Occupational Therapy, a Treatment for Sensory Processing Issues

Today, I will advocate for any child out there who is struggling with Sensory processing issues, who it is not being diagnosed yet. The static of kids having sensory issues and/or autism is dramatically increasing. This is an issue I worry because the future of this country can be affected if the future women and men keep developing with neurological issues. 


The exact cause of sensory processing and autism is unknown, but research are begining to link it to the environment, a contaminated environment with Toxins. The last research I read mentioned that the cause may be 60% environmentally. 6 of every 10 kids, in our school nationwide, have sensory issues and they are not receiving treatment due to they are not diagnosed. The United States is the country with the higher statistics in Autism and sensory processing world wide. We have huge battle to win at home, not just in the middle east.


The best way help a child with sensory issues is to recognize sensory processing issues in yourself. At some point, we all have sensory issues; but for people who have healthy neurological pathways, it is easier to regulate themselves. I will share two of my auditory issues, so you can understand how a child with sensory processing struggles:

I cannot stand the noise of a marker against a board. This bother my auditory sense, it causes weird chills on me, but it is something I can control. In a child with auditory processing issue with the same noise of the marker will panic and even feel pain in his ears, resulting in an overreaction that people around, who are not aware of sensory processing, won't be able to understand and help the child.

I couldn't drive with the windows in my car half way down. The noise produced by the wind getting into the car was disturbing for my ears. The windows had to be all the way up or all the way down. Now, I can handle it. I learned to self regulate this noise. A child with sensory processing is not able to self-regulate himself or herself resulting in withdrawn from the environment because the auditory input is not pleasant; instead, is painful, lauder of wath realy is. Here is when a child needs professional help.

Finding help for a child with sensory processing issues
One should be an advocate first and a parent second. It is not easy to do it when your child is already facing a diagnosis which is affecting him or her. But getting to understand your child's needs is the open door to help the child to overcome their sensory challenges.


Requesting to the  local school district/school board for an evaluation for sensory processing disfunction if the child is over age three. It is a way to begin finding answers of what it is happening to the child. The evaluation should be done by an Occupational therapy with knowledge on Sensory processing —Not all Occupational Therapist are certified in Sensory Processing. The school must provide OT services at no charge, but not all schools include the Occupational therapy services focused on sensory issues in the IEP. Teachers are not specialist in Sensory Processing Disorder, either. They can provide certain activities or sensory diet, but  Sensory processing issues is with the child where ever he or she goes, so school services are not enough to decrease to the maximum extend sensory issues in a child. But you can work with the child's IEP team  to provide activities that can help the child to get organized in the school setting. Hiring an private paid Occupational Therapist who specialized in sensory processing is highly recommended. Actually, is the one who will help the child to heal and is the one who truly has the knowledge on how your child sense the world and how the child can learn to cope with his or her sensory challenges.

Take time to shop for a good sensory specialist center according to the child's personality and sensory issues; and not about the therapy cost. This is crucial to be successful in the treatment. When I was looking for a place for Tommy, I checked three places that I got good recommendation from parents and therapists and I have previous experience with one of them. Things I considered to chose the place that will work with tommy: I observed personality, how they are organized and environment because it has a big impact in how kids with sensory processing disorder take and process the sensory information throughout the 7 senses. In the center  Tommy attends,  they teach kids to be quiet when certain noises affect other sensitive kids. They also ask for not wearing strong fragrance due to there are kids very sensitivity to smell some odors or scents. 

A good Sensory Specialist Center to consider is a place where the whole family is encourage to be part of the treatment. So you can feel confident in talking about your concerns about your child and ask questions about how you can help at home and find the answers your are looking for. Look for a place that has updated/innovative methods and sources for the treatment, including link you with other specialist that are an important factor in treating sensory processing, such as: nutritionist, developmental optometrist, and others.

Finding ways to pay for services
Depending on your insurance plan, you may get coverage for an occupational Therapy of your choice. Or you may have to choose from plan-approved providers, but is not very common that specialists in pediatric sensory issues are in in the list of the insurance providers. If your insurance doesn't cover for this services, look for non-profit organizations that can fully or partially help to pay for the services of occupational therapy for sensory processing. If your family household salary is based in two incomes, you may not qualify for most of the free services. If this is your case, keep looking in your local organizations, you may find funds that will help with some of the therapy bills, other activities or sports, such as: swimming, soccer, gymnastic, among others. This activities help with sensory processing depending on your child sensory needs. 

Online Sources

• The Interdisciplinary Council on Developmental and Learning Disorders (ICDL). This website has valuable information on how to entice your child and how you get into their world when the child is withdrawn. I highly recommended the free recorded broadcast. I have put in practice some of the principals of their neurodevelopmental approach DIR® FLOORTIME™ and it works. 
• The Greenspan Floor Time approch is an organization funded by Jacob Greenspan, who is son of Dr. Stainley Greenspan the developer of DIR® FLOORTIME™. Dr. Stainley Greenspan is well know world wide for his remarkable work with kids with special needs. His family has decided to continue with his job after he left us in 2010. They are training parents and professionals in the Dr. Greenspan Floor time approach.
• The sensorysmarts.com website is the continuation of the book Raising a Sensory Smart child book. They have great tips for sensory diets, working with school and so on. Check it out!
• The American Occupational Therapy Association may be able to help in finding a local Occupational therapist certified in Sensory processing.
• SPD Foundation. They have a directory of specialized therapists in occupational, physical and speech/language therapies, as well as, other specialist for children with sensory issues.
• Western Psychological Services. This website has a list of therapists in the U.S. and other countries, who are certified to perform the Sensory Integration Praxis Test (SIPT). 

Self-education

It is not easy to understand what sensory processing really means for parents. Most people aren't familiar with this topic, either. So self education is a key in treating sensory processing disorder. Two books I highly recommended are:

1. Raising a Sensory Smart Child By Lindsey Biel, OTR/L and Nancy Peske. This book is foreword by Dr. Temple Grandin, who has Autism. When I read this book, I asked my self: Why I didn't get this book before? This compile all the start point information you need to start treating sensory processing disorder. I found out a lot of the info in this book on my own, so I know for sure what it is in this books is highly recommended. I would save time, if I would read this book before when I was looking for answer to what happen to my son.
2. The Child with Special Needs by Stanley I. Greenspan, M.D. and Serena Wieder, PH. D with Robin Simons.  It is a long book with 496 pages. So you have to take the time to read it. They explain how to do FLOORTIME techniques can be done as a based home-therapy. Because the book is long, for working parents will take time to go throughout the whole book. I try to read it during my lunch time or before going to bed. I have found answers in this book that any other doctor or specialist has answered. This books has become a important tool to help my son to reach his full potential. The information in this book is worth reading!

In the pictures bellow is Tommy, happily working with Miss C.

Miss C. has recommended to decrease services from every week to 

every other week due to the great progress Tommy has done since last June.

The pictures are courtesy of Leaps & Bounds,

The Sensory Specialist Center where Tommy gets 

his therapies.

Here is brief curriculum of our Private Paid OT:

Miss C. earned her Master of Occupational Therapy degree from University of Missouri in Columbia, MO. She has experience working with clients of all ages in a variety of setting, which includes: school based therapy, pediatric inpatient therapy, pediatric outpatient therapy, inpatient acute rehabilitation and outpatient adult therapy. Miss C. has received training in splinting, sensory integration and processing, handwriting and primitive reflexes. She has worked with children with a variety of diagnoses including: sensory processing concerns, attention deficit disorder, attention deficit hyperactivity disorder, reactive attachment disorder, autism spectrum disorder, hearing impaired, Down syndrome, cerebral palsy and hypotonia.

Advise to Parents

My advise to expecting patents or patents who are starting the journey on raising a child with special needs, start your child in occupational therapy with emphasis on sensory processing, as soon a you can, while your child is a baby. If you can afford private pays therapy don't wait, just because your child is receiving services from the state. You can also ask to your EIP service coordinator to incorporate sensory activities in the early intervention program because most kids with special needs or with genetic disorders have sensory processing issues. This is something your doctor won't tell you!


If you think your child have sensory processing, please look for help. Sensory processing affects the overall development of a child with or without a genetic disorder. Dysfunction on sensory processing stops development and cause regressions. I have suffered my son's regressions, but I have found the help he needs. So today, I am happy because Tommy is progressing and beginning to regain the lost skills and learning new skills!

Parenting, UNCONDITIONAL LOVE

When one is expecting a baby, one cannot know what will bring the bundle of joy that is growing in the womb. But I knew, when I got the call confirming I was pregnant of my first child, that my child would be first and anything that would come with him would be after. My motherhood began to bloom right in that moment.


The RESPONSIBILITY as PARENTS starts since the moment a little form of human life begins to develop in the womb, NO when the baby is born! Since the first appointment with the genetic counselor, the first thing my husband said to the counselor: We will keep the baby regardless the results. We never let anyone to disturb our family, Tommy was already part of us, even when he was a tiny human fetus!  When I read how much abortion statics, in general regardless the prenatal diagnosis, are increasing makes me wonder about what values parents are transmitting to their kids. Why do they chose to kill the beginning of a human life? When I think of people chosing termination of Pregnancy becasue of T21, It is something I do not accept. Giving a child in adoption is an option for what ever reason a person cannot take the responsibility of a being a parent. I have had the opportunity to meet adopted adults who were adopted by wonderful families. I also know a mom who has a child with T21 and adopted a little girl with T21 from Europe. I see on all of these families something in common, 'LOVE,' which is probably what our society is losing. 


Both of my kids were screening for T21 and results were "very high risk for T21." I know how it feels and I know how scary it could be! But nothing could more than my LOVE for my kids. Here is were the moral values, faith in God and knowing the feeling of unconditional love, that were transmitting from my family, began to work on me without knowing it. Politician are working for building a strong society, but they won't be able to do it if they keep forgetting about 'family ties.' The family is the solid base of any society, abortion goes against it. So this is not about wrong or right, it is about respecting ourselves as humans.

I believe in my kids potential regardless the oldest one has developmental challenges and the youngest one is developmentally advanced. When Francis was born, we didn't notice any difference when Tommy was born. We just saw "BABIES". Because Tommy didn't have serious health issues made possible we could enjoy him, even when he had pulmonary high pertension, he wasn't suffering. Tommy was very alert, even the doctors noticed that. He, in fact, gave us a harder time as a newborn than Francis. Tommy's first month didn't let me sleep much at night and I had help from my mom and my sister. Francis's first months just waked up once at night. Tommy slept through the night since he was tow months old. Francis was 8 month old when he began to sleep through the night. Tommy knew what to do right away when he ate baby food for the first time. It took Francis a month to get the idea. I can go on and on as many differences I see in my kids and I just see that my boys are special, different and unique as all we are. This is our parenting experience with our kids, every family who is raising a child with developmental challenges and a child with a typical development also have their own experiences. Trisomy 21 is not like a cookie cutter. Kids with T21 share the same diagnosis, but the way they are affected varies because T21 is not a diseases, it is a genetic disorder.

Both of my kids don't follow charts. They both are doing things in a different way that what a milestone chart says. Therefore, I don't put  them in the box of stereotypes and I respect them as little individuals. I just praise them! They have taught me sterotypes are breakable and 'average' doesn't exist. There is not way to put a full potential of a child in a chart or in an evaluation. Therefore, believing in my kids' potential is crucial, for me, to develop good parenting skills. 


Having a child, takes you to a most deep understanding of bond and love. In general, Parenting can be stressful, but when you have a child with developmental challenges things get more challenging than having typical kids, but not less rewarding.  The first 3 years of Tommy's life, we spent a lot of time learning and being couch by a staff of therapists who trained us in early intervention, physical therapy, occupational therapy, oral motor therapy, sensory issues, developmental milestones, behavioral issues, social skills, and so on. So parenting my son with a generic disorder, for me, has been the door to knowledge on how to improve my parenting skills. But along the way, I have also deal with frustration, sadness,  tiredness, worries, stress, anxiety, anger and a grift. Not easy! But all these feelings has brought me to growth as a person, as a mother and as a woman for better and forever.


Having my sencond child with advanced development make things just amazing easy, in the way, I don't have to work with him because it seems he knows it all and he has a very strong sense of independence. He reaches his milestones way ahead or right on track without struggles. However, I feel I don't stimulate him, but I try to have a good time when I am with him! I don't know how different things will get as he gets older; if he keeps having an advanced development, this may bring challenges, but I am ready for it!


My boys are my life couches, they are the ones teaching me what really matters in life. Instead of worry about supperficial things, I care for my kids developing a nice personality and social skills. Physically, they are cute kids, but this is a superficial beauty. The true beauty is the one comes from the heart. If a person it is not considered or doesn't have kindness and love for others; then, It doesn't matter how beutiful face, nice body or a perfect height a person can have, if he or she has an evil personality, it will bring the inside ugliness right to the face. I have known people who are physically attractive, but very evil and no one wants to be around them. So Beauty is not all!


Parenting is very complex. It requires a lot of time to learn how to raise kids. Everything I know about child development it's from therapists; reading many, many books like getting ready to take test; as well as, watching other parents how they interact with their kids and following my mom's example on how she raised us with our feet on earth. After all, Parenting is very rewarding. For my husband and I, it is what has made us complete.

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Adoption vs. Abortion
I have become a supporter of an orphanage that is just a few miles from my house, this is my way of fighting against abortion. These little ones need a lot of LOVE and support because they have been abandoned, but they are also facing disabilities. It is already hard for them to face their challenges, but it is harder if they don't have a supportive family on their side. Please if you like to do volunteer job or want to adopt a child, check in your local organizations, you may find an orphanage near you with little ones who just need warm hugs and heard the magic words: 'I LOVE YOU.'

Brotherly Love

When I was little, I refereed to my sister as 'hermanita' (Little sister). Today, I still call her "hermanita," I use the word 'hermanita' as part of keeping the memories of our childhood. She always was protecting me from the monsters in my nightmares or throwing rocks at me because I did something to her. We were not lovely girls to the time we got mad at each other. All these experiences made our relationship stronger. Even, we are 3 years apart, today, my sister knows she can count on me for absolutely everything. I know I can unconditionally count on her. This is exactly what I wish for my boys!


I am just happy that Tommy feels jealousy because of Francis, it is how it should be. Not much different from how it was with my sister  when I was born. My sister jealousy didn't stop until we became teenagers. I am happy that Tommy and Francis have their fights—we are working on be nice and gentle, but boys are rough, so they will get it one day. I am happy watching them playing together because, more than brothers, they are playmates. I am happy watching Francis imitating everything that his big brother does because it is how it should be. Tommy loves to jump in the trampoline and while he jumps he says "salta', "salta." Guest what! Francis climb to the trampoline and pretend he jumps while saying "salta", "salta." 


As a mom, I care about how my kids feel and how they are building the base of their relationship. So I try to do everything equal for Tommy and Francis. I cannot love one more than the other because they both are part of me. I don't treat Tommy with privileges just because he has T21. I don't treat Francis with privileges because he is the baby. The way I see it, it is that they are little individuals that deserve being treated with respect and dignity regardless their ages or developmental challanges. If they are treated with respect and dignity, they will learn to  treat people with respect and dignity.


I show them my unconditional love. My moms made us understand that she would never love one more than the other. It is my turn, now, to help Tommy to cope with the jealousy feeling regardless his communication barriers. I know in their own individual way, they care about each other. The other day, Tommy was in the master room and he heard Francis crying. Tommy got down the bed while saying 'baby' and ran to Francis' room to check on his little brother. Between them there are not differences. They are just brothers!

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take a look at Kelle Hampton's daughters. Her pictures talk by them-self, Trisomy 21 doesn't exchange the love among siblings. Click HERE!

Love without limits

As usual tonight, I got in Skype to talk to my mom and my sister. We chat almost everyday. But tonight, something was different. Tommy, as usual, give them kisses through the screen. But today, he touched my sister face and he realized it was just a cold crystal of computer monitor. He touched again the screen and couldn't feel her face. He got disappointed and it brought tears to his eyes. Of course, we couldn't content our tears either. But we know we love each other, not mater how distance we are. We know that not mater what, we always support each other. We know not mater what, Tommy and them are building something special regardless the distance between two countries. We are excited because my mom will be here in a few days. We are hoping my sister can come soon because we have about  a year and half we haven't seen her. I am glad Tommy is experiencing that love doesn't have limits.

Lovely Discipline

Discipline a child bring the better and the worse of our inner self as adults. Because It is very easy to lose patient when you are trying that the child does one thing and the child does the opposite. Therefore, to discipline a child with or without developmental challenges, it is imperative one learn to know the child's likes and dislikes beyond the labels. 


Discipline my son with developmental challenges has made me realized discipline should be lovely and positive. It is not about 'I am the adult, you are the child, so you have to obey.' This aptitude doesn't teach anything to a child, specially to Tommy who has a strong personality and sensory processing that makes harder for him to make sense of the environment around him. 


He is my life coach! He had taught me I needed to redirect my discipline methods because he may be at a higher level of understanding, but people around him cannot know it because his communication barriers. When I realized this, it was a day he got mad at me and pull my hair so hard. In my inner self, I wanted to spank him so bad. But instead, I played my role as an adult. I controlled my self, with a lot effort, and with a very calmed and lovely voice I told him: Tommy, I do love you. Mammy and Daddy love you so much, so we don't hurt you. We don't pull your hair. I could tell, he realized his action wasn't right. He immediately stopped pulling my hair and began to cry. So I kept talking: Mammy and daddy don't pull your hair because we love you. You made a good choice in stopping pulling my hair. Mammy is not mad.  He couldn't still stop his tears, so I hugged him and kissed him. Then, he began to sing with a tumble voice and with watery eyes, he tried to be silly to make me smile. Then I told him: 'You learned a lesson, you are sorry. Just say sorry.' So we practiced saying sorry, until he could say 'Sorry' very understandable...Since that day,  I just say: Remember, I love you. and he stops his aggressive action.


The situation describes abobe taught a lesson to all of us. Never underestimate a child with developmental challenges. Tommy learned that a bad action has a consequence and one feel sorry after doing something wrong. I learned 'self control' and an authority aptitude makes the situation worse and the child takes control of the situation because the child gets into a defensive mode. Therefore, discipline is about emotional and behavioral growth from both sides,  parents/caregiver and children. I have learned I am the adult and I am the one who has set the example of 'self-control,' so fighting with a child it doesn't show much self control. When a parent/care giver gets to this point an emotional and behavioral growth begins that steps into a trusting relationship between adult and child.


Discipline a child with a genetic disorder changes the rules of the game, but the goal is the same, WIN to teach a child how to behave. Regardless developmental challenges, we has began to set goals about  discipline in our family based on:

• to obey/respect adults
• to self control
• to be responsible
• to follow the families rules

Setting goals has helped me to not lose the perspective of what discipline should be about. So when one get to this point, it is easier to establish discipline methods according to the kids' personalities and ages, including to follow psychological techniques, to be consistent (which is hard) and be patient, very patient.  To get to this point, I did a mental exam on what I was failing and what I should consider to set boundaries to achive a lovely and positive discipline. I got to the conclusion, I should discipline according: 

• To understand what a typical behavior is
• To help my boys to achive a emotional and behavioral growth
• To build a trusting relationship
• To recognize sensory sick behaviors from my oldest child
• To understand my children's world according the age and developmental challanges
• To help my kids understand that an aggressive behaviors are not acceptable (pulling hair, bite, kicking, etc)
• To respect the child as individual by giving the child  the opportunity to express his feelings, regardless if the child has communication barriers

I have felt these points have helped me to set boundaries with Tommy. Because he is my first child, so many things are just new experiences for me. Beside that, Tommy's personality is strong as mine. But the key is learning from every experience when you have to apply discipline, so one can take from every experience what worked and to improve what didn't.

Setting the limits

As Tommy's advocate, I have to see beyond the picture. So I always looks in detail about anything related to tommy, because regardless I have the opportunities to work with great professionals to help Tommy to achieve his full potential, at the end, I am the one that truly knows him. This is the reason, I constantly educate myself about any aspect related to a child development. 


I felt I didn't know what typical behaviors was for a child around my oldest son age. So I talked to other parents who have typical kids. One day, I even so my little neighbor, who is 3 months older than Tommy,  trying to bite and hit his mom because she didn't allow him to do something. When I saw this, I just laughed! I realized Tommy's emotions are just typical as a child of his age. Thank God, it is in this way! I truly thought Tommy was needing professional help because he was having serious behavioral issues that are very common in kids with T21.


I also search online about how kids behaved around my son's age. According to Baby center.com this is how a typical 4-year old child behaves:

At this age your child still lacks self-control. It can take more than one, two, sometimes ten times for a lesson to sink in. Repeating transgressions is also a way of testing the limits. Are they firm or mushy? If Dad ignores me this time, maybe what I did isn't such a big deal after all.
Aggression is a normal phase at this age. Specific situations in which your child feels uncertain or out of control usually trigger the incidents. Respond quickly and calmly. Establish set rules and consequences for antisocial behaviors like hitting and kicking.
Not everything needs to be a battle. Overlook small things or give your child a mild verbal warning ("Keep your feet off the sofa") so your messages about the big ones get the emphasis they deserve. Don't get drawn into battles you can't win, such as those over eating.

It was a huge surprise for me. This exactly describes Tommy's behaviors. This make me feel so good because he is having a range of emotions according to his age. One more time, he is proving to me that 'stereotypes are breakable' that one day, the medical community will get the tools to truly unluck the potential of our kids. 


We are working on setting rules in our house that should be followed for everybody, including Baby Francis. Francis will be 18 month in a few months, which is the age some toddlers begin to show their first tantrums, so my little funny guy will also experience a range of emotions. He won't be the lovely guy we all are used to. So it is better we star setting limits with discipline according to his age. I also think Francis should be disciplined because it is not fair for Tommy, if he sees Francis doing something wrong and Francis doesn't get disciplined. We know Tommy is still struggling having someone to compete for our attention. He gets jealous when we pay too much attention to Francis. Therefore, it is imperative we keep a balance so this not hurt Tommy's self steam and he thinks we prefer Francis rather than him. To keep a balance by doing things I used to do with Tommy previous to Francis. I keep going to Tommy's room first as always has been previous to Francis. Then, I let Tommy play around while I get Francis ready. If Francis throw the toys out of the crib, I ask Tommy for help to put the toys in the crip. I make sure I point to the toys so he can locate them, taking in consideration he needs a guide for his sense of sight to register the toy. So when I am done, The three of us go down the stairs together. I hold Francis and Tommy's goes down holding the rail. The same thing if we go up stair, I let Francis to climb the stairs because he enjoys it and it is less back pain for me. I hold Tommy's hand, as always has been, and we both walk behind Francis. Francis has fun and Tommy gets my attention


There are many discipline methods, but not all of them apply to every child. So we are finding ways to understand how our kids's sense the world around them, specially, Tommy because his sensory issues. There are many behaviors people takes for 'typical' or even don't notice them, but they are not Typical. For example: I have noticed, Tommy visually doesn't see what is one the sides, he looks just straight ahead. If you put the blocks in front of him, he stacks them. If you put the blocks on the side, for him to look for them and stack them, he doesn't see them.  Tommy's vision is perfect, but his sense of sight doesn't register that there are objects, or even, people beside him. So if he throw a toy and Francis is close, he doesn't see Francis. For a person, that it is not familiar with sensory processing, it would look like he is trying to hit Francis. So what I do, it is redirect him to play properly with the toy. If it is a car, I take the car and roll the car while interacting with Tommy in a funny way. And say, Oh, you almost hit Francis, be careful next time.  Or I try to prevent the situation by saying to Tommy, "You could hurt Francis if you throws the toy, and again, I friendly redirect him to play properly. As an adult and has become a piece maker. I am educating my-self about sensory processing behaviors because if we as adults don't understand a sensory child's world, we can emotionally hurt the child's self steam by applying unnecessary discipline. Because the child thinks 'I am not doing anything wrong, I am just playing, why I am being punished?'  If I can understand how my son's perceives the wold, it is easier to teach him to recognize dangerous situations and that he can hurt others. Brain Highway has created awesome videos that explains and help to recognized sensory behaviors. All the actors in these videos have sensory issues. Click here to see the videos.


To establish appropriate discipline methods, I have also looked into if Tommy could recognize emotions. So in this way, I can work with him in identifying them and help him to cope with them. Thanks to technology, Tommy could show me he recognizes emotions, such as: unhappy, happy, disgusted, upset, sad, excited, mad.  Once again, he has showed me 'stereotypes are breakable'. We worked on this by the end of the Early Intervention Program about a year and half ago, but it wasn't deeply. After he finished the EIP, we didn't work on this again. I know, at school, they haven't work on this either. I am happy he can recognize these emotions without work on them. I am incorporating emotions into play so he can learn through play how to cope with the emotions. 


I feel so much better now, because with a lovely and positive discipline, I can see how my relationship with Tommy is changing for better, because we are building a trusting relationship. In my next post I will talk about discipline methods we are applying and will apply according each child's age and personality. 

The Sky is the Limit!

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For parents and caregivers
I found an article, by Dr. Sears, that is focused in discipline kids with Trisomy 21. It is a very helpful in this matter. Click here!