Through my Parenting Eyes

By: Theresa Forthofer, CEO & President of Easter Seals DuPage & Fox Valley

While I am the President and CEO of Easter Seals DuPage & Fox Valley, I also happen to be the mother of three children.  Two of my children have Myotonic Muscular Dystrophy and Autism. My oldest, Ryan, was diagnosed when he was 7 years old.  He is now 24 years old. My youngest was diagnosed with the Congenital form of Muscular Dystrophy within days of his birth and he is now 18.

forthofer family

Having two boys with Muscular Dystrophy, meant lots of doctor visits and hours of therapy every week.  Throughout the years we had several different therapists and we liked them all.  They were all very nice and the boys were making progress.  Therefore, we assumed everything was great and the boys were doing the best they could.  Looking back, I sincerely wish I knew then, what I know now.  While they were progressing, they were not reaching their full potential.

I may be biased, but what I have learned since becoming President and CEO isn’t as significant as what I have learned about raising two boys with disabilities.  I share my story to help at least one other family find their child’s true potential.

For nearly 7 years, my son had (unsuccessfully) worked on putting his shoes and socks on independently.  His Early Intervention therapist worked on it, his private therapists from a nearby clinic worked on it, and his school therapists worked on it.  Over and over again we were told, he doesn’t have the strength.

17b_ProcoposJustinDip.jpg
Photo by Alexi Procopos

However, when I came to Easter Seals, I asked about Occupational Therapy for Justin.  I wanted him to put his shoes and socks on independently.  In just two sessions, his therapist asked me what our next goal was because he was putting his shoes and socks on independently.  I didn’t believe her and made her show me.  He did it and is still doing it!  His therapist explained it was a motor planning issue not a strength issue for Justin.  For years, I dreaded leaving the house because putting his shoes and socks on became something to battle over. Now those days are long behind us.  No more excuses for being late!

Occupational therapy worked so well, I signed Justin up for the feeding clinic.  At 12 years old, he weighed 40 pounds and we had tried everything.  We saw an endocrinologist, feeding therapists, nutritionists, etc.  The best solution was growth hormones, but Myotonic Dystrophy has cardiac complications, so this was not advised.

After attending the feeding clinic and starting a few relatively small changes, he gained 10 pounds in three months – 25% of his body weight!  He will likely always be small for his age, but we wish it hadn’t taken us so long to figure out these needs and find the experts at Easter Seals.  They imagined a future beyond what we had been told to expect by other professionals and without any limitations.

leadership meetingI hear these same stories like mine, nearly every week.  Children who have been seen for years and aren’t reaching their fullest potential.  When they find their way to Easter Seals DuPage & Fox Valley they often can’t believe what they have missed out on.  The progress their children are making so quickly surprises their families, their doctors and sometimes even us.

If you are looking for a therapy center or therapist for your child, here are the top 10 questions to ask:

  1. Is the center CARF Accredited and have a Medical Advisory Board?
  2. Is the center directly affiliated with any major research hospital systems?
  3. Who are your primary referral sources?
  4. What are the published results of your satisfaction survey and where can I find them?
  5. Is the therapist NDT (Neuro-Developmental Treatment) trained?
  6. What diagnoses has the therapist personally treated?
  7. What is the average level of experience of the therapists at the center?
  8. How many children do you treat annually?
  9. What training do you receive on a regular basis?
  10. How do you support parents and siblings?

As parents, we all want the absolute best for our kids. I found it here at Easter Seals and you can too!

Easter Seals DuPage & Fox Valley is a CARF accredited facility with a medical advisory board and affiliations with University of Chicago, University of Illinois at Chicago, Northwestern University and RIC (Shirley Ryan Ability Lab). With 87 therapists and professional staff with an average tenure of 19 years, the majority of therapists are NDT trained and are required to receive on-going training. The therapists are specialized in many specific areas including feeding, motor, sensory needs and more.

Easter Seals serves more than 1,000 families a week with locations in Naperville, Villa Park and Elgin.  Through an annual client survey, 99% of families report satisfaction with the services they receive and 98% of families report progress. The parent liaisons and social workers on staff provide support and family activities for all members of the family. Learn more at eastersealsdfvr.org. 

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What is a “Sensory Diet”?

By: Laura Van Zandt, OTR/L

A “sensory diet” is a treatment strategy occupational therapists use to help children learn to process and understand sensory information from their environment and their own body to more effectively interact within the environment and with others. The term sensory diet was first coined and originated by occupational therapist, Patricia Wilbarger. A sensory diet is meant to be individualized to the child so that the activities provided are a ‘just-right’ challenge for the child. The “just right” challenge is defined as “a challenge that is on the edge of competency and engages the drive for mastery.”

A sensory diet is not too hard, yet not too easy. An effective sensory diet should include a wide variety of activities within the child’s day that provide a variety of sensory input for play and learning. An effective sensory diet should also be a collaboration with the client, family, and caretakers.

Occupational therapists often use the analogy of comparing a sensory diet to a balanced food diet to help parents and caretakers understand we need a variety of activities that feed all our sensory systems to allow them to work well together. Just like a well-balanced diet is often tailored to our individual bodies for different nutritional needs at different points in our lives, a sensory diet is an ongoing list of activities that is established over time and modified as needed to help address the imbalance in the child’s sensory processing abilities or as the environment changes and the demands shift.

A sensory diet is designed to help keep the child calm and organized via activities that based on a child’s preferences which then helps them to be able to learn, attend, and fulfill social expectations. As a child learns to remain calm and organized, they learn to better self-regulate and hopefully move from depending more on others to being more independent in managing their sensory needs. The goal of any sensory diet is to help overtime retrain your child’s brain to process sensory information in a more typical way so that can perform at their own unique best.

Each child has a unique set of sensory needs. Generally, if a child is more sensory seeking, they may benefit from adding more movement and stimulation that includes heavy work as well as other sensory stimulation (e.g. tastes, colors, smells) to help achieve a calm, organized more focused state so they are not constantly on the go looking for input. If a child is more sensory avoiding, they may also benefit from heavy work but may need it more graded and introduced slowly over time. The child may benefit more from activities that focus on reducing sensory input and breaking tools that allow them to limit information from their environment. One of the trickiest aspects of developing and implementing any sensory diet, is beginning to recognize your child’s signs and signals as well as starting to recognize when your child is over-reacting, shutting down, or under-reacting and adjusting the sensory input so your child remains just right and able to function.

Ada
When occupational therapists provide ideas for a sensory diet, they keep in mind several different guiding principles:

  • Frequency of input: The frequency of need varies for each child and should be guided by observations of the child before and after each activity.
  • Intensity and duration of input: How much time you spend on each activity and how much sensory input (e.g. how much weight to use to push/carry/drag/lift, how loud to play the music, what type of tactile media to present, how much tactile media to present, etc.) is directly related to the child and how the child is doing not only on a specific day but also at a specific moment in time.
  • Timing of activities: Sensory diet activities are meant to be proactive and are best used before as well as during activities that are known to be tricky to the child.

    For example, if you know sitting for a mealtime is difficult for your child, you might want to help prep your child’s body and sensory system prior to sitting down. These activities should be tailored to your child; however, heavy work activities that actively require the child to use their muscles to push, pull, carry, drag, climb, bury, dig, suck, etc. are usually beneficial to many children. Sitting for a mealtime is a very complex sensory activity that involves all your sensory systems working together. You can try prepping your child’s sensory system prior to sitting down by re-arranging the chairs around the table and cleaning the table with spray bottles and towels to dry. You can try exploring different options for their chair- maybe your child might do well with a move-n-sit cushion or having a band around the legs of their chair to kick against. Your child might be bothered by the sounds of other people chewing their food and might benefit from noise cancellation headphones. Your child might be bothered by the sights of all the different foods or by all the foods touching each other. There are many different ideas and strategies to help both of those difficulties.

Your occupational therapist may ask you to become the detective and create a daily log of behavioral changes. You are your child’s best advocate and are the best expert in your child’s abilities and areas of growth. By creating a log of activities and your child’s responses to activities over the course of different days and different times, you can help better curtail some of the trial and error process that is inherent within any sensory diet due to our own individuality.

The sensory diet activity that might have worked well for another child with a similar difficulty, may not necessarily work for your child. The various times of the day and different environments may be work better for certain activities. Not all strategies work all the time. It is important to keep track of all the different activities your child responds positively to, so that you can create variety and have more than one strategy to help your child.

With help from an occupational therapist, your child can develop the ability to process sensory information in an adaptive manner and learn strategies to help him or her cope with everyday experiences. Learn more about our program. 

Resources:

  • Shiela Frick and Julia Wilbarger – “Creating Effective Performance, Precision, and Power in Treatment and Sensory Diets”
  • The Out of Sync ChildThe Out of Sync Child Has Fun, Growing an In-Sync Child by Carol Stock Kranowitz
  • childdevelopment.com

How to Help A Clumsy Child

By: Cassidy McCoy PT, DPT

Developmental Coordination Disorder (DCD) is a delay in motor skill development or a difficulty with coordinating movement that makes a child unable to perform common daily tasks. This delay is not due to an identifiable medical or neurological condition that would explain their coordination problems.

Children with DCD are frequently described as “clumsy” or “awkward”, but typically have normal or above average intellectual abilities. However, their motor coordination difficulties may impact their academic progress, social integration and emotional development.

DCD is commonly associated with other developmental conditions such as learning disabilities, attention deficit disorders, speech-language delays, and emotional/behavioral problems.

Meeting Challenges
Photo by Ann Mehrman

Children with DCD generally have difficulty with activities including, but not limited to, climbing up and down stairs, tying their shoes, riding a bike, or doing buttons on their clothing.

How does a child with DCD present?

Typical Presentation:

  • Decreased balance
  • – Decreased bilateral coordination
    • Skipping
    • Jumping jacks
  • Decreased ball handling skills
  • Decreased high level balance skills
    • Hopping
    • Balance beam walking
  • Decreased postural control
  • Decreased proprioception

Other areas of concern may be handwriting, executive function, and initiating social interactions.

How to help

Because children with DCD typically have normal to above average cognitive skills, using a cognitive approach to improve their motor planning can help to ingrain motor skills to make movements more automatic. This cognitive approach helps by working on breaking down a motor skill into smaller pieces, as well as, having the child verbalizes the activity before performing, and reporting on the outcome of the attempt.

Example: GPDC

  • Goal: What am I going to do?
  • Plan: How am I going to do it?
  • Do it: Perform the skill
  • Check: How did the plan work?

Other Activities

Core strengthening is important for children with DCD. You must have a stable trunk/core to appropriately move your arms and legs. Improving core stability will improve balance, postural control, and proprioception, leading to improved coordination.

Some activities to improve core strengthening:

  • Heavy pushing: fill a laundry basket to weight it down and have you child push it across the floor. Carpet flooring will add extra resistance from friction.
  • Hannah_TClimbing: climbing up onto furniture or onto playground equipment while maintaining their abdomen off the surface and arms extended.
  • Wheelbarrow walking or planks: putting weight through extended arms will help to increase abdominal engagement and strength.
  • Standing on unstable surfaces: Standing on various surfaces such as: pillows, cushions, foam mat, or BOSU ball helps to improve postural control. They can perform a variety of activities on these surfaces including balancing with eyes closed, squatting to pick up a toy from the floor, catching/tossing a ball, or reaching up overhead for an object.

Click here to learn more about Physical Therapy programs to improve strength, balance and coordination at at Easter Seals DuPage & Fox Valley.

References:

  1. https://canchild.ca/en/diagnoses/developmental-coordination-disorder

Got Calcium?

By Dana Sivak, Easter Seals DuPage & Fox Valley Dietetic Intern and Northern Illinois University Student

“Got milk?” is a saying originally part of a campaign generated by the dairy industry to remind consumers of the importance for consuming milk on one of the premises that it serves as a good source of calcium. But why, we might ask, do we need to focus our energy on consuming calcium? Calcium is the most abundant mineral in the body, with 99% of it found in bone and teeth. Throughout the course of the day, calcium is constantly being broken down, reabsorbed, and resourced back to form new bones.  In children, especially, the turnover rate of bone is ever-present to support growth and development. By age 24, on average, humans reach peak-bone mass, and thus it is important that we maximize our efforts to nutritionally meet our body’s calcium needs– so encourage your child to sport that milk mustache proudly!

The Recommended Dietary Allowance (RDA) for calcium changed last November after further research determined a greater need for calcium in our diets. The following are the US Food and Nutrition Board’s updated RDA values for calcium based on age:

  • 0-6 months = 200 mg
  • 7-12 months = 260 mg
  • 1-3 years = 700 mg
  • 4-8 years = 1000 mg
  • 9-18 years = 1300 mg
  • 19-50 years = 1000 mg
  • 51-70 years = 1000 mg (male) or 1200 (female)
  • 71+ years = 1200 mg

Now you might ask, how do I know if I’m meeting my child’s needs? (…and yours?! Your health matters, too!) The simplest answer for this is to check the nutrition label for the exact content of calcium provided for the food items typically consumed in your household.

leafy greensCalcium rich foods are commonly thought to be those that exist within the dairy food group, such as milk, cheese, yogurt, and ice cream. These types of food provided a natural, readily available, and rich source of calcium to our diets. But what if your household is “dairy” free or someone in your household either has a lactose intolerance or cow’s milk protein allergy? Not to worry! There are other rich food sources of calcium to consider, too! Non-dairy sources of calcium include dark green leafy vegetables such as spinach and kale, as well as broccoli, green beans, and green bell peppers.  Other sources included fortified food products such as cereals, fruits juices (orange juice) and cow’s milk alternatives.  Smaller amounts of calcium can be found in seafood (sardines, scallops, shrimp, whitefish/salmon), tofu, legumes and nuts, eggs, and yes – even chocolate! Table 1 demonstrates the calcium content comparison for these various food sources.

Table 1. Calcium content of various calcium-rich food sources. (from the National Institute of Health’s website.

Food Item Recommended Serving Size Calcium Content (mg)
Milk 1 C
·         Cow’s milk, nonfat, with added vitamins A and D 299 mg
·         Silk Soymilk, unsweetened, with added calcium, vitamins A, D, B12, and riboflavin 299 mg
·         Rice milk, unsweetened, with added calcium and vitamins A and D 283 mg
·         Hemp Milk, Living Harvest Tempt, Vanilla 300mg
·         Oat Milk, Pacific Foods, Organic Oat Original 350mg
·         Coconut milk, Silk Original 450mg
·         Almond Dream almond milk, with added vitamins A, D, and B12 300 mg
·         Ripple Milk 450mg
·         Silk Protein Nut milk 450 mg
Yogurt, plain, low fat 1 C (8 oz) 415 mg
Mozzarella Cheese, part skim 1.5 oz. 333 mg
Cheddar Cheese 1.;5 oz. 307 mg
Orange Juice, Calcium-fortified 6 oz 261mg
Tofu, firm, made with calcium sulfate ½ C 253 mg
Fortified Cereal ½ C 100-1000 mg
Spinach 1 C 216 mg
Green Vegetables ½ C 60 mg
White Fish or Salmon 3 oz. (1 filet) 70 mg
Nuts (Ie. Peanuts or Almonds) ¼ C 60 mg
Chocolate 5 squares 50 mg
Eggs 1 egg 25 mg

Inadequate intake of calcium over time can cause osteopenia, a less severe and reversible precursor to osteoporosis. Those who do not sufficiently meet their calcium intake, are at an increased risk for skeletal fracture injuries.  Similar to vitamin D deficiency, additional at-risk populations are those who spend most of their time indoors and those who live north of the equator. This is because Vitamin D functions with calcium to aid in its absorption. Without adequate Vitamin D, the calcium of foods eaten may not be fully functional once digested. Lastly, those who do not partake in weight-bearing activities on a routine basis are more likely to have an increased need for calcium. This is because bone is not able to be broken down and thereby calcium is not able to help contribute to the reformation of new bone. Annual bone-DEXA testing is recommended for those who are at risk.

Efforts should be made to maximize bone development during critical stages of an infant, toddlers, and child’s growth to minimize future risk of osteoporosis. If efforts cannot be made from a physical activity standpoint due to a disability, one’s calcium intake in the form of food or possible requirement for supplement should be highly prioritized. To help with such planning, it is recommended to advocate for your child’s welfare and seek out further information for the level of risk your child is at by discussing this with their physician. Furthermore, it is recommended to meet with a dietitian who can assess the diet specific to calcium and offer suggestions for ensuring adequate intake.

 

If you find your child has nutrition problems including failure to thrive, obesity, poor feeding skills, sensory disorders, and gastrointestinal disorders or others, schedule a nutritional evaluation with Easter Seals DuPage & Fox Valley today. Learn more at eastersealsdfvr.org/nutrition.

What is Sensory Processing Disorder?

By: Laura Van Zandt, OTR/L

As an occupational therapist, I have heard sensory referred to as many different things. Just a few examples include “sensory integration, sensory processing, sensory disorder, sensory dysfunction”. Not only is this confusing as an occupational therapist, but it has to be extremely confusing to parents too.

Sensory processing is a broad term that is used to refer to the way sensations are received and organized by the brain and how our bodies respond to this sensation and appropriately use it to interact within our environment. Our brains not only process information through the senses of touch, taste, smell, sight and sound but our brains also process information from our inner ear, muscles, joints, and ligaments to help us with movement and body position. All the sensory systems need to work together for effective sensory processing.

Overview of these sensory systems

  • Visual sense: is the ability to interpret what is seen regarding contrasts of light and dark, color, and movement.
  • Olfactory sense: is the ability to interpret smells
  • Auditory sense: is the ability to interpret what is heard regarding volume, pitch, and rhythm.
  • Gustatory sense: is the ability to interpret to receive taste sensations
  • Tactile sense: is the ability to interpret touch sensations like pressure, vibration, movement, temperature and pain.
  • Proprioceptive Sense: is the ability to interpret where your body parts are in relation to each other.
  • Vestibular sense: is the ability to interpret information relating to movement and balance related

If there is inefficiency in processing sensory information, a child’s ability to function is compromised and there be difficulties in the child’s arousal, alertness, attention as well as play, self-care, fine motor and gross motor skills. This difficulty has increasingly become known as sensory processing disorder and was first recognized by Dr. A. Jean Ayres, occupational therapist, educational psychologist, and neuroscientists.

Sensory processing disorder can be a confusing term. No two children are alike. Symptoms of sensory processing disorder, like most disorders, occur within a broad spectrum of abilities. While most of us have occasional difficulties processing sensory information, for individuals with sensory processing disorder, these difficulties are persistent and can significantly disrupt everyday life.

22_Everett_MazzieSome children may experience difficulties processing sensory information in all or only a few areas of sensory processing. Likewise, it is also common for some children to not experience difficulties in any one sensory system but have difficulties combining the sensory systems to develop a meaningful response. A child’s response to a certain type of sensory input or activity may vary from one instance to the next and is impacted by the events preceding the activity, how the child feels (tired, fidgety, ill, healthy), and the context in which the activity occurs (quiet, noisy, busy, structured). When describing a child’s sensory processing, it is important to remember that anyone’s sensory processing patterns are merely a reflection of that person’s ways of responding to sensory experiences in the course of everyday life (at home and school). Knowing a person’s patterns creates a tool for gaining insights about what settings and activities are likely to be easier or more challenging and reveals possibilities for navigating successfully in everyday life.

Sensory processing disorders can be divided into three main areas: sensory modulation, sensory-based motor, and sensory discrimination.

Sensory modulation disorder refers to the ability to filter sensations and to attend to those that are relevant in a graded and adaptive manner whereas sensory discrimination disorder refers to difficulty interpreting subtle qualities of objects, places, people or other environments.

Sensory modulation disorder can further be broken down into children who are over-responsive, under-responsive, or sensory cravers/seekers. Children who are sensory over-responsive are often predisposed to respond too much, too soon, or for too long to sensory stimuli most people find quite tolerable. These children are often in ‘fight or flight’ to common daily sensations and may try to avoid or minimize sensations or act out to counterbalance feeling constantly bombarded.

20150320_ES-LegoRoom-19.jpgFor example, a child who is over-responsive to touch sensation may find physical contact, clothing, and other touch sensory input difficult. Children who are sensory under-responsive are often unaware of sensory stimuli, have a delay before responding, or responses are muted/less intense as compared to the average person. They may appear withdrawn, difficult to engage, or self-absorbed because they do not detect the sensory input to the environment. For example, a child who is under-responsive to touch sensation may not be aware of clothing twisted on their body or messes on their face. The child who is sensory craving is driven to obtain sensory stimulation but getting the stimulation results in disorganization. They tend to be constantly moving, crashing, bumping, and/or jumping. They may “need” to touch everything and not understand what is their space versus other space. Sensory cravers can be difficult to decipher between children with ADHD.

In children whose sensory processing of messages from their muscles and joints is impaired, posture and motor skills can be affected. Children with a sensory postural disorder may have a poor perception of position of body, poorly developed movement patterns that depend on core stability, and appear weak with poor endurance. When posture is impaired these children might seek additional support by leaning on walls or resting their head on their hands when working at the table. When motor skills are involved these children often have difficulty with the ability to make a plan to execute an action as well as execute the necessary actions supporting the performance.

Click here to link to our sensory processing intake form to see if your child might benefit from an occupational therapy evaluation to determine if there is a sensory basis for your child’s difficulties.

With effective treatment provided by an occupational therapist, your child can develop the ability to process sensory information in an adaptive manner and learn strategies to help him or her cope with everyday experiences. Our occupational therapists are trained to use a variety of different standardized tests and clinical observations as well as caregiver input to help put all the pieces together of the puzzle and make appropriate referrals. Then our therapists expertly look at the match between the child, the activities and expectations, and the context to determine when there is a mismatch that needs intervention attention.

For more information visit our sensory processing webpage and visit the links below.

 

How to Talk to Your Baby: Tips for Parents Expanding Speech/Language Skills

By: Valerie Heneghan, CCC-SLP/L

Each baby’s development is unique and magnificent! However, parents will often ask us these questions:

  • How do I know if I am doing enough to foster speech and language development to keep my baby on track?
  • What communication milestones should I be looking for?

In general, these are a few communication milestones that you should be looking for in the first year of life from the American Speech-Language Hearing Association (ASHA). 

Birth-3 Months

  • Seems to recognize your voice and quiets if crying
  • Makes pleasure sounds (cooing, gooing)
  • Cries differently for different needs
  • Smiles when sees you

baby34-6 Months

  • Moves eyes in direction of sounds
  • Babbling sounds more speech-like with many different sounds, including p, b and m
  • Vocalizes excitement and displeasure

7 Months – 1 Year

  • Begins to respond to requests (e.g. “Come here” or “Want more?”)
  • Babbling has both long and short groups of sounds such as “tata upup bibibibi”
  • Uses gestures to communicate (waving, holding arms to be picked up)
  • Has one or two words (hi, dog, dada, mama) around first birthday, although sounds may not be clear

Here are 8 tips to help meet these milestones, engage, and expand your child’s ability to communicate.

  • Child-directed communication. The amount and quality of language has a huge impact on your child’s communication development. Research has shown that babies benefit greater from child-directed communication rather than language that is overheard (e.g., asking your child a question vs. listening to the TV in the background) Take the time to smile and enjoy your child through communication exchanges.

 

  • Imitate your child’s sounds and actions. Imitation is a very important skill for your child to learn.  Imitating your baby encourages him/her to notice you and even imitate your actions and/or words. This skill is vital for expanding babbling to initiating first words (e.g., “Mamama”, “babo”, etc.).

 

  • Put the child’s message into words.  When your child sends you a message by reaching, pointing, looking, or making a sound; put into words what you think he is trying to tell you.  Be repetitive, children learn through repeated exposure to target words. (e.g., Do you see the ball? Ball, Here is the ball.).

 

  • Talk with your child during every day routines and activities. When your child hears familiar words and sentences in the same contexts every day, it helps to build his understanding of language.  This is one of the best ways to learn more difficult concepts as well such as verbs, prepositions, etc. (e.g., Look the dog is running. He is running so fast!)

Baby nico on swing

  • Be face to face. When playing with your child, get down to his/her eye level.  Sit facing him/her when he is in his high chair or while playing on the floor.  This way, your child can see and hear you better fostering communication and imitation attempts. During this time, use gestures such as pointing, and imitating daily routines (e.g., washing hands, stirring spoon, kissing babies, etc.)

 

  • Offer your child choices. Hold up two objects and show each object as you name it.  You can ask, “Do you want crackers or bananas?”  Observe how your child communicates his/her choice-looking at the one he/she wants, reaching toward it, pointing to it, making a sound or saying the word.  As soon as your child lets you know what he/she wants, give it to him/her which will allow him/her to experience the power of communication!

 

  • Pause during a familiar routine to tell your child it’s his turn. When you and your child are doing something repeatedly (e.g., swinging, tickling).  Pause during the activity from time to time.  For example, after you have tickled your child, stop the game and WAIT for him/her to let you know that he/she wants more.  Don’t say anything-just look expectantly.  See if your child will tell you to continue in anticipation for that desired activity.

 

  • Sign Language. Sign language is the use of a gestural system to communicate. Signs can be used to reduce frustration and give the child a way to communicate his wants and needs while he/she is still coordinating their speech production system. (My personal favorites are “more”, “all done”, “milk”, and “up”).

    all_done
    From babysignlanguage.com

 

In summary, the best way to foster speech-language development with your child in their first year of life is to: TALK, PLAY, READ, and SING!  If you have any questions or need additional support, please contact a speech-language pathologist for more information.

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.org. 

 

My Kid is a Picky Eater and I Need Help!

By: Laura Van Zandt, OTR/L

peblog2Around 2 years of age, children enter the age of autonomy where they become aware of their individuality and become increasingly independent. This is also the age where they become increasing comfortable testing limits. Around this age, kids are most likely to start becoming “picky eaters.” By the time children enter preschool, many have begun to move past this phase and start to expand their food preferences; however, some children don’t move out of the picky eating stage and continue to refuse foods. Foods once liked may become dropped and not added back into their diet. The big difference between typical picky eating and avoidant /restrictive food intake disorder (AFRID) is that typical picky eating fades away in conjunction with repeated food exposure and a positive mealtime environment.

Children with ARFID may also have other health issues or conditions such as attention deficit hyperactivity disorder, autism, sensory processing, food allergies, constipation, and/or anxiety. Some children who were born prematurely may have required breathing and feeding tubes during hospitalization which can increase oral sensitivity. A child who had a choking episode in the past, was forced to eat, or who had multiple respiratory infections at a time when she was learning to eat may have developed negative associations with eating. Some children may have a sensory system which is offended by the texture, smell, odor, or appearance of food. These sensitivities may alter how kids experience food and result in their refusing to eat many foods. Anxiety can stem from the food itself, especially if it’s unfamiliar or disliked, or it can result from other factors such as pressure to eat at mealtime or a negative memory of eating. Older kids may experience social anxiety around their peers.

Parents often have good intuition and know when something is not right with their child’s eating patterns. Some signs of AFRID include refusing food due to its smell, texture or flavor, or a generalized lack of interest in eating. Children may have poor eating or feeding abilities, such as preferring pureed foods or a refusal to self-feed. They may be underweight or demonstrate slowed growth due to inadequate or poor nutrition. They may also show signs of anxiety or fear of eating. If you feel like your child’s eating patterns is moving beyond typical picky eating, please schedule an appointment with a pediatric occupational or speech therapist that specializes in feeding.

What can be done:

  1. Schedule a comprehensive evaluation with an occupational or speech therapist can assist you in helping rule in/out other medical conditions which may also be influencing your child’s eating behaviors and patterns. A therapist may also be able to make recommendations to further evaluate nutrition or evaluation for gastrointestinal issues causing discomfort or pain influencing feeding. They will help develop a comprehensive treatment plan that addresses all different angles of feeding.
  2. Read occupational therapists Maureen Karwowski’s blog regarding playing with your food. Research suggests that when too much negative pressure is placed on the child for eating, the child’s appetite may also decrease and could spur an emotional response leaving the child to dread mealtimes. Vice versa, additional research also suggests that when children are allowed to mess with their food and are given permission to touch, handle, and even squash foods they are actually more likely eat them. Allowing your child to handle food without the expectation to eat the food allows them to gradually desensitize their body to the sights, smells, and feeling of a variety of food. Allowing your child to play with food helps to build new brain pathways that help to reshape prior negative experiences with food.
  3. peblog1Recruit your child’s help. If you do not already meal plan, start meal planning and involving your child as much as possible in the process. When at the grocery store, ask your child to pick out food on the grocery list (even if it is not food your child regularly eats). At home, encourage your child to help rinse fruits and vegetables, stir batter, use scissors to cut herbs, or set the table. During mealtimes, serve dishes family style where everyone passes the different food bowls.
  4. Be patient and start very small. Your child might need repeated exposure to try a new food. You may also need to start by presenting a single bite of a vegetable or a fruit versus presenting a lot of the food immediately off the bat. Sometimes, even reading books about different foods, might be the place to start with your child.
  5. feast for 10.pngThink of fun and creative ways to present the same food. For example, if you child is learning how to like pizza, you can try serving pizza on a tortilla shell or on an English muffin. The following are a few books on food that are good to read with children:
  • Eating the Alphabet: Fruits and Vegetables from A to Z by Lois Ehlert
  • Cloudy with a Chance of Meatballs by Judi Barrett
  • I Will Not Ever Eat a Tomato by Lauren Child
  • The Seven Silly Eaters by Mary Ann Hoberman
  • Growing Vegetable Soup by Lois Ehlert
  • Feast for 10 by Cathryn Falwell
  1. Enroll your child in a food group. Easter Seals has routinely been offering an occupational therapy and speech therapy group called “Fun with Food” that helps children learn how to explore foods using all their senses, including touch, smell, sight, and taste. Each session will utilize sensory “warm up” games prior to heading to the kitchen for our snacks. Parents are encouraged to continue with food exploration at home based on weekly recommendations following each session.

Learn more about our occupational therapy services at http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/occupational-therapy.html. 

My Child Needs Deep Pressure! What Do I Do?

By: Laura Bueche, MOT OTR/L

Sensory Processing

Our bodies are constantly receiving and processing sensory information around us. Our senses give us the information we need to function in the world. We receive information from stimuli both outside and inside our bodies. Our sensory systems include auditory (hearing), vision, olfactory (smell), vestibular (movement), tactile (touch), gustatory (taste), and proprioceptive (body awareness). Sensory processing is the neurological process that organizes and interprets all the sensations we receive so we can function effectively within the environment.

What is Deep Pressure?

CatherineDeep touch pressure is a combination of a tactile and proprioceptive input which is often provided by firm holding, firm stroking, cuddling, hugging, and squeezing.

The proprioceptive sense refers to the sensory input and feedback that tells us about movement and body position. Proprioceptive receptors are located within our muscles, joints, ligaments, tendons, and connective tissues. It is one of the “deep senses” and could be considered the “position sense” (as Carol Stock Kranowitz refers to it in her book entitled  The Out-of-Sync Child.

If a child is having difficulty processing proprioceptive input, they’re brain isn’t receiving proper messages regarding whether muscles are being stretched, whether joints are bending or straightening, and how much of each of these is happening, children may seek out more intense forms of proprioceptive or deep pressure input. Kids with tactile and/or proprioceptive sensory processing dysfunction may seek out deep pressure input to send a stronger message to their nervous system. Deep pressure may help them “dampen” averse tactile sensations or may give them a greater sense of where their body is in a space.

 

Indicators of Deep Pressure Seeking

  • Tensing/squeezing muscles of the body
  • Crashing into furniture
  • Enjoys climbing into small spaces
  • Head banging
  • Grinding teeth
  • Pushing on chin
  • Stomping feet
  • Mouthing non-food items
  • Toe walking
  • Leaning into people

brushingDeep Pressure Input Activities

Deep Pressure Input Benefits

Deep pressure touch has been found to have beneficial effects in a variety of clinical settings (Barnard and Brazelton 1990, Gunzenhauser 1990). In anecdotal reports, deep touch pressure has been described to produce a calming effect in children with psychiatric disorders. Deep pressure stimulation, such as rolling up in a gym mat, has been used to calm children with autistic disorder and ADHD (Ayres 1979, King 1989). Lorna King (personal communication, 1990) reports that children with sleeping problems appear to sleep better inside of a mummy sleeping bag, which adapts to fit the body snuggly. It also has been used to reduce tactile defensiveness in children who cannot tolerate being touched. McClure and Holtz-Yotz (1991) found that deep pressure applied by foam-padded splints on the arms reduced self-injurious behavior and self-stimulation in an autistic child. (Ayers, 1992)

Deep touch stimulation is beneficial to typically developing babies (Barnard and Brazelton 1990, Gunzenhauser 1990). Institutionalized babies who received supplemental tactile stimulation, mainly deep touch pressure, developed more typically (Provence and Lipton 1962). Premature babies who receive stroking and tightly bound swaddling also are reported to show definite benefits (Anderson 1986, Field et al. 1986, Lieb et al. 1980). (Ayers, 1992)

If you think you child is seeking deep pressure input or has a sensory processing disorder, schedule an occupational therapy evaluation before trying to implement a sensory program at home. For more information on our occupational therapy program visit: http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/occupational-therapy.html. 

 

All About Adaptive Bikes

By: Bridget Hobbs, PT, DPT

img_7454.jpgWant to see pure joy in a child’s face?  Put him on a bike!  Children of all abilities love the freedom, weightlessness and fun that bicycles (and tricycles) provide.  Just like children, bicycles come in all varieties and can be adapted for children with special needs.

Bicycle riding provides not only the physical benefits such as leg strengthening, increased balance, coordination and endurance, but also the social benefits of riding with family and peers.  Below are just a few examples of modified cycles that are made to assist children with special needs in their bike riding goals.

bike

Adaptive tricycle: The three wheels on this tricycle provide a wide base for increased stability which helps children feel safe not only when riding the bike, but when getting on and off it as well.  The high back and seat belt also provide proper trunk support to help a child stay upright and midline.  There are also Velcro foot holders to prevent feet from sliding forward.

Rhys

Tandem bicycles: Tandem bicycles allow for a parent to propel the bicycle with the option to turn the child’s pedals on or off, which enables a child to rest and enjoy the ride when they are tired. The tandem bicycle also allows for communication while simultaneously enjoying the benefits of exercise.

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Bicycle Trailer: A bicycle trailer is a good option for longer family bike rides where everyone in the family can be included.  The bicycle trailer allows for a lot of leg room and a child or adult can be easily transferred in and out of the trailer and positioned in many different ways.

cycle

Hand and Foot Cycle: A hand and foot cycle can be used for children who have lower extremity weakness, spina bifida, cerebral palsy or low muscle tone. This type of tricycle has the ability to be propelled with either arms and/or legs.   A benefit of this type of tricycle is that children can increase their range of motion in their arms as well as work on a reciprocal motor pattern of their upper extremities.

Your child’s physical or occupational therapist is a great resource to help you and your child learn what kind of bicycle or tricycle would be good for your child.   A few companies/websites that may be helpful in adapted cycles are below:

jonathan-goers-logo.png

Thanks to a generous donor, we are pleased to launch the Jonathan Goers Bike Club at Easter Seals DuPage & Fox Valley. This program was established to share Jonathan’s joy of biking with children who have developmental delays and/or disabilities and may not otherwise have the opportunity to ride or own a bicycle. The program will provide a child with an adapted bicycle free of charge.

Any family of a child with a developmental delay or disability is eligible to apply to this program. The bike must be returned to Easter Seals DuPage & Fox Valley if the child outgrows or no longer uses the bike. This will allow another child to enjoy the benefits of biking. Speak with your Easter Seals DuPage & Fox Valley therapist for more information on the application.

The first bike giveaway will be at our 2nd Annual Bike for the Kids event on September 17 in Elgin. Adapted bikes and trailers are welcome and all ages and abilities are encouraged to participate. Choose your distance from 100 Miles to the 2.5 Mile family ride. Learn more at www.EasterSealsDFVR.org/BikeForTheKids.

Back to School…. Yay or Nay?

By: Sharon Pike, Parent Liaison

As the first day of school is fast approaching I am hearing two camps of parents.  The ones that are counting the days till the bus comes with the routine of school that brings a sense of normalcy and structure to their homes.  The other camp, is the one that are holding onto summer with all their might, dreading the routine and busyness that the school year promises.

Marita Blanken_4 cropped MG_9142BWhichever camp you’re in, know you’re not alone! Either way it’s time to shift gears and focus your energy on getting everyone ready for earlier bedtimes and wake ups, school lunches and getting out the door in time to catch the bus.

By now you’ve learned who your new teachers are so the kids know it’s coming. No one wants to send their child off to school frazzled so I recommend getting as organized as possible.
How to prepare your child

  • Move bedtime back and set alarms for earlier wake ups.
  • Start having the kids pick out their outfits the night before so everything is together in one spot for quick dressing.  If a schedule in your child’s room helps, make one that outlines the morning routine.
  • Have them help make lunch the night before so it’s all ready to go in the morning.

Preparations with the school before the first day

  • Review your child’s IEP especially the accommodations page so you can go to school and ask that things are in place before the first day of school. You don’t want to wait for the sensory diet items or special chairs to be available weeks later.
  • If your child has medical issues and things changed over the summer, ask to schedule with the school nurse to review any changes.
  • cammy can.pngCreate a one page at a glance about your child in a nut shell.  So, everyone from the principal, school secretary, janitor and lunch ladies understands your child’s unique needs and abilities.

Then hang on, as the first couple of weeks might be difficult. While there may be a few bumps to work out, before you know it will be October  and a nice routine will be established.

For help with your child’s IEP or other back to school assistance, contact our parent liaisons and visit our web resources at: http://www.easterseals.com/dfv/explore-resources/for-caregivers/iep-help.html 

Another great resource for back to school tips is from the American Academy of Pediatrics.