Nutrition/Feeding Clinic at Easterseals DuPage & Fox Valley –The Comprehensive Approach 2021

By – Cindy Baranoski MS, RDN, LDN and Laura Van Zandt OTR/L

Updated February 2021

In January 2019, a groundbreaking article was published in the Journal of Pediatric Gastroenterology and Nutrition describing children challenged with feeding problems and their care. Pediatric Feeding Disorders (PFD) is the term the expert team of authors define as “impaired oral intake that is not age-appropriate, and is associated with medical, nutrition, feeding skill, and/or psycho-social dysfunction.” It establishes the basis for creating and implementing a medical diagnosis code that would support children identified as having problems in any of these four areas, which are impaired by or impairing a child’s ability to eat a diet that is expected for age.

It concludes with the primary need for children to be identified early and receive interdisciplinary evaluations and interventions instead of seeing one practitioner alone to try and help all areas. Interdisciplinary thinking, evaluations, and treatment have been the core practice of Easterseals DuPage & Fox Valley’s Feeding Clinic for the past 21 years, since its inception in 2000.

What Brings You Here

From the moment we are born, feeding and eating is something that is supposed to come naturally to everyone. When a baby is born, we feel an overwhelming sense of love and a strong desire to watch over, protect, and nourish to grow. When it’s time for feeding, our bodies are already preparing the necessary tools to breakdown and process what is provided. Feeding involves more than just our mouths. At play are the sights (color, shape, size), feelings (warm, hot, cold, crunchy, chewy, soft, sticky), smells (sweet, stinky), sounds (loud, quiet), and most significantly, the way our body works. From how our muscles work together to align our trunk in sitting, allowing our arms to reach, grasp, and explore, to coordination of suck, swallow, and breathe, and manipulating the food in our mouths, everything sets the foundation for a good relationship with mealtimes and foods. Our past and current experiences all shape our belief around feeding and nutrition. Your body must work all together to receive and process nourishment.

For some children, however, this process isn’t easy and doesn’t always come naturally. Many children struggle to coordinate their bodies to eat or drink and have GI systems that do not process foods well, leading to constipation, diarrhea, vomiting, and gastroesophageal reflux, which then leads to poor growth, frustrations, fear, and worry. For children with respiratory conditions, poor coordination of breathing, overall weakness, eating a meal like other children their age is nearly impossible. Yet, they still need what other children need – nourishment, socialization, variety, scheduled mealtimes, and interaction with foods. For children, who may be fed through a tube, eating may not be the primary mode of nourishment, but all the other factors promote development, health, and good growth.

As a parent, there is nothing more important than watching your child grow and thrive, and nothing is more heart-wrenching than watching them struggle. When a child does not eat, parents feel blame and guilt. We ask ourselves why? Did I do this? What could I have done differently? We try a host of different strategies. We Google and seek advice from family, friends, and medical providers. We fall back to what we know, which may or may not work.

Who We Are

Our Feeding Clinic at Easterseals DuPage & Fox Valley consists of a team of individuals who have a passion for helping kids with feeding, mealtimes, tolerance, health, and growth. Our team assesses the many different reasons why a child might be struggling. We are not just looking at their ‘behavior’ but dig deeper and aim to understand the core source of the behavior and what it is communicating. Eating is so much more than bringing food to the mouth, chewing, and swallowing.

Our Clinic consists of a pediatric gastroenterologist/integrative medical practitioner, registered dietitian nutritionist, speech and language pathologist, occupational therapist, and parent liaison. The team has over 230+ years of combined expertise and has gone on for extensive training in many areas, such as NeuroDevelopmental Therapy (NDT), Sequential Oral Sensory (SOS) Approach, DIR/Floortime, Respiratory and Rib Cage Development, Homeopathy, and Chinese medicine.

As a team, we review your child’s birth and developmental history before the appointment, with a thorough analysis of the diet record you submit. We ask you to let us know your evaluation expectations when filling out the paperwork, both online and written forms. Our goal is to meet these expectations. During the actual meeting we are looking and listening for red flags that clue us into issues driving the challenges your child is having. A list of possible reasons why your child might be seen by our feeding clinic is found in Table 1.

Table 1

What Happens, What We Do, and What’s Next

In this unexpected time of a pandemic, Easterseals DuPage & Fox Valley has seamlessly moved to a more virtual experience for nearly all services, including our Feeding Clinic. Keeping our clients, their families, and our staff safe is a number one priority while continuing to be one of the most impactful Feeding Clinics around. Our clinic has been providing virtual evaluations since April 2020, and our use of HIPPA compliant Microsoft Teams platform has allowed everyone to participate fully. When your child is referred for an evaluation by the team, our Clinical Admissions Coordinator will guide you through our secure system of the intake process. We have revamped the process to make it easier for you and provide written suggestions to help you prepare for the evaluation day. Being in your own home for the evaluation has so many benefits but also can seem overwhelming, so we offer tips on setting up your space to allow a more successful evaluation of your child with the least amount of stress for you.

During the interdisciplinary evaluation, the full team meets with your family virtually. Engaging with and helping your child feel comfortable, the speech and language pathologist and occupational therapist will give suggestions while listening and performing their physical assessment. We have worked hard to create a safe, calm, effortless process to continue to successfully support our Feeding Clinic evaluations, which continue to be very much in demand even in a pandemic. Parent’s positive comments and impactful outcomes of our evaluations speak for themselves.

Medical & Nutrition

First the team reviews and establishes your child’s medical health and overall nutrition status. Many medical complications from birth can impact a child. Undiagnosed medical and gastrointestinal (GI) problems often come to light in the clinic.

Think of your child’s health as the foundation of your house. If your foundation is weak, then the floors above it will compensate for weakness. If your child struggles from constipation, diarrhea, dysmotility, gagging, GE reflux, they are most likely subconsciously learning to connect food and drink to feeling poorly. Additionally, understanding your child’s nutrition helps the team understand what might be contributing to what is not medical, allowing the team to make appropriate recommendations to ensure optimal growth and health. Analysis of current nutrition includes what is expected for your child, balance, the timing of meals/snacks, calories, protein, fluid, hydration, vitamins/minerals, route of nutrition, and growth. Understanding both medical health and nutrition status allows for changes from the foundation first and foremost.

Speech and Language Pathology & Occupational Therapy

Observing how your child interacts and engages during the evaluation can help the speech and language pathologist and occupational therapist before they move on to assess the physical portion of eating and drinking. No matter where your child is in their journey with food and feeding, our goal is to have a positive relationship during the process. While observing your child, both therapists also look at their underlying motor skills and evaluate if any postural supports might be beneficial. Mary Massery, a well-known physical therapist, has said “breathing always wins”, and she is not wrong. Breathing dominates. Where your body is in space and stability is its second priority. Swallowing and feeding behavior must continually adapt to changing respiratory and postural systems.

The speech and language pathologist works to get a better sense of your child’s oral motor skills while the occupational therapist observes potential underlying sensory processing difficulties and relationship issues with food. Anxiety around meals and feeding can increase adrenaline which suppresses our desire to eat. Assisting with overall regulation is essential for comfort at mealtimes.

Social Services

The emotion with feeding and nutrition difficulties can be overwhelming for both the parents and child. Often, a child’s survival from birth and medical health is the primary focus, as it should be. When a child becomes more stable, a parent can start to see beyond the medical fears and begin to focus on other things such as the experience of feeding. With this new focus, the emotions, fear, concerns, and hope are still there. Whether your child is struggling to be an oral eater or being fed by tube, the emotions can be immobilizing. Our parent liaison is a vital team member in our clinic, helping every parent know they are not alone. She provides support, empathy, and connections to any number of resources.

Wrapping Up

By the end of the evaluation, the team confers together, with immediate and long-term recommendations being made. Often, these recommendations focus on gut health, breathing, positioning, or establishing improved nutrition, before working on some of the more therapeutic needs such as oral motor skills or sensory processing/relationship interactions. Sometimes recommendations are made to work on several key things simultaneously to help your child be more clinically stable, or a single recommendation that may be central to all other concerns identified. Returning to our 90-minute clinic for a follow-up visit may be one of the recommendations made.

Final Thoughts

Wherever you are at in your child’s journey, there are many aspects to feeding disorders in the pediatric population. Therefore, identifying and addressing all of them is a priority that should not be overlooked. Easterseals DuPage & Fox Valley’s Feeding Clinic has been and continues to view your child and his care from this interdisciplinary “Pediatric Feeding Disorders” approach, involving a skilled and expert team of professionals. Nutrition issues is an area that brings an enormous amount of stress and anxiety to a child and his caregivers. Our team is uniquely qualified and experienced to assist children at all levels of feeding, instilling hope and helping them be their very best.

Every child is unique, and each intervention is tailored to fit your child and family. While you research options you have, consider the following –

  • Aim to help your child feel their best. They need to feel well – this is key for success in any area.
  • Ensure your child is receiving sound nutrition, regardless of what they are currently receiving. There are many ways around getting your child good nutrition.
  • Assess their positioning with mealtimes and feeding to be sure they are fully supported. Positioning is key. Seated on a firm surface with feet flat on the floor or chair rail, with head and shoulders aligned over hips, equal weight bearing, is the most optimal positioning. Allow her arms to rest on her tray or table with shoulders down.
  • Ensure a regular schedule. Regardless of if your child is orally fed or through a tube, a mealtime plan is essential, and helps your child learn hunger and fullness, allows their bodies to sustain through the day, can improve their overall tolerance, and should have a positive beginning and end.
  • Patience – feeding therapy is a journey with bumps and curves along the road. Share your compassion and empathy. Learning to eat and mealtimes, after a rough beginning, might involve reshaping many memories. You might have to start over to build trust. Remember even the tortoise finished the race with the hare.
  • Expose, expose, expose and don’t limit opportunities for exposure. Have fun and play with food. Model appropriate food reactions – don’t “yuck someone else’s yum.” Continue to find ways to present food to your child even if he is not ready to taste them. You can read books together about food, visit different grocery stores and markets, kids cooking classes, and find ways to get them involved in mealtime preparation without eating. And even if it involves a tube feeding.

To learn more on our Feeding Clinic and Nutrition Department at Easterseals DuPage & Fox Valley visit our website at: https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/specialized-clinics/feeding-clinic.html.  Contact Clinical Admissions at 630.261.6287 or mscholtes@eastersealsdfvr.org  for questions or to schedule an appointment. 

18 Children’s Games to Stay Active Indoors

By: Laura Basi, PT, MPT

With the cold winter weather and limited ability to participate in many activities due to COVID-19, it can feel challenging to continue to find ways to keep children active. Fortunately, with a little creativity and imagination, there are many ways to help your children stay active indoors and have fun while you do!

I have listed the following activities and ideas to give you ideas as a starting point, but remember, some of the most engaging activities are when you place your own twist on them! Nearly all of these activities can be modified to fit your child’s unique needs, and don’t require buying extra toys or supplies. So don’t be afraid to change, break, or make your rules. You may even want to challenge your child to develop their own unique game or activities after taking inspiration from some of these existing ideas!

  • The Floor is Lava
    There is an actual board game one can purchase with this name, but it’s easy to create your own game with household items. You can create a course across a room or even throughout the house to navigate that has a start and finish with the goal being that you cannot touch the floor (the lava) — creativity wins here. The game can easily be tailored to age/ability level (and parent tolerance for furniture climbing). Try using couch cushions, pillows, toys, and other objects that can be used to jump to and from safely!
  • Simple Exercise Training Routine
    For elementary school aged kids who like to feel like they’re “training”, a good way to tackle a few exercises for building strength and endurance is by completing a number of reps that match the date.  For example, my son Will and I do jumping jacks, squats, sit ups and push ups every day…. 1 of each on the 1st of the month, and build up to 30/31 of each by the 30th/31st of the month…we break them up into smaller sets as the number gets high. Our goal is to complete them all in one day.
  • Have a Dance Party
    Put on a favorite song and dance/move any way you like to — this appeals to all ages because the kids can choose the songs. To get increased time out of this activity, try setting a timer and announce the family will be dancing for a set amount of time or a certain number of songs- perhaps one song per family member so that everyone gets to choose one. Make it even more fun by hanging up lights (a string of holiday lights works excellent) and otherwise darkening the dance party’s room.
  • Play Freeze Dance
    For younger children or those with limited endurance, play Freeze Dance. Parents can pause the song at random, at which time everyone dancing must stop in place. Kids 10 and under will find it funny to freeze in silly poses (or see their parents do so!), and the pausing will allow a brief rest break for those that need it. As a bonus, freeze dance works on pairing movement with listening skills and practicing starting/stopping on cue, something that kids with coordination disorders may need extra practice with.
  • Movement and Action Songs
    For preschoolers, many movement songs can be found on the web. This list here from Preschool Inspirations has many good ones. In addition, on youtube, I like Freeze Dance (The Kiboomers) and Listen and Move (TheKidsCartoons) because they prompt kids to vary their movement (i.e., dance, hop, skip, twirl, tiptoe, gallop, etc.).
  • DIY Stationary Bike
    For kids who need to practice pedaling for bike riding or for active kids who need to move, a bike with training wheels can be brought inside and transformed into a stationary bicycle. Modify the bike to become stationary by placing the front wheel on a towel and training wheels propped inside a pair of shoes to lift the back wheel enough that it will spin when the child pedals.
  • Keep the Balloon Up
    Keep the balloon off the floor gets everyone active and can be played solo or as a whole family – for families who enjoy some competition, hang string or yarn across the room as a “net” and play volleyball with the balloon.
  • Board Games
    Family Board Games that get you moving: Twister, Hullabaloo, Pancake Pile-Up, Floor is Lava
  • Minute to Win it
    Minute to Win It games are various 60 second challenge games based off the international game show of the same name. The games are engaging and practical because they all utilize everyday objects you probably already have around the house. A quick internet search will result in hundreds of ideas and you can also easily make up your own games for more fun. https://www.familyeducation.com/family-games/our-favorite-minute-to-win-it-games-for-kids
  • Prone Scooter Board
    For those with a skateboard, clean off the wheels and bring it inside to use as a prone scooter board — have your child lie on the board on their stomach and challenge them to get across the room only using their arms.
  • Build a Fort
    This one is a classic for a reason. Kids love the process of building forts! This activity encourages creativity and problem solving as kids figure out what materials to use and how to keep the fort from falling apart. Make sure your child takes the lead and participates in the building so that they are lifting, pushing, and pulling pillows, cushions, furniture, blankets, etc., to help create the fort. Modify your level of involvement based on your child’s age and abilities. Just make sure to challenge them to be creative and be active!
  • Build an Obstacle Course
    Younger children might enjoy turning this into a pretend game of animals in which the course is their animal home. Older children might enjoy acting like ninja warriors on their obstacle course. Be creative and incorporate lots of variety (climbing under, climbing over, jumping down, jumping over, crawling, reaching). Painters tape works great to place lines for walking or jumping over without damaging floors. Use sturdy furniture or objects for stepping/jumping from one area to another.
  • Create a Cocoon
    For kids who like/need deep pressure input or those who just enjoy pretend play, spread out a bedsheet or beach towel and have the child lie down along one edge as a caterpillar – the child can grasp the edge, or parents can tuck the edge between child’s arm and torso. The child then rolls themselves up in the sheet/towel, turning into a tight “cocoon” with only their head sticking out – they can push against the sides of the towel, imagining they are growing their wings. When ready, they roll in the reverse direction to unroll the sheet/towel and burst out as a new butterfly. This activity can be done on its own or incorporated into other “animal walks.” These walks could include:
    • Bear walking (walking on hands, feet, belly, and face down).
    • Bunny hopping (small jumps).
    • Frog jumps (big hops).
    • Crab walking (walking on hands and feet, belly and face up).
  • Cosmic Kids Yoga
    For kids who enjoy following along with a story, Cosmic Kids Yoga on YouTube and Amazon (free and subscription based options) is an excellent resource with a LOT of variety in length of time and story content. I recommend this program for children 3 to 8-years-old range who have difficulties with strength, postural control, balance, coordination and motor planning.  
  • Create a Dance/Gymnastics Routine
    Creating a routine can be done solo or works excellent with a sibling set. For extra fun, add in performance clothes, create a “stage” and encourage your kids to put on their show.
  • Spray Bottle Activities
    For hand strengthening, let kids play with spray bottles and squeeze bottles (could finger paint on the shower wall and then let them spray it off and then wipe it down or spray/squeeze water into cups). You can find countless spray bottle activities here.
  • Stuffed Animal Bowling
    Set up stuffed animals in a circle around your child and specify which animal the child should knock down. The child will need to turn their body and roll ball to knock down and stuffed animal. A great toddler movement activity!
  • Row, Row, Row Your Boat
    Child sits in a laundry basket, and caregiver will push the basket or tilt it side to side like they are on a boat. You can do it to the tune of Row, Row, Row, Your Boat or other songs.

I hope these ideas have helped you think of fun activities and games to keep children occupied and active in these unusual times. Remember that with a little creativity and imagination, the possibilities are endless! For more information on physical therapy services at Easterseals, visit: https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/physical-therapy.html.

Indoor Activities to Release Energy and Build Imagination

By: Occupational Therapist, Laura Van Zandt, MS, OTR/L,

Container Play Activity

By using simple materials and exploring your child’s natural interests, you can ‘sneak’ in some various fine motor or speech and language development for toddlers. Remember, get down on the floor and see where they take you in play – play is the work of the child, but it shouldn’t be hard. 

Work together to put some of your child’s favorite small toys in different containers. Containers can be found all over your house or after meals. Use a (cleaned) yogurt cup, oatmeal container, cereal or pasta box, delivery package, etc. 

Watch this video for the overview, or scroll down below for more information.

For my three-year-old, I had him pick out the toys, but you can do this ahead of time to keep it more of a surprise. You can easily incorporate different developmental skills into this simple task but remember to keep it fun and easy for you both. If it is too hard (or easy), here are some other ways to update:

  • Decrease or add language skills by sorting toys into different sizes or colors of containers
  • Use simple words that match the action and the emotional experience paired with affect in your voice to keep your child present and engaged (e.g., hard – stuck – pull –wow – etc.)
  • Explore pretend play (the options are limitless) – go to a store, have a party, have a snack, greet guests in different ‘houses,’ put bad guys into time out or jail, and more!
  • Work on fine motor skills by opening different containers or using different household materials to practice wrapping them) adjust the type of container based on your child’s abilities and base how you decorate on your child’s age.
    • If your child is between 15-20 months, you may only want to have them work on removing the tape and having the lids pre-opened, so they only have to focus on pinching and pulling. You can add simple things like markers or stickers to decorate if you desire.
    • If your child is closer to 24 months, you can sneak in scissors (supervised) to snip the tape before you wrap up the container. You can also include markers and stickers but add large shapes to scribble so you can color.
    • If your child is closer to 36 months, you can do all the same things above, but you can add more of a challenge by drawing lines or circles together to decorate.

Simple Sensory Play Ideas: Dump Truck Game

Ask any specialist working with kids, and they will tell you play is the work of the child. It’s through play that a child’s life becomes alive and enriched with endless life lessons. It is through play that boundless learning opportunities unfold.

The good thing about play is it doesn’t have to be complicated or even expensive. Play should be about you connecting with your child and following their lead. A toddler’s mind is like an unread book full of adventures just waiting to be experienced if we just let it unfold. The most essential component of play is being one with your child. If you allow them to express their interest, unlimited possibilities will present themselves.

In this video, I use my son’s interests in construction vehicles to provide him with some sensory input. When the seasons start to change, and winter is upon us, most parents find themselves all going a little stir crazy being stuck inside. Kids need movement just as adults need movement. However, kids especially need an outlet for all the fun imagination developing inside their little bodies.

Materials needed for this activity:

  1. You
  2. Your child
  3. Lots of pillows or you can use your bed for a soft landing cushion

Let your child lead you, however, here are some ideas to expand this play.

  1. Count to a specific number or use a particular word that your toddler needs to listen to before he can be dumped
  2. Have your child take an object with them to hide under the pillows / within the bedsheets to bring to the junkyard if pretending to be a dump truck
  3. Hide people/animals under the pillows / within the bedsheets to be a rescue hero flying and going to save the people/animals -> can expand the steps of play to bringing the people/animals to their homes once safely found
  4. Depending on where your child is at with his or her unique development, use less language and highlight only the key words paired with the actions (up, go)
  5. Wait for your child to do something to tell you he or she wants to play (e.g., comes back to you, lifts arms up, leans closer to the pillow to fall, etc.)
  6. The benefits of sensory play are endless and certainly can be enjoyed by all ages!

Make it Fun!

Remember, this is your time with your child. This activity can be as long or as short as you need it to be based on your available time. There are many ways to expand to work on speech sounds, language skills, movement, and fine motor. Sit back and
enjoy the process while the play unfolds. Have fun!

Ending Notes

For more play activities for all ages, search our blog at eastersealsdfvr.wordpress.com. If you are curious about how your child is doing or have concerns about his/or her development, we have a free screening available at askeasterseals.org. This tool looks at
key developmental areas: communication, gross motor, fine motor, problem-solving, and personal-social skills. Based on your responses, the results will help you see if your child’s progress is on track and alert you to any potential concerns.

If delays are identified, Easterseals DuPage & Fox Valley can offer the support needed to be school-ready and build a foundation for a lifetime of learning. Research proves that when children receive the right treatment and therapy they need before age five, they are more prepared to learn alongside their peers, build lifelong skills and achieve their dreams.

Supporting Families’ Mental Health

By: Easterseals DuPage & Fox Valley Social Services Team

Easterseals DuPage & Fox Valley’s family services team provides information, education, and support that address the concerns and stressors that may accompany having a child with a developmental delay or disability. In the past eleven months, these services and support for families were more vital than ever.

As we all gathered as much information about the novel coronavirus (COVID-19) as we could, it still left many unanswered questions, especially for children and caregivers, on how to communicate the potential illness changes. Social Worker Yvonne D. Anderson, LCSW, CADC, CODP II, shared many short stories to introduce resources and bring clarity and comfort to young children while their everyday routines are disrupted.  Our team quickly pulled together resources on wearing masks, social stories for a number of situations, and indoor activity ideas. Many can be found here.

Mental Health Needs

We also helped parents and caregivers of children with disabilities face overwhelming demands and difficult decisions based on the pandemic, stress of remote learning and loss of usual supports. As a recent NPR story shares, “(Lindsey) is one of almost 3 million children in the U.S. who have been diagnosed with a serious emotional or behavioral health condition. When the pandemic forced schools and doctors’ offices closed last spring, it also cut children off from the trained teachers and therapists who understand their needs.”

We know there will continue to be elevated needs and all of our clinicians, parent liaisons and social workers are participating in specialized training to broaden our mental health support services and help keep children and their families emotionally strong.

Clinical Successes

June* is a 9-year-old girl who has been treated for the past four years for anxiety through monthly social work visits.  Monthly visits were adequate to meet her needs and keep her anxiety at a level that did not affect her daily activities.  However, due to continued difficulties with school, it was recommended that June obtain a Neuropsychological evaluation.  The family had just completed the evaluation when the pandemic hit and home quarantine began, turning June’s world upside-down.   (*All children’s name or other identifying information has been updated.)

In March 2020, June began receiving weekly social work services to reduce her feelings of anxiety and to cope with staying home, remote learning and separation from her grandparents. June shares a close relationship with her grandparents and was used to seeing them daily, and suddenly she was not allowed to see them at all. June went to school every day, but her school shut down when quarantine started, and she began remote learning. Remote learning intensified her difficulties at school, and she began to resist attending school. Then June started to have nightmares about her family contracting COVID and dying, resulting in difficulty sleeping.

In April 2020, June increased to social services twice a week, and her treatment focused on reducing her anxiety. The results of her Neuropsychological evaluation were received, and she was diagnosed with dyslexia and severe dyscalculia. June’s parents were assisted in finding tutors for June to help with her reading and math delays and working with her school to adjust her expectations. June attends a private school and did not have access to having an individualized education plan initiated. Her school needed to be educated on these disorders and understand how they affected June’s ability to comprehend math and reading.

June continued to work with social work services twice a week from May through December 2020, working on adjusting to her new diagnoses and how it impacted her school performance, reducing her anxiety, coping with COVID, and being separated from her extended family and friends.

With a lot of hard work, adjusting home and school expectations, developing safe ways to visit her grandparents and implementing new coping strategies, June has reduced her counseling visits back to once a week. Her Easterseals social worker has been a big part of her success. The social worker, school, tutors, and parents, all worked together to advocate for changes and help her apply coping strategies to reduce her anxiety. 

Support for Virtual Learning & Socialization

Additionally, we found ways to assist families struggling to provide socialization and educational supports during their time at home. In one situation, a five-year-old with autism struggled with virtual learning and a new visual schedule helped the family manage school Zoom calls and other activities. By pairing mask wearing with screen time, it helped him get used to wearing a mask in order to successfully return to in-person learning.

Another child, Megan, needed support with safe socialization opportunities during the pandemic. By problem solving and working with the family, Megan was able to schedule virtual play dates, outdoor socially distanced scavenger hunts with neighbors, and more.

Support for Loss, Diagnosis and Care

One of the more difficult but vitally important aspects of caring for a child or adult with disabilities, is planning for care should something happen to a caregiver. During the pandemic, as parents realized their vulnerability in potentially contracting covid-19, we helped with guidance and resources to solidify care plans. While difficult, one set of parents planned for scenarios such as isolation from their seven-year-old medically fragile son if one of them became sick. Having a plan in place, helped ease the anxiety and the unknown of a virus we were all still learning about.

Many of our families have a large network of friends and family to support one another while caring for a loved one with disabilities. The pandemic cut off many of those support systems or diminished the ability to safely gather and care for one another in different households. Then, when a beloved grandparent ended up in the hospital for one of our families, they needed coping strategies to help with the inability to see their family member and more support after his passing. We were able to create new rituals for visiting virtually, help with saying goodbye and finding meaning in this difficult loss. These are tough concepts for any child and hard to understand when these visits and goodbye is virtual.

While a loss of a family member is difficult to process for all, we understand the loss of a job can also bring similar feelings of grief and anxiety to a family. As the primary wage earner in his family, when Josh was fired from his job, he felt lost and overwhelmed on how to help his family’s many needs. With the help of the social work team at Easterseals, he was connected with various resources from rent assistance, food pantries and free internet service to enable his children to attend school virtually.

One resource that has been helpful for families is Internet Essentials from Comcast, a low-cost, high-speed internet at home. During the stay-at-home order, a home Internet connection was more essential than ever for families. Comcast provides the Internet service and computers along with free training for the family. Families can get approved if they qualify for programs like the National School Lunch Program, housing assistance, Medicaid, SNAP, SSI and others. Learn more at: https://www.internetessentials.com/apply.

More than ever, we are reminded no one is truly alone at Easterseals. We fostered connections between families and found virtual opportunities to connect. We help reduce the many difficult child care decisions in a pandemic and find solutions that fit each family’s unique needs. Visit eastersealsdfvr.org or stay tuned to our Facebook page for more resources, parenting webinars and support in transitioning children back into school.

The Home for the Holidays Gift Guide

By Easterseals DuPage & Fox Valley Clinicians

If you are looking for the perfect holiday gift for your child, here are some gift ideas that will be both enjoyable and helpful for development as recommended by our team of therapists!

Pictures/Personalized Gifts

Personalized gifts, including pictures of family, can be used in numerous ways and grow with children. Babies and toddlers love to look at pictures of people they know. Children can drop the images into a small slot or bucket for a simple game as they practice saying and remembering the person’s name.

As children get older, they can also use the pictures to work on language skills like describing who they see in the picture, what they are wearing, where they are, and what they are doing. You could also play a game where you describe the picture, and the child has to find the one you are talking about. Or you can use a collection of photographs and design any number of your own memory games! Shutterfly even offers customizable matching card sets to make this extremely easy! 

https://www.shutterfly.com/photo-gifts/kids-games/memory-games?icid=Kids%7CSub%7CC1S13%7C10232020%7CFamilyActivities%7CMemoryGames&esch=1

Another option would be this photo album from Amazon, which holds up to 15 4×6 photos and is made durable for children. This is also a great product to help teach your child to recognize faces and learn family and friends’ names.

Another excellent option for an interactive gift is designing a custom book with personalized pictures for your child. PinholePress offers several different variations of custom books you can make based on it’s intended purpose and your child’s interests. Some of the custom book themes you can choose from include: Names & Faces, Healthy Habit’s, ABC’s, Colors, Emotions, and more!

https://pinholepress.com/c/board-books

Balance Toys

Balance toys are a great mix of both functional and fun and come highly recommended by our therapists. This particular toy is a favorite for kids aged 18 months up to 5 years. The 12-inch ball is the perfect size for little ones to sit on and can be used to address areas such as balance, core and leg strength, body awareness, and proprioception. It can be used during everyday activities such as playing with a toy or watching a favorite TV show, and it keeps the core much more active than sitting on the floor or sofa. For an extra challenge, children can try bouncing on the ball while keeping their feet on the floor (with pillows around them if you are afraid they might fall) or reaching forward toward their feet for toys and returning to upright sitting.

Clocks

This link below is an excellent visual clock to support understanding of time concepts. This analog clock helps children see the passage of time while using colorful graphics for those who cannot read traditional clocks yet. The minute hand has a bee on it because bees move fast, like minutes. The hour hand has a snail on it because snails move slow, like hours. When your child keeps asking when it will be time for dinner, you can tell them, “When the snail gets to the butterfly”. Setting the clock up on a stand or with magnets on the fridge can help children always have it available.

https://www.etsy.com/listing/650832335/bee-a-time-keeper-clock-childrens

Another option is the DIY Wondertime clock, which can be printed as a pdf and then added to a standard clock from staples or target. The instructional video can be viewed below if you want to follow along!

Click to access wondertime_clock.pdf

 

Books

Cooking with kids is so much fun (and maybe just a little messy)! Having children help select foods to make and participate in the cooking process frequently increases their willingness to try new foods. Cooking with kids is also an excellent opportunity to work on waiting, following directions, impulse control, math concepts, and turn-taking. Best of all, it’s sure to promote lots of smiling!

This cookbook offers some great healthy recipes for inspiring and introducing young chefs to cooking. Each recipe is easy to follow and includes pictures for every step to make the process fun and interactive.

This book all about vegetables is another great option for kids, as it introduces vegetables in a fun and approachable way with both activities and recipes. The author has over 15 years of experience as a feeding therapist and picky eating expert. Her book includes fun activities like making beet tattoos and jungles made of broccoli!

Just Ask is a WONDERFUL book to give kids and adults alike an overview of different disabilities. It teaches diversity, awareness, acceptance, and inclusion. The introduction to this essential topic will help your child become more aware and open-minded to all kinds of disabilities.

Adapted Toy Resources:

Adaptive Tech SolutionsAdaptive Tech Solutions is a therapist owned and operated company that provides adapted equipment for individuals with disabilities at affordable prices.

Beyond Play: Features switch toys which are wonderful way to teach cause and effect and can help children develop a sense of control over their environment and self-esteem.

Amazon Wishlists

While you complete your holiday shopping, don’t forget to checkout at smile.amazon.com with Easterseals DuPage & Fox Valley as your selected charity. You can also take a look at our wishlists for therapist and teacher requested items to send to our centers. Both efforts on Amazon can provide year-round support of our services and programs. The featured items make great developmental toys and gift ideas for children of all ages too. Thank you for supporting us this holiday!

  • Villa Park Wishlist
    • Features pretend play toys, art supplies, bubbles and baby and toddler toys
  • Elgin Wishlist
    • Features books, movement and baby toys for use in therapy
  • Naperville Wishlist
    • Features board games and sensory materials to use in therapy
  • Lily Garden Wishlist
    • Features kinetic sand, paint and playdoh supplies, fidget toys and more for our infant, toddler, preschool, and pre-k classrooms.

Remote Learning Seating Tips

By Laura Donatello, Physical Therapist and Positioning & Mobility Clinic Coordinator

As school districts return to remote instruction (many for the rest of the school year), the learning environment at home should be revisited. As an observer of your child’s school day you may notice when he/she needs a break or help focusing. Their seating position has a large impact on their ability to focus! You may have to experiment with seating positions to find the best productive space for their child.

Ideally, you want to help create a workspace conducive to good posture and free of distractions. The pictures below demonstrates what good posture looks like in an at-home learning environment. As you can see, there are multiple ways to position an at-home learning environment!

Seating Positions

1. Laying in prone on your stomach is a great way stretch your trunk and hips after sitting in a chair. You can put a small pillow or rolled up towel under your feet to relax your back.

2. Sitting on a peanut ball is another great alternative to sitting in a chair. The ball will provide proprioceptive feedback to assist with increasing arousal levels. Be sure your child’s feet are flat on the floor. It might be easier for your child’s feet to touch the floor with a peanut ball versus a round exercise ball because of the shape. Put something under the computer to be at eye level. A physical therapist can help identify the right size ball for your child. Also, a general tip is to measure the distance from the child’s armpit to the middle finger tip. This measurement will give you a decent estimate of what the diameter of your ball should be.

3. Tall kneel and half kneel are different floor positions which can be balance challengers. Encourage your child to keep their stomach away from the support surface. You could use a small towel or move the desk slightly away from their trunk to strengthen their core!

4. Using the wall is an easy tactile cue to encourage your child to sit with a flat back. If you do not have a small bench you can use a box. Your child can sit in pretzel style sitting while using the wall as support.

5. If you have an adult size desk chair, position blankets to make it child size! Watch for a couple minutes to see if your child is comfortable. If you notice your child leaning to the side, you can also put a rolled-up towel or blanket by their hip. Make sure their feet are supported with hips and knees at a 90 degree angle. If you notice your child leaning back, you might need another blanket behind their back. If you notice their trunk starts to come past their hips, you might need to take a blanket away. If their knees are higher than their hips, the support surface under their feet might be too big. If their knees are lower than their hips, you might need a higher footrest.

In this picture the height of the desk is set as if Henry were talking to his teacher and looking at the camera. If your child is watching something on the screen, you would need something else under the computer such as a thin box to keep their eyes level.

6. Another example of what a blanket can do for posture! In this example the blanket is rolled long ways and wrapped around Henry’s back to provide total trunk support.

Foam Roller Stretch

This exercise is one of the best activities you and your child can do after a long day at the computer! Grab a foam roller or roll up 1-2 towels. Lay on your back with your arms stretched out, your palms facing up, and your feet flat on the ground. Keeping your arms on the ground, bring your hands in line with your shoulders. If you notice your back start to arch bring your hands down. Stay here for the length of 1 song per day to stretch your pectoralis muscles!

A special thank you to Henry for being our model!

Alternate Seating Options & Focus Ideas

Occupational Therapist, Laura Harmasch, OTR/L, shares some additional strategies to help children who need extra help focusing! Headphones help and our recent blog post, covers how to help children with hearing aids use headphones and hear the best during remote learning sessions. Also creating a space with a trifold display board around the computer can help some children if they are easily distracted, have siblings playing or learning nearby to tune out all the other “noise” or activity around them.

Wobble stools may provide a good option for children who like to move around some when learning or working on assignments. I only recommend wobble stools or balls for kids with good trunk strength. Children with low muscle tone will fatigue too quickly using them, which may further limit their attention. A sit and move cushion is also a good option for children who need movement and have good trunk strength.

Additional Resources

Caring for a child during this pandemic is difficult, and it can be hard to know the proper supports for child development. Read our resources, find support and more here: https://www.easterseals.com/dfv/explore-resources/for-caregivers/covid-19.html.

Also if you need assistance documenting your child’s learning progress or needs, Matt Cohen and Associates, a law firm specializing in special education, disability rights, and school-related issues, provided a number of resources on our blog here.

How to Ensure Greater Videoconferencing Success for all Hearing Abilities

By: Karyn Voels Malesevic, AuD, CCC-A, Audiologist & Manager of Audiology

Living under the conditions of COVID-19 has many of us becoming more reliant on Zoom, Microsoft Teams, or other video conferencing apps than we ever thought we would be. Between conference calls for work, children learning at home, or catching up with friends or family, it’s apparent that these programs are here to stay. Using these video conferencing tools for an individual with a hearing impairment can be challenging. Below, I have a few headphone and room setup recommendations to make the experience successful for all. 

Considerations for those with Hearing Impairment

Using headphones with hearing aids

If you are the person with hearing loss and you need to videoconference, built-in speakers and mics are generally not going to cut it. When determining what headphones are right for you as an individual with hearings aids, you first need to recognize what type of hearing aids you use. Hearing aids are separated into two main categories, behind the ear (BTE) and in the Ear/Canal (ITE/C) hearing aids. Some ITC aids fit entirely in the ear canal and are known as Completely In the Canal or (CIC). These are the smallest and least visible hearing aid types. 

ITE/C and CIC hearing aids may give you the most flexibility when finding a pair of headphones. According to Audiologist, Brian Fligor from a consumer reports article, “BTEs are especially finicky because the microphone, which picks up outside sounds that are then processed by the hearing aid, is outside the ear canal.” “If you have a headphone that doesn’t sit up and over that, then you’re not going to pick up any sound through the hearing aid itself.” In either case, there should be an option that works for you and your specific style of hearing aids that can be found after some trial and error. 

According to Fligor “the key is to find a pair that’s comfortable and holds the headphone speakers a reasonable distance from the hearing aid microphone in order to avoid feedback. Fligor says a distance of 1 centimeter, if not a little more, is usually a safe bet.” It’s also important to note that some people who wear ITC aids may also comfortably wear on-ear headphones, which are typically lighter and more portable. For some users who wear CIC aids, which are the smallest, they may even be able to wear earbuds depending on the fit of their hearing aid. The end process will likely come down to experimentation as each individual, and their preferences will vary. 

The articles below share more information on the topic of hearing aids and headphone’s and will provide recommendations for specific headphone models.

https://www.consumerreports.org/hearing-ear-care/headphones-and-hearing-aids/

https://www.healthyhearing.com/report/52907-Using-headphones-with-hearing-aids

General Tips for Hearing-Friendly Video Conferences

Setup and Communication Style

Photo by Julia M Cameron on Pexels.com

The Hearing Journal addresses the importance of a successful video conference setup and recognizing communication styles. As a bonus, many of these tips help foster a better video conferencing atmosphere for everyone, not just those with a hearing impairment. The authors share:

  1. Secure a strong internet connection and a reliable visual setup to enhance non-verbal communication. Turn on your camera and sit in a well-lit space to brighten your face and avoid backlighting, such as light shining through a window behind a workstation. Sit reasonably close to the webcam with the top of the head to your elbows seen on camera.
  2. Foster high-quality audio and eliminate background noise. Use a high-quality microphone, headset/microphone combo, or earbuds. When you’re not speaking, put your microphone on mute to reduce background noise.
  3. Practice respectful communication etiquette. Speak in turn and state your name before speaking. Project your voice succinctly and articulately, and avoid fillers such as “so” and “um.” People with hearing loss have a hard time keeping up with spontaneous discussions and details, so try not to sway from the agenda and type your questions or clarifications in the chat feature of the videoconferencing tool you are using.
  4. Suggest these communication facilitation tips to the meeting host: Publish and stick to an agenda, request that questions, links, contact information, and other logistics be typed in the chat box that is visible to all participants, inform participants when the topic has changed, and give everyone, including the person with hearing loss, time to process the information and formulate a response.

For individuals with hearing impairment, adding real-time closed captioning can make a tremendous difference in their video conferencing experience. Many videoconferencing providers such as Google Meet, Microsoft Teams and Skype now include an automatic live captioning feature.

Your hearing needs are important and our Audiology Department can help. Hearing loss is one of the most common conditions detected in infants, children, and older adults. We welcome people of every age, from newborns to adults, and offer a wide variety of services from basic hearing tests and evaluations to hearing aids and hearing aid fittings, all using leading-edge technology. For more information on our audiology services for all ages and help for hearing aid , please visit: https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/hearing.html.

Support for Special Education Services in a Pandemic

By: Sharon Pike, Parent Liaison, with Brad Dembs, J.D., Matt Cohen & Associates

Easterseals DuPage & Fox Valley clinicians and staff provide information, education and support that address the concerns and stressors which may accompany having a child with a developmental delay or disability.  As a parent liaison at Easterseals, a highly trained parent of a child with a disability, we provide caregivers support from the unique perspective of someone “who has been there.” To provide more virtual support, we are connecting our favorite professionals to you through free webinars that answer your needs during this unique time.

Towards the end of the summer, we hosted a live Q&A event where caregiver’s asked questions to prepare for the complex upcoming school year with COVID-19 and how to best advocate for their children’s unique needs.

Now that school has been in session, join us for Part 2 on October 1 at 5:30 PM. Register for the Special Education: Remote, Hybrid & In-School Learning Check-In by clicking here.

Discussions was led by Brad Dembs, J.D., an Attorney with Matt Cohen and Associates, a law firm who specializes on special education, disability rights, and school-related issues. The following is paraphrased from the original discussion to provide insight to any who missed.

In general, caregivers for children who have an IEP are an essential part of their child’s education, now more than ever.

Q1: With so much conflicting information on education plans, and things changing so often, how can parents actually plan, or prioritize the most important parts of a child’s education right now?

The first step in answering this question would be to determine what’s the most essential part of your child’s educational goals. Ask yourself questions such as “What skills is my child learning and developing,” “Where was my child’s progress when remote learning started,” “Where did my child’s goals on their IEP expect them to be by now,” and “Has my child’s learning progressed, failed to progress, or regressed since remote learning started?” Asking yourself these questions can help clue you into what aspects of learning are most important to focus on. 

For many families, the most critical areas to prioritize are the development of threshold skills. For example, learning to read is a crucial threshold skill. Reading is used in all subjects and is one of the key fundamental building blocks of educational learning. If reading is something your child struggles with, that is something to prioritize when talking to your child’s teacher and about your child’s needs. Another essential threshold skill to focus on could include social skill development. It depends on your child and their disability, but in general, it’s helpful to think about the question “What does my child need now to take them to the next step” when thinking about educational goals to prioritize. 

Therapy Minutes & IEP

Q1: What are our rights in regards to e-learning and therapy minutes for remote learning?

A: As a parent, your rights have not changed. You are entitled to the same minutes that are in your child’s IEP. However, the reality is that school districts don’t have the same capacity to provide all those minutes or the ability to offer them in the same way they did in the past. Because of this, you must be flexible with your expectations even though your rights have not changed.

Q2: What should I expect for IEP minutes for OT & PT when a child usually received individual treatment. In the Spring, I was emailed a lesson, no Zoom tele-therapy offered. Is this correct?

A: No, and especially no, if there was not a discussion about it. This is what we would call a unilateral change outside the IEP process and is inappropriate. I would recommend putting a request in writing about the minutes that are needed and why those minutes are required. It always helps to have things in writing and to have additional support for what you’re requesting. If your child sees a private ST, PT, OT or mental health therapist and those clinicians provide a letter attesting to your child’s needs; it further validates your school district request. 

Service Minutes & Remote Learning

Unfortunately, not every school district will fulfill every obligation the way it is supposed to, and you may have to advocate for those services with methods discussed previously. Being flexible with your expectations is necessary as the guidance received from the State Board of Education is somewhat inconsistent and much is dependent on available funding and resources at each school district.

If you have any concerns about your child’s services, it is essential to request a meeting with your district and express your concerns. Start with what’s in the IEP and let them know what you have determined as a team for your child needs going forward. 

Again, make the process as collaborative as possible, be communicative in writing about what you’re looking for with your school district. If possible, provide documentation about why the request is essential and needed (more below and in resources). If you or another caregiver are home when your child receives remote learning, you have more insight because you have more opportunities to see what’s going on in your child’s education and see if what’s written in the IEP is being provided.

Q1: How do I communicate concerns with regression and remote learning?

A: Caregivers need to gather as much data as they can about how their child is performing. Because schools see their children less in remote learning, it’s essential for parents to be that resource and tell their child’s school what they can and can’t do. If remote learning is becoming impossible for your child, it is a tough position to be in.

In this situation, we recommend you talk to your school about having a teacher or service provider come to the home and provide service at a responsible distance. The accommodation is unfortunately unlikely, but it never hurts to ask. The end decision is up to the individual school district’s discretion. If you’re in a position where your school denies at-home accommodations, keep track of your child’s regression to be ready to advocate for more intensive services to make up for the regression when more in-person learning and services are available. 

This is called compensatory education, which refers to services that are needed above what has been provided to make progress that should have been made without a gap of service in the first place. This could include extra therapy minutes or more intensive instruction.

A Return to School

Q1: Some disabilities make it difficult to comply with COVID precautions, how can we navigate these to ensure the safety of all children but continue our child’s education?

A: This would need to be taken on a case by case basis depending on what the situation is. The Board of Education and Department of Public Health’s guidance is relatively general, and the end discretion is left up to the school district. In the case of masks, if a child cannot wear a mask, a face shield may be recommended as a reasonable substitute. Still, the child would have to practice social distancing as rigidly as possible because there is less protection with a face shield than a facemask. Not every school will allow children to wear face shields because it could be considered a significant alteration of their safety precautions. Some children who cannot wear a facemask may also not be able to wear a face shield. In other more extreme cases, a child who cannot comply with school safety procedures such as wearing a mask may be asked to remain in remote learning even when other children go back to school. 

Q2: How should students with disabilities who require one-to-one paraprofessionals be accommodated in a plan that emphasizes 6 feet of social distancing?

A: This may be a scenario where the support that’s written in the IEP may have to be changed due to practical considerations. The child’s individual needs need to be assessed alongside safety practices. This would depend on whether the child can attend school without the help of a paraprofessional. If they cannot, and it’s still possible to have safety protection in place via wearing a mask, it may be appropriate to have an aide closer than 6 feet. Schools should be training and updating their staff on safety procedures, particularly related to individual students with disabilities. Individual accommodations will need to considered by staff to make it possible for students with disabilities to attend safely. 

Q3: Can I request certain precautions to be taken if my child goes back to school in the Fall? My child likes to lick and put her fingers/hands in her mouth.

A: You have the right to request accommodations for safety. You should discuss this with your district and any outside providers your working with as they can help you determine what can be done to accommodate any safety issues or concerns. This is a challenging example because accommodations of gloves or other hand protection could quickly become contaminated as easily as bare hands. This is a case where a collaborative effort would need to be reached between your education provider and any other outside clinicians. If no attempts work, the school should be willing to accommodate and continue to provide remote learning. 

Resources

Matt Cohen & Associates provide a number of resources that can help document needs and open communication with your child’s education providers. See the links below.

This is a big topic that has many variables for each child’s needs and school district. For more information, there are recorded presentations on our website that go into detail at: https://www.mattcohenandassociates.com/presentations/

Parent Liaisons at Easterseals DuPage & Fox Valley have firsthand experience with IEP meetings and are available to answer questions or provide resources on the topic. For more information, visit: https://www.easterseals.com/dfv/explore-resources/for-caregivers/iep-help.html.

Girl in mask playing with tree toy in classroom

Prepare Your Child for Kindergarten During the Covid-19 Pandemic

By: Katie Kwiatek, Pre-Kindergarten Teacher at The Lily Garden Child Care

Will your child be five years old before September 1st, 2020? If so, get ready to send them off to kindergarten this Fall!

But, wait!

Since schools and day cares have closed, I’m afraid my child will have a tough time transitioning back to a school setting. What skills do they need in order to be kindergarten ready? There are so many new procedures for children to learn too! How can I help?!

Here’s what you can do to prepare your little one!

Create a daily schedule that mirrors the average school day.

It can be a rough transition from quarantine life to a school schedule. It’s so easy to fall in to the habit of staying in pajamas all day, being a couch potato, eating right when you feel hungry, etc. Once your child goes back to school, they will have to follow a schedule of: when to eat, when to play outside, when to sit still, when to be silly, and when to be serious. For everybody’s sake, create a structured schedule for the typical work week and keep weekends open and fun!


To mirror your child’s average school day, contact the teacher! They’ll be more than happy to send you an outline of a typical day. Make sure to keep your schedule consistent! Children need structure and consistency! They like to know what comes next and what is expected of them. If your child tends to feel nervous/anxious, having a consistent schedule will help ease them. Let your child know before you implement a new schedule- explain the new routine, make a chart together! Here is a resource for parents about creating structure and rules.

For all children’s success in this current pandemic, practice wearing masks at home and getting comfortable with wearing them for extended amounts of time. Practice frequent, good hand washing and reminders to limit touching of their face. We know this is easier said than done! Check back on our blog and social media for upcoming tips and resources around mask/face coverings and remote learning.

This is a challenging time for families and it is hard to know what the school environment and year will be like for your child. With some careful preparations and conversations, your child can have success. By sharing a positive attitude surrounding school, the new rules and the big change to Kindergarten for your child, it will help him/her feel ready to learn and ease some anxiety.

Work on social and emotional skills at home. 

Social and emotional skills are a key ingredient for kindergarten readiness. Your child needs to learn how to express and cope with their emotions appropriately and form healthy relationships with their peers and grown-ups. How can you work on social and emotional skills at home? Its very simple! Do your best to keep your own emotions in check and talk, talk, TALK!

Remember, your child is always observing your behavior. Think out loud, show them your thought process when you’re upset. When your child is upset, describe their face & body language, label the emotion, and provide a solution,  “I see your body is tense and your eyebrows are drawn. You are frustrated. Lets take 2 deep breaths and do 3 hand squeezes together.”  While reading a book or watching a TV show, describe the characters and ask questions, “That man is yelling at that girl and his face is red. He is very angry. How do you think she feels?”


Here is a resource about building social & emotional skills at home:
https://www.naeyc.org/our-work/families/building-social-emotional-skills-at-home


Click this link for a list of books about emotions:
https://www.pre-kpages.com/books-emotions-preschool/

Encourage your child to be independent! 

Being independent and having self-help skills is another key ingredient for kindergarten readiness. Your child will likely be in a classroom with over 20 students and 1 teacher and keeping distance between each other. This requires your child to be as independent as possible.

 

Here is a resource about self-help skills:
https://childdevelopment.com.au/areas-of-concern/self-care/self-care-skills/

Click this link for the self-help development chart:
https://childdevelopment.com.au/resources/child-development-charts/self-care-developmental-chart/

To promote independence and improve self-help skills at home, work on these tasks:

  • Picking out clothes for the day
  • Getting undressed and dressed independently
  • Putting dirty clothes in a laundry basket
  • Brushing teeth & hair
  • Take off & put on shoes
  • Put on a jacket and zip/button it up
  • 100% bathroom independent (potty trained & wipe independently)
  • Properly wash hands
  • Hang up a jacket & a backpack on a hook

Allow boredom 

Why do you want your child to be bored? From boredom comes imagination and creativity! Its essential for every child to have a lively imagination, to think outside of the box, and to express themselves creatively. They’ll be able to carry this trait through school to adulthood. Keep your child’s imagination alive! Provide them with art materials and encourage open-ended art, have them express themselves through music with pots & pans (put on headphones if you’re working from home 😉), encourage them to create puppets and put on a puppet show! Even chores can provide great lessons in executive functioning.

Here is a parent resource to fire up your child’s imagination:
https://www.parenting.com/activities/kids/10-easy-ways-to-fire-your-childs-imagination-21354373/

Make learning fun!

Each kindergarten has different standards and academic requirements prior to starting. Contact your local school district to get more information. Typically, your child should be able to copy upper & lowercase letters, recognize some-most letters, know numbers 1-10, classify objects by shape & size, and be able to use scissors & glue with ease.

Here is a resource of more skills your child should know:
https://www.scholastic.com/parents/school-success/school-life/grade-by-grade/preparing-kindergarten.html

With many kindergarten screenings cancelled this summer, you can use the Easterseals FREE child development screening tool, the Ages & Stages Questionnaire, to help measure and keep track of your child’s growth and development. This is a great tool to provide your teacher and child’s doctor on areas they may need assistance to grow.

Take a free development screening. askeasterseals.com

How to make learning fun?

Create a pretend classroom for your child to play teacher and you play student! This area can serve as your child’s remote learning area too. This is an opportunity to grow your child’s love of learning. Give them assorted classroom materials: clipboards, pencils, paper, books, alphabet & number cards (use whatever you can find in the house or find free printables online). Are there certain letters, numbers, or shapes they have trouble with? Don’t focus so much on worksheets- instead find fun hands-on activities!

Click this link for letter activities:
https://www.pre-kpages.com/alphabet/
Click this link for number games & activities:
https://www.pre-kpages.com/counting-games-activities-preschoolers/
Click this link for shape activities:
https://www.pre-kpages.com/shapes-activities-preschoolers/

We know how agonizing the decisions for the next school year are for your family. If your child receives school therapy services, is unable to wear a mask, or if remote learning is not an option for your family, it can feel especially challenging. Whatever decision you make, we are here to support you. Contact our Social Services team for support and resources at socialservices@eastersealsdfvr.org. We will have more information on our blog around these important subjects in the months ahead.

We remain committed to providing the highest quality services to improve the lives of children and those who love and care for them. We understand that a child’s needs to succeed look different for each family. For over 75 years, our clinical team has provided individualized therapy plans to best achieve a child’s goals and support healthy families. This pandemic only solidifies our commitment. Let us know how we can help you in the comments.

Understand and Boost Your Immune System

By: Manager of Nutrition Therapy, Cindy Baranoski MS, RDN, LDN

Better Immunity is Achievable

What better time than now to start building your defenses against illnesses? With coronavirus or COVID-19 here, there is a lot of fear and a feeling of helplessness to do anything. But you should know that there are things you can do to help protect yourself and your family’s health overall.

As a human we are bound to become ill, but how that illness manifests in us, how extreme are the symptoms, how long does it last, when does it go away, and can we get it again, can be under a bit of our control if we do the right things to keep our body’s immune system and defenses strong.

What Protects Us From Illness

Many components make up our defense system, some we can control and others we cannot. A human body contains trillions of microorganisms or microbes that outnumber our cells by 10 to 1. The term ‘microbiome’ refers to the genetic material all of these microbes contain, and their total genetic material is 200x more than the number of genes in a human body. Many of these microbes are pathogenic, or able to cause disease, but coexist with a human body never causing disease. Consider that two to six pounds of a 200-pound person would be bacteria!!

The immune system

Our immune system is made up of cells that perform the ‘immune response’ to foreign invaders, such as disease causing bacteria, viruses, fungi, parasites or any other foreign matter. B cells, T cells and Memory cells are all mobilized in some manner when they determine there is an antigen – a toxin or foreign substance – that has entered the body. The response is antibodies matched to an antigen, like a key in a lock, helping to neutralize or destroy the antigen.

Physical protection from foreign invaders

Our body has many physical systems in place to keep us healthy and protect us from foreign microbe invaders, or the ones living within us, from causing disease.

  • Skin – is a physical barrier, with a pH that discourages growth of organisms, and our secretions of sweat and oil can kill many bacteria.
  • Stomach – acid in the stomach can kill organisms.
  • Tears – will wash away any foreign matter and contain enzymes that kill bacteria.
  • Saliva – helps clean microbes from our teeth, tongue and oral area.
  • Respiratory tract – including our nose, which contains fine hairs to trap foreign matter, mucous lining the system to trap invaders, and cilia to sweep away trapped organisms.
  • Large intestines – contains bacteria that help keep invaders in check. This ‘gut microbiome’ makes up 70% of our immune system.
  • Bladder – urine washes away microbes from the area leading to the outside world.

What we Have Limited Control Over

Chronic noninfectious conditions, such as cancer, diabetes, hypertension, high cholesterol, heart disease, inherited genetic conditions all play a role in diminishing the defense system of the human body. Those that are most notable include the following –

Heredity – is one of the greatest factors that influence our noninfectious disease risk. Our genes play an important role in what conditions, such as diabetes, cancer, hypertension, may occur in our lives. These conditions impact our immune system, and can leave us more susceptible to disease.

Age – after 40 years of age the human body is more vulnerable to chronic diseases, though very young children whose immune systems are still developing, or those over 65, are especially vulnerable.

Environment – and the ability to have clean, sanitary living conditions is key to keeping us healthy. Though our bodies need to be exposed to microorganism to help our immune systems develop resistance. Too clean doesn’t allow our systems to recognize good and bad microbes. Additionally, conditions that include the presence of drugs, chemicals, pollutants, waste in food and water, or the absence of medical care, increase risk for disease.

Microorganisms – severity of or resistance to pose challenges as well. For some, only one cell is needed to create drastic illness in the human body. Bacteria that become resistant to antibiotics from overuse by us have mutated to be able to bypass the antibiotic’s effectiveness.

What We Have Control Over

Though we cannot see most of the microbes that cause sickness, they are there, and we can create an environment within and outside of our body that prevents them from causing illness. Stress, personal hygiene, nutrition, fitness, sleep, substance use, environment, and behaviors are all under our control.

Stress, such as what we are experiencing right now diminishes our ability to fight disease. When we are stressed our body will divert its energy away from nonessential functions to those that are essential – the Fight, Flight or Freeze response. Our blood is redirected to muscles to run or fight, breathing is faster, heart rate increases, pupils dilate, and hearing is keener, ready to take on the Sabre Tooth Tiger that generally doesn’t exist. What our body prepares to fight remains invisible, but it is prepared at all times. This leaves body functions required to exist in an unstressed state diminished in their ability.

Reducing Stress

If you’ve not already received numerous emails or suggestions from friends, there are many ways to manage your stress. Any one of these should be done with care, intent, and in such a gradual manner a snail could pass you by. Safety is key, to not create an injury or situation that will cause you more stress.

Exercise is one way, and has more than just stress reduction benefits. A workout club or gym may not be available to you, but you have so much in your home that is available!

Walk out your door for 15 minutes, turn around and come home. You’ve just walked for 30 minutes.

Turn on some fun music and simply march or walk in place for 20 minutes.

If you live in a condo or apartment building, do the stairs (taking precautions with social distancing and face masks right now.)

If you don’t have weights, you can use cans, bottles, something of weight that you can use for dumbbells.

Floor exercises that are easy, safe and you do not over do such as sit ups, leg raises, push ups. You only need to do a few, or even just one.

Yoga can be done on your own, without one piece of equipment. There are recorded and live streams of yoga all over the Internet today. As a yoga instructor, I can share that anyone can do it! Yoga is not just for bendy, flexible, skinny-legged sweaty 25-year-olds.

Chair yoga is amazingly beneficial, and is done by 85-year-olds around the globe.

Restorative yoga is one of the most relaxing forms of yoga, where you are supported by props, which increases your parasympathetic nervous system, slowing your heart and relaxing your body.

The yoga many are familiar with regular upright movement, is a wonderful stress reliever-though remembering if you’ve never done yoga, it may contribute to more stress.

And if nothing else, just laying on the floor, on your back, legs and arms out on the floor (or knees bent), known as savasna, is one of the most important poses in yoga. Lay there for 10 minutes.

Meditation may sound all “woo woo,” but it is more than just crossing your legs into a pretzel, closing your eyes and chanting ‘ommmm’. Meditation is simply anything you do to direct your mind to become focused on one thing, taking you away from this world momentarily. It reduces the physical reactions to stress mentioned above, slows your breathing, quiets your organs, increases your parasympathetic nervous system, and quiets your racing mind. The benefits of meditation are not IN the meditation, but in your body’s response when not meditating. By helping to maintain the ‘quiet’ your body should be in, your immune system can work it’s best.

Reading a book, gardening in the yard, coloring, drawing or painting, and praying are all forms of meditation.

Traditional meditation takes practice, and yes, sitting quietly, not moving, eyes closed, is what many think of. Try sitting still for 1 minute with your eyes closed. You’ve just started meditating. Now, get comfortable in a supportive seated position, and try it for 5 minutes. This is how you start to meditate with intention to do so, knowing it can only help.

Numerous meditation apps exist now, with timers, streamed and recorded meditations from 1 minute to many. Examples include:

Laughter should not be discounted by any means. Laughter is the best medicine! It can decrease stress hormones, relax muscles, and decrease pain. Ten minutes of laughter is better than any drug!

Sleep is a time when our body heals, rests, and prepares for our next day. Restful sleep is often not possible when we are stressed. 7-8 hours a day for an adult, and more for children and teens. There are many activities that can impact restful sleep, including technology, alcohol, eating before bed, and stress. Helping reduce your stress will promote restful and restorative sleep. Aim to create a bedtime routine for you and your family with no technology, eating, bright lights, noise – good sleep equals less stress, and less stress equals good sleep.

Personal Hygiene is something we take for granted. We have soap, water, tooth brushes and toothpaste, showers, baths, shampoos, hand sanitizers and hand soaps. Just so many forms of how we can keep ourselves clean on a daily basis. We forget this is not available to everyone in our area or the world. But keeping ourselves clean is something we can do, easily, by washing our hands routinely – especially now.

Improving Personal Hygiene

The greatest source of infection is our hands. We touch everything, then ourselves, transmitting to someone or us, germs and potential antigens. Wash your hands – for 20 seconds – with soap and water, between the fingers, back side of the hands, under the nails and wrists.

When you cough or sneeze, cover up! Most of the time we have on shirts, right? Pull it over your nose and mouth, use your elbow and sleeve, and if you use your hands, wash them after.

And now we have face masks. So treat your face mask like you do your underwear

only wear it if it’s clean

don’t touch it or adjust it – especially in public

don’t lend it to anyone

don’t borrow anyone’s

make sure it fits well

wash it after wearing

if it’s stained or torn, throw it away I

From A Chalkboard a Day

Nutrition is one of the key contributors to the immune system. Remember, we are built on what we consume and do with our bodies. The ingredients for a great body include what we consume, and if all we eat and drink is lacking in nutrients, then that is who we become. Under nutrition or malnutrition is not reserved exclusively for poor families and children who are skinny and wasting away. Malnutrition is found in obese individuals as well as healthy weight ones too. http://www.MyPlate.gov shared by the USDA gives a basic outline of what should be consumed for variety of all the nutrients, including Carbohydrate, Protein, Fat, Calories, Fluid and 29 known vitamins and minerals. We are what we eat! To learn more about helping a child with nutrition or feeding issues, visit: https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/nutritional-therapy.html.

Improving Nutrition 

  • A balanced diet containing of all the different food groups is the starting place. Review your family’s diet, and see if you have foods representing Fruits, Vegetables, Protein, Dairy (animal or plant), Grains (whole) as well as fat. Is there enough fluid each day? Are there vitamin/mineral supplements taken already. Are there nutritional drinks being consumed each day, and what might these be replacing or supplementing if they are used regularly. What about processed foods, high sugar, fat and salty foods that are being consumed more than they should be. Are fresh foods represented well? And is one food group consumed in a much greater quantity than it should be? You need to review your diet before you know what to change to make it better.
  • Protein is one of the most important nutrients, helping make antibodies of the immune system. We all need varying amounts of protein, but we also don’t need as much as we think we need. An average adult needs about 50 grams of protein a day, and consumes about 100 grams a day in the US. Children need less than this, yet often consume more than they need as well. Main food sources include meat, fish, poultry, egg, legumes, dairy.
  • Malnutrition and under nutrition exists in this country, and includes lack of calories and protein, but often times our society consumes more than enough of these two nutrients, however, lack many vitamins and minerals. A recent government study shows potassium, calcium, Vitamin E, C, A, D and magnesium are all less than optimal in our diets. All vitamins and minerals are ingredients of our immune system.
  • A few nutrients identified in research as key to the immune system and it’s response, that you should be sure you are receiving adequate amounts of, include the following –
    •  Zinc – found in tuna, beef, poultry, pumpkin and hemp seeds and dairy. Caution, over consumption of zinc, or taking large supplements, can interfere with copper balance in the body.
    • Selenium – found in Brazil nuts, tuna, sardines, salmon, chicken egg, brown rice.
    • Vitamin C – found in acerola extract, rose hips, camu camu, black currents, guava, lemons, limes, oranges, strawberries. Though higher doses can cause loose stools.
    • Vitamin D – does not have many great food sources. Fortified animal and plant milks will contribute when consumed in the right portions. Short periods of exposure to the sun without sunblock allows for production of Vitamin D beginning in the skin. However, with the concerns for skin cancer, sun exposure is limited. Supplementation of Vitamin D3 is the most reliable source.
  • Probiotics are beneficial for the human body. Studies have shown their benefit to the digestive tract, and ultimately the immune system, by ensuring the line of defense in the gut microbiome is balanced and working well. They are found naturally in some foods, and more common are manufactured supplements taken orally. ‘Prebiotics’ are food for the probiotics and are found naturally in our gut through consumption of fiber, but can also be found along with probiotic supplements.
    Important Note on Vitamins, Minerals and Probiotics – Taking large amounts of any supplements, or consumption in large amounts of any individual or multivitamin/mineral supplement is not advised. If you are choosing to do this for you or your child, you are directed here to speak to a physician or dietitian.

Environment and Behaviors could be discussed in so much more detail than this post can provide. But know your behaviors are under your control. What you do impacts anyone and everyone, including our world. The environment is not just something that happens, but is changed by everything we do. Being thoughtful of ourselves is so important, but if we become so self absorbed and focused in the long run, our world will become more skewed from what it should be, which ultimately comes back to our ability to be healthy in this world.

In summary
Creating a place in your world that is safe, clean, nutritive, and supportive of your immune system is totally within your reach, taking time and attention. The scary world of viruses and diseases that are out of your control can be managed, and the impact it has on health – yours, your family’s, friends, and society – is pretty significant. There is so much more, but I hope some of the thoughts and ideas mentioned here might stir you to rethinking your role in this world of immunity.

I wish you and your family the best health. For more information on our nutrition services, please visit: https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/nutritional-therapy.html.