Monthly Archives: March 2017

Executive Function Skills: CO-OP Model

By: Laura Van Zandt, OTR/L

GOALPLANDOCHECK.

Executive functioning skills seems like the new ‘buzz’ word for therapists and parents working with children of all ages. Executive functioning skills include the ability to pay attention, recall a series of information, manage your time, be flexible, self-monitor for your emotions and impulses, initiate tasks, problem solve, persist as well as plan, organize, and sequence. One of our former speech therapists, Jennifer Tripoli, wrote a nice blog in August 2014 which you can refer to for more information regarding the definition of executive function skills.

One strategy that I like to teach children is a concept from the Cognitive Orientation to Occupational Performance or CO-OP model by Helene Polatajko and Angela Mandich called GOALPLANDOCHECK.

The CO-OP model is a “client-centered, performance based, problem solving approach that enables skill acquisition through a process of strategy use and guided discovery.” Occupational performance is what we do and how we do things throughout our day. Cognitive orientation implies that what we do and how we do things involve a cognitive process. The approach is designed to guide individuals to independently discover and develop cognitive strategies to meet their goals. That sounds like a lot of executive functioning skill development to me!

The use of self-talk is key with GOALPLANDOCHECK. When we require children to walk us through their plan and teach us their steps by talking aloud, they engablogge in more effective approaches to learning.

When teaching children, we start with the GOAL. We teach the child to understand the word GOAL as being something we are working towards completing. One strategy that has been helpful for visualizing the end GOAL is the concept of “future glasses.” Have the child wear funny glasses or simply make your hands in the shape of glasses. Then close your eyes and visualize the completed GOAL and what it might look like when completed.

The word PLAN implies there are a series of steps we need to do in order to meet our GOAL. To me the PLAN is critical for developing our problem solving skills.

Next we DO our goal.

Finally, we CHECK. The CHECK is really important for developing and strengthening our meta-cognitive skills. It is very important to understand how we can do better next time based on what we did today. CHECK gives the opportunity for feedback control by finding and correcting a mistake before the plan is final. It allows for incorporating flexibility and the ability to shift strategies when the current plan is not working.

KevinThis process helps children strengthen their executive function skills in the areas of working memory to pull from previous experiences, planning and prioritizing steps involved, persisting to achieve goals, and reflecting back by checking in with the plan to see if it was successful. If not, make alterations in order to be successful, eliminate time robbers to help with impulse control, and manage their time. Remember, initially it is about the practice and not the end result. It is okay to make mistakes. We all learn from mistakes.

Parents and family are an important part of the CO-OP approach. The effectiveness of the intervention is greatly increased when everyone is involved. Parents and family help the
individual child to acquire and practice these skills. It also helps them to transfer and generalize the learned strategies into everyday life. By providing explanations as well as guidance and asking questions at an appropriate developmental level, we provide just enough support necessary for the child to be successful. The more you can help children think about what they do and why, the more they will be able to use that thinking in any problem solving situation. The overall goal is to teach a child how to work through a problem using a planned approach instead of acting impulsively.

To learn more about Easter Seals DuPage & Fox Valley’s occupational therapy services visit: http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/occupational-therapy.html. 

Advertisements

Get Your Little One Walking

By: Bridget Hobbs PT, DPT

A child’s first year of life is so full of milestones… first smiles, first solid foods, and the first time s/he sits up on his/her own.  As the first year is coming to a close, many parents desire to see their little one taking their first steps around the time of their first birthday.  The typical window for children taking their first steps is anytime between 9 and 15 months, which is a big spectrum of time.

Below are some things that parents or caregivers can do with their child to help them get walking when they are showing signs that they are ready.

  • Set a good foundation for your baby. Walking involves strength from the entire body, not just the legs.  Believe it or not, creeping on hands and knees is an important milestone to achieve before walking.  Also, climbing over obstacles, such as couch cushions or parents’ legs is another good way to help build a solid core, or base for walking.  You can also help build strength in the core, arms and legs by teaching your child to crawl up steps. Try placing a favorite toy on the landing as motivation.
  • 01_Lucas_Vasquez2After a child learns to pull up and stand at the couch or coffee table, place toys away from their body so that the child has to rotate their body away from the support surface to reach for the toy. This technique will not only help build important rotator muscles in their trunk but will also gradually encourage them to stand with less support.
  • Once your child is standing supported holding onto furniture, have them practice little squat to stand movements. For example, motivate your child by placing a stacking ring at the height of their knees. While supporting them at their waist, encourage them to bend at their knees and hips to pick up the ring and then stand back up to help them place the ring on the stacking toy.
  • When your child is pulling up to stand, cruising side to side along furniture and starting to experiment with standing on their own, they are likely ready to start taking some steps. Hold onto one end of a hula hoop or small ring and encourage your child to hold onto the other side. While facing your child, encourage them to take a few steps while holding onto the ring for support.  You can also use a motivator, such as walking to pop bubbles or to grasp a puff snack as encouragement to get your child to talk some steps.
  • Weighing down a push toy, such as a small shopping cart or ride on toy will provide them the support they need to take forward steps. Often times these toys will move too fast, causing a child to face-plant forward if they are not weighted down, so place a gallon of milk or carton of orange juice in the shopping cart or ride on toy to help with this.

02_Josephine_Huard.jpg_waterIf your child is not showing any signs of pre-walking skills, such as pulling up to stand, walking along furniture or walking with hand held assist, and they are at the age when many of their peers are starting to walk, it’s always good to talk to your pediatrician about possible reasons why they are late to walking.

To learn more about  Physical Therapy and play-based therapy services at Easter Seals DuPage & Fox Valley, visit our website.

 

Recommendations for Pacifiers

By: Jessica Drake-Simmons M.S. CCC-SLP

Babies show a natural tendency to suck on fingers and thumbs from the time they are in utero.  Sucking provides comfort and is a natural way for babies to explore the environment.  Allowing a baby to suck on a pacifier can have the advantages of helping to sooth a fussy baby, providing a distraction and helping a baby fall asleep.   Additionally, pacifiers may help minimize reflux.  The Mayo Clinic suggests that a pacifier could help reduce the risk of sudden infant death syndrome when used at nap time and bedtime.

Baby nico on swingThe problem with pacifiers comes when little ones become dependent on them.  As a speech-language pathologist, seeing kids more frequently in their toddler years and beyond, I see some of the detrimental effects that persistent pacifier use can cause.  The preferred oral rest posture is having the lips closed, tongue placed up against the roof of the mouth, a slight space between the teeth and nasal breathing.  This oral rest posture supports dental alignment and wide rounded dental arches. Prolonged pacifier use (or other sucking habits) can cause a child’s teeth to be misaligned or not come in properly.

A study from Van Norman, 2001 found that 60% of dental malocclusions were related to sucking habits.  When the shape of the roof of the mouth is changed and dental malocclusions are created, kids can develop articulation errors such as a forward tongue position for production of /s/ (lisping).  Obstructing the mouth with a pacifier can negatively impact babbling and imitation of sounds.  Additionally, there is a correlation between pacifier use and increased incidence of ear infections.  Frequent ear infections are a common cause of speech and language delays.

Guidelines to follow for pacifier use:

  • The American Academy of Pediatrics recommends waiting to offer a pacifier until a baby is 3-4 weeks old when breast feeding is well established.
  • Don’t use the pacifier as a first line of defense. Try other strategies such as changing positions or rocking the baby to sooth them. pacifier
  • Use the appropriate size pacifier for your babies age in order to help maintain correct jaw alignment.
  • Recommendations vary between 6 months and 2 years for when it is appropriate to discontinue pacifier use. It can be easiest to wean the pacifier by the time a baby is 12 months.
  • Use pacifiers that are rounded on all sides. This allows for a more natural position of the tongue during non-nutritive sucking.

For help with discontinuing pacifier use: http://www.orofacialmyology.com/StopPacifier

To learn more about speech language-pathology and Easter Seals DuPage & Fox Valley visit eastersealsdfvr.org

How to Promote Reading Awareness in Young Children

By:  Kelly Lopresti, Director of Child Development & Christopher J. Lopresti, Reading Specialist

Each year at the beginning of March, school children kick off National Reading Month by celebrating the birthday of the beloved Dr. Seuss. Teachers design contests, family literacy events, and even pajama and pillow days to provide cozy mornings of uninterrupted reading. With help from Read Across America, the goal is to motivate kids to read every day of the year.

What about the little ones? Some think young children can’t participate. With a little help, they can enjoy National Reading Month too.

Literacy skills begin to develop at birth. At the Lily Garden Child Care Center we know how important early reading can be to help a child’s later success with reading and writing.

Skills closely related to later success with reading and writing:

  • Writing letters or one’s own name—the ability to write single letters in isolation, or write their own name
  • Alphabet knowledge—the ability to name letters and the sounds they make
  • Phonological awareness—the ability to hear and manipulate the sounds of spoken language (such as hear the beginning sound of a word)
  • Rapid letter or number naming—the ability to quickly name letters or numbers
  • Phonological memory—the ability to remember spoken information for a short period of time
  • Rapid object or color naming—the ability to quickly name random series of colors or objects

readOne way to develop these skills, give the gift of reading aloud to your child.

There are several benefits of reading aloud to your children. From bonding with your children to helping them strengthen skills in writing, creativity, listening and more. According to Scholastic’s Kids and Family Reading Report, the frequency of children being read aloud to at home drops sharply after age 5.  It drops even lower after age 8.  Try these resources to keep your reading bond strong with your kids.

  • The more you read aloud to your kids the more they will love reading.
  • It builds their vocabularies.
  • It develops background knowledge that they will need to understand the meaning of texts when they read on their own.
  • It inspires a lifetime love of reading and is a great way to model making reading a part of their everyday lives.
  • It’s one of the best ways to bond with your kids.

What you read aloud can vary day to dayMix it up – short, long, funny, factual – it’s all good.    

tipLiteracy Coach Reading Tip:  Please remember to read boldfaced headings and captions to your children in preparation for their academic careers.  The information therein is often used as source material for higher order thinking questions and can be used to expand their knowledge.

  • Chapter Books: Some read alouds go on for days and weeks because you may be reading a chapter a night of a longer novel or chapter book.
  • Picture Books: You may want to share a favorite picture book. Pick a former favorite of your child’s and revisit it.  They will love it just as much as they did when they were younger. Picture books are short 10-15 minutes. You can read picture books over and over again.
  • Poetry: Reading a short poem in the morning (or whenever you have time) can be a great idea. Find poems that relate to the season or what’s happening in their daily life.

Try one of these poems and see if your children like it.

Visit the below websites for a list of the top children’s book of 2016 and other resources.

Lily Garden Teacher’s Top Pickskeep-calm-and-love-reading

The Little Mouse and The Big Hungry Bear by Don and Audrey Wood -The pictures are amazing.  I also like that the big hungry bear is mentioned throughout the book but never pictured.   It is left up to the child’s imagination to picture the bear. -Jenni Moses

How I Became a Pirate by Melinda Long – It’s a story from a child’s perspective which the children can relate to. It’s a story about fun pirates! Every class I’ve worked with loves pirates and it’s something that holds their interest. Also, the author uses very descriptive words that really puts you in the story! -Katie Kwiatek

Harold and the Purple Crayon by Crocket Johnson – Harold lets his imagination go through art and his drawing! -Julie DeSalvo

We are in a Book by Mo Williams – I love this book! Mo Williams is such a creative author and I recommend all his work. The characters come to life well if you have a crazy imagination like I do or enjoy doing voices. Piggie reminds me of myself, so doing voices for Piggie and elephant is very fun. -Melissa Gonzalez

Go Away Big Green Monster by Ed Emberly – Toddlers love this book.  The children like to point to whatever facial feature is on that page.

The Bunny Rabbit Show by Sandra Boynton  – Toddlers love to sing along! -Christy Stringini

Naughty Little Monkeys by Jim Aylesworth -This book is about what happens when you leave twenty-six little monkeys home alone.  It’s a funny and colorful book that children want to read over and over again.  My son loved this book! -Kelly Lopresti

For more information about our inclusive daycare and our program philosophy visit: eastersealslilygarden.org.

Preventing illness through clean hands, food and home

By: Cindy Baranoski MS, RDN, LDN

Bacteria and viruses are everywhere, all around us. They live in our bodies and on our bodies. Even our digestive and immune systems depend upon their presence to provide us with optimal health. While viruses create illnesses we all remember, bacteria are the culprits more often, bringing us foodborne illness or that nasty ‘stomach flu’. With bacteria the obvious places, such as the kitchen sink, bathroom, garbage can, are usually associated with ‘germs’ and the potential for some sort of illness.  But bacteria are an invisible society living among us. Bacteria’s numbers are in the millions, and the types of bacteria we are exposed to can bring illness and health.

Wash your hands!

One of the easiest ways to prevent illness is to keep clean. Our hands, foods, kitchens, bathroom, anything we come into contact with in our world. If we simply wash our hands regularly, and not touch our eyes, noses, mouths, our chances of becoming infected by bacteria are significantly lessened.

The Centers For Disease Control and Prevention (CDC) has a dedicated web page to washing hands, with clear instructions and tips such as:

  • Wash hands before, during, and after preparing food
  • Before eating food
  • Before and after caring for someone who is sick

Keep your food and kitchen clean!

In kitchens, we have a ton of opportunities to come into contact with bacteria that can bring on an illness.  With millions of bacteria foundbac in the tiniest of places, imagine the size of your kitchen and just how many places are teeming with the little critters.

The Partnership for Food Safety Education at www.fightbac.org has a wonderful website loaded with helpful information on food safety. If you visit their site, you can find answers to many questions about the food you buy, prepare, eat, store, throw away and reheat. One of the most helpful sections of their site is The Core Four Practices. These are simple practices for food safety.

bacCLEAN – Wash hands and surfaces often

  1. Wash your hands with warm soapy water for at least 20 seconds before and after handling food, using the bathroom, changing a diaper, or handling your pets. (Check out the hand washing guide from the CDC).
  2. Wash items in the kitchen – dishes, utensils, counter tops, cutting boards with hot soapy water, after you use an item and before you use it on something else.
  3. Use paper towels for clean up, or if you use cloth towels be sure to wash them on hot.
  4. Rinse all fruits and veggies under water. For those with firm skins, use a vegetable brush.

SEPARATE – Don’t cross-contaminate

  1. Separate raw meat, poultry, seafood and eggs from other foods in shopping cart and bags, as well as your refrigerator.
  2. Do not use the same cutting board for meat and fresh produce.
  3. Do not place cooked food on a plate that had raw meat, poultry, seafood or eggs on it.

COOK – Cook foods to a safe internal temperature

  1. Use a thermometer to measure internal temperature when cooking meat, poultry and egg dishes.
  2. Cook roasts and steaks to no less than 145°F. Poultry to 165°F. Ground meat to 160 °F. Fish to 145 °F.
  3. Cook eggs until the yolk and white are firm.
  4. Be sure there are no cold spots when cooking foods.
  5. Heat leftovers thoroughly to 165 degrees Fahrenheit.

CHILL – Chill foods immediately

  1. Refrigerate foods quickly to 40°F or below. Use an appliance thermometer to be sure of the temperature. Freezers should be 0°F or below.
  2. Refrigerate foods as soon as you get home from the store.
  3. Never allow raw meat, poultry, eggs, cooked food or fresh fruits or veggies to sit at room temperature for longer than 2 hours. If the room is warm, then less than 1 hour sitting out. Do not defrost food at room temperature. Allow foods to thaw in the refrigerator. In a pinch you can use cold water or microwave for thawing, but these foods need to be cooked immediately.
  4. Marinate food in a refrigerator – and do not use marinate from raw meat, fish, poultry as a dipping sauce.
  5. Divide large quantities of foods into shallow containers to allow for faster cooling when storing foods, such as leftovers.

Your Refrigerator

eat-rightWatch this video from the Academy of Nutrition and Dietetics (AND) on keeping your refrigerator clean. Wiping the inside and outside down, cleaning the shelves and the front grill are as important as the counter tops you use to prepare foods. Going through your refrigerator often to toss outdated foods is something you should do on a regular basis. Know that foods have ‘use by’ dates which refers to food quality, and ‘expiration’ dates to know when to throw something away that is no longer consumable.

nutrition blog.pngYou can access more Home Food Safety resources at the AND website including:

  • Apps like Is My Food Safe?
  • Videos on how to wash fruits and vegetables
  • Safety tips on Holiday cooking to raw milk or keeping lunch boxes clean,
  • Food safety with hiking and camping, as well as keeping fruits fresh and reducing food waste are at this site as well.

Be Aware

Use common sense with foods and have respect for the fact that much of what we consume comes through a process where many people have been in contact with our food before we even purchase it.  Who has picked the apple from the tree?  Where did the chicken egg even come from? Who prepackaged your deli meats? Was the tomato you purchased ever rolling around the grocery store floor before you picked it off the shelf?

nutrition-therapy
Photo by Rich Howe

Certainly we don’t want to become so focused on cleanliness that we bring more harm than good to our bodies. Remember that millions of bacteria depend on our bodies for their home. When these bacteria are living in a symbiotic relationship with us, we have health. And when they have a good life, we do as well. But when the good bacteria are outnumbered by the bad bacteria, we have illness. An awareness to clean hands, foods and areas that support our mealtimes is great place to start.

For more information on Nutritional Therapy and scheduling an evaluation at Easter Seals DuPage & Fox Valley, visit our website: http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/nutritional-therapy.html.