Wednesday, May 30, 2012

End of Year Lists for Students by the Students

Have you ever considered having the children you currently work with create a list of advice or tips for other children for the next school year?  You could ask the children to submit tips and suggestions that make functional tasks easier for them.  This activity will hopefully empower the children to see that they can help others.  It may also allow them to think about different aspects of functional tasks possibly leading to goal setting for the following school year. 

Perhaps they could answer questions such as:

1.  What do you do to be more organized at school?

2.  What is your favorite physical education activity to participate in?

3.  If an activity has to be adapted for you to participate in gym class or recess, what have you found to be the most helpful adaptation?

4.  Is there anything that makes getting dressed easier for you?

5.  Is there a certain entrance to the school you find easiest to enter in at?

6.  Is there a staircase that is easier to navigate than others?

7.  Is there a bathroom at the school that is easier to use than others?

You don't even need to suggest these questions.  Maybe just throw it out there to the students from now until the end of the school year.  Set up an easel in the therapy room or carry a note pad.  When a student thinks of a tip write it down.  Once all the suggestions have been gathered, organize them into categories.  Then next school year hand out your tip sheet to all the students on your caseload. 

Want to take it one step further?  Ask parents for their tips and suggestions to complete functional skills for a successful school year.  Make this information available to parents the following school year. 

Tuesday, May 29, 2012

Pediatrics Policy on Sensory Integration Therapies

The American Academy of Pediatrics has released a policy statement on sensory integration therapies for children with developmental and behavioral disorders.  It is a brief 4 page document that briefly discusses the history of sensory integration, recent research on sensory integration and that there is not an official diagnosis for "Sensory Processing Disorder". 

The policy statement makes 4 recommendations for pediatricians:

1.  Do not use sensory processing disorder as a diagnosis.  Be sure to thoroughly evaluate for other developmental disorders when sensory symptoms are present.

2.  Inform parents that there is limited data on sensory integration therapy.

3.  If a child is receiving sensory integration therapy work with the parents to determine if it is effective by helping to establish functional goals and ways to track progress.

4.   Inform families that occupational therapy can be a "limited resource" therefore prioritize treatments based on functional goals related to childhood development.

If you are a pediatric OT, PT, parent or teacher who works with children with sensory symptoms, this is a quick, worth while read to keep yourself informed.

This was just released yesterday but there has already been quick a bit of chatter around the internet and news regarding the statement - some positive and some negative.

In my opinion, this is a necessary and positive policy statement in terms of the field of occupational therapy.  It states that OT may be beneficial to some children but it should be followed closely to determine it effectiveness.  I also think it is very important that the pediatricians and the public realize that "sensory processing disorder" is not an official diagnosis.  I liked how that statement reinforced that sensory integration treatments should result in progress towards functional goals.

My only negative comment is the statement summarizes that there is not sufficient, strong research studies to back up the efficacy of sensory integration treatment.   They discuss the weak research designs.  BUT then they discuss ONE study that resulted in "possible negative behavioral effects of sensory integration therapy in certain populations".  Meanwhile this study had only 4 participants.  Doesn't seem fair to discuss this one negative study without mentioning more details about several positive studies.

Another positive aspect is the recommendation that OT is a limited resource.  Occupational therapists can offer so much to children in terms of reaching functional goals.  If the pediatrician starts the process out with an outlook that there is not a lifetime supply of occupational therapy all people involved, therapists, parents, teachers and the child, will benefit from establishing goals that are attainable with constant progress monitoring.

What is your opinion?  Do you feel the policy statement with help or hinder children who may benefit from occupational therapy services for sensory processing?

You can read the full text article here.  

Reference:  Sensory Integration Therapies for Children With Developmental and Behavioral Disorders. SECTION ON COMPLEMENTARY AND INTEGRATIVE MEDICINE and COUNCIL ON CHILDREN WITH DISABILITIES. Pediatrics peds.2012-0876; published ahead of print May 28, 2012, doi:10.1542/peds.2012-0876

Thursday, May 24, 2012

Active Play Boxes

Have you ever considered creating active play boxes for the school or home to encourage physical activity time for children?   Sometime playground equipment is not always available at a school during recess times.  Or perhaps it is available, but the children are tired of climbing on it.  Provide the teachers with play boxes or ideas to include in an active play box. These active play boxes can then be taken outdoors during recess or any time of the day. You can also create a lending library of active play boxes for the elementary school teachers. As an additional benefit, research has indicated children increase moderate to vigorous physical activity time when there is more portable playground equipment.
Here are some suggestions for different themed active play boxes: 
  • Ball box - include various sizes and textures of different playground balls
  • Bubble box - include bubbles, different bubble wands and bubble trays
  • Jump rope box - add traditional jump ropes, chinese jump ropes and double dutch ropes
  • Sidewalk chalk box - have an art contest, create new black top games, hopscotch, etc.
  • Activity card box - write one playground game on each, i.e. freeze tag, hide and go seek, obstacle course, etc. The children can pick out one card at a time to choose a game.
  • Science box - magnifying glasses, bug containers, tweezers
  • Water paint box - buckets for water, large paintbrushes and paint rollers to "paint" the black top with different designs
  • Beach party box - include beach balls, tether ball set, paddle ball and Velcro mitt set
  • Celebration box - include streamers and ribbon sticks to run and play with
  • Catch All Box - Velcro mitts, Frisbees, soft footballs, small balls, recycled plastic milk jugs with tops cut off but handles left on to catch balls
  • Hula Hoop Box - suggest hula hoop contests or use hoops to create obstacle courses
  • Race Box - include stopwatches and cones; the children can set up races and time each other
Don't forget to create some active free play boxes for indoor recess as well.  These would make nice gifts for teachers at the end of the school year.  
  • Pedometers - children can see how many steps they take during recess and try to increase each time.  You can get these at some dollar stores.
  • Dance party box - radio with batteries, dance music.  Find an old radio player at a garage sale.
  • Indoor balls - balloons and cardboard tubes.  Have the balloons all blown up.  Put them inside stockings if you are worried about balloon pieces if they pop.
  • DVD box - collection of exercise DVDs for kids
  • Bean bag box - include bean bags and targets to throw at
  • Ebooks - Print these ebooks and put in a box or folder for teachers/parents to use to encourage motor activities:  Mini Movement Breaks, Classroom Activity Posters, Roll Some Fun , Dancing with the Owls , Imagination Action Journeys and Motor Minute Challenges.  
With the amount of recess time dwindling, physical and occupational therapists can play a crucial role in educating school staff and parents on the benefits of physical activity for ALL children.

Reference:   Dowda, Marsha, Brown, William H., McIver, Kerry L., Pfeiffer, Karin A., O'Neill, Jennifer R., Addy, Cheryl L., Pate, Russell R. Policies and Characteristics of the Preschool Environment and Physical Activity of Young Children Pediatrics 2009 123: e261-e266

Wednesday, May 23, 2012

3 More Tips on Using A Smartphone to Get Moving

Screenshot from Play-Move-Develop
Yesterday's blog post was on 10 apps that get you moving.  For today here are 3 more tips to encourage movement when using smart phones or tablet computers. 

1.  You Tube - There are so many exercise videos on You Tube that you can access for free.  Watch learn tai chi (wonderful for seated exercise),  learn new yoga moves or try out some popular Zumba fitness.

2.  Add ebooks to your library - Tired of carrying lots of equipment and papers?  Did you know that you can add the ebooks from Your Therapy Source to your smartphone or tablet?  Just email yourself the pdf document once you download it to your computer.  Open it up on your phone or tablet and save it.  For example you could open up Action Alphabet and follow the physical activities for all the letters of the alphabet.  Open up the Imagination Action Journeys and move through your imaginary journey.   Turn on some music and try some new dance moves with Dancing with the Owls.   Use the picture symbol cards from Mini Sensory Processing Books to allow children to choose the next activity.   Open up Roll Some Fun and use a dice app to roll the die.

3.  Screenshots - Tired of running to the copy machine to provide parents and teachers with ideas?  Tired of paying for color copies?  Use screenshots from the Your Therapy Source ebooks.  For example, open up Roll Some Fun on your iPhone.  Go to the page that you want to use.  Take a screenshot of the page.  Email yourself the screenshot.  Now you can send that page to parents for "therapy homework" or teachers for an in class movement break.  A teacher can even put it up on a projection screen (ie Smartboard) so the entire class can view it.  Want to email activities to parents?  Try Play-Move-Develop (picture above is from Play-Move-Develop).  Again, open it up on your smartphone, take a screenshot of the activity page and email it to a parent.            

Now you have a HUGE collection of sensory motor activities right on your smart phone or tablet.

Tuesday, May 22, 2012

10 Apps that Get You Moving

Here are 10 apps to get you moving with your iPhone or iPad (in no particular order).  You can click on the links to get more information about the apps.

1.   Dance Party Zoo - dance and iphone measures your rhythm.

2.  Walk N Play - track physical activity with the iPhone

3.  Footsteps - pedometer that can track gait speed and distance

4.  Move Like Me - dance steps to follow

5.  Time Motion App -  use this video app to analyze movement

6.  Using Apps to Evaluate Posture - doesn't exactly get you moving but does get you to sit up straight

7.  FitQuest - Jog, hop and duck with this app

8.  Egg and Spoon - walk with iphone trying to keep egg on spoon

9.  Short Sequence - Kids Yoga - nice images to provide as a visual

10.  Motion Maze - maze powered by your movement.

Check out tomorrow's post on more tips to encourage physical activity using your smart phone or tablet.

Monday, May 21, 2012

Exercise and ADHD

Neuroscience published research on the effects of exercise on ADHD symptoms. The Dartmouth researchers concluded that:
  1. The effects of exercise are different on memory as well as on the brain, depending on whether the exerciser is an adolescent or an adult. 
  2. A gene has been identified which seems to mediate the degree to which exercise has a beneficial effect. This has implications for the potential use of exercise as an intervention for mental illness.
The researchers, Bucci and others, found that "the implication is that exercising during development, as your brain is growing, is changing the brain in concert with normal developmental changes, resulting in your having more permanent wiring of the brain in support of things like learning and memory.  It seems important to [exercise] early in life."

Their hope is someday to be able to look at a person's genotype for brain derived neurotrophic factor (BDNF) and determine if a person with ADHD will benefit from exercise instead of medication.

This research once again supports the benefits of children being physically active at a young age.  This is the time when wiring of the brain is taking place so seems obvious that the effects of exercise on learning and memory would be more beneficial the earlier you start. 

Reference: Dartmouth researchers are learning how exercise affects the brain. Retreived from the web on 5/18/12 at 

Sunday, May 20, 2012

Shoes 4 Kids

Brad Thuringer is an enthusiastic PTA who started Shoes4Kids.  I posted about this organization last year which you can view here.  I received a request to publicize this wonderful idea again this year for when they are at the APTA Annual Meeting and Exposition - PT 2012.  Please take the time to read his story and donate money or new sneakers if possible.

"This June will be the 7th anniversary of the first Shoes4Kids a.k.a Shoeless Sunday outreach effort.  Much has developed since my good friend Kerry Williams and I collected 55 pairs of new athletic shoes and visited children at a local Salvation Army in Orlando, FL.  Kerry is no long with us, he passed away a few years ago of cancer, but I know he would be amazed.

The one thing that has not changed over the years is the mission of Shoes4Kids. Shoes4Kids is all about serving the underprivileged and underserved child and their families by providing them with a new, brand name pair of athletic shoes.  Shoes4Kids mission is to make a difference in the life and health of our children 1) by making sure they have shoes that fit and 2) promoting and encouraging the benefits of exercise. 

Since 2006, Shoes4Kids has distributed over 3000 pairs of new, brand name youth athletic shoes and over 5000 pairs of youth athletic socks to the children of Orlando, FL, Washington, DC., San Antonio, TX, Baltimore, MD, Boston MA, and National Harbor, MD.

This year, Shoes4Kids (S4K) is scheduled to be in Tampa, FL., June 2-9 in conjunction with the American Physical Therapy Association (APTA) Annual Meeting and Exposition - PT 2012.  It would be great to have you, your family, your church group or friends at work be involved in this year’s efforts.

S4K will be visiting The Hospitality House and the Red Shield Lodge Emergency Shelter, shelters associated with the Salvation Army, Tampa.  S4K will also be visiting a local grade school and distributing new shoes.

I am pleased to announce that the Doctoral Physical Therapy (DPT) students and faculty at the University of St. Augustine, St Augustine, FL has agreed to accept and transport the shoes to the shelters in Tampa. I am extremely grateful for their support and help with this year’s efforts. By their partnership, I will now be able to fly to Tampa in June instead of driving my SUV packed full of shoes, which I have done each year to each city visited since 2007.   

How can you help? Your help is needed by either purchasing a pair(s) of "NEW" youth athletic shoes (toddler sizes 3-4 to teenager adult sizes up to 13-14) or sending a monetary donation to help purchase shoes.

Every pair of shoes represents the child whose face lights up when receiving them.  A child like Anna, a little girl who followed me as I left a shelter, saying, “Will you come back? Please come back.” 

There is a child who needs you in Florida.

Mail financial donations to: 

Brad Thuringer, PTA
Instructor, ACCE
Physical Therapist Assistant Program
Lake Area Technical Institute
230 11th Street NE
PO Box 730
Watertown, South Dakota 57201

Mail Shoe donations mail to: 
              c/o University of St. Augustine
              1 University Blvd.
              St. Augustine, FL 32086

Deadline for ALL donations shoes and monetary is May 25th, 2012.  No donation is too small.  In today's world, every child deserves a new pair of shoes and every dollar can help make that happen.

On behalf of S4K, thank you! Thank you for believing that every child deserves a new pair of athletic shoes!  For more information, please contact me at 800/657-4344, ext. 325, or ."

Friday, May 18, 2012

Physical Activity And Lower Odds of Psychiatric Problems in Children

The Journal of Pediatrics published research that measured the physical activity of 199 eight year old children. Wrist accelerometers were worn to determine if there was an association between physical activity and parent/teacher rated psychiatric problems in the eight year olds. The results indicated that "higher overall physical activity and more time spent in more intense physical activity were associated with lower odds for psychiatric problems in emotional, social, and behavioral domains".

Need ideas to get children more active? Check out 50 Sensory Motor Activities for Kids, Dancing with the Owls, Mini Movement Breaks and Locomotor Games.

Reference: Silja Martikainen MA et al. Physical Activity and Psychiatric Problems in Children. The Journal of Pediatrics. Article in press and published online 11 May 2012. doi:10.1016/j.jpeds.2012.03.037

Thursday, May 17, 2012

Head Lag and Autism

Recent research indicates that infants who exhibit a head lag are at risk for autism, language and/or social development delays.  Forty infants who were considered at risk for autism (due to sibling diagnosed with autism) were tested for head lag at 6, 14, 24, and, for outcome diagnosis, at 30 or 36 months. The results indicated the following:
  •  90% of infants diagnosed with autism spectrum disorder (ASD) exhibited head lag as infants
  • 54% of children meeting criteria for social/communication delay had exhibited head lag as infants
  • 35% of children not meeting the criteria for social or communication delay or ASD exhibited head lag at 6 months.
An additional aspect of the study examined twenty-two, 6 month olds for a head lag.  The results indicated that 75% of high risk infants exhibited a head lag but only 33% of low risk infants had a head lag at 6 months of age.

Finally, there was a separate longitudinal study indicating that motor delay becomes more evident as children with ASD near their third birthday.  Not all children with ASD experienced motor delay.  Although the children with ASD that did have motor delays were more severely impaired by three years of age.

Here are two YouTube videos with examples of typical head/neck movement and head lag at 6 months of age.


Reference: New Study Shows Simple Task at Six Months of Age May Predict Risk of Autism. Retreived from the web at on 5/17/12.

Wednesday, May 16, 2012

Using Your Cell Phone's Accelerometer

Footsteps App Free Version
Gait and Posture published interesting research regarding the accelerometers in cell phones.  By examining data collected from 55 adults while on a treadmill, the researchers concluded that cell phone accelerometers were strongly associated with treadmill gait speed.  The cell phones were tested while being worn as a pendant around the neck, and on the left and right wrist, hip, and ankle. The best results were seen when the cell phones were worn at the hip.

This is a great tool to use in the school setting for quick assessments.  Some children may benefit from the feedback to determine what is an appropriate gait speed.  Another idea would be to use the cell phone as a pedometer - see this previous blog post.

You can get a free app - Footsteps that will track up to 3000 steps per day (the paid version is only $0.99).  Good to try out and upgrade if necessary.  I have tested out this app and it works quite well.  You can adjust the settings for walking or running.  In addition you can change the step length and weight based on the user.  The screen displays steps, amount of time walking/running, distance, speed, calories burned and average speed.  Then it even tracks your history and graphs data for you!  This would be a wonderful data collection tool when measuring gait speed and distance for children in the school or home setting which is extremely helpful in making therapy goals objective.  Nice useful tool for pediatric therapists.  Attach the phone to a belt, put it around the child's hips and you will get some accurate data.

Reference:    Richard H. Carlson Jr et al. Treadmill gait speeds correlate with physical activity counts measured by cell phone accelerometers. Gait & Posture. Available online 2 April 2012. 

Tuesday, May 15, 2012

Free Graphing Game

Here is another free printable to practice visual perceptual skills, math skills, scissor skills and categorization. You can download the freebie at YourTherapySource.

Sunday, May 13, 2012

Free Printable - Robot Gross Motor Activity

Here is a fun printable activity that is perfect for partners.  Take a movement break with this activity that encourages gross motor skills, following directions, body awareness and motor planning.

You can download the printable at YourTherapySource -

Thursday, May 10, 2012

Wheelchair Breakdowns

Wheelchair breakdowns are very disrupting to children and their families.  When a specialized wheelchair breaks many children do not have a back up, making it difficult for positioning, comfort and most importantly a mode of transportation.  Pediatric therapists are frequently called upon to help with quick fixes of wheelchairs. 

Recent research in the American Journal of Physical Medicine Rehabilitation found that about 53% of wheelchair users with spinal cord injury experienced a wheelchair breakdown requiring repair per 6 month period. Previously the rate was about 45% from 2004-2006. In addition, the number of adverse consequences was more than twice as high during the 2006-2011 period than the 2004-2006 period. Power wheelchairs had more problems than manual wheelchairs. Another interesting point was that individuals whose wheelchairs were funded by Medicare or Medicaid had higher rates of breakdowns and consequences, compared to those covered by private insurance or other sources.

Do you find that wheelchairs are breaking down more often than they used to?  Do you find that routine maintenance helps to decrease wheelchair breakdowns?

Reference: Wheelchair breakdowns becoming more common. Retrieved from the web on 5/10/12 at

Wednesday, May 9, 2012

Shaving and Autism

I came across this video from RealLookAutism that shows how a young man with autism is learning to tolerate shaving with the help of his occupational therapist and his mother.  This is such a wonderful video that really helps to explain how sensory techniques can help some individuals to learn activities of daily living.  It also helps to demonstrate that certain skills can take a long time to learn but the goal is achievable.  The OT breaks the skill down, offers preparatory activities,  slowly introduces the shaving equipment followed by parent education helping this young man to be successful!

Tuesday, May 8, 2012

Spray Shapes and Patterns

Here is an old favorite therapeutic activity - spray shapes and patterns.  Cut up some fun foam into different shapes or use any foam shapes.  Using a spray bottle, squirt some water on a white board or mirror.  The fun foam will stick to the surface.

You could trace the shapes on a dry area of the board.  Once the shapes are damp the child can match them up to the outlines.  

This activity encourages:
  • hand strengthening
  • wrist extension
  • visual perceptual skills
  • math concepts
Looking for more activities like this?  Check out Play - Move - Develop.  

Monday, May 7, 2012

Fine Motor Skill Level and Handwriting

A student recently did a research review on the influence of fine motor skills on handwriting.  Of the nine articles that could be included, 7 researched the relationship between fine motor skills and handwriting legibility and 4 studies investigated fine motor skills and handwriting speed.   The results indicated that children with poor handwriting received significantly lower scores on fine motor assessments than children with good handwriting.  In addition, the research showed low to moderate correlations between fine motor skills and both handwriting legibility and handwriting speed.  The researcher concluded that in order to manage handwriting deficits in children occupational therapists need to address fine motor skills as one of many components in a comprehensive handwriting assessment.  Recommendations were made to undertake randomized controlled trials to examine if a fine motor skills intervention program leads to improvements in handwriting legibility and speed in children with poor handwriting.

Reference:  McKay, Rachel, "Fine motor skills influence handwriting performance in children : a systematic review; and, Handwriting performance in children with developmental coordination disorder : the influence of manual dexterity and motor overflow." (2011). Theses : Honours. Paper 27.

Friday, May 4, 2012

Hippotherapy and Balance

Physical Therapy published research on the effects of hippotherapy on balance.  Sixteen children with documented balance problems participated in 45 minute hippotherapy sessions, 2 times per week for 6 weeks.  Following the intervention the participants exhibited a statistical difference on the Pediatric Balance Scale (PBS) on the Activities Scale for Kids—Performance (ASKp).  The researchers concluded that hippotherapy may be a viable strategy for reducing balance deficits and improving the performance of daily life skills in children with mild to moderate balance problems.

Reference:  Debbie J. Silkwood-Sherer et al. Hippotherapy—An Intervention to Habilitate Balance Deficits in Children With Movement Disorders: A Clinical Trial.  PHYS THER May 2012 92:707-717; published ahead of print January 12, 2012, doi:10.2522/ptj.20110081

Thursday, May 3, 2012

Handwriting and Keyboarding Standards

Zaner-Bloser has proposed Written Language Production Standards for Handwriting and Keyboarding.   These standards offer developmentally appropriate, research–based indicators to integrate handwriting and keyboarding into the curriculum.  From the Zaner-Bloser website it states that the standards are:

"research-based and includes basic letter formation and keyboarding indicators included in the Common Core State Standards for English Language Arts, national and local technology standards and policy, state handwriting and keyboarding standards, studies in motor skills development from occupational therapists and data on language (written and oral) and brain activation from academic researchers".

You can get more information on the standards on the Zaner-Bloser website.

View the final Written Language Production Standards for Handwriting and Keyboarding.  

After perusing the document quickly, it has a great summary of the research on why handwriting is a functional skill that is necessary for literacy, enhances neurological development and facilities writing fluency.  It also discusses why children need to learn both handwriting and keyboarding to be successful in this age of technology.

 For each grade level kindergarten through grade 8, it provides standards for form and legibility, spacing and size, direction and alignment, rate and fluency, writing application and word processing (only grades 4-8).

Experienced and new pediatric occupational and physical therapists will benefit from reading this comprehensive document.

Teaching Motor Skills

The development in children of fundamental motor skills such as ball handling and locomotor skills need to be learned, practiced and practiced some more.  A recent research review in Child: Care, Health and Development aimed to determine the effectiveness of motor skill interventions in children.  The results indicated the following:

1.  A significant positive effect of motor skill interventions on the improvement of fundamental motor skills in children was found.

2.  Object control and locomotor skills improved similarly from pre- to post-intervention.

3.  Overall effect size for the control groups who only had free play had no significant changes

4.  There was a a non-significant, negative correlation between effect size of pre- to post-improvement of fundamental motor skills and the duration of the intervention (in minutes).

The researchers concluded that early childhood centers should schedule motor programs to facilitate motor skill development in children. 

Pediatric occupational and physical therapists can help to educate teachers and parents on the importance of teaching and practicing fundamental motor skills.  If you need ideas check out these sensory motor books:

Sensory Motor Group Activities A to Z
Locomotor Games 
50 Sensory Motor Activities for Kids!

Reference:  Logan, S. W., Robinson, L. E., Wilson, A. E. and Lucas, W. A. (2012), Getting the fundamentals of movement: a meta-analysis of the effectiveness of motor skill interventions in children. Child: Care, Health and Development, 38: 305–315. doi: 10.1111/j.1365-2214.2011.01307.x

Wednesday, May 2, 2012

Toothbrushing and Children with Significant Disabilities

Since occupational therapist's may teach tooth brushing for self care here are two recent research studies of interest that were published:

1. The results from a study of 176 individuals (76 had spastic cerebral palsy and 89 had no neurological impairment) indicated that intellectual disability can be considered a contributing factor for the development of dental cavities in patients with cerebral palsy.  The degree of motor impairment did not effect the development of cavities. 

2.  Brain and Development published research on the first report of passive tooth brushing seizures in an 11 year old girl with with severe mental retardation, hypotonic cerebral palsy and epilepsy. There has been reports of rare seizures that are induced when brushing one's own teeth but this is the first report of seizures from someone else brushing another person's teeth.

1.  Moreira RN, Alcântara CE, Mota-Veloso I, Marinho SA, Ramos-Jorge ML, Oliveira-Ferreira F. Does intellectual disability affect the development of dental caries in patients with cerebral palsy? Res Dev Disabil. 2012 Apr 19;33(5):1503-1507. [Epub ahead of print]

2. Kumada T, Nishii R, Higashi T, Miyajima T, Saito K, Hiejima I, Nozaki F, Hayashi A, Fujii T. Passive toothbrushing-induced seizures: Report of a severely disabled girl. Brain Dev. 2012 Apr 18. [Epub ahead of print]
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