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Tot Therapy


“Circle time,” when children gather around to sing a song or listen to their teacher read a book, has become the Heartbreak Hill for the developmentally delayed pre-kindergartner. It’s here that a toddler’s flaws—be they low muscle tone or lack of focus—are made flagrantly manifest.

A teacher for two decades at an Upper East Side preschool says she’s far more attuned to such problems than she once was. “When we were kids and our kids were little, we called them awkward and clumsy,” she explains, adding that problems pop up not so much on the jungle gym or seesaw, where you’d expect them, but at the snack table, suggesting the challenges these children face are as much social as physical. It’s behavior that could conceivably raise a red flag to visiting grammar-school admissions officials—this kid might not be quite ready for the task-oriented rigors of kindergarten.

“That child’s chair is always turned to the side,” the teacher said, offering an example of a problem, “not because that kid is being naughty, but the kid has trouble organizing himself.”

They’re called “sensory integration” issues. It’s the latest buzzword, referring to the problems some children have coping with their environment. The parent of one such kid compared it to the disorientation she experiences shopping.

Poor pencil grip also sets off alarms. “I got sent an evaluation another therapist did with goals for the child,” recalls occupational therapist Rebecca Daniels, recently arrived from Atlanta, where she says such pressure hardly exists. “The goal was, ‘This 3-year-old will use a tripod grasp to draw circles and squares.’ That’s setting the bar really high.”

To keep their toddlers from reverting, therapists, who also sit in on preschool classes these days, employ a number of devices. These include “dots,” cushions the consistency of waterbeds, forcing “low tone” children to use their stomach muscles to stay aloft and occupied during circle time. There are also weighted vests, similar to those one dons before having an X-ray. “The deep pressure helps to ground kids,” says Marie Leo. “You have to wear it for twenty-minute intervals at transition times. It helps them to take the edge off.”

“New York is a great place for services,” says one pediatrician. “And once you put the kid under the microscope, you’re going to find something.”

Indeed, often the tactics help. One mother’s 3-year-old became adept not only at knowing when his sensory-integration demons were upon him but also how to cope with them. “He had all this energy he needed to get out,” recalls Judith Fox-Miller, the boy’s speech therapist. “We taught him he should jump at those times—learning it was okay to jump on the bed.”

“He would go on my bed and count twenty times,” the mother says. “It helped him get the bugs out.”

Marie Leo’s “sensory-integration gym” on West 94th Street is a kind of toddler finishing school for the developmentally delayed. Scheduling toddlers can occasionally present a challenge. “A lot of the families there do not want anyone to know their kid goes to anything,” Leo says of one preschool in particular. “I have to be careful not to make a faux pas—that one kid doesn’t run into another.”

She also attends “team meetings” at the schools where as many as eight or ten adults—the nursery director, teachers, assistants, therapists, and, it is hoped, the mother—will convene to strategize a single child’s development.

“We talk about what the kid’s behavior is like in class,” Leo explains. “If they need sensory supports—squishy balls, a weighted vest.”

Not all parents readily accept their preschool’s advice to seek help just because their kids can’t cope with the heightened demands of toddler social life. In fact, Anne, the mother of a Tribeca 11-year-old, still gets angry, years later, when she remembers how they pressured her to send her daughter to therapy.

“The preschool said, ‘This child has a problem,’ ” Anne remembers. “ ‘She’s not patterning.’ I said, ‘What’s patterning?’ ‘She’s supposed to go to the bathroom and come right back.’ On her way back, she’d pass the stairway that led to the toddler gym and occasionally she’d take a detour. I said, ‘She’s 3 years old.’ They said, ‘This means she’s not going to read.’ They sent me on a wild-goose chase. I went wherever they sent me. I listened, shook my head, and didn’t do anything.”

Despite her teacher’s predictions of doom, the child became a voracious reader of the newspaper, according to her mother, and even wanted to take The Diary of Anne Frank out of her school library—she got into all the schools to which she applied—at 6.

“It’s rotten what they do to you,” Anne goes on. “Everybody learns how to use the bathroom. They all learn how to speak and hold a fork. But everybody is very impatient and specialist-driven. You don’t learn that with the first child; you learn that with the second one. I knew he wasn’t a big talker either, but I just waited.”

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