By: Loren Shlaes, OTR/L
Certified Teacher of the Alexander Technique


Photo Credit:  Rolf Sachs Design

1. The child does not get enough exercise. Children require huge amounts of movement, preferably outside, every single day. Movement and exercise is as essential as food for children in order to stay organized, develop and mature their nervous systems, improve their coordination, strength and motor planning, and to be healthy! So many of us live in cities now and have just forgotten how vital it is for a child’s health and development to go outside and play. Have parents bring the child to the playground for half an hour before school starts, and let him play on the equipment, or have a game of touch football, statues, or tag. And if his teacher takes away recess as a punishment, you must insist that she find another way to help him manage his behavior. He is acting out because he needs to move more, not less!
2. The child has poor postural stability, low muscle tone, and a weak trunk and spine. This makes sitting physically exhausting, uncomfortable and painful. Circle time is especially grueling since sitting unsupported is such hard work.
3. The child’s chair/desk at school does not fit. I can’t tell you how many times I’ve walked into classrooms and seen children whose desks literally come up to their necks while their chairs are so high that their feet are dangling on the floor. Could you sit and do your work like that?
4. The child is tactile defensive and his clothing bothers him. Or he is sitting in too close proximity to others and his alarm system is clanging away, instructing him to flee.
5. The child is sitting with his back exposed and people are walking behind him, again setting off alarm bells. He should be sitting with his back to the wall, preferably niched in a corner.
6. The child is auditory defensive and his ears hurt. A child who can manage in a quiet, low stimulation atmosphere but can’t control his behavior in a noisy environment is probably suffering mightily in all of the chaos. Or he may not understand the teacher’s instructions if she is talking over many chattering voices. A good clue about auditory defensiveness: a child who runs around the perimeter of the classroom, acts out, and can’t engage in any goal oriented behavior when the room is noisy.
7. The child is a poor breather. Shallow breathing sets up the body for fight or flight, and it’s very hard to sit still when every cell in your body is urging you to get up and check for predators.
8. The child has undetected visual problems. It’s exhausting and frustrating to try to attend to close work if you can’t see what you’re doing. The child’s eyes may be so unstable that he is seeing double, seeing floaters, or visual images are shimmering, which is anxiety provoking. The light in his classroom might be bothering him. In Manhattan many children are expected to sit all day long in inside classrooms with no natural light or outside ventilation. I get headaches just thinking about it.
9. The child’s inner ear is not functioning well. The inner ear tells us how alert/upright or at ease we should be in response to movement. {Roller coaster: very alert and upright! Hammock: very drowsy and relaxed.} If the child’s inner ear is not registering movement very well, it’s not telling the body to sit up and attend. The child is driven to move in order to provide the intensity he needs to stay upright and aroused.
10. The child’s nervous system has not matured along with his chronological age. This means that primitive movement patterns, which should be dormant, are instead active and present, dominating the way the child responds to his environment. Primitive reflex patterns lower the child’s muscle tone automatically when he turns his head and body in certain positions. This interferes with, among many other things, his balance, equilibrium, and vision. Or things that would not even register to us, like a dog barking in the distance, can throw the child’s system into a startle, making it hard for him to stay grounded.
11. The child’s metabolic processes are not functioning well. Does the child have undetected food allergies, difficulty sleeping, leaky gut syndrome, candida, heartburn? Is the child constipated? Is he subsisting on a diet of refined carbs, sweets, and processed food, and so is inadequately nourished? Children need lots of high quality protein and complex carbs to fuel their bodies for learning and attention.
12. The child does not get enough sleep, or the sleep that he does get is not resting him properly. Can he transition well to bedtime? Does he get ten or eleven hours every night? Is there good ventilation in his bedroom? Are the lights off in his room? If a child is hard to wake up and grouchy in the mornings, chances are that he isn’t a good sleeper. A poorly rested body does not support the brain for learning.
13. The child may be too young or too immature to be in a classroom. In my clinical opinion, most three year old boys would be much better off waiting another year or two before starting school. They simply don’t have the emotional or neurological maturity to be handle all of the rules and expectations of the classroom.
14. The expectations of the classroom are too much, and the child feels lost, inadequate, and confused. Four year olds should not be expected to learn to write. They simply don’t have the internal stability, attention span, or visual discrimination required for such high level work yet. Let them wait until they are developmentally ready. One of the very best schools in Manhattan, the Rudolph Steiner School, does not start the children writing until they are seven. Their children have beautiful handwriting and are exceptional scholars.
15. The child is hungry, thirsty, tired, or has to go to the bathroom.
16. The child is over scheduled. Children need lots of unstructured down time to recharge their batteries, allow their brains to integrate new information and their nervous systems to develop and mature, and to connect with their creativity. A child who has two or three activities every day after school and on the weekend is expected to be “on” way too much. Urge parents of young children to cut back on the enrichment programs, schedule just one or two activities after school, and take them outside to play instead.
17. The child is spending too much time in front of screens. This is especially true if the child can’t transition well to sleep after spending time on a computer. Is the child watching or playing games with excessively violent content? Instruct parents to strictly limit time spent in front of televisions and computers and use the time instead for playing outside and creative pursuits {crafts, painting, writing stories, playing a musical instrument, dancing, etc.}. Have them turn off the computer a minimum of two hours before bedtime, or better yet, allow the child just an hour or two on the weekend. Screen time takes away from the time a child should be physically active, strengthening his body and developing his nervous system, and it shows up later when the child is driven to move.
18. His parents are going through a hard time, or don’t get along. Strife at home will upset any child’s equilibrium. Children are far more sensitive to these things than we know. If parents are stressed out, rarely home, argue a lot, tense and hostile with each other, or are otherwise going through their own issues, it will show up in the child’s behavior.
19. The child’s parents and caretakers don’t teach him to respond to adult redirection, so he thinks that obeying grownups is optional.
20. The adults who care for the child spend inordinate amounts of time on their electronic devices during their time together, or otherwise ignore him.
21. The child is expected to sit still for too long. I have so very often observed classrooms where very young children were expected to sit for long, long periods without ever getting up, being given a drink of water, or anything to eat.
22. The child is bored. Many reasons why this could be — the grownups don’t have a realistic idea about the child’s attention span, the activity is too difficult or too easy, or the child expects everything to be like television or the computer: loud, lots of chatter and images quickly passing by, lots of novelty.

Featured Author: Loren Shlaes, OTR/L
Many thanks to Loren Shlaes for providing us with this article for our newsletter and website.
Loren Shlaes, OTR/L is a pediatric occupational therapist specializing in sensory integration and school related issues, particularly handwriting. She lives and practices in Manhattan. She blogs at http://www.pediatricOT.blogspot.com/