November’s News


I know November is almost half over.  Well, better late than never, right?

The theme in our office for the month of November is Thanksgiving.  We will be focusing on the holiday for sure, but we will also be intentionally fostering an attitude of being grateful.  Here are some of the fun things that have been happening in the office so far this month.



Here at SenseAbleBrain, we cherish family time.  For that reason we will be closed from Wednesday-Friday the week of Thanksgiving.  We hope and pray that you enjoy the precious moments you get with family!

If you are usually scheduled for therapy on those days, and are interested in rescheduling for Monday or Tuesday, please call to see if we have any available openings.  And if you are usually scheduled for Monday or Tuesday, but will be taking the week off, please let us know!


We are offering a new workshop in December, and it’s unlike anything we’ve offered before!  This will be COMPLETELY unstructured!  We are inviting parents to come and “Ask the OT” questions, and we will engage in thoughtful conversation to provide insight into how their child(ren) are wired, as well as suggestions for tips to help them get through the holidays in peace and harmony!  (Registration is limited due to the conversational nature of the event.)  Register here.


IMG_20161112_075901.jpgWITH GRATITUDE…

Many of you know that I’ve been a little out of touch lately.  My mother has been extremely ill in Maryland, and I’ve been trying to be as available to her and my sisters as I possibly can.  I want to personally thank all of you.  You have all been so supportive and prayerful, and our whole family appreciates it!  Mom seems to have finally turned a corner.  I was able to visit her in rehab this past weekend, and she is regaining strength and balance.  (I can’t begin to tell you how hard it was for me to let the staff therapists do their job without me directing them!)  She still has several months of treatments to go through, but this is progress!  Here’s a picture of my mom working hard in OT on Saturday morning.

~Kim Hazelton, OTR/L


Here at SenseAbleBrain, we are truly thankful for the trust you put in us to help you with your precious children.  We hope that you have much to be thankful for as well.


Introducing Our Newest Team Member!

Sense Able Brain Therapy and Learning Services is extremely excited to announce an addition to our therapy team!  We are honored to introduce Marla Scaglione, MS, OTR/L.marlascaglione

Marla has over 20 years of experience working as an Occupational Therapist.  Her career has included positions in skilled nursing rehabilitation, home health care, acute care trauma center rehab, and serving school-based therapy needs in the homeschool community.  She has been instrumental in helping many children improve their handwriting, learning abilities, and skills for life.

Marla is a homeschool mother to her three beautiful children.  In her free time, she enjoys spending time outdoors with her backyard chickens, gardening, fitness, and camping.

Join me in welcoming her to the Sense Able Brain Team!

Florida Personal Learning Scholarship Accounts (PLSA)- Homeschooling Special Needs Scholarships

Anecdotal evidence points to a growing number of families choosing to homeschool their child(ren) with Special Needs.  This can often mean that the child(ren) are no longer eligible for services they would have been eligible for in a public school setting.  In an effort to offset the disparity in access to therapies, in 2014 the Florida Legislature created a statewide scholarship program to help families who chose to homeschool their child(ren) with Special Needs.  This program is called the Personal Learning Scholarship Account (PLSA) and is administered through Step Up for Students.  There are eligibility requirements and limited funds, which are disbursed on a first come, first serve basis.  The program is in its first year of administration, and I have discovered that they are still working out the bugs.

As a homeschool mom, and as a provider of therapy for traditionally and homeschooled children, I was thrilled to learn of this program!  The mother of a homeschool child that I work with enrolled in the program and became my guineau pig, so to speak, to see if they would actually pay for private therapies.  The test was to see if the parent could be reimbursed for the therapy after paying for it.  (Versus the traditional insurance model where the therapist provides the service, then bills the payor and waits for payment.)

The mother has submitted invoices and 3 weeks later she has not yet received reimbursement.  When I talked to a representative at Step Up for Students today, she assured me that this mother can be reimbursed for services she’s paid for.  This is with the assumption that the services are provided by a licensed provider, and they are the services that the provider is licensed to provide.  (In other words, parents can not be reimbursed for a speech therapist who is providing gait training.)  However, the representative informed me that reimbursement is much faster if the parents request pre-authorization through their online account.   So, pre-authorization is not necessary for reimbursement, but it might speed up the process.

While it could be frustrating waiting for them to iron out the bugs in the system, this is truly a beneficial program for homeschool families.  It is another avenue to allow parents to make truly individualized education plans for their child with Special Needs, and to access often financially burdensome services.

For more information and to receive updates, go to Special Needs Kids at Home and register.

ADDENDUM:  This mother was reimbursed for all of the therapy/groups her son participated in with me.  It took approximately 5 weeks for her to receive the money.  Yay!

PAUSE and YET, They Are the Magic Words

Academics can be challenging for many children.  Repeated frustrations can lead to feelings of helplessness and self-defeat.  “I can’t do this!” becomes a mantra.

When trying to communicate with children, I have often found that words can mean something entirely different to them than they do to me.  Children hear adults tell them to stop doing this and stop doing that so often that it takes on a sinister meaning for them.  They learn to ignore it completely, or they over-react the minute they hear it.

I have found PAUSE and YET to be magical and helpful words when managing these frustrations.  The magic lies primarily in the child’s understanding of the word PAUSE.

Children as young as 2 understand PAUSE these days thanks to the variety of electronics they have available to them.  They get that PAUSE doesn’t necessarily mean STOP entirely.  They understand that it means to temporarily interrupt the activity, to (hopefully) be resumed within a short period of time.

This word is best put into play before hitting full-on meltdown mode.  When you can sense frustration, despair, and/or anger, tell your child to PAUSE the emotion/behavior.  (I’ve actually had children take a step away from their position when they PAUSED, to indicate that they have removed themselves from the emotion.)  Then help them assess the situation now that they are more calm and able to reason it through with you.

While they are in PAUSE mode, this is where the magic word YET comes in handy.  The child needs help understanding that when they say “I can’t do this!”, they need to add a YET to the end of that statement.  I often remind them that they couldn’t do xyz at one time, but now they can.  And even though they can’t do [insert academic challenge here] YET, they most likely will someday.  (I hope it’s obvious that the child may need help figuring out how to tackle the problem and what supports they may need to continue working.  The point here is to help them de-escalate the negative spiral that comes with the frustration so that they can honestly assess their abilities and need for assistance.)

Once you have helped them come to an understanding of what is going on, and you’ve (hopefully) de-escalated the negative emotions and instilled some hope, tell them to hit the RESUME button in their mind.  More often than not, they do not feel the need to resume the negativity.  And if they do, they have definitely lost a great deal of the momentum.  And they are ready to tackle the challenge in front of them with a renewed sense of the possibility of success!

Painter’s Tape and a Bath Mat

IMG_20150224_103923[1]I’ve been working on mature reciprocal crawling and improving tactile tolerance with this little guy. I have learned that he is a huge race car fan and I decided to use that to my advantage. With just some painter’s tape and a bath mat, I created an infinity race car track that goes over “gooey water”. We raced (crawled) around the track several times in each direction with our miniature cars. Each time we got to the bridge over the “gooey water” I’d model “crashing” into the water and landing on different body parts, starting with the least sensitive for him (fully clothed back and hips), and working to most sensitive (palms).

After watching me crash several times, he decided to get in on the fIMG_20150224_103844[1]un! After about 15 minutes, he was able to put his car on the bath mat using his open palm, and I’m hopeful that his hand actually brushed against the bath mat (though it was hard to tell while I was trying to take pictures!). While he didn’t ever actually place his open palm flat on the bath mat, it’s definite that he made progress toward desensitization, and he’s now wanting to explore this texture.

I hope this spurs your imagination as to what you can do with simple household items!

Cutting Curves


When learning to cut curved lines, many children struggle with how far to open the scissors.  Those little hands can have a hard time grading the finger extension required to open the scissor blades.  One way you can help them is to wrap a rubber band around both blades about half way down the length of the blades.  This prevents the blades from opening all the way, while also offering increased proprioceptive feedback for those little hands to be able to better grade their muscle contractions in the future!

Letters from Grandpa

I just got back to my office after seeing E, and I wanted to share what I thought was one of the most heartwarming, adorable inter-generational interactions I’ve been blessed to witness.

I’ve gotten to know this little 6-year-old girl and her family very well over the years, and I know that the grandparents on both sides of the family live a long distance away.  Both sets of grandparents are involved in the lives of their grandchildren.  One grandpa sends a letter in the mail, every week, to each of his grandchildren.  He always includes a small gift with the letter.

A letter arrived from Grandpa while I was there today, and at the end of our session E opened the letter.  She read it out loud, with minimal prompting from Daddy for top-to-bottom sequencing.  Below is a copy of the letter, which also contained a $1 bill.

Grandpa's letter to E

This letter was printed in plain, large font that makes it easier for E to read.  (Studies suggest that Comic Sans is the most easily read font for people with Autism Spectrum Disorders.)  This letter contained things that E enjoys or would be interested in (counting, ants, money, Grandpa).  This letter was black and white, with no major visual distractions.  Sentences were short and direct.

After E read the letter, Daddy questioned her on her comprehension.

E:  “Money!”

Daddy:  “E, who sent you that letter?”

E:  “Grandpa.”

Daddy:  “What animal did Grandpa have in his letter?”

E: “No more questions.”

Daddy:  “Grandpa sent you six….”

E: “Ants.”

Daddy:  “That’s right!  Time to go swimming!”

Wow!  What a beautiful inter-generational conversation they just had!  Grandpa communicated with E in a way that she could understand with minimal assistance.  Daddy supported Grandpa’s communication with his assistance and questions.  E replied correctly to Daddy’s comprehension questions regarding Grandpa’s communication, and was immediately rewarded with what she loves:  swimming!  And best of all, E knows that Grandpa loves her!

How cool is this entire family?!

Visual Schedules

This is a visual schedule for a child that can read.

Many parents, teachers, and therapists are familiar with the Visual Schedule.  Most people use the icons from programs such as Boardmaker, actual photographs of items, or labels from items.  These are routinely laminated, cut out, and attached to a laminated sheet or board with Velcro.

I wanted to share another option with you.  I work with many children who have the capability to read, but still have a need for something to help them with transitions and anxiety.  On a basic level, the above agenda is, indeed, a visual schedule.  I write the activities on a piece of note paper, and as each one is completed, it is crossed off.   Much like a To-Do list.

An added benefit to providing this type of Visual Schedule is having the child cross off each task as it is completed.  I like to have them circle the task, then cross through it with horizontal lines.  This incorporates Visual Motor skills and practice using a pencil/pen within a given boundary, while at the same time reinforcing the schedule.

Visual Schedule after
Visual Schedule at the end of the session.

All activities are completed and crossed through.  The child knows that the therapy session is finished and that it is time to transition to something else.

The Oh-So-Important-Pencil Grip (or maybe not?)

I have worked as a Pediatric OT for 18 years with 10 of them being in the school system.  By far, pencil grip and handwriting (alone or combined with other areas of concern) are the biggest reasons for student referrals to OT in the schools.

But try to tell a teacher or parent that, while the student isn’t using the Dynamic Tripod Grip (the Holy Grail of grips), the grip that they are using is still efficient.  Or that at 10 years old, there might not be much hope that the child would be willing to change the grip they have cultivated and developed for lo these past 7-8 years, even if they could qualify for OT 5 times a week.  They’re not having any of that.  The child MUST receive OT to change the child’s grip to the Dynamic Tripod Grip so the child will be able to access their education and achieve their goals and be successful in life.

(DISCLAIMER:  If I get a referral for a child for handwriting and/or pencil grip issues, I take them seriously.  And I address those that require treatment to achieve exactly what I stated above: access to education, attainment of goals, and success in life.  But sometimes it’s obvious to me that a poor pencil grip isn’t going to prevent a child from these things.)

Hence the reason I was going to write a post about grips.  I had done some research and taken some pictures of pencil grips.  But, luckily for me, someone beat me to it.  And from the looks of it, they did a much better job than I was probably going to do.  So, I felt it would better serve any and everyone reading my blog to just direct you to the well-written and well-presented post over at The Anonymous OT.

But just to prove that I was going to actually write a post, I’ll leave you with the picture I took of my banker’s horrible-looking, but effective, pencil grip.

Bankers pencil grip 1

That, my friends, is a Fingertip Grip.  And it’s painful to these OT’s eyes.  But it’s effective for him.  How do I know, because I “interviewed” him about it.  He said that his Catholic nun teachers used to punish him for using this pencil grip.  And that when he was in high school and college, he found taking written notes to be laborious.  Fortunately, he’s moderately creative, so he just used a tape recorder to take notes.  And now he has a high school diploma AND a college degree, a successful career, lives in his own apartment, and pays his own bills.  So this ugly, inefficient pencil grip didn’t prevent him from accessing his education, attaining goals, or finding success in life.

To be honest, if I had gotten a referral for him when he was 8, I would have tried to change it to something more efficient to lessen the challenges he would have coming with written work.  But, apparently this grip didn’t prevent him from achieving success.  I know for sure because I asked.