As Children Blossom Therapy Center

Pediatric Speech/Language and Occupational Therapy

(408) 866-4700

Lisa R. Worrell, M.A, CCC-SLP
Jodi E. Huber, M.A., OTR/L
621 E. Campbell Avenue Suite 11A Campbell CA 95008


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Do you use the TV or iPad to get your child to eat?


The toddler years can make you feel desperate. One minute they enjoy food, the next they’re rejecting everything you offer them, and the word “yuk” and “no” feel like they’re on repeat. 

It is often during this time, that I see parents using “distraction” techniques in an attempt to get their child to eat. By distraction I mean doing things like allowing them to watch their favourite TV show, propping an iPad up at the table, or allowing books and toys to be played with whilst they eat their meal. 

And do you know what? It can work for a while, but what are the consequences of doing this, and what are you really teaching them?

Did you know that all children are born with the ability to regulate their appetite and consequently their energy intake? Studies in healthy young babies have shown that if you increase the calorie strength of their infant formula, they will simply decrease the amount of formula they take. It makes sense really. To survive as a species, our bodies need to have some inbuilt ability to know how much energy we need. This is what our appetite is. What’s interesting, is that whilst we know babies can self regulate their appetite, studies have shown that by the pre-school years many children display “non hungry” eating behaviours. In other words they have learnt to eat in the absence of hunger and are not responding to their appetite. How does this happen?

Non hungry eating is a learnt behaviour that evolves from the environment around us. It occurs when we learn to associate eating with other things. It can come from very simple experiences. For example has your child ever hurt themselves and you’ve soothed away their pain by offering up an ice block or some other treat? Or perhaps you’ve had the opposite experience and rewarded your child with a treat because they excelled at something? These simple experiences repeated over time start to teach us to use food in a way that isn’t linked to our appetite.

Going back to using distraction techniques at the dinner table, what you are really teaching your child is to eat to an external cue, not to their appetite. Your child is learning to eat mindlessly and is far more focussed on the tv or iPad. But I can hear many of you crying “but it works, they stay at the table and they eat!”. Well yes it can. Providing something enjoyable at the dinner table (tv) will certainly be more likely to get them to stay there. But let’s be clear, they’re there to watch tv, not to enjoy the food or your company. If your long term goal is to have your children willingly coming to the table and participating in the family meal, this approach isn’t going to solve it.

Far and away the biggest concern with offering a distraction at the dinner table is the fact that it doesn’t allow the child to properly listen to their appetite. As I’ve already explained, young children can be very good at self regulating and will eat when they’re hungry and stop when they’re full. Allowing them to watch tv or do other activities whilst they are eating, erodes this ability, and over time contributes to non hungry eating. This is a risk factor for becoming overweight or obese. Teaching your child to listen to their appetite is probably one of the best things you can do early on to set them up for a lifetime of healthy eating.

So how do you get your child to come to the table, stay there and eat? This is the million dollar question isn’t it? First of all you need to think about the reasons that your child is not coming to the table or wanting dinner. For young children the reasons for this can often be that they are simply not hungry or they are just too tired. If your child is healthy and growing, you need to trust that they know how much they need to eat. Our expectations as parents often need checking as well. Most parents I have interviewed serve their child far too much food. Toddlers are strange creatures and can adopt all manner of eating patterns. One Mum recently told me that her 2yr old eats breakfast and then doesn’t eat again until dinner. Many toddlers are very good at going for several days eating very little to then have a few huge days of eating. These are all frustrating experiences for us as parents.  As always I recommend that you adopt a “division of responsibility” around feeding. That is you decide what, when and where your child is going to eat and then it’s over to them as to whether they are going to eat it at all, and how much of it they are going to eat.

You have no way of knowing how hungry or full your child is. Don’t ask them to have a prescribed number of bites or “clean their plates”. This is reinforcing not eating to their own natural appetite and over time can erode their ability to tune into it. 

So if your child only eats a teaspoon at dinner try not to obsess over it. I’m going to finish by quoting the guru of infant feeding, Ellyn Satter “Be happy with what you serve, not what they eat”. 

A word on feeding disorders in infants and children…

I’ve written above that all children are born with the ability to regulate their appetite, there are however, some exceptions to this.

Infants or children that experience medical problems early in life can often get off to a horrible start with feeding. These experiences can completely destroy their ability to regulate their appetite. 

For example I have worked with many premmie babies who have required nasograstric feeding from birth to survive. Being in a hospital environment, these babies are usually fed to a schedule with quantities and times dictated by dietitians and nursing staff. Whilst every effort is usually made by staff to try and adapt the feeding regime to how they see the baby responding, it is simply not the same as feeding the baby on demand and to their appetite. There may also be traumatic oral experiences such as orogastric or nasogastric tubes being inserted multiple times, oral medicines, ventilators etc etc, all of which can contribute to making a child what we call “orally averse”. That is, they don’t want anything (even things we think of as pleasant such as food), anywhere near their mouth.  Other children with severe sensory issues or Autism, can also find eating such a challenge that this overrides their instinct to tune into their appetite.

These children are HARD work to feed. Whether you are trying to wean your child off a feeding tube or avoid having one inserted, it has probably made you stressed and anxious, and willing to try anything to get your child to eat. In many instances, parents find they can get a little more in if they let their child watch tv. Unfortunately while this appears to work in the very short term, it’s not solving the underlying problem, which is allowing this chid to reconnect with their natural appetite. If you are struggling with a child with extreme eating behaviours, we would still recommend not using tv or other distraction techniques at the dinner table. This just puts another barrier in place which prevents your child from learning how to self regulate their appetite. 

If you are struggling with a child with a severe feeding disorder get in contact and we will try and point you in the right direction for help.

Julia @ Bloom


 Why Children Aren't Behaving, And What You Can Do About It



Directions to make a weighted blanket


Parent training/community resource website links:

American Speech-Language-Hearing Association | ASHA

California Speech-Language-Hearing Association > Home 


5 Research-Backed Benefits of Weighted Blankets and Vests.

Weighted blankets and vests have been around as a therapy tool for a while now. Many parents have observed the calming effect they can have on children with autism and sensory issues. The science behind these weighted items is called Deep Touch Pressure (DTP). This is the term for the feeling of gentle, distributed weight on the body.

You can get the benefits of DTP in a variety of ways. Hugging is one way that everyone can experience DTP. Weighted vests, blankets, stuffed animals, or lap pads are all ways to get the benefits of DTP. As long as there is gentle, distributed weight, there will be benefits from DTP.

Research into the benefits of DTP can help you find new ways to help your child with weighted items. It may also be helpful in convincing your child’s school to take these tools seriously and make them part of your child’s behavior plan. The following are some areas on which research has focused.

1. Promoting and Improving Sleep

Benefits of Weighted Blankets: Improving and Promoting Sleep

Weighted blankets have been shown to increase serotonin in the body. Serotonin is an important chemical that helps regulate mood and ease relaxation. It’s been shown that children with autism are low in serotonin. This could be one of the reasons why they see so much benefit from weighted blankets.

Serotonin is necessary to create melatonin, a chemical that tells your body when it’s time to sleep. Your body produces melatonin based on the timing of your sunlight exposure and uses that as a schedule to help your body know when it’s time to relax.

Nervous system changes

On top of the chemical changes, there are changes in the nervous system when using weighted blankets. Our nervous systems calm down when under the weight of a heavy blanket. This can be a major help for those who can’t fall asleep due to anxiety.

The weight of the blanket also helps reduce restlessness during sleep. It is harder to move around while under a blanket of the right weight. The general rule is that the weight of the blanket should be 10 percent of the individual’s body weight plus a pound or two.


A weighted blanket could perhaps be the non-pharmaceutical answer to getting a solid nights sleep for those struggling with insomnia. One study found that not only did participants with insomnia feel like they got “a more comfortable, better quality, and more secure sleep,” but the data from tracking their sleep showed they got better sleep as well.

2. Improving Focus in the Classroom

Benefits of Weighted Blankets: Improving Focus in the Classroom

There are quite a few studies that show that using DTP in the classroom can help improve children’s performance. One study found that children with ADHD improved their in-seat behavior, attention, and task completion while wearing a weighted vest.

Another study looked specifically at fine motor activities like writing and found that DTP had a positive effect on on-task behavior. It’s also been shown that children with autism specifically have better in-seat behavior when using DTP.

Self-Stimulatory Behaviors

Weighted vests have been found to reduce self-stimulatory behaviors, also known as fidgeting or stimming. There are many reasons why a person might engage in self-stimulatory behavior, but one of the main reasons is that they are feeling sensory overload.

Whether used in therapy or at home, a weighted blanket is a great addition to a sensory room. The extra weight adds a sensory input that allows people to feel their body. For those with sensory issues, not being able to feel where your body ends can be a challenge.

Use in Long Sitting Situations

A lot of times, simply getting your child to sit still can be a struggle. Whether it’s for a presentation, assembly, movie, or just a car or bus ride, getting your child to sit calmly can often feel impossible.

For these situations, a weighted blanket would be a great option. Not only would it help calm the nervous system and release serotonin, but the sensory input of the fabric could give your child something to play with for an extended period of time.

While you could bring a weighted blanket with you wherever you go, this would be a good time to have a weighted lap pad on hand. Since you’ll be out and about, we’d recommend getting a blanket or lap pad that is easy to wash.

3. Reducing Anxiety

Benefits of Weighted Blankets: Reducing Anxiety

This may be an overall theme to all of the other benefits of weighted blankets. A lot of them stem from the fact that weighted blankets have been shown to reduce anxiety.

One study looked specifically at dental patients and used weighted blankets as a way to reduce their anxiety in a high-anxiety situation. The study showed that the weighted blanket caused physiological changes on the patients’ nervous system, helping them feel calmer at the dentist.

Another study found that even short periods of DTP brought about a reduction in sympathetic arousal, which generally means a calming-down effect. If anxiety is an issue for your child, a weighted blanket could be a good tool to have on hand.

Obsessive-Compulsive Disorder

One of the common ways to help alleviate OCD anxiety is to improve serotonin production through pharmaceuticals. However, since weighted blankets have been shown to improve serotonin production, they can be used to help alleviate OCD anxiety as well. There are a lot of disorders that are related to low serotonin in which a weighted blanket could be useful, including depression, aggression, PTSD, and bipolar disorder.

4. Calming Meltdowns

Benefits of Weighted Blankets: Calming Meltdowns

If you’re raising a child with special needs, meltdowns are something that you will most likely have to deal with. Whether due to sensory overload or an unexpected change, meltdowns can be very difficult to deal with.

Fortunately, a lot of what we’ve already talked about can be related to meltdowns. Calming the nervous system, producing serotonin, and feeling a “hug” from the blanket can all help wind down a meltdown or even prevent it.

A related study found that the use of a sensory room led to significant reductions in distress and improvements of disturbed behaviors of individuals in an acute inpatient psychiatric unit. They specifically mention that those patients who “used the weighted blanket reported significantly greater reductions in distress and clinician-rated anxiety than those who did not.”

5. Making Transitions Easier

Benefits of Weighted Blankets: Making Transitions Easier

Struggling to get children with autism to change from one activity to another is a common theme among teachers and parents. In some special education classrooms, teachers have turned to weighted blankets to help make this transition easier. It works especially well when coming in from recess. The teachers give the children who need extra help a weighted blanket and dim the lights for five to ten minutes.

This is one of the practices that the University of Washington Autism Center helps implement in schools around the state of Washington. The strategy can be used at home for when your child comes home from school or inside from playing, or has just finished an activity and is overexcited. Since children with autism tend to do better with transitions when they have a routine, you can even work the weighted blanket into the routine. Let them know it’s time to transition when you get it out.

To find a weighted blanket or other weighted items to help your child, consult “Weighted Blankets: 13 Stores to Choose From.” Pictured at the top of this post is a weighted blanket in a dotted minky fabric from Harkla.



National Sleep Foundation Completes Rigorous Study and Updates Recommended Sleep Times at Each Life Stage

WASHINGTON, DC, (February 2, 2015)--The National Sleep Foundation (NSF), along with a multi-disciplinary expert panel, issued its new recommendations for appropriate sleep durations. The report recommends wider appropriate sleep ranges for most age groups. The results are published in Sleep Health: The Journal of the National Sleep Foundation.The National Sleep Foundation convened experts from sleep, anatomy and physiology, as well as pediatrics, neurology, gerontology and gynecology to reach a consensus from the broadest range of scientific disciplines. The panel revised the recommended sleep ranges for all six children and teen age groups. A summary of the new recommendations includes:

  • Newborns (0-3 months): Sleep range narrowed to 14-17 hours each day (previously it was 12-18)
  • Infants (4-11 months): Sleep range widened two hours to 12-15 hours (previously it was 14-15)
  • Toddlers (1-2 years): Sleep range widened by one hour to 11-14 hours (previously it was 12-14)
  • Preschoolers (3-5): Sleep range widened by one hour to 10-13 hours (previously it was 11-13)
  • School age children (6-13): Sleep range widened by one hour to 9-11 hours (previously it was 10-11)
  • Teenagers (14-17): Sleep range widened by one hour to 8-10 hours (previously it was 8.5-9.5)
  • Younger adults (18-25): Sleep range is 7-9 hours (new age category)
  • Adults (26-64): Sleep range did not change and remains 7-9 hours
  • Older adults (65+): Sleep range is 7-8 hours (new age category)

“This is the first time that any professional organization has developed age-specific recommended sleep durations based on a rigorous, systematic review of the world scientific literature relating sleep duration to health, performance and safety,” said Charles A. Czeisler, PhD, MD, chairman of the board of the National Sleep Foundation, chief of sleep and circadian disorders at Brigham and Women’s Hospital, and Baldino Professor of Sleep Medicine at the Harvard Medical School.  “The National Sleep Foundation is providing these scientifically grounded guidelines on the amount of sleep we need each night to improve the sleep health of the millions of individuals and parents who rely on us for this information.”








The Little Known Health Risks Of Sitting In The ‘W’ Position



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Image via: Youtube

It is really common to see children sitting in the “W” position, and I have to admit that I always thought that indicated good flexibility.  However, this position can lead to some really serious orthopedic conditions, as it prevents kids from being able to shift their weight and achieve what is called “trunk rotation”.

Not only will this inability to rotate prevent a child from stretching to grasp things out of their immediate reach, but it will have long-term serious consequences.  In order to develop adequate balance reactions, such as the ability to catch a fall, a child needs to have developed this weight-shifting and rotating ability.  These abilities are also integral to crossing the midline, which is necessary for writing.

As children develop, each motor skill that gets mastered is necessary to go on to the next one. If bilateral coordination is interrupted because of constant sitting in this “W” position, this can very well lead to significant delays in achieving other skills, such as: developing hand dominance, skipping, throwing, kicking etc.

Additionally, W-sitting causes actual shortening and tightening of the hip and leg muscles, causing the child to be “pigeon-toed” when he walks.  This will eventually lead to complications of back and pelvic pain as they grow.  The video you are about to watch below will help to explain both the physiological dangers of allowing your child to sit in the “W” position, as well as the impairment to properly developing  motor skills.

Please SHARE this important, little-known information with your friends and family

YouTube Video Link on W Sitting