child’s comfort level by exploring and learning about the different properties of food. The program allows a child to interact with food in a playful, non-stressful way, beginning with the ability to tolerate the food in the room and in front of him/her, then moving on to managing the smell of the foods, learning about how foods feel on the body and in the mouth, and then enjoying tasting and eating new foods following the ‘Steps to Eating’.
The SOS Feeding approach is appropriate for children who:
- May eat a limited variety of foods (picky eaters)
- May eat a food for some time then refuse that food even after taking a break from it
- May refuse entire categories of food groups, or texture groups (i.e. hard foods, soft cubes, puree textures)
- May eat something different than the rest of the family at almost every meal
- Sensory processing skills
- Oral motor skills
- Learning/problem solving
- Relationship with food
- Comfort and confidence with eating
Therapeutic Listening Programs
Trauma Informed Care
Trauma informed care is a framework that guides our practice at OT4KIDS. It focuses on the knowledge and understanding of how trauma affects the child across the various domains of life, and the significant importance of supportive, responsive relationships in fostering physical and emotional safety through empowerment.
Trauma informed care is an integral part of our philosophy and essential when working with children whose relationships and participation in every-day activities has been significantly impacted by attachment and early trauma. We work in partnership with parents/caregivers, with special consideration to promote healing and recovery throughout the therapeutic experience, while concurrently being attentive to avoid practices that may inadvertently retraumatize the child. We work with children to identify how their sensory and motor skills have been impacted, identify their fight and flight responses, and the impact of triggers across home and school environments. Overall, the focus is on the physical, psychological and emotional safety of the child, while working together to rebuild a sense of confidence, control and empowerment that can eventually be generalized to other domains of life, and foster improved engagement in self-care, social engagement, learning activities and play.
- Regulation of arousal state, attention, emotions and behaviour using bottom up strategies (sensory) and top down strategies (cognition)
- Optimum arousal levels
- Focus and attention
- Sensory processing
- Social engagement and attachment
- Functional skills affected
- Self-esteem and sense of self
Wilbarger Brushing Protocol
Zones of Regulation
Zones of Regulation is a framework designed to foster self-regulation and emotional control. Using a cognitive behavioural approach, the step by step curriculum helps children recognize, understand and change their physical/emotional state, referred to as “zones”, as needed to meet the demands of the environment. Each of four zones is represented by a specific colour, reflecting a continuum of regulation:
- The Blue Zone describes a sad, ill, tired, bored or generally low state of arousal
- The Green Zone describes a calm, focused, happy, open and engaged state of arousal
- The Yellow Zone describes a nervous, anxious, frustrated, excited, hyper or generally heightened state of arousal
- The Red Zone describes feelings of anger, rage, terror, devastation or an extremely heightened state of arousal which may lead to out of control behavior.
The Zones of Regulation curriculum is used by the clinicians at OT4KIDS to support children to develop the skills necessary to consciously regulate their emotions and actions, by using appropriate tools to shift to a calm and focused state when required. Tools can be sensory, environmental, cognitive or social in nature. The clinicians work one-on-one with each child to validate and normalize all emotions, while helping them navigate their emotional states across various environments; The overall goal being increased self-control and problem-solving skills for improved capacity to function and engage in everyday activities. While children learn these skills, parents and caregivers are also mentored on how to best co-regulate their children across various emotional states. With improved regulation, children are better ready and able to navigate social environments, engage in activities requiring attention and focus, and deal with potential stressors in their environments with confidence and independence. This allows for improved success during self-care tasks, social engagement, academic activities and play.
The Zones of Regulation curriculum compliments many other approaches, including Interoception. Consider the Interoception tab for more details.
- Emotional and sensory regulation
- Perspective taking
- Social problem-solving
- Executive functioning