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.
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.
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 email@example.com. 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!
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.
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.
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.
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 firstname.lastname@example.org.
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:
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.
This type of bilingualism occurs when the second language is introduced AFTER 3 years old.
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
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?
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:
Must follow the grammatical structure of both languages
The word order has to make sense
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.
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.
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.
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.
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.
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.
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.
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:
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.
Count to a specific number or use a particular word that your toddler needs to listen to before he can be dumped
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
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
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)
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.)
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!
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.
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.
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 visualschedule 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 Facebookpage for more resources, parenting webinars and support in transitioning children back into school.
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!
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!
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!
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.
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.
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!
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 Solutions: Adaptive 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.
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!
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!
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.
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.
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.
General Tips for Hearing-Friendly Video Conferences
Setup and Communication Style
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:
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.
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.
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.
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.