Greg Santucci Top 5 Questions I Often Hear as an Occupational Therapist

Greg Santucci demonstrates an occupational therapy activity with two children.

We are happy to introduce you to Greg Santucci a pediatric occupational therapist with over 20 years of experience who simply loves to play. And he knows the power and value of play in a child’s life. Certified in sensory integration therapy, Greg looks at the “why” of any behavior issue both at home and at school and partners with both to help the child function well in society and the activities of daily life.

Play is an integral part of any therapy for Greg and that is why we asked him to share with us his top 5 toys that he uses in therapy. You can easily find all of Greg’s top choice by looking for the therapist’s approved/thumbs up logo.

We also asked Greg to share with us the 5 most asked questions that he gets when doing his presentations and seminars for both parents and professionals alike.

Enjoy the information from a therapist who considers it an honor to be able to work with any child that he can help.

How can I better understand my child’s sensory needs?

Parents often seek the advice of an Occupational Therapist when their child presents with sensory processing challenges. Every piece of information we get from the world comes in through our senses. So yes, it’s very important to understand your child’s sensory needs and preferences. Since we all process sensory input differently, it’s also important not to impose YOUR sensory experiences onto your child. For example, if you think something is NOT spicy, they may think it’ VERY spicy. You may think it’s cold outside, but they may not. Validating your child’s unique sensory preferences are a great starting point for understanding how they process sensory input, and it’s a great way to build a relationship based on trust. If your child is unable to tell you that they don’t like the way something tastes, sounds, or feels, their behavior is a window into their preferences. For example, if they’re holding their ears when you walk into a store or a room with a lot of people, the auditory environment may be overwhelming for them, and their challenging behavior may be a signal that they don’t feel safe. Facial expressions, a change in their tone of voice, a red face, changes in visual attention, or changes in breathing rate are all stress cues that can let you know that they’re having a hard time in the sensory environment they’re in. Notice them. Validate what they are feeling and work together to solve the problem of creating a more sensory safe environment.

How do I get them to listen?

I get this question A LOT! It seems that the reaction from most parents is that if your child isn’t listening, just repeat the demand many, many times, and get louder each time. Then, when yelling doesn’t work, they threaten to take away something they love and force them into compliance. Parents think that this technique may “work” (for them), but it’s not a long-term solution. It’s a power grab that endangers the relationship with your child and there are healthier, less threatening options.

Before answering why the child isn’t listening. I want to know when they aren’t listening. Are they distracted or focused on something else? If a child “isn’t listening”, then assume their auditory sense isn’t their most efficient sensory channel right now. When that’s the case, change the channel! For example, if you’re telling your child to put their shoes on over and over and they’re “not listening”, stop relying solely on their listening skills to communicate your expectation. If you approach them (they “see” you- the visual sense) and you hand them their shoe (they “feel” the shoe- tactile) and then ask them. You’ll have a better chance for success, with less yelling or repetition. So, if they’re not listening, change the sensory channel.

He loves to play, but I have a hard time getting him to play a game the right way and follow directions. What can I do?

There’s not really a “right way” to play. Dr. Jacqûelyn Fede, an autistic researcher and program evaluator from Autism Level Up, gave a great example in a recent social media post about how society gets hung up on expected routines and playing games only as intended. She used Mr. Potato Head as an example: A parent or teacher may notice when a child takes out a container of Mr. Potato Head pieces and begins lining them up. Since that’s not how the toy is typically played, the adults start becoming concerned because lining up toys may not be considered ‘functional play’. Dr. Fede clarified that the expectation of sticking human appendages into a plastic potato was considered “functional,” but lining the appendages up to examine them is concerning? Meet kids where they are with play. Let them lead. You may discover entirely new ways to play by letting go of social expectations and allowing their creativity and curiosity to guide what happens next.

Link to post here: https://www.facebook.com/AutismLevelUP/posts/854182542082643

He has so much energy! How do I get him to calm down!

If your child is a “sensory seeker,” they may need a lot of vestibular (movement) and proprioceptive (muscle and joint) input in order to meet their sensory threshold. When they meet threshold, you will see that they’ll have an easier time sitting down, focusing, learning, and meeting expectations. If they’ve not met their sensory threshold, then they’ll have difficulty meeting expectations. That’s not a behavioral issue, that’s a regulation issue! I find it very helpful to talk to kids about their “energy” levels. I’ll ask them what their energy level is at that moment. Often, I will use numbers from 0 to 100, or colors (ike red for high and blue for low). Then, I will ask them what the energy demand for the task is. If they report their energy is 100, and it’s bedtime (an energy requirement of zero), that’s a mismatch! So, I’ll ask, “What can we do to get a match?” Solutions could include reading a book under the covers, playing flashlight tag in a dark room, or snuggling under a heavy blanket.

High energy is not always bad, though. You need high energy for a soccer game or gym class. However, that high energy may not work in the library, or during a reading block in class, when the energy requirements are much lower. Including your child in the problem-solving process is a great way to teach them about their bodies and provide them the regulation tools so they can meet daily expectations. If you child is unable to verbally communicate, you can still use the energy level mindset to get their bodies and brains in a regulated state for optimal participation. Some may be thinking, “if my child gets a little movement, he goes from 0 to 100 instantly and he’s difficult to settle”. This isn’t uncommon. Sometimes, a child mobilizes because of a physiological sense of threat. Something may be unsettling or difficult for them, and the movement is their way of communicating that they’re stressed. While they may appear to be a “sensory seeker”, movement may be too dysregulating for them. This is also when talking about energy levels is beneficial. If they are too amped up, notice that they’re having a hard time and talk about other, more calming, sensory strategies that can help them get regulated and participate at their highest level of ability.

He plays so well in OT, how do I get him to play with other kids?

Feeling safe, both physically and physiologically, plays an enormous role in socialization. If a child feels safe and is interested in an activity, there’s a better chance that they’ll be able to socially engage and participate in play with other people. That being said, other children can be very unpredictable. In order to limit the unpredictability, you’ll often see children try to control the situation with whatever skills they have. They may not share toys, wait their turn, and they may even get upset and lash out when something unpredictable happens. All of this is an indication that they don’t feel safe, and they need our support. Dr. Ross Greene, a psychologist and founder of the non-profit organization Lives In The Balance, reminds us that “Kids Do Well If They Can.” Doing poorly does not work out better for them, so if a child is having a hard time or behaving in a way that you consider less than optimal, always remember that they would prefer to be doing well. That’s when they need our support the most. So, if your child is having a hard time playing with other kids, be there with them. Model socially appropriate behavior. Help them navigate social situations. Over time, with these new skills, they will improve their social engagement.

Have more questions for a Pediatric Occupational Therapist? Follow Greg Santucci, Occupational Therapist, on Facebook and Instagram or go to gregsantucci.com for more information.

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https://www.parentingspecialneeds.org/article/top-5-favorite-toys-in-his-bag-of-tricks-as-an-occupational-therapist/

https://www.parentingspecialneeds.org/article/dr-cherina-williams-therapist-approved-toy-and-gift-ideas/

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This post originally appeared on our November/December 2021 Magazine

Greg Santucci Top 5 Questions I Often Hear as an Occupational Therapist

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