Monthly Archives: October 2016

Visual Supports

By: Laura Bueche, MOT/OTR

Visual supports are concrete cues that provide your child with information about a routine, activity, behavioral expectation, or how to learn the component of a new skill. They may include pictures, symbols, written words, objects, visual boundaries and schedules.

Goals that can be addressed by using visual supports include:

  • Increase frequency of smooth transitions.
  • Decrease amount of time to transition.
  • Increase predictability.
  • Reduce inappropriate behaviors associated with a task or transition.
  • Increase independence.
  • Minimize teacher and adult support (e.g. prompts and reinforcement).
  • Increase understanding of expected task or activity to complete.
  • Maximize understanding of environment.
  • Decrease distractions.
  • Reduce self-injurious behaviors.
  • Increase social interaction skills.
  • Increase demonstration of play skills.
  • Increase understanding of behavior expectations.

There are three types of visual support: visual boundaries, visual cues, and visual schedules.

Visual boundaries are a helpful way to help your child make sense of the world around them. It will help your child to stay on task, understand personal space, and stay organized. Visual boundaries can include:

Floor tape

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Spot markers

spot-markers

Visual Cues are helpful for a variety of different applications. For example they can help with:

Breaking down the steps of a task.

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Organizing concepts and ideas.

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Assisting with communication.

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Organizing materials.

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Time Management.

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Visual Schedules – Visual schedules can increase your child’s understanding of expectations and provide support for transitions in between activities.

When developing a visual schedule, there are a lot of components to consider:

  • schedules-jpgForm of the visual (picture, photos, words, phrases).
  • Length of the sequence (one item, two items, half day, full day).
  • Presentation (left to right, top to bottom, technology based).
  • Manipulation of the visual (child carries object to next activity, “all done” pocket, marks).
  • Location of the schedule (on a wall, desk, notebook).

Be sure to work with your child’s speech and language pathologist, occupational therapist, or special education teacher to determine what the most appropriate type of visual schedule is for your child.

For more information on occupational therapy services including helping children and adults with sensory-processing abilities, coordination, peer interaction, play and self-care skills to participate in daily life activities, visit eastersealsdfvr.org.

 

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Pilates for Kids

By: Laura Znajda, PT, C/NDT

A study in the British Journal of Sports Medicine last month ranked United States children among the least fit in the world—the US ranked 47th out of 50 countries in physical fitness of our children!   With a sedentary lifestyle linked to heart disease, diabetes, and obesity, it is more important than ever to get our children moving and instill healthy behaviors that will last a lifetime.  It’s been shown that children whose parents exercise regularly are more likely to exercise and be active as adults.  Exercising together is fun and more motivating for both parents and their kids.

A good physical fitness program includes a variety of exercise and movement activities.  Pilates is just one of many exercise methods that is gaining popularity among adults, and with its focus on core strength, stability, and body awareness, this exercise method can be used with kids too–and with great benefits.  And since many Pilates exercises use body or limb weight for resistance strengthening,  little to no equipment is needed.  So  grab a piece of floor and perhaps an exercise ball, and have fun while being active with your kids!

Pilates Bridge is an exercise that strengthens gluteal (buttock) muscles and hamstrings, while providing a stretch to flexor muscles across the front of the hips.  It requires core muscles to work together, leading to good posture and balance for all future dancers, gymnasts and sports enthusiasts. To make it fun for kids, help them place feet (and lower legs if more support is needed) on an exercise ball and lift hips and spine off the floor.  Weight should be on the shoulders and feet.  You can stabilize the ball if needed, or have the child wedge the ball in a corner before starting.

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Swimming Exercise strengthens extensor muscles of the back, hips, thighs and calves that kids need for running and jumping.   Lying flat on the tummy, have the child lift one arm at a time, keeping the legs straight and long.  As the child gets stronger, cue him to lift one or both legs off the floor , always keeping them stretched as long as possible.

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Younger children might need help stabilizing one arm against the floor while they lift the other.  Make it fun by pretending to be an alligator chomping on his dinner or reaching for small objects.

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Pilates Leg Circles are hard for many adults, and even harder for young kids who lack abdominal strength to stabilize the trunk while moving their legs above their body.  But working on the starting position for this exercise will help kids learn to engage abdominal muscles prior to moving their legs when climbing or kicking a ball. Ask the child to lie on his back and lift his feet above his body (hips at a 90 degree angle).  Make it fun by placing small bean bag animals on his feet or ask him to squeeze the animals between his feet.pilatesblog2

Plank strengthens core muscles that are critical for a stable, balanced body, whether your child likes to exercise on the playground or by playing a competitive sport.  The key with plank is to only hold the pose for as long as you can keep good form.

Give your child the support of an exercise ball to start, bringing her forward onto her hands.  Keep the ball positioned under the hips if needed; move it to the lower legs as the child gets stronger.  She should be able to keep her tummy lifted and the back straight (not arched or sagging).  As soon as the trunk starts to lose its form, take a rest and try again after a minute or two.  Make it fun by singing a song while holding the plank position.

Proof that Pilates exercise can be used by everyone, many Pilates moves have been adapted for use in rehabilitation.  Pilates is used to rehabilitate orthopedic injuries in adults as well as to strengthen and improve body awareness for children with neuromuscular disorders.

Easter Seals DuPage & Fox Valley therapists are expanding their knowledge of using Pilates in therapy with a continuing education course taught by Sara Koveleski Kraut, DPT,  on January 21-22, 2017.  The course is open for registration by adult and pediatric therapists at eastersealsdfvr.org/ce.

Easter Seals DuPage & Fox Valley is also a teaching center that provides innovative continuing education courses that promote therapeutic excellence for speech and language pathologists, physical and occupational therapists, educators and other professionals.  To be added to the course email list, please email us.

 

Speech and Language Evaluation: What to Expect

By: Jennifer Tripoli M.S.Speech Language Pathologist

You and your child may wonder what to expect when participating in a speech and language evaluation. Many children (and parents!) feel less anxious when they know ahead of time what they will be doing. Of course, the outline of a speech and language evaluation depends on the age of the child and the areas of need. Below is a general outline for a speech and language evaluation:

1. Parent Interview

Parents are the best reporters of their child’s development. They know their child and can paint a clear picture of their child before the speech pathologist begins the formal assessment. A formalized assessment does not always “pick up” everything that should be known about a child. A caregiver or parent’s role in a pediatric speech and language evaluation is crucial in helping the speech pathologist determine your child’s needs. During this interview, the therapist will usually ask you why you have come in for an evaluation, and ask about your concerns and goals for the evaluation.

2. Case History

A case history usually includes a medical history and developmental history. Typically, the speech pathologist is able to review provided information prior to the evaluation, but often there are additional questions that need to be answered.

A medical history includes any medical issues that your child has encountered since birth or before birth. Often this includes, but is not limited to pregnancy/birth history of the mother (e.g. complicated pregnancy, premature birth, complicated delivery), major surgeries, procedures or tests (e.g. tonsillectomy/adenoidectomy, ear surgeries, brain surgeries, hearing screenings/tests, MRI/CT, etc.), significant illnesses, infections or injuries (e.g. chronic ear infections, chronic congestion, respiratory illnesses) and/or hospitalizations.

It is also important for the speech pathologist to be aware of any specialty physicians your child has seen such as otolaryngologists, gastroenterologists, neurologists, etc. A developmental history is taken in order for the therapist to understand your child’s developmental progression. Developmental histories include all areas of development; not just speech and language milestones. They can include when your baby first sat unassisted, crawled, walked, babbled, etc.

3. Speech and Language Concerns

During this part of the evaluation, the therapist will ask more detailed/specific questions related to your child’s speech and language skills. The types of questions will depend on your child’s age and the type of evaluation. The therapist will ask you questions related to your child’s expressive language skills, receptive language skills, social/pragmatic language skills, oral motor skills, and speech sound production.

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4. Discussion of Previous Therapies

It is important that your therapist knows what services your child has participated in previously. Has your child received early intervention services? School based services? Other private therapies? You should be prepared to explain the other therapies your child has participated in including occupational therapy, developmental therapy, physical therapy, or behavioral therapy. Please be specific in the goals of each of the therapies if applicable.development

5. Formal Assessment

01_Lucas_VasquezThe point where the therapist begins the formalized assessment can vary significantly depending on the age and deficits of your child. For a young toddler, this part of the assessment may be play based. The clinician will likely be observing your child’s current communication skills in a play setting while administering a standardized or norm referenced test. The therapist may ask to observe you playing with your child.

For a preschool or school aged child, a standardized/norm referenced test would likely be administered depending on the abilities of your child. This would yield a score that will compare your child’s skills to other children his/her age. A standardized test will likely be your child looking/naming pictures in a book and answering questions.

The clinician will also interact with your child in a less structured way by engaging in conversation or asking questions related to his/her life. The therapist may also take a language sample, which will analyze your child’s expressive language skills and speech intelligibility (ability to be understood by others). Additionally, the therapist will likely complete an oral motor assessment if appropriate in order to examine your child’s oral structures. An oral motor assessment usually asks the child to do certain movements with his/her lips, tongue, jaw and face. The therapist may also have your child eat/drink something. Though this is not a feeding evaluation, it is often difficult to separate speech and feeding skills.

6. Discussion of Results and Recommendations

Toward the end of the evaluation, the therapist will discuss your child’s results and make recommendations for any further evaluations needed. If your child would benefit from therapy, a recommended frequency would be given (e.g. weekly therapy, twice weekly, monthly, etc.) At this time, you can ask questions regarding the evaluation or your child’s prognosis.

Think your child may need a speech and language evaluation? Learn more about speech and language services provided at Easter Seals DuPage and Fox Valley here.