Positioning and Mobility Clinic Overview

By: Allie Katsiris, PT, DPT

What Does the Mobility Clinic Do?

The Positioning and Mobility Clinic at Easterseals provides a comprehensive evaluation of a child’s adaptive equipment needs. It is a collaborative clinic consisting of a physical therapist (PT) and an assistive technology professional (ATP) from a durable medical equipment vendor. Of course, the child and their family members are also valued members of the team. The two vendors that attend clinics at Easterseals are Numotion and National Seating and Mobility. There are a lot of options for seating and mobility devices available on the market, so the PT and ATP will utilize their knowledge, experience, and expertise to recommend the most appropriate equipment for your child.

The Process

At the initial evaluation, the PT and ATP will complete a comprehensive evaluation of the child including assessment of posture, range of motion, functional mobility skills, home assessment, and child/caregiver goals. Recommended mobility equipment may include: adaptive strollers, manual wheelchairs, power wheelchairs, or power assist wheelchairs. The clinician will also assess the need for specialized car seats or adaptive bathing equipment.

Following the initial evaluation, the PT will write a letter of medical necessity for the device. This letter will be sent to the child’s physician to be reviewed and signed. The vendor will submit the order and the letter to this insurance company for approval. Once approved, the device is ordered then delivered to the child. The PT and ATP work closely upon delivery to ensure the child is positioned appropriately and that the family understands all features for safe and effective use of the device. We recommended yearly rechecks to ensure that the device continues to properly support the child.

Home and Environmental Factors we Consider

There are many factors that are considered when deciding on a mobility device. In addition to evaluating postural alignment and medical history, the team will ask about your child’s current mobility skills and goals. We will consult with primary therapists as needed to best understand your child’s abilities, functional goals, and endurance level in order to best recommend a mobility device. The team will also ask about your child’s home and school environments. Some considerations include: whether your home has stairs, location of the child’s bedroom/bathroom, and width of doorways.

It is important that the child be able to utilize recommended equipment in all environments to promote his/her best alignment and independence. Another important factor in recommending a mobility device is how the child is transported. Do you drive a compact car or SUV? Do you have an adapted vehicle? Does your child ride the school bus? The answer to these questions will help guide to whether a folding or non-folding option and transit accessories are required. Due to insurance limitations and expectations that mobility equipment will last 5-10 years, it is important that all of these factors, growth, and future needs are considered in order for the equipment to support the child for years to come.

Quick facts about the various types of equipment:

Adaptive Strollers:

  • Provide support for children who have decreased postural control, endurance, or safety in the community.
  • They are typically lighter weight than wheelchairs and fold more easily.
  • There are some limits to the customization of these devices.

Manual wheelchairs:

  • Provide postural support for children who walk with limited endurance or who are unable to walk.
  • A child can push/ move this device independently.
  • There are folding and non-folding options.
  • Can be customized to fit a child’s needs.

Tilt in Space wheelchairs:

  • Provide postural support and can tilt backward for rest breaks or medical needs.
  • Children are dependent on caregivers to propel the device.
  • There are folding and non-folding options; although they tend to be bulkier than manual wheelchairs.
  • Can be customized to fit a child’s needs.

Power wheelchairs:

  • Provide postural support and power control
  • Can be operated by the child.
  • These are unable to fold so the family should consider home and car accessibility.
  • Can be customized to fit a child’s needs.

How to Get Started

At Easterseals DuPage and Fox Valley, we appreciate the importance of providing children with a safe means of mobility. This allows children better access to their communities and increases overall participation with their family and peers. We also recognize that the equipment ordering process can be overwhelming, so we are here to support you and help your child obtain the equipment he/she needs to thrive! Please contact us to schedule an appointment: 630-282-2023 or click here to learn more.

Formula Concerns & Availability

by: Easterseals DuPage & Fox Valley Nutrition Team

Given the shortage of formula in the country (a combination of supply chain issues and product recalls), we know many families are looking to us for help. We understand the ability to feed your child shouldn’t be a concern. For many, this is a scary and anxious time. It has been hard during our nutrition evaluations to recommend any specific type of formula, as the availability is hard to control. A can today may not be available the next time you need it. No one should be without the nutrition they need, and we are here for you.

To help, we have talked with all of our formula contacts to give you resources to find formula and recommendations. We did our best to get you access and an insider view on what steps you can take. Scroll to the manufacturer you need for QR codes, guides to switch formula and more.

We know that manufacturers and legislators are doing everything possible to make more options available. But it will still take 6-8 weeks to get availability at a more comfortable level. In the meantime, please only take what you need for a week or two. Leave formula, especially specialty formula for children with allergies, on the shelf for those that truly need it. And please don’t dilute formula to make it last longer. This results in a lack of nutrition and not enough calories for infants. This can have serious consequences, such as increase risk of seizure.

Finally, please be cautious with recipes that are floating around to make your own baby formula, without consulting with a medical professional first. Many homemade recipes contain ingredients that are not safe for young infants, are low in calories, and are not nutritionally complete. Feeding a baby homemade formula can cause problems with growth and nutritional deficiencies.

About Formula & Brands

Just like adults, babies need protein, fat, and carbohydrates in their diet. Infant formulas sometimes differ in which specific proteins, fats, and carbohydrates they feature. Breast milk has two protein sources: whey and casein. Some infant formulas have both of these proteins, while others only have whey. All meet the FDA’s requirements. Similarly, infant formulas can differ in the type of fat they use. All infant formulas sold in the U.S., whether they are name-brand or store-brand, must meet the FDA’s standards to ensure proper nutrition for your baby.

Generic or store brand infant formulas are very similar to national brands. They even use similar marketing terms, including:

  • Advantage = Advance
  • Gentle = Gentlease
  • Sensitivity = Sensitive
  • Tender = Gentle

Most store-brand baby formulas contain DHA and ARA, prebiotics, and nucleotides, just like brand-name infant formulas. Almost all—including store brands made for Walmart (Parent’s Choice), Target (up & up), Walgreens (Well Beginnings), and Kroger (Comforts for Baby), etc.—are made by the same manufacturer: Perrigo Nutritionals. Read more from verywellfamily.

Some children have no issues with transitioning to a new formula, while others may need a little time to adjust. For some children, new adjustments to their diet may cause gastrointestinal (GI) changes. If you need support for your baby’s allergies, constipation or other emerging GI issues, please contact a pediatric dietician for support.

Due to the shortage, now may be the time to move a toddler or older child off of formula and transition to another option. We know this change can be scary. But many families have found this has been a needed push with a beneficial outcome.

See below for a formula comparison chart that you can use to find comparable formulas if your usual brand is sold out. Again, generic brands are perfectly okay to feed your baby.

From Feed to Succeed LLC

Online Support

The support from communities to help those in need of formula is so heartwarming. Consider reaching out to friends and family to help find formula for your baby as they shop. Purchasing donor breast milk from your local milk bank, may be an option. While there is a high demand they are also experiencing more donations of extra milk. One such resource is the Mothers’ Milk Bank of the Western Great Lakes.

Use caution with milk sharing or buying milk over the internet from places other than an official milk bank as these may contain contaminants. If someone is offering extra formula they no longer need, please be sure the formula is not expired and has been stored in a temperature controlled location (i.e. not in a garage).

Instacart is a helpful resource that shows where formula is on shelves. You don’t have to shop on Instacart, but use as a locater in your area.

Community Facebook groups like local Mom Groups, parenting groups and more can help share tips or resources for formula. Chicagoland Formula Finders is a recent and helpful resource for many.

Formula Availability

Scroll down to find more information from Enfamil, Gerber, Kate Farms, Nutricia, Similac and WIC programs (alphabetized).

Enfamil

Enfamil.com has a store locater that is updated three times a day. They also share this qr code and product comparison chart below.

Nutramigen is an extensively hydrolysed formula for the dietary management of infants with mild to moderate cow’s milk allergy. It is hypoallergenic, which means it has been specially formulated to not cause allergic reactions in most infants with cow’s milk allergy. This formula has been more available at this time, but please only purchase if necessary.

At Reckitt/MJN, we see this as a very serious issue, because we understand the responsibility we have in making the single source of nutrition for so many infants, therefore can be no short cuts for this vulnerable population. Our manufacturing facilities are operating 24/7. This has allowed us to supply 30% more product to market YTD, which allows us to provide formula to an additional 200,000 babies per month since the Abbott recall occurred.

It is important to note our manufacturing is near pharmaceutical grade and quality and safety are paramount. Our goal is to get as many feedings to shelf as possible, but our highest priority are those mothers and infants in the WIC program as they are the most vulnerable in our society. Where Abbott can no longer meet their commitments, we are filling the gap as much as we can.

We’re continually looking for more ways to increase supply, while ensuring the highest levels of safety and quality. We’re also working closely with President Biden, the FDA, and the USDA to expedite approval for us to use a factory outside of the U.S., access key ingredients, and make it easier to ensure the most vulnerable babies have access to the formula they need. We know parents and caregivers are concerned about formula supply on the shelves, we are working with our retail partners to support limiting purchases to 1- week supply per household and always recommend buying formula from a reputable source.

This is the highest priority for us as a company and the entire industry. We are confident that by working together and remaining focused on this problem, we will solve it, ensuring that parents and infants have access to the nutrition that they need.

Helping Hand for Special Kids Program

This program can help with a one time gift of formula in cases of financial assistance or multiple births. With help from a medical professional or one of our dieticians, choose from one of the three applicable programs. Offer is limited to one formula gift per household, per birth. Programs and offers subject to change without notice. Only parents and/or legal guardians who meet offer qualifications are eligible. View the program application.

Gerber

While we are a small player in the U.S. infant formula market, we are absolutely committed to doing everything we can to help get parents and caregivers the formula they need so their babies can thrive. We have significantly increased the amount of our infant formula available to consumers by ramping up production and accelerating general product availability to retailers and online, as well as in hospitals for those most vulnerable. We are also working through our Parent Resource Center, website, social media and industry groups to help make sure essential information is available for those parents and caregivers seeking it.

Demand for Gerber formula has increased due to a national infant formula shortage. This increased demand may result in some temporary out of stock issues at certain stores. Each retailer has the best estimate of when specific products will be on their shelves. For information about which retailers in your area carry Gerber formula, you can visit https://www.gerber.com/shop-by-product/formula.

While individual stores may be temporarily out of stock, it should return soon, or you can order from our website.

Our Parent Resource Center is available 24/7 to help parents with any feeding queries, including help in finding our formulas and suggesting recommended alternatives, as it is generally okay to switch routine infant formula brands (800-4-GERBER). If an infant is on a specialty formula for a medical condition or for treatment of allergy, switching infant formula should be discussed with your health care provider before doing so.

Kate Farms

We understand that patients, caregivers, and healthcare professionals are pressed to find alternatives. Kate Farms formulas may be a solution for patients affected by the Abbott recall. Our formulas are only for children one and up, but could be appropriate for kiddos aging out of an infant formula including those who are appropriate for a peptide challenge and were formerly on an amino acid product. Below are a a few crosswalk tools which show which Kate Farms products would be considered “equivalent”, and we have a dedicated out of stock webpage here:  https://www.katefarms.com/customer-service/out-of-stock-support/.

The Nutritional Applications Pediatric Formulas is also a helpful resource to show what may be appropriate by disease state.  The pediatric transition guide is also helpful for tube fed patients. Learn more about transitioning to a new formula with this guide in partnership with a Registered Dietician.

Kate Farms formulas:          

  • Indicated for ages 1 and up
  • No common allergens. Do not contain milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, or soybeans —but are not tested to be hypoallergenic
  • Unlike powdered formulas, Kate Farms formulas use aseptic processing and are commercially sterile
  • Offer pediatric peptide formulas made with organic hydrolyzed pea protein (HCPCS B4161) and pediatric standard formulas made with organic intact pea protein (HCPCS B4160)— not amino acid or elemental
  • Nutritionally complete, taste great, and designed for oral or tube feeding (flow smoothly through tubes down to 6.5 Fr)
  • Eligible for insurance coverage: Medicare, Medicaid, private plans, and select WIC* programs
  • Samples arrive within two days to healthcare offices or patient homes at the request of a healthcare professional. Visit katefarms.com/samples.

Kate Farms formulas are broadly eligible for insurance. Your home medical supplier will check your coverage and ship Kate Farms to you. Or you can purchase any one of our formulas online with free 2-day shipping at katefarms.com.

Nutricia

We offer nutritional solutions that positively impact the health from early life and onwards into old age.

  1. Nutricia Navigator contains information on the service which can investigate coverage options and locate DMEs or pharmacies in their area that may have product available. 
  2. Neocate.com.  Always provides updated information on ordering directly from Nutricia. Parents can enter in their email addresses to receive a notification when it is back in stock at Nutricia.
  3. Walgreens.com.  They will indicate if they have availability in any store.  If they see it is available, you can call the store first before going. 

Similac

For families whose babies require specialty, metabolic formulas, the FDA recently informed Abbott Nutrition that the agency has no objection to releasing urgent, life-sustaining supplies of certain specialty and metabolic formulas on a case-by-case basis. Abbott has established a request line for patients and caregivers seeking access to their specialty formulas: 1-800-881-0876.

We know that our recent recall caused additional stress and anxiety in an already challenging situation of a global supply shortage. We are working hard to help moms, dads and caregivers get the high-quality nutrition they need for their babies.

Abbott is working closely with the FDA to restart operations at the Sturgis, Mich., facility. We continue to make progress on corrective actions and will be implementing additional actions as we work toward addressing items related to the recent recall. In the meantime, we are working to increase the supply of infant formula by prioritizing infant formula production at our facilities that provide product to the U.S. market.

Below is a QR code that is updated regularly to show availability of infant formulas at different large box stores. More will be available in the next few weeks.

WIC

We have a special obligation to WIC families. About one-half of babies born in Illinois participate in WIC in the first year of their lives. We will continue to do everything possible to safeguard their development and access to safe, nutritious formula.”

said IDHS Secretary Grace B. Hou

The state of Illinois is taking a series of steps in response to the current, nationwide infant formula shortage. Senate unanimously passed the House’s bill to add flexibility to WIC benefits. The federal nutrition program for women, infants, and children is the largest infant formula buyer in the country — making up about half of all formula purchases. The approved legislation would waive the contract requirements for emergencies (like during a formula shortage), and allow mothers to purchase other formulas available without having to pay out of pocket.

In coordination with the USDA Food & Nutrition Service, Illinois retailers are being encouraged to set aside formula for low-income families enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children program.

The Illinois Department of Human Services has also trained caseworkers to assist families with formula questions. The IDHS Help Line at 1-800-843-6154.T he Help Line is designed for Supplemental Nutrition Assistance Program and WIC customers primarily but is open to all residents of Illinois. Read more here.

For more information on our Feeding Clinic, nutrition and feeding services, visit: https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/nutrition-therapy.html.

Dealing with Sensory Overload

By: Megan Fickert, Therapy Aide

What is Sensory Overload?

Simply put, sensory overload is when one’s senses become overwhelmed to the point that a person is negatively impacted. Sensory overload can affect anyone but is particularly common among those with developmental disabilities like ADHD or autism that cause difficulty with filtering external input that other people might find perfectly tolerable.

Sensory overload can be a physically painful experience. As a small child, if I was outside and someone a block away was mowing their lawn, I would crouch low to the ground and clasp my hands over my ears. I used to run out of the bathroom in elementary school because of the automatic toilets, and to this day, I still have to cover my ears whenever I flush!

To an observer, it will often be obvious what is happening to a person experiencing sensory overload, but other times people may simply appear distracted or disengaged from their surroundings or may lash out in frustration instead.

For many disabled people, sensory overload becomes an everyday challenge. Let’s go over some ways of dealing with it.

Prevention

The ideal scenario is preventing instances of overload from happening in the first place. This means being mindful of your surroundings and planning ahead. Know how certain stimuli affect you or others. Have an escape route in mind and a way to communicate your needs. Avoid situations you know will lead to sensory overload if you can.

But of course, life doesn’t work seamlessly and there will always be unexpected scenarios that bring on overload. Here is how you can help yourself or someone else when it arises.

1. Remove Yourself

If possible, one of the quickest ways to handle overload is to remove oneself entirely. If you begin to feel overwhelmed, excuse yourself or ask someone to help you get out of the area. If you are assisting someone else, keep an eye on their reactions and give them chances to escape their environment if it seems like they have become overloaded.

Some adults and children may not have the self-awareness or communication skills to let others know they have become overloaded, so check in with them often when you are in especially stimulating or busy environments, and remember to take breaks even if sensory overload hasn’t occurred yet.

2. Block Incoming Senses

If leaving is not an option, the next best thing is to block stimuli. Wear earplugs or headphones if sound is an issue. Cover your eyes, look to the floor or even hide under a blanket to block visual input. Plug your nose to keep smells away. Have alternative clothes in case you become irritated by tags, seams or textures.

3. Ask for Help

In some cases it may be possible to ask for help. Admittedly this can be a scary task and isn’t always feasible, but some venues may be able to accommodate your needs if you speak up! Ask for the volume to be lowered or lights to be turned down, ask to be seated away from others. This is often best done as part of prevention, but sometimes it’s necessary to ask for help on the spot, too.

4. Override External Input

When it comes to sensory overload, sometimes the most overwhelming part is experiencing excess stimuli that we have no control over. To counter this, it might help to create your own stimuli to focus on instead. (Be mindful that in public scenarios, this might not be possible if it will be disruptive for others). 

Stimming, or self-stimulatory behavior, is often a natural reaction to sensory overload. If external sound is bothersome, listen to music or make sounds of your own to focus on instead! Draw a picture or focus on a specific object to drown out other visual input. Flap your hands, wiggle your toes, or stomp your feet to express control over how your body feels. Use a weighted blanket to control proprioceptive input.

Basic Sensory Overload Kit

Here is a list of some good items to keep on hand for situations when sensory overload may be expected. Because different things work for different people, make sure to customize your own kit with what works for you based on the situation and circumstances.

  • Ear protection (headphones, earplugs)
  • Eye protection (sunglasses, hats, eye masks)
  • Hand fidgets (tangles, stress balls, marble mazes, etc.)
  • Chewable fidgets (handheld or wearable “chewelry”)
  • Weight/pressure tools (blankets, vests, compression garments)

Sensory Overload Summary

Ultimately, how one deals with sensory overload will greatly depend on the individual and the situation, but these are the basics on how to help yourself or others when faced with it in daily life.

Remember that instances of overload are inevitable, but being proactive and utilizing tools at your disposal can minimize these unpleasant experiences for yourself or someone you care about.

To learn more about sensory processing disorder and how we can help, visit: https://www.easterseals.com/dfv/our-programs/sensory-processing-disorder.html

A Therapist’s Review on The Rabbit Listened

By: Natalie Donald, Social Worker

It’s Read Across America Week! This week, led by the National Education Association (NEA) and guided by a committee of educators, is the nation’s largest celebration of reading. This year-round program focuses on motivating children and teens to read through events, partnerships, and reading resources that are about everyone, for everyone.

Readers who feel included, recognized, and a part of the world are engaged readers. As we celebrate Read Across America, we invite you to read one of my favorite books, The Rabbit Listened, or our other recommended books to start conversations about disability and inclusion.

The Story

When I first discovered The Rabbit Listened, it moved me to the point of promptly buying 10 copies for friends and family in my life (child and adult alike). At its core, it is a picture book about empathy and kindness, a skill everyone needs, especially when others in your life need support.

Taylor, the main character, is a child who has something unexpected and challenging happen. With that challenge comes confusing feelings that Taylor doesn’t know what to do with. Many animals like the bear, the elephant, and the ostrich come along and try to help Taylor feel better, but nothing seems to help. Eventually, the rabbit comes along and gives Taylor exactly what he needs. It’s a simple yet profound message about choosing to be “with” someone in their pain. It’s a story that resonates with grief and loss, moments of dysregulation, and those days when you feel like nothing is going your way.

The Lesson

The story provides a beautiful lesson on one of the best things we can do for others. Some call it co-regulation, attunement, affect matching, or mirroring. Others call it listening with warmth, care, and calm. It’s uncomfortable to resist the urge to fix a problem and instead choose to sit with someone and listen.

This connection is the chief thing that calms down the nervous system. It’s what makes someone feel seen, heard, and understood (and isn’t that what we all want after all?). It makes our bodies and brains feel like we can take a deep breath, that we’re not alone, and that we don’t have to feel bad for the way we feel. Sometimes we just have to stop what we are doing, get to the child’s level, and give them our full, undivided “I’m not going anywhere” attention and choose to ride the wave with them until they feel back to themselves again.

In the book, we see that Taylor’s brain and nervous system weren’t ready yet for laughter, or to try again, or feel better. It’s a reminder to all of us (*hand raise- myself included) that we must try to meet others in their pain before we can help them move on to feeling something new. This is true empathy. And again, this connection is the fastest way to get kids (and adults) back into their “thinking brains.” Once the thinking brain is back online, we can then access coping strategies like the animals in the story offer to Taylor.

But remember, coping strategies are not one-size-fits-all. Today one strategy might work great, and by next week… it might not work at all. Some days, I need a good laugh with my husband to shake off the day. Some days, I need to scream into a pillow or need movement to discharge those stressful feelings in my body. Other days, I need a bubble bath or some alone time to myself to reset. And for all of us, there are just those days when NOTHING seems to work at all and on those days, we have to be gentle with ourselves and others. Maybe those are the days we need our own rabbit.

The Lesson in Practice

So with all of that, my challenge for you is to find someone in your life and BE THEIR RABBIT. Being a human is hard sometimes and one of the best gifts you can give to someone is your presence. RESIST THE URGE TO FIX.

Here are some ways to to increase connection when someone is in a challenging moment: (This works for both adults and children. Sometimes you have to repeat multiple times or in different ways.)

  • Sitting with someone
  • Mirroring their body language
  • Offering a hug

Saying something like the statements below (with genuineness or as much care as you can offer in the moment):

  • “I am right here with you”
  • “I hear you”
  • “I’m not going anywhere”
  • “I’m listening”
  • “You are not alone”
  • “I don’t know what to say, but I’m here”
  • “I’m here for you now and I will be here whenever you’re ready to share”
  • “Take as much time as you need
  • “I have felt that way before too (share example)”
  • “I think everyone feels that way sometimes”
  • “I haven’t been through what you are going through but I imagine that it’s so hard”

*REMEMBER: Give yourself LOTS of grace with this practice. This is hard, and we are all still learning. And remember, even when you mess up, making a relational repair is just as important and powerful!

Social Services at Easterseals

The Easterseals’ Social Services team strives to provide children and families with the mental health support they need to help in these unexpected and challenging moments. We strive to help caregivers and children experience more joyful interactions through attunement and connection. For more information on our services you can contact us at socialservices@eastersealsdfvr.org.

2021 Holiday Gift Guide

By: Citlaly Gonzalez Psy.D Clinical Psychologist

Winter brings chillier temperatures, twinkling lights, extra family time and the opportunity for holiday shopping and gift-giving. There are many gift guides out there. Big City Readers put together this one that includes toys to support learning and development, and sensory play and of course books!  There’s this one by Buzzfeed for kids with endless energy. Easterseals DuPage & Fox Valley offers something unique- a holiday gift guide carefully curated with the needs of our families in mind and offered through the lens of mental health and wellness for the whole family.

Many of the links included in this guide take you to Amazon, so add Easterseals DuPage & Fox Valley as your selected charity through smile.amazon.com and get ready to shop!

Family Time at Home

The old adage your presence is the best present is never truer than during the holidays. This is a great time to think of ways to spend time together during the winter months and look toward ways to create memories throughout the year. Board games bring the family together and there are many great options for even the youngest children. Worried about the meltdowns that happen when a child is still learning to lose graciously? Stick with cooperative games such as those by Peaceable Kingdom. The Race to the Treasure is in heavy rotation in the Social Services department as is Monkey Around, a non-competitive game that includes gross motor play, imitation, vocabulary, and social-emotional skills through a card game that prompts players to do movements together.

There’s no rule that therapy games have to stay in the therapy room. Consider adding some Social Services classics to your own toybox at home and normalize talking about mental health. These Kimochis provide a cute way to talk about feelings and Create a Story cards support sequencing and story-telling. To support calm feelings this card deck introduces mindfulness while this expandable breathing ball brings deep breathing to life.

Winter is long so think of games that keep you moving indoors. Painter’s tape in the multi-color pack is great for creating homemade obstacle courses with little equipment. Add in stepping stones, wobble boards, a figure-eight balance beam, or even tunnels and ball pits to level up the fun indoors.

The Tricky Spots

Not every routine at home brings smiles to children and caregivers. But what if we could provide some tools to support these “tricky spots?” What if we could identify toys that we could integrate into daily routines and incorporate them in ways that help? Think of what part of the day feels challenging and add in some gifts to help make those tasks feel more exciting or run more smoothly.

Bath-time: Put together a Bath bin to make bath time more appealing. “Time for bath” and “Time to choose a bath toy” have a different ring to them. Consider bath crayons, bath paint, bath bombs, bath confetti, color drops, glow-sticks, –any of which would make great stocking stuffers, or you can choose something like this interactive set that lights up and has music parts or a bath-time basketball hoop.

Bedtime: Help create a calm environment and support a healthy bedtime routine with these recommendations that might make your child look forward to bedtime! Create a soothing and distraction-free environment with this bed tent or try a light projector such as this one that creates dinosaur images on the ceiling, this huggable turtle, or this brave bear with his flashlight and book.

Mealtimes: Take some of the struggles out of mealtimes with some of these fun gifts. Which food to try next? Depends on the spinner or the order of this path or these fun plates that are sure to make meals fun.  You can also help promote self-help skills and independence with gifts that help your child participate in cooking –not to mention the gift of time and memories made together in the kitchen. Both of these wooden knife and wooden knife set are safe for most novice chefs whereas this one might be more appropriate for children who are ready to use a real knife that is still child-safe.

The classics

It would be remiss to make a holiday gift guide without mentioning “the classics” –open-ended toys, art supplies, and books. Here are some Easterseals Dupage & Fox Valley favorites:

Must-Have-Toys: Dolls and dollhouses, blocks, and play food are the play trifecta. If you have these, your play kit is complete! Dolls are great for both boys and girls and help foster pretend play, teach routines, and promote caregiving. Melissa & Doug has a beautiful wooden one while Woodzies offers an option at a lower price point. (Hint: Woodzies have a lot of other settings you can add like the school set to help your child share and tell you about their day). There are many options for play food, with Melissa & Doug offering a wide variety of beautiful sets, some that invite “cutting” or with Velcro pieces to assemble. Speaking of building, blocks are always a hit! Whether it’s Legos, wooden blocks, or a fun option like these, blocks are a great open-ended toy that provides endless possibilities for creative play.

Art: Art provides not only the opportunity to create but also to connect and express thoughts, feelings, and experiences. Some favorites include Crayola Slick Sticks which provide rich color with minimal pressure, perfect for toddler hands and those with motor challenges and Sharing journals such as this one provide a great way to connect with your children through art.

Books: Every book has its perks and particular uses and reasons to recommend it. Poke-a-dot books help support pointing and the Indestructible book series is perfect for children still learning to be gentle with books. Two of my all-time favorite books are The Rabbit Listened which reminds us to stop and listen to what children really need and All the Ways to Be Smart which celebrates the many ways kids learn, play, and explore. Remember, books are not just bound paper, they’re the promise of time spent together bonding and reading with your child.

We have a wonderful library at Easterseals and a carefully curated book list. Ask your therapist for recommendations or contact the Social Services Team. Two favorite resources for book recommendations are Miss Beth and her team at Big City Readers and Kido.

Let’s not forget the caregiver

While the focus of the holidays is often on the children, let’s not forget the gift of a healthy, happy, and well-taken care of parent. I recently saw a post of Mothercould (highly recommend for ideas of activities and sensory play!) where Myriam, the blogger, shared the idea of a gift basket she made for herself for self-care following the birth of her youngest daughter. What an amazing idea! So, this last recommendation is to put together some of your own favorites. Your favorite snacks, gift cards for your favorite store (who doesn’t love a solo trip to Target?), and a note to remember to take care of yourself this holiday season and into the new year.

The best gift for your child . . .

Of course, the focus of any gift should be the recipient and what brings them joy. You are the expert on your child and what they like most! Grant yourself the permission to fill their stocking with the Guaranteed Wins! Confession: my child’s stocking includes a bottle of eczema cream because he loves this part of our nightly routine and a wooden McDonalds food set –a Frankenmixture of trendy wooden toys and the food parents don’t always want to admit their kids love. Those items aren’t likely to be found on anyone else’s gift guide, but they are things I know will bring a smile to his face and will be immediately put to use, and that makes them good gifts!

To determine the best gifts for your child, think of the parts of your day where you could use some support and choose a gift that will grant it. Reflect on your favorite routines and memories with your child and consider ways to incorporate these into your gift. Consider how the gifts you select will be used in a way that supports your family’s health and happiness and above all the time you share together.

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.

Tips to Decrease Added Sugars in Children’s Diets

By: Jodi Hoppensteadt MS, RDN, LDN

Why Track Added Sugar?

It’s Kids Eat Right Month this August, and below is the skinny on added sugar. It can be tough to track and understand labels and how much is added into our daily food products. The easiest method is for families to focus on foods and beverages that do not contain added sugars.

Too much sugar in a child’s diet can lead to adverse health conditions, including tooth decay, obesity, heart disease, high cholesterol, type two diabetes, and high blood pressure. According to the American Academy of Pediatrics (AAP), children under two years of age should avoid added sugars. Children two years and older should limit their daily intake of added sugars to less than 25g (approximately six teaspoons) each day.

How to Identify Added Sugar on Food Labels

There are two ways to read a food label. One way is to check the Nutrition Facts Panel and look for the line titled: Includes XXg Added Sugars. Focus on foods that contain less than 5% of the Daily Value for added sugars.

The second way to read a label for added sugars is to read the ingredient labels. Added sugars come in many forms and go by many names, including sugar, brown sugar, corn syrup, high fructose corn syrup, fruit juice concentrates, fructose, dextrose, honey, molasses, malt, turbinado, and any ingredients ending in -ose.

Tips to Reduce Added Sugars

The following suggestions are other tips on how to avoid added sugars in your child’s diet:

  • Limit foods containing added sugars for children over two years of age and avoid beverages with added sugars for children two and under.
  • In place of foods with added sugars, try offering foods with natural sugar, which is the sugar naturally found in foods such as fructose found in fruits or lactose found in milk and milk products.
  • Limit 100% fruit juice for children and it is a good practice to dilute with water. Do not give fruit juice to children under the age of one.
    • 1-3 years of age up to 4 ounces daily.
    • 4-6 years of age up to 6 ounces daily.
    • 7-14 years of age up to 8 ounces daily.
  • Read labels for added sugars in all packaged and/or processed foods and drinks, including crackers, flavored milk (chocolate or strawberry), condiments, cookies, bread/baked goods, and cereals.

Added Sugar Replacements/Substitutes Tips

Here are some food replacements/substitutes to reduce added sugars in specific foods:

  • Serve water or milk in place of soft drinks, sports drinks, fruit drinks, sweetened coffees, or teas. Try naturally flavored water at home by adding berries, lemon, lime, cucumber slices, or mint.
  • When looking for something sweet, try fresh fruits, frozen fruits, dried fruits, or canned fruits. Canned fruits should be canned in water or natural fruit juice and drained and rinsed. Read food labels for added sugars in both canned and dried fruits.
  • Many cold cereals are high in sugar. Look for low sugar cereals such as Chex (Corn or Rice), Cheerios (unflavored), or Kix (unflavored).
  • Applesauce often has added sugar but unsweetened applesauce is available.
  • Offer only 100% real juice, fresh-squeezed juice, or homemade juice with no sugar added.
  • Cookies/cupcakes/baked goods are often high in added sugars but can be homemade with less sugar by substituting part of the sugar with applesauce or reducing the amount of sugar in a recipe by ¼ to ½ of the amount.
  • Popsicles and ice cream can be replaced with 100% real fruit popsicles or dark chocolate-covered frozen bananas. Popsicles can also be made at home using fresh fruit, pureeing, and freezing in popsicle molds.
  • Peanut butter and jelly sandwiches can be made with less added sugars by replacing the jam or jelly with fresh fruit such as sliced bananas, apples, or strawberries, or low sugar jelly jams are available. No sugar-added peanut butter is also available.
  • Syrup for pancakes and waffles can be replaced with fresh fruit, or frozen blueberries can be heated and pureed to make a “fresh fruit syrup”.
  • Read labels for condiments and chose lower sugar varieties or reduce the amount used.
  • Granola bars/cereal bars/yogurts look for low added sugar on the nutrition facts panel or ingredient label. There are also many recipes for breakfast cookies online that are low-sugar and easy to make.
Photo by Julia Zolotova on Pexels.com

Notes on Artificial Sweeteners

Artificial sweeteners (nonnutritive sweeteners) such as Aspartame, Acesulfame-K, Neotame, Saccharin, Sucralose are found in many food and beverages. The AAP recommends that the amount of artificial sweetener be listed on the nutrition facts label to better help parents and researchers understand how much children are consuming and the possible health effects. There is still a lot to learn about the impact of nonnutritive sweeteners on children’s health. Children under the age of 2 should not be consuming artificial sweeteners.

Notes on Milk and Supplemental Diets

There is no need to limit milk as it contains natural sugars, not added sugars, and provides necessary nutrients, including calcium and vitamin D. Supplemental nutritional beverages such as Pediasure, Boost, and Carnation Breakfast Essentials should not be limited when used to supplement diets to provide additional calories or nutrients or when recommended by a doctor and dietitian. Lower added sugar supplemental nutritional beverages can be purchased from companies such as Kate Farms or Else. Ask your doctor or dietitian if a lower added sugar formula is right for your child.

Photo by Cats Coming on Pexels.com

Comprehensive Pediatric Nutrition Services

If you have any questions or any concerns about your child’s nutrition visit our nutrition therapy page or contact us at info@eastersealsdfvr.org. Our nutrition team is comprised of RDN’s (Registered Dietitian Nutritionist) who have years of specialty experience working in pediatric nutrition and are ready to help!

Keeping Children with Disabilities Safe in a Digital World

By: Yvonne D. Anderson, LCSW, CADC, CODP II

All parents want to protect their children. And all children are vulnerable online, whether they’re using email or chatting on social media sites. When your child has a disability or developmental delay, those protective instincts switch into high gear. Identifying potential threats online is more challenging than, for instance, spotting a danger on the playground. Additionally, many children with disabilities struggle with reading social cues, managing emotions/ behavior, and making judgment calls about others. As a result, they are at a higher risk for cyberbullying and online victimization. As a parent or caregiver, you are your child’s first line of defense. Use the following guidelines to navigate the online world and keep your child safe.

Make your home network safe.

Avoidance is the best policy when it comes to sexual content, violent images, online predators, malware, and cyberbullying on the Internet.

  • Increase your security. Use updated virus protection and other safety measures, such as firewalls, to protect your computer from hackers and other cyberattacks.
  • Make it public. Keep smart phones, iPads, and computers in shared places where it’s easy for you to monitor online behavior.
  • Filter content. Install filters to block unapproved websites and images.
  • Set up parental controls. Limits can be set in multiple ways, such as through your internet or mobile service provider, directly on the device itself, and through site-specific services, including YouTube, Netflix, and Facebook.
  • Use child-friendly browsers. Some browsers are designed specifically to allow young Internet users to explore and learn without coming across offensive or dangerous content.
  • Review the browsing history regularly.
  • Disable location-tagging. A GPS-enabled smartphone or computer can reveal your child’s location through online posts and uploaded photos.
Photo by Dzenina Lukac on Pexels.com

Teach your child how to behave online.

Educating your child about appropriate online behavior is vital if you want to keep her safe no matter where she accesses the Internet.

  • Establish ground rules. Identify what is OK to do online and what activities are prohibited. When it comes to content, use the same guidelines that you employ for television viewing: if they can’t watch it on TV, they shouldn’t look it up online either.
  • Teach your child that information shared on the Internet becomes and stays public forever.
  • Review information that should not be shared. Help your child understand what types of information are unsafe to share online, such as their full name, address, phone number, school, or other images/ information that could help someone identify them. To help your child remember, post a “Do Not Share” list by the computer or on the device.
  • Explain the limits to online relationships. Emphasize that it is okay to say “No” to requests for personal information, photos, money, and joining social media networks.
  • Be smart about emails. Let your child know how dangerous it can be to open an email or attachment from someone they don’t know. Reinforce the importance of checking with you or another trusted adult if they get a message that they’re unsure about.
  • Encourage your child not to delete messages. Tell them to save anything that they’re not sure about, doesn’t feel right, or seems hurtful. Set aside time to review the messages together.
  • Explain cyberbullying, predatory behavior, and sexting. Although it may feel uncomfortable to talk about, your children can’t protect themselves from what they don’t know about. Rehearse “what to do if…” scenarios.
Photo by Julia M Cameron on Pexels.com

Provide resources and support.

Children also need to know how to identify when someone else is behaving inappropriately online and what to do about it.

  • Use online tools. Websites such as InternetMatters.org or NetSmartz.org provide a wealth of resources for both parents and children. InternetMatters is a resource hub specifically designed for children with additional learning needs and their families. These sites offer tools help children learn about online dangers using role-playing, pictures, and other strategies. NetSmartz resources also include the SymbolStix safety pledge, a visual online safety contract designed with support from the National Autism Association.
  • Encourage them to trust their gut. Teach your children to be skeptical and listen to their own instincts. Use role-play to practice recognizing and responding to several different scenarios your child may encounter online.
  • Give them a lifeline. Make sure your children know that you and other trusted adults are available for them if they run across something online that makes them uncomfortable. Even if they’ve done something they shouldn’t have, it’s important for them to be able to reach out to adults they can rely on.
  • Find safe online spaces. Seek out social networks and peer support that are focused on activities and interactions that match your child’s interests and developmental level.
  • Be curious and ask questions. Find out what websites your child likes to visit. Have they ever seen something online that made them feel sad, scared, or confused? What would they do if they saw something online that made them uncomfortable?
  • Connect with your child by learning how to use the technology and social media that s/he is using. Ask them to show you how it works and specifically how they use it.
Photo by Ketut Subiyanto on Pexels.com

Reach out to Easterseals’ Social Services team for more ideas about how to support your child’s social and emotional development. You can contact us at socialservices@eastersealsdfvr.org.

Common Questions About Bilingualism

By: Joanna Nasiadka, M.S., CCC-SLP

Speech-Language Therapy strengthens children’s communication and feeding skills so they can participate fully in daily activities and achieve success. Easterseals DuPage & Fox Valley therapists have numerous years of experience in typical and atypical speech and language development and offer a fun and engaging environment for children to learn and develop their skills. We also have a number of therapists fluent in several language such as Polish (myself), Korean and Tagalog. There are often questions shared about raising a bilingual child and I wanted to discuss the many benefits and what to look for if you suspect a speech delay below.

Q1: Does bilingualism mean my child is equally proficient in two languages?

Being bilingual does not mean that the child has equal proficiency in both languages. It is common for children to have a dominant language. Children can also have a dominant language for specific contexts. For example, a child might speak English at school and communicate most effectively in English when the context is academics but might prefer to talk in their family’s native language while talking about a sport, religion, or while talking to their family members. The dominance of language fluctuates depending on the amount and nature of exposure. There are two types of bilingualism:

Simultaneous Bilingualism:

This type of bilingualism is the acquisition of 2 languages at the same time, typically before age 3.​ Early language milestones are met in typical time and manner in both languages.​

Sequential Bilingualism:

This type of bilingualism occurs when the second language is introduced AFTER 3 years old.

Photo by Stan Kedziorski-Carr

Q2: Will my child be confused if we use two languages at home?

Many studies on bilingualism have shown that using two languages does not confuse a child, even when they are young and learning two languages simultaneously.

Q3: What if my child has a language delay or disorder?

There is no evidence that using two languages confuses a typically developing child OR a child with a disability. Bilingualism can actually be beneficial for children who have disabilities, and it allows them to be active participants in their daily activities. It also allows them to have full social-emotional growth since it will enable them to communicate with family members and friends who have a shared language and culture.

Q4: Will bilingualism cause my child to have a language delay or academic difficulties? Will he or she be behind other kids?

Bilingualism does not cause language delay or disorders in children. It also does not exacerbate delays or disorders that are already present. If a child presents a disorder in one language, they will have the disorder in the second language as well. If the difficulties only arise in one language, this could be a sign of limited language proficiency.

Bilingual children develop language similarly to their monolingual peers. However, bilingual children may have lower proficiency in one of the languages until they catch up to fluent speakers.

  • Average time to achieve social proficiency (conversations, social interactions): 2-3 years
  • Average time to reach academic proficiency:  5-7 years
Photo by August de Richelieu on Pexels.com

Q5: What are some pros and cons of raising a bilingual speaker?

Q6: What is the best way to support two languages? Should I wait for my child to be proficient in one language before introducing a second one?

Photo by Alex Green on Pexels.com

The best time for a child to learn two languages to be proficient is before 3. Younger children are more likely to develop a natural accent, more likely to become proficient and achieve higher syntax levels in the long run. Therefore, there is no need to wait for your child to learn one language before introducing a new one.

Many families have found success in speaking both languages at home. Other families prefer to speak both languages and spend time reading, writing, or doing activities in each language. A very effective way to help a child learn both languages is to have one caregiver speak one language and a second caregiver speaks the other language. This choice depends on the family dynamic and your preferences.

Q7: My child started to mix the two languages together in the same sentences. Is this normal?

Using both languages or alternating between languages in the same utterance or conversation is very common for bilingual speakers and is called code-switching. Competent bilingual speakers often code-switch for many reasons, including using a word that is not present in the other language, quoting ideas, emphasizing, excluding others from conversation, showing status, or adding authority. Code-switching can happen more in certain cultures and contexts.

Code-switching does require rules to be done appropriately:

  1. Must follow the grammatical structure of both languages
  2. The word order has to make sense
Photo by Julie Hermes

Q8: How will a speech-language pathologist evaluate and treat my bilingual child with a language disorder or delay?

A speech-language therapist can help determine a speech-language disorder from a limited language proficiency by considering the sound and language rules of both languages that your child speaks. Your therapist will administer evidence-based methods of testing that are adjusted for your child’s needs as a bilingual speaker. These tests include speech-language samples, writing samples, play-based observations and assessments, standardized measures (if appropriate and adjusted), and assessments of ability to learn new skills. If your child benefits from services, treatment will focus on improving speech and language skills while supporting both languages.

Take our Free Developmental Screening

If you are concerned about your child’s language or other development, take our free online developmental screening tool for children birth to age five. The Ages and Stages Questionnaire (ASQ) will showcase your child’s developmental milestones while uncovering any potential delays. Learn more at askeasterseals.com. 

To learn more about Speech Language services at Easterseals DuPage & Fox Valley, call us at 630.282.2022.

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.