Automated Transcript Episode 18

Episode  18: The value of occupational therapy for neurodiverse children

Speaker Rachael Horner Occupational Therapis

Please excuse any errors as this transcript has been automatically generated

Dr Olivia Kessel (00:11):

Welcome to the Send Parenting Podcast. I'm your neurodiverse host, Dr. Olivia Kessel. And more importantly, I'm mother to my wonderfully neuro divergent daughter, Alexandra, who really inspired this podcast. As a veteran in navigating the world of neurodiversity in a UK education system, I've uncovered a wealth of misinformation alongside many answers and solutions that were never taught to me in medical school or in any of the parenting handbooks. Each week on this podcast, I will be bringing the experts to your ears to empower you on your parenting crusade.

Dr Olivia Kessel (00:53):

In this episode, we will be joined by Rachel Horner, who will explain what is an occupational therapist and how can an occupational therapist help your neurodiverse kids with activities of daily living in the home and at school. She will give us practical tips and advice looking at challenges such as handwriting, attention and focus and personal care skills, like getting dressed. The key she says is to breaking it down into activities or simple blocks, making it into just the right challenge to maintain your child's motivation. So welcome Rachel to the Send Parenting Podcast. It is a real pleasure to have you here today to explain to myself and our listeners everything about occupational therapy, but also particularly how occupational therapy can help neurodiverse children and their parents really as well. So it's a real pleasure to have you on the show. Thank you.

Rachel Horner (01:54):

Thank you. It's a pleasure to be here.

Dr Olivia Kessel (01:56):

I guess, my first question is, what drew you into the field of occupational therapy?

Rachel Horner (02:03):

It's a good question. So. It's my second career and I was looking for something that was more meaningful for me in many ways... a career that I felt could have a bit more of an impact, but on the ground level. So then I could see some changes and I felt like I was providing a useful service, I suppose, to the world. So I sat down with my mom one day. Both my parents were in the medical field. My dad was a doctor and mom used to be a nurse, and I sat down with her and I told her what my values were with work and she mentioned occupational therapy and I had never heard of it before. I think most people haven't !

Dr Olivia Kessel (02:59):

I mean I've always thought of it as similar to rehabilitation, you know, in my medical hat. It seems it's not that well known.

Rachel Horner (03:06):

Yeah. And and lots of people model it up with occupational health as well. I mean we kind of get confused. There's all sorts really. So I went and I did some work experience at a hospital and actually it was with older adults. I could really see it kind of ticking all the boxes that I was looking for in a job. So after this work experience, I went back to university and I studied as an occupational therapist.

Dr Olivia Kessel (03:35):

Excellent! And I guess that brings up a big question. What is this thing called an occupational therapist? How would you define what you do?

Rachel Horner (03:46):

So, I think that took me a while to figure out, even through my degree. And when you qualify, you're still trying to figure out how best to explain it to people. But when you train, you can work with either adults or with children. So, occupational therapists typically support human beings across their lifespan. If you're working with children like me, then what we are looking at are the everyday activities that children will engage in. And the technical term that you might hear from time to time is "activities of daily living". For a child that, might be them going to school, how they participate in their learning, their self-care skills - for instance can they get themselves dressed or go to the toilet, or use cutlery? Those sorts of things.

Rachel Horner (04:39):

And then we'll also look at their motor skills. So, we'll work quite closely with physiotherapists sometimes, and look at the child's mobility. Like can they walk, can they hop and, and is all of that sort of thing appropriate for their age? Or whether they have a diagnosis, is that in line with their diagnosis? And what can we do to support them to develop those skills? And then we also look at things like their fine motor skills, their play skills and their handwriting and those sorts of things. So how you use your hands and your arms, and again, what can we do to help that child develop the skills that they need so then they can flourish in their everyday activities? So then they can go and play with their friends and they can go to school and they can get themselves dressed and all of those sorts of things. Really, we are breaking each of those activities down. We're looking at what is it that they're finding difficult and what can we do to help them develop those skills?

Dr Olivia Kessel (05:38):

Yeah. And it takes sometime. I know from my own experience with my daughter who's had cerebral palsy, that occupational therapy has really helped. And I have to say I was probably one of the biggest hindrances to my own child. And with the best intentions as a parent, you put their clothes on for them because it's so difficult for them. And you know, I remember having this nursery teacher and I didn't like her very much and she said to me, Mrs. Kessel, you must stop dressing your child. She needs to learn how to do it herself. And I'm like, well, you know, that's all good and well, but when they're crying and when you're late and when there's not enough time, you know, it's sometimes just easier. But, you know, I think one of the great things that occupational therapy does is it breaks it down, like you were saying and you'd mentioned to me the just right challenge. And I think that's a brilliant way of looking at how to overcome some of these barriers that we have as parents. Because I think there's probably a lot of your job that involves educating the parents as well as the children.

Rachel Horner (06:39):

Yeah! We have to kind of provide that education for the parents and also teachers and anyone who's with that child or working with that child to support them. And I think there's quite a healthy dose of compassion as well, really. Because we have to understand that parents and teachers are under so much pressure, especially from a parent perspective, you need to get out of the door and get your child to school so you might not have hours in the morning to let them try and do everything for themselves. So I think it's about really being compassionate and fair and choosing something that's going to be just a little step forward for them. And making sure that it is just right amount and level of challenge for the child.

Rachel Horner (07:33):

So then it gives them a motivation, but it's not going to be so hard that they fail. You want them to achieve and develop their confidence whilst they're developing their skills. Because that way they're going to think, "yeah, I can do this...I can keep learning and I can keep trying, i can keep learning how to tie my laces." So I think it's also choosing your timing as a parent, when are you going to practice these things? So then it's not really stressful on the whole household.

Dr Olivia Kessel (08:08):

it's so true. I mean, this morning I went to zip up my daughter's jacket outside, it was cold and I couldn't do it. And I, she's like, mommy, let me show you how to do it. And she goes, "...first you put this in like this and then you do this and then you pull it up..." and I asked myself, "why was I even trying to zip up your jacket? You're way better at doing it than I am." And you know, she was so proud of herself, but she had obviously broken it down into those little steps through her experience of learning how to get dressed. And now she can share that with me. And she loved it actually.

Dr Olivia Kessel (08:43):

Yeah. And I think that's a really good point in terms of pressure of time. Doing it in a time where you don't have that extra pressure, so that you are able to give yourself the patience and the compassion to learn the skills. it's often challenging in these busy times that families live in, to find that space. So it's nice to be able to have an expert like yourself to give the right tools and techniques to be able to know what those steps are and when to do it. So do you work with parents as well as the school in a holistic approach? Or does the parent go and then teach the school about it? How does that usually work?

Rachel Horner (09:29):

So, it partly depends on where I get my referral, as to what approach I'm gonna take and also what the child's needs are. I would say more often than not, I do actually carry out my assessments in school because a lot of the challenges that parents might be seeing or hearing about are within school or impacting the child in school, if that makes sense. So often, I'm going to their school, and seeing them in their classroom environment. And also if we think about it, children spend such a huge portion of their time in school, I think quite an important area to look at. And while at their school, I would speak to the teachers and I'd speak to what are they seeing, and then provide some training around what strategies might be helpful. But I'd always be providing that support to the parent as well. So it involves sharing activities and strategies for both home and for school that are going to help from both angles because the more we support children in all of those environments, the more input they're going to get, the more progress they're going to make.

Dr Olivia Kessel (10:58):

Yes, it's that reinforcement. I know we've talked about this before, like with my daughter and her cerebral palsy, she's had to renet her nerve cells because they were damaged due to the infection that she had. And so through doing exercise and activities, she learned her nerve cells, learned how to communicate in a different way around that area of damage. And it's really that reinforcement and that continuing to do it that set that up. And I know you've discussed with me as well how that can happen from a sensory perspective for neurodiverse children who maybe are overwhelmed with sensations that come in, maybe it's too loud, that they can actually desensitize their reaction to that stimuli through doing activities. I hope I've got that right from what you've said before.

Rachel Horner (11:51):

Yeah, it's a complex one. So, with sensory integration, there are two parts to it. There's actually your motor skills, so what you are talking about with your daughter and learning - the physical skills. And from a sensory perspective we might be looking at their balance and their coordination and their body awareness - those sorts of motor skills. And then we're also looking at the other aspect that you just mentioned about being - are they overwhelmed in their environment? Is the noise really affecting them or, do they particularly dislike certain textures of food? And that's overwhelming for them. You know, there are two main areas that, that we would look at with sensory integration. And the best way I can describe it is if you went into a sensory integration therapy session, if you were a parent, you were going into a session, you would probably see a room with a swing and a ball pit and some bean bags and some Skittles and all sorts of sort of games and toys.

Rachel Horner (13:10):

And you're going to challenge the child through play, to develop those motor skills using all of that equipment. And that helps the brain to learn those motor skills and those physical skills.

Dr Olivia Kessel (13:31):

That makes sense.

Rachel Horner (13:33):

There is a nice phrase that scientists use - Neurons that fire together, wire together! The more you do something, whether it's a physical skill, a motor action, or whether it's, learning to cope with different sensations slowly through desensitization, the more you are going to create those neural pathways and, and hopefully desensitize any sort of overreactions.

Dr Olivia Kessel (14:10):

So, it's fascinating to me because it's almost like you're training your brain so you're exercising it - to be able to work in a different way than it was able to before. And my daughter really struggled to ride a bike because of her left hemiplegia. So for three months we had a stationary bike and I velcroed her foot to the pedal and her right leg could push on the pedal and her left leg just went along with it and I'd be on my runner, she'd be on her bike in the living room and we would just do that for months. And then eventually her left leg learned, and I guess this goes with your firing and wiring... Her left leg learned how to do it. And now actually she can pedal a bike without the velco straps, which would've been rather dangerous out on the street, but her left leg has learned from her right leg. Fantastic!

Rachel Horner (15:04):

So

Dr Olivia Kessel (15:04):

I think it's amazing as a parent that there are ways that you can help your child to learn how to make those maps and learn how to rewire your brain a bit to be able to do those activities of daily living that kids want to do. It's almost like magic, I think.

Rachel Horner (15:26):

Yeah, it's pretty clever.

Dr Olivia Kessel (15:28):

With a lot of hard work... all of this comes with hard work. What you've said about doing it in the classroom, doing it at home - that reinforcement is so important in order to get the results that you want. Now in terms of, some of the common things that parents would come to you with, and I know we've picked out like three different scenarios because I think it would be really beneficial to know, what can I do as a parent? Because sometimes it's difficult to get into C N O T, I know from an NHS perspective it can be challenging and it can also be challenging for parents who maybe can't afford to do it privately. So as we have you on the podcast today, it would be great to look at some of those (maybe) three scenarios and get your input on what parents can do at home. And I think the first one that you said was really common was handwriting, which we struggle with in my house to this day. But, occupational therapy has really enabled my daughter to write a little bit, which is great. So, can you take us through what it would be like when someone comes to you with handwriting issues?

Rachel Horner (16:42):

Yeah, so, with handwriting, we're looking at children right from when they're in reception or maybe even looking at their pre-writing skills. And that will extend all the way until secondary school. So we're looking at that whole range of ages. Obviously you would potentially expect different things from children at different ages. So if I had a parent come to me and they're in reception and they said, "my child's really struggling with their writing and they're not in line with their peers, and I'm a bit worried," one of the first things I'm gonna look at is whether they can draw their pre-writing shapes. So your pre-writing shapes are a prerequisite for letter formation. And those are being able to draw simple shapes like a horizontal line, a vertical line, a circle, a square across, and a triangle.

Rachel Horner (17:48):

So all of those letters help to form the letters of our alphabet. And for a typical developing child, you'd expect them to be able to draw a triangle around the age of five years and three months roughly. Obviously there needs to be a bit of give and take because everybody develops at a slightly different rate. So if they were in reception or year one or even year two, and they can't draw those shapes, one of the first bits of advice I would say is let's practice those shapes. Because if they can't draw those, they're gonna struggle with their letters. So that's one of the first things I'd look at. But then I'd also be looking at how are they holding their pencil? What is their posture like? Have they got the attention of focus or are they looking all over the room and distracted?

Rachel Horner (18:49):

And if they've got all of those skills and maybe they're a little bit older and they're struggling with letter formation or the output, or not being able to keep up with their peers, I'd have a look a little bit more closely at their letter formation - are the letters sitting on the line, have they got spaces between their words? And then we could do specific assessments to look at their speed of writing as well. And if they're struggling with their speed of writing, then maybe they need additional time in tests and exams. And if they're really struggling with writing, because writing can become a really stressful thing for children. And as soon as that happens, they can become quite avoidant of doing their work, which is quite a worry. So, sometimes putting in a compensatory thing, like allowing them to type their work instead of handwriting can take off so much pressure from them and they're much more likely going to engage in their lessons and in their learning. And it gives them the opportunity to actually put their ideas down on paper. Whereas before they might not have been able to, which you can imagine would be so frustrating. You know, you've got all these ideas in your head and you can't put it down because you know that you just don't have the motor skills or the ability to pop it down on paper. And that's, that's just gonna be so frustrating.

Dr Olivia Kessel (20:15):

So frustrating.

Rachel Horner (20:16):

So frustrating. Yeah,

Dr Olivia Kessel (20:17):

I kind of look at it or have tried to explain to teachers that it's like trying to write with your left hand when you're right-handed and get your thoughts out. You can't think because you're struggling so hard with the actual mechanical activity of it that your thoughts are lost because you're using so much energy and I think it's amazing now that technology has changed my life. My daughter's written a 600 word essay with dictation by herself! But, it's still really important to have the handwriting skill, and those neural networks that we were talking about, that wiring and firing. So it sounds like creating a combination of practicing the writing and the the shapes while also giving them an avenue to be able to express themselves to decrease that frustration is a good like combination as they get older.

Rachel Horner (21:11):

Yeah, definitely. And there's lots of other strategies I might recommend as well. So if they struggle to forget to put spaces between their words, I might say, okay, let's get you just a little lolly stick or something like that and we can use that as a visual guide, just put that between, after every word. And that just helps them to learn and visually see where should they be placing their, and

Dr Olivia Kessel (21:37):

Then you can eat the lolly after as well, which is a reward.

Rachel Horner (21:40):

Yeah, it's your reward. Or maybe you can get special handwriting paper as well, which might highlight where do you place the line, where does the body of the letter go? You can actually use a highlighter pen in all honesty and just highlight the line or just above it. And that's where you need to place the body of the letter, if that makes sense. Because quite often you might see a letter floating up above the line.

Dr Olivia Kessel (22:14):

It's made a huge difference with the highlighting actually, because that visual cue of where to put the letters on the page is very helpful. And it makes a remarkable difference actually.

Rachel Horner (22:25):

Yeah, just simple things like that. It doesn't have to be overly complicated. And also, it's really important to look at how the child is sitting. They need to be supported with their sitting, so their feet ideally should be on the floor, flat on the floor, and if it's not, then put some books underneath or a box underneath their feet to step on. So then their ankles, their knees and their hips are approximately around 90 degrees. And then that will support their posture. And then that in turn helps to support your upper limb function. So how can you move your arm, and hands if you're not...

Dr Olivia Kessel (23:07):

Stabilizing the, the body.

Rachel Horner (23:09):

Yeah. That's important because if you think about it, if you were sitting in a giant chair and your feet couldn't touch the floor and you had no support around your back or your body, you are going to be working really hard to try and keep yourself upright. And actually it's harder then to control your fine motor movement. So how you move your arm and your hands not only affects your kind of motor function or your handwriting, it's gonna affect your attention and concentration as well.

Dr Olivia Kessel (23:45):

That makes total sense. And I have a very good visual now to understand how challenging it can be for kids. That's brilliant and great tips and really easy to implement those yet not at great cost. So thank you. That's really, fantastic. So moving on to our next scenario, in terms of attention and focus, - which are challenging for both children and adults - I think kids are required really to focus a lot at school, especially as they go from nursery upwards. What kind of things can you advise parents in terms of attention and focus as a challenge for their child?

Rachel Horner (24:28):

Yeah, so in a way it partly depends on what we're seeing. I would probably go into class first of all and I'd observe that child in class and see what is actually going on. And I might also get the teacher to complete a sensory profile questionnaire as well, just to give me a little bit more information about how they might be reacting. Generally speaking, when I'm not there. So how are they reacting? Can they work in groups? Can they get upset if it's really loud? Do they cover their ears with their hands or do they walk out of class and how are they responding? And then how does that affect their attention and focus to work? And then depending on those as well as other observations that i might make, i can determine which way to go. Other things you might observe include them fidgeting with lots of objects.

Rachel Horner (25:23):

They might be the type of child who is asking to go to the toilet every five minutes even though they don't need the toilet. So again, quite avoidant of being in the classroom. They might find endless ways to go and approach their teacher because they just need to get out of their chair. Or they might be just be really overwhelmed and get quite distressed quite easily. So there's lots of different things you might see. It's not as simple as just saying they've got really poor attention. We've got to look at the underlying reasons as well as to what's going on. And so if they're the type of child that's really fidgety and they're getting out of their chair and they are moving around a lot and they're fiddling with things, I would then suggest something like movement breaks, for example. It's quite unreasonable sometimes for us to expect a child to sit in their chair and not fidget or not need to move for an extended period of time. So I would suggest then, okay, let's put in some movement breaks, say every 10, 15 minutes depending on their age.

Dr Olivia Kessel (26:39):

How long are kids expected to sit in class? I don't even know that.

Rachel Horner (26:46):

That's a good question. I think it varies depending on what year group you're in.

Dr Olivia Kessel (26:52):

As you get older it gets longer and longer. Till you're sitting there for an hour.

Rachel Horner (26:56):

Yeah. And everybody's got different sensory needs as well, so some people will be able to tolerate sitting for longer than others. I'm a real fidget, so I know, even just from my own needs, I would need to just wiggle around a little bit or probably play with a pen so I don't fall asleep. . So, everybody's got their own kind of sensory needs and art, their own ways of managing them. And children will do the same thing, but it might not be so acceptable. So actually what I would say is. Let's give them a movement break, let's make it productive. Get them to hand out the resources or get them to run an errand into the office, so it gives them a purpose and a sense of responsibility at the same time.

Rachel Horner (27:45):

Or if that's not appropriate, then sometimes they might take a walk around school with their, teacher, and I might suggest that they wear la little backpack. So, and you could put a book or two in the backpack and that gives them some weight through their shoulders as well. And when you're getting that weight through their shoulders while walking, you're getting what we call pro-perception into their body and that's regulating on their nervous system. I might get them to do things like wall pushups as well. So that's where you literally put your hands on the walls and your arms are out straight and then you bend your arms, and your nose goes towards the wall like a pushup and you might try and do 10 of those. And again, you are getting your muscles to work and that comes back to that fancy word pro perception.

Rachel Horner (28:38):

And when you get their muscles working hard and they get pro percept, it helps to regulate their nervous system. And then what you might find is if they do some of those activities and then they come and sit back down at their table, they are ready for learning again because they've regulated your nervous system and they can focus again. So it's just about putting little things in throughout the day that help them to regulate their nervous system so they can focus.

Dr Olivia Kessel (29:09):

It's almost like pressing the reset button. So pro perception is making you aware of your surroundings and making that motor connection in your nervous system and resetting it so that then you're able to concentrate and sit down and do the task that is expected of you from school. So it's a clever tool to be able to not end up flicking your pen around or going to the toilet or doing things that aren't constructive

Rachel Horner (29:37):

Yeah. And there are other things that you can put into place as well, like sitting on a wobble cushion or a move and sit cushion, which is basically a cushion that's got some air in it and they usually have some little bubbles on as well. And that gives you some feedback into your body and helps you, if you're a bit fidgety, to get a bit more input. It can just be help with their attention and focus and their posture as well. You might give them fidget toys, or even an individual desk screen if they're the type of child that's always looking around the room and really easily distracted by the other things that are going on in the room, you might just need to block out a little bit of that visual input. So you're not separating them from class because you wanna be as inclusive as possible, but limit the amount of stimulus that is going into them, which is highly distracting.

Dr Olivia Kessel (30:39):

It's overwhelming them. So decreasing the amount of input so that they can then concentrate more. That makes a lot of sense. And again, easy to do. You know, funnily enough, my daughter had a wobble cushion as well and one of the biggest challenges was they couldn't keep air in it. You know?

Rachel Horner (30:57):

No <laugh>

Dr Olivia Kessel (30:58):

You have to also make sure that the school is using the tools correctly in the school. Those are really easy simple things to implement. I guess it would be hard if you had a classroom of 30 children and 30% of them need to do this movement break. do classrooms ever do it with everyone in the classroom or is it specifically geared to a particular child in your experience?

Rachel Horner (31:34):

Again, it varies from school to school. And I would say when you are in the lower years of reception - year one, year two-, you might find that they have some more movement breaks. Sometimes they do these little dance videos as a class, which is quite sweet and then they sit back down and do their work. Typically though these sorts of programs are for a specific child, and it is down to the school to try and support implementing it. And all we can do is really go in and train them and then say why it's really important and also try and make it as easy as possible. Because schools are under a lot of pressure and they've got a lot to fit in the day. So we try and make it as easy as possible for them.

Dr Olivia Kessel (32:26):

So it's easy to implement and there is no barrier to having it happen. That makes sense.

Rachel Horner (32:32):

Yeah. But actually I think it's important to understand why we're doing this because if we don't put these strategies in place, that child's gonna struggle to learn anyway. So it's so important.

Dr Olivia Kessel (32:46):

It's almost like the precursor to being able to learn is to be able to get the nervous system in the right place. And that's what your techniques are doing - getting the body and the nervous system in the right place to be able to concentrate and to to learn. That's fantastic. Those are really helpful tips. And I guess the final scenario is helping children to do things that are appropriate for their age. Like getting dressed or brushing their hair or any of those things that maybe your child isn't doing or what other children are doing in your friend's circle, you know. How can you help parents who are still struggling?

Rachel Horner (33:33):

Yeah. Sleep!

Dr Olivia Kessel (33:34):

Another big one, you know, my child still doesn't sleep through the night.

Rachel Horner (33:40):

Yeah, that's a really tough one, isn't it? Especially when you're all exhausted. So again, there's lots of different strategies you can use to help develop your self-care skills and your independence. And obviously depending on what's going on we would then change what we would recommend. But in terms of some simple ideas, if your child is struggling to learn how to dress themselves, it might be helpful to have some visual aids so then they can see the sequence of what they're supposed to be doing. And i could share some websites with such resources.

Dr Olivia Kessel (34:26):

Yeah, anything that would be of helpful, please tell.

Rachel Horner (34:35):

Okay, so there's a fantastic website called Twinkle. And they have so many resources. A lot of schools use Twinkle and I use it all the time too. And you can get lots of visual aids from there, including the sequencing of dressing. So, you've got to put your pants on first, then trousers, then your t-shirt, then you jump that sort of thing. And it breaks it down and makes it really easy. So if you have that out in front of the child, you can work through the sequencing of dressing together. You might want to also have a little reward chart which motivates them to give it a go.

Rachel Horner (35:28):

And if they manage to do their own dressing everyday, then they get a reward that's suitable for within your family, whatever that might be. But you could also put up a reward chart to to help them track their progress with self dressing or whatever it is that you are working on at the time. There's a technique we quite often recommend, it's called backward chaining. So if your child was struggling to learn how to do zips, what I would recommend is that for a start, I would practice doing the zips when they're not wearing their coat or their jacket or whatever the item of clothing is. I'd put it down in front of them on the table, or on the floor if you're sitting on the floor.

Rachel Horner (36:27):

And then I would start the zip for them. So that's usually the trickiest bit - starting the zip. And then I'd start it just a little bit for them and then I'd get them to pinch the zip with one hand and then hold the clothing at the bottom or the other hand and then pull the zip up. So they're doing the easiest bit - that pulling up bit at the very end. And that way they get to complete the task. It gives them a sense of accomplishment and confidence and it's the easiest bit as well. And they've learned that bit. So once they're doing that really well and really easily, then I would get them to do the next bit, which is putting the two zip pieces together into class. Just get them to practice that bit. So you are really breaking the task down into these little manageable stages and you are getting them to finish the easiest bit first and then working backwards, if that makes sense.

Dr Olivia Kessel (37:37):

Makes total sense. And it gives them the confidence and then you feel like you're winning instead of in a struggle which can't be overcome. So it changes the whole mentality I would imagine.

Rachel Horner (37:49):

Yeah. And buttons - which is another really tricky one for a lot of children - I would start the buttoning for them. So you put half of the button through the hole and then you get them to use their fingers to pinch the button and then pull the rest of it through. So you've done half of it for them already and they're just doing that fine a little bit. And then you just work backwards and they do the little bit before or after. You keep doing it that way and work on big buttons before you work on small buttons because bigger buttons are generally easier.

Dr Olivia Kessel (38:30):

It makes so much sense, breaking it down into the smaller components so that it's doable. That's fantastic advice.

Rachel Horner (38:42):

Yeah, so that's just a few dressing tips. On cutlery skills, I would say commonly children struggle to know how to grasp cutlery, especially adult cutlery, which can be quite slim. So you can buy children's cutlery, which is molded to their hands. it's got a curve in, fits nicely in the palm of their hand and it usually has a little indent at the top of the cutlery, so they know where to put their index fingers. So it's, really a lot clearer on how to hold the cutlery. And then they could practice with either some play-doh or something during playtime. You could put your hands over their hands so you can guide their movements.

Rachel Horner (39:38):

We call that hand over hand. You literally poke the play-doh with one hand with the fork and then use the knife to cut it up. So you are breaking it down, you're putting your hands over theirs so they can learn the motor action. Moreover, the child-friendly cutlery is a lot easier to hold than adult cutlery. And when it comes to transferring that to meal times, get them to practice that with the soft food. It could just be some mashed potato. Don't expect them to do difficult food just yet. It's always about making things as achievable as possible. Like we were saying at the beginning, it has to be just the right challenge, so it's achievable.

Dr Olivia Kessel (40:39):

And, I think oftentimes I will cut up my daughter's food because it's easier and quicker. But it's finding those opportunities where you're not in a stressed environment. It maybe dinner time or even just before bed or in any a non pressurized environment.

Rachel Horner (41:03):

Yeah.

Dr Olivia Kessel (41:03):

Because sometimes you feel it's easier to do it yourself, but actually you need to take that time and be patient for them to get to the place where they're comfortable to do it in those small steps. So I think that is something I've had to tell myself as well, that even though sometimes it's easier to do it for my child, it's better to take the time and to use these techniques that you're talking about to actually get them to be independent and be able to do those tasks themselves. But it's a long journey. It's not something that happens overnight depending on how much of a challenge it is.

Rachel Horner (41:35):

Yeah, exactly. And you hit the nail on the head when you said independence. And that's what we're looking for at the end of the day, for our kids to be able to grow up and be as independent as possible. So unless we give them that opportunity to learn those skills, how can we expect them to become independent adults. It does take some patience and time.

Dr Olivia Kessel (42:02):

I think that's the best thing about being a parent actually, - my levels of patience have grown so much compared to where they were before I had a child. And that's a great thing, to learn how to be patient. So those are some really practical tools and techniques I think that everyone can use. And what I will do after this is I'll get some of the handouts that you've mentioned that you have and I'll put them on the website so people can come and download them themselves so that they can get all this information if they're experiencing these challenges with their children.

Rachel Horner (42:36):

Yeah. Sure.

Dr Olivia Kessel (42:37):

Excellent. And as we wrap up the show today, if there were three key takeaway points that you could give to parents, what would they be?

Rachel Horner (42:51):

Anything at all?

Dr Olivia Kessel (42:54):

Anything.

Rachel Horner (42:56):

That's a good question. One that comes to mind is - encourage your child to be as active as possible. I know it's really hard, but I think going to the park and getting outside and playing with your friends or, going to the playground are so important. And it's all too easy for all of us to sit on the sofa and watch TV or play computer games and there's a time and a place for that. We all do need to relax and unwind, but I think having that outdoor time and going to play outside is hugely important and beneficial for so many reasons. I would also say, try if you can, to not rely on screens too much.

Rachel Horner (43:59):

I think when you can allow your child to have times when they get a bit bored or they have to try and use their imagination or, they play with the toys that they've got at home, they're going to develop their imagination, they're going to develop their fine motor skills.

Dr Olivia Kessel (44:48):

Good for those neural networks in the brain,

Rachel Horner (44:50):

So yeah, I've probably blended all three together there, but I would say, don't be afraid to get a bit messy. Try not to rely on screens if you can and allow your child to just have that time where they are having to think things up themselves, what are they going to do and problem solve for themselves. And every child is a bit different and some children do need a bit more support and structure than others. But try not to rely too heavily on screens.

Dr Olivia Kessel (45:33):

I think that's really good advice and everything in moderation and making sure that there's such a varied experience that kids have. It goes back to our earlier point. If you fire it, you wire it. So having a time for screen, a time for being outside, a time for getting messy, a time for imagining their play. And the more that you can have that total experience, the better our brains and our mental wellbeing will be. And, it's good advice for parents as well as children. Because we sometimes don't find the time to get out and have a walk or do different things. So it's good advice for everyone I think. So I wanna say thank you so much Rachel for coming on the show. It's been really enlightening and you've really given some practical tools and tips that I think a lot of parents can use at home with their kids. So thank you.

Rachel Horner (46:23):

It's my pleasure. It's been great. I hope it's been helpful.

Dr Olivia Kessel (46:26):

It's been very helpful. Thank you very much,

Rachel Horner (46:29):

Okay, thank you.

Dr Olivia Kessel (46:32):

Thank you for listening. Send Parenting Tribe. Please follow us on Instagram and Facebook or directly through the Send Parenting website. We would love to hear your comments about the podcast on the website. You'll also find links and some downloadable fact sheets with tips and tools that Rachel mentioned today. Wishing you and your family an amazing week ahead.