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Self-Regulation and Behavior Flexibility (Birth-teen)

Keeping the parent-infant/child relationship in the forefront of all interventions, my goal is to develop strategies to help regulate fussiness and crying, sleep disturbances, difficult feedings and behavior difficulties throughout the developmental stages. Children will learn strategies to regulate their emotions and become more flexible in their responses to others.  Parents will learn practical tools to understand what their infant or child is communicating to them through his behavior and gain skills to help them more effectively manage their feelings and behaviours. The result is a more relaxed and connected family experience.

Feeding Evaluation and Treatment (Birth - teen)

Most feeding issues have a sensory, oral motor or medical component, which have in turn shaped the child’s response to eating and the parent’s response to feeding. Only a very small percentage of feeding issues are exclusively behavioral. The goal of a feeding program is to develop a safe, nutritive, feeding routine to restore peaceful and enjoyable family mealtimes.  Difficulties with breast and bottle feeding are addressed in the newborn and infant populations. Oral muscle tone, positioning and nipple shape are some of the areas we will consider in building a more satisfying feeding experience for mom and baby.  Picky eaters vs. problem feeders are assessed in babies and children having difficulty transitioning to solid foods and age appropriate textures. Using DIR/floortime, Talk Tools, SOS and Mealtime Connections feeding techniques, a full feeding history and oral motor evaluation will be performed. Pre-feeding exercises, therapeutic feeding, sensory-based diet shaping and nutritional concerns will be addressed. Parent instruction, demonstration and feeding practice will be provided. I work in conjunction with dieticians, GI specialists, speech-language pathologists, and lactation consultants, as necessary. Written reports are provided to parents and referring specialists upon request.   

Developmental Evaluation and Treatment (Birth – 5 years)

In-home evaluation of; cognitive, language, fine/gross motor, adaptive, visual-motor, social-emotional and sensory processing skills. Nationally recognized, standardized assessment tools, as well as clinical observation and parent interview are utilized to determine the extent of delays. A variety of developmental challenges and diagnoses are appropriate for OT referral including but not limited to; fussy baby or colic, gross and fine motor delay, visual-motor difficulty, feeding difficulty, Sensory Processing Disorder, Down Syndrome, Cerebral Palsy, genetic syndromes, Autism Spectrum Disorder, ADHD, Anxiety, and Depression. If ongoing OT treatment is recommended, DIR/Floortime informed, neurodevelopmental and sensory techniques are incorporated, as appropriate. Attachment and relationship building treatment strategies are employed. Parents are invited to be present and active throughout treatment. I regularly interface with other team members involved in the child’s treatment. Detailed recommendations, goals and any appropriate referrals are provided. Written reports are provided and thoroughly reviewed with the parent and referring specialist upon request.

Bewildering Babies (Birth-1 year)

Your baby seems hard to settle and is most often fussy. Some babies are not predictable and never seem to develop a rhythm or pattern, making it quite difficult to soothe them. Some babies seem to be very light sleepers, sensitive to every sound and may require an extended bedtime ritual to get them to sleep or to stay asleep.  Other babies only relax when held in very specific positions. Others may always seem uncomfortable after feedings and may be suffering from reflux or other gastrointestinal problems that make them difficult to calm. If your baby seems difficult to figure out or seems overly sensitive in nature, it is not likely anything that you are doing wrong.  Some babies seem to have very sensitive nervous systems and may interpret sound, light, touch and movement differently than most. There are techniques that you can learn to help your baby become more regulated and calm. I will gather a detailed history about your baby’s behaviors, observe your baby over a few sessions and together we will find strategies that will calm your baby and make your time together more relaxed and enjoyable. These techniques will allow your baby to be more relaxed and subsequently more available to explore his environment for learning. Routines will slowly emerge that you can predict and gradually, life with your little one will be manageable and more joyful.

Sensory Processing Evaluation and Treatment (Birth - teen)

Differences in sensory processing can disrupt a child’s learning, behavior and social interactions. It may significantly affect a child’s ability to concentrate and pay attention in school. Often times it is confused with overlapping symptoms of ADHD, ASD, oppositional defiant disorder, anxiety or depression; making a clear diagnosis complicated. A child may be over or under responsive to stimulation like sounds, touch, or vision which may alter a child's behaviour. He may not respond when you call his name, ignore requests to stop a behavior, be irritated or bothered by sounds or touch and seem to tantrum more frequently than other children his age. Alternatively, he may have difficulty with movement, balance and awareness of his body in space, which affect his ability to navigate the environment in a coordinated manner. As a result he may be frightened of swinging or climbing or may bump into objects in his path, not understand personal space, give a friend a hug that is a bit too harsh or avoid physical contact with others.  Through parent interview, clinical observation and standardized assessment tools, each sensory system is evaluated and a treatment plan devised. Evidence based, relational and sensory play techniques are utilized to help your child gain control over responses to the environment, and in turn, changes in behavior and functioning are noted. Reports are provided and reviewed with referring specialists upon request. Communication with parents during the treatment process is ongoing and regular.

Handwriting/Prewriting /Fine Motor Skills (Birth - teen)

Utilizing a variety of fun techniques, including the Handwriting Without Tears program model, fine motor skills are addressed in order to help children use their fingers and hands for function. All areas involved in preparation for functional activities of daily living and writing are addressed. For example; reaching and grasping toys, building strength and coordination, using appropriate force, touching a variety of textures, understanding body position, scissor skills, using feeding utensils to self-feed, pencil grasp, and formation of shapes and letters.

Facilitated Playdates (3-teen)

Are you concerned that your child does not have regular playdates or when they do, are they fraught with conflict or tears? Successful play and social skills are essential for building your child’s self-confidence with peers over a life span. Many parents experience stress and disappointment after playdates, saying that their child does not want to have playdates or are often unhappy after playdates. Sometimes children need assistance in choosing appropriate activities, assistance with social conversation, help navigating the expectations and feelings of another child and taking turns. At times, children need guided intervention to make playdates go more smoothly.  I will supervise a 2 hour playdate that has been pre-arranged by a parent. Prior to the playdate we will spend time together choosing an appropriate playmate, choosing the timeframe and selecting a few activities to ensure success.  The playdate will take place at the child’s home after the preparations have been made. 

Integrated Listening Systems (iLs) (3-teen)

I am a certified iLs clinician.  iLs is a complementary approach to brain fitness which can be integrated into a broad variety of educational, therapeutic and self-improvement programs. In the same way we can train our bodies to become stronger and healthier, iLs trains the brain to process sensory, cognitive and emotional information more effectively. We start with music and movement, and then gradually integrate language and cognitive processes. The exercises appear simple but become increasingly difficult as we add new layers for simultaneous processing. The program involves no computers or screens of any type. It simply involves wearing headphones and listening to classical music, while participating in fun movement activities. I will evaluate your child to determine if iLs is the right approach for their unique needs.

Toys, Tools and Techniques (Birth -5 years)

There are a confusing number of toys and therapy tools available on the market. I will coach parents in making informed decisions about purchasing developmentally appropriate toys and assess the benefits of a therapy tool or technique for your child’s unique needs, prior to you purchasing expensive equipment. I will coach you to help you engage your child in play, and how to effectively use your natural environment to promote development. Occupational therapists are experts at analyzing play, toys and therapy tools.

Referrals, Teacher Consultations, (preschool and Kindergarten) and Community Resources

Having a longtime presence in the Los Angeles community and excellent relationships with many pediatric professionals, affords me the opportunity to assist parents in identifying appropriate services that suit their child’s unique needs. Upon request, I meet with a child’s teacher to assess social, sensory and academic skills in the classroom environment and discuss manageable accommodations that will enhance school success. Teacher workshops are also available.

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