All posts by eastersealsdfvr

About eastersealsdfvr

Our vision is that all children receive the developmental services they need to live their best life. Our mission is to enable infants, children, and adults with disabilities to achieve their maximum independence, and to provide support for the families who love and care for them.

Protein and Vegetables: What’s the Big Deal?

By: Nutrition Graduate Student, Cristal Medina and Pediatric Nutrition Therapist Cindy Baranoski MS, RDN, LDN

Most parents know it is important for children to eat a balanced diet. What exactly does a balanced diet mean? Generally, it means eating a variety of foods and getting enough of each food group. The five food groups are fruits, vegetables, grains, protein foods, and dairy. Although every food group is important, it seems as though protein foods and vegetables receive the most attention. You may be wondering why these two food groups are so important, how much of each is needed, and how to get your child to meet the recommendations. We will cover all this, but let’s start with how much food your child needs.

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Protein

Protein is a key nutrient for everyone from growing babies to elite athletes. It is necessary to build, maintain, and repair tissue. We need protein to form healthy bones, muscles, cartilage, skin, and nails, as well as to make enzymes, hormones, and other chemicals. Protein foods are also important sources of nutrients such as iron, niacin, vitamin B12, vitamin B6, riboflavin, selenium, choline, phosphorous, zinc, copper, vitamin D, and Vitamin E. These vitamins and minerals offer a myriad of benefits to a growing child.

leafy greensA common misconception is that protein is only found in animal-based foods, like meat. However, protein can also come from plant-based foods, like beans (example: pinto, black, kidney beans) and soy products (example: tofu, tempeh, edamame). The protein food group includes meat, poultry, seafood, beans, peas, eggs, processed soy products, nuts, and seeds. Dairy foods such as milk, cheese, yogurt, and cottage cheese will also provide your child with protein. Your child’s protein needs vary based on age, sex, and activity level. (Please see Table 1 above for recommended intake amounts.)

A serving from the protein food group, also referred to as an ounce-equivalent, is 1 ounce of meat, poultry, or fish, 1 egg, ¼ cup cooked beans or peas, ¼ cup tofu, 1 ounce of tempeh, 1 falafel patty, 2 tablespoons of hummus, 1 tablespoon of peanut butter, or ½ ounce of nuts or seeds. Please see Table 2 for common protein food portions.

Table 2. Common Portions and Servings of Protein Foods*

Protein Food Common Portion and Servings  
Meats 1 small steak = 3.5 to 4 servings
1 small hamburger = 2 to 3 servings
Poultry 1 small chicken breast half = 3 servings
½ Cornish game hen = 4 servings
Seafood 1 can of tuna, drained = 3 to 4 servings
1 salmon steak = 4 to 6 servings
Eggs 3 egg whites = 2 servings
3 egg yolks = 1 ounce-equivalent
Nuts and Seeds 1 ounce of nuts or seeds = 2 servings
2 tablespoons peanut butter = 2 servings
Beans and Peas ½ cup cooked beans (example: pinto, black, or kidney) or peas = 2 servings

1 cup split pea soup = 2 servings
1 cup lentil soup = 2 servings
1 cup bean soup = 2 servings
1 soy or bean burger patty = 2 servings

2 tablespoons of hummus = 1 serving

*Adapted from https://www.choosemyplate.gov/protein-foods

A couple examples of convenient and kid-friendly protein foods are hamburger patties (examples: McDonald’s, White Castle [yes, fast food is okay]), fish sticks, chicken nuggets, Boca vegan burgers, and milk (examples: cow’s milk, Ripple milk, hemp milk). If your child prefers to drink rather than eat, try supplementing with a nutritious drink (examples: Kate Farms, Vega, Orgain, PediaSure). If your child does not eat solid foods, you can puree meat, poultry, seafood, and tofu, mash beans and peas, and provide foods like creamy nut butters, hummus, blended soups, and smooth yogurt. If your child relies on formula given through a feeding tube or drinking a supplement for most or all of his/her daily nutrition intake, s/he may be getting enough protein if s/he is consuming enough. Make sure to speak to a registered dietitian if you have any concerns about your child meeting his/her protein needs.

QUICK RECIPE: Black Bean Quesadilla*

INGREDIENTS

  •  ¾ cup pico de gallo
  • 1 can (15.5 oz) black beans (great protein source!)
  • ½ cup shredded Colby and Monterey Jack cheese
  • 2 tablespoons chopped cilantro
  • 4 eight-inch flour tortillas
  • ½ teaspoon olive oil

DIRECTIONS

1.      Using small-hole strainer, drain liquid from Pico de Gallo; discard liquid. Transfer leftover tomato mixture to medium bowl. Mix in black beans, cheese and cilantro until combined.

2.      Divide black bean mixture evenly over half of each tortilla (about ½ cup each). Fold tortillas in half.

3.      Heat large griddle or skillet over medium-high heat. Brush with oil. Place filled tortillas on griddle. Cook, carefully flipping once, until tortillas are golden brown and crisp and cheese filling melts, about 5 minutes. Cut quesadillas into wedges. Makes 8 servings.

Optional: For additional protein, add chicken or your favorite meat!

*Adapted from: https://choosemyplate-prod.azureedge.net/sites/default/files/misc/GOYAcookbook-EN-HealthyTastyAffordableLatinCooking.pdf

Vegetables

Vegetables are full of nutrients including dietary fiber, potassium, iron, vitamin A, vitamin C, vitamin K, copper, magnesium, vitamin E, vitamin B6, manganese, thiamin, niacin, and choline. These nutrients can help your child build healthy bones, heal cuts and wounds, protect against infection, support heart health, promote healthy aging, and maintain healthy eyes, skin, teeth and gums.

The vegetable food group is made up of vegetables and 100% vegetable juice. Vegetables come in a variety of forms to fit any diet. They can be raw, cooked, fresh, frozen, canned, dried/dehydrated, whole, sliced, mashed, pureed, or juiced. Please see Table 1 above for recommended intake amounts.

spinach
Dr. Praeger’s Food

A serving, or cup-equivalent, from the vegetable group can be 1 cup of raw or cooked vegetables, 1 cup of vegetable juice, or 2 cups of raw leafy greens. There are some great brands out there that sell kid-friendly, veggie-containing foods. Two examples of brands are Dr. Praeger’s Purely Sensible Foods and Happy Family. Dr. Praeger’s line of foods includes a variety of “Puffs”, “Cakes”, and “Littles” (these are shaped liked stars, dinosaurs, and bears!) that are made with ingredients like broccoli, spinach, kale, and carrots. Happy Family sells everything from bars, to squeeze pouches, to puffs (some of these are also shaped like dinos!). These foods can have veggies like tomato, kale, spinach, and carrots. Their foods are appropriate for all ages, from infants to adults.

You can also try incorporating vegetables into other foods at home. Combine leafy green vegetables, celery, carrots, or beets with fruit to make a juice or smoothie. Store-bought, single serving vegetable juices and smoothies (example: Bolthouse Farms or Naked Juice) are also an option if you are on-the-go. You can also try blending pureed cooked cauliflower in mashed potatoes and mixing pureed cooked sweet potato or carrot into a cheese or pasta sauce. Blending cooked pumpkin, carrot, squash, or sweet potato into a tomato or vegetable soup can also increase your child’s vegetable intake. These ideas are also appropriate for children who do not eat solids.

If your child relies on a tube feeding formula or an oral supplement, s/he may be meeting all vitamin and mineral needs if s/he is consuming enough. If not, your child may benefit from a multivitamin. A registered dietitian can help you plan on the best way to get more nutrients into your child. If you are interested in adding blended vegetables to your child’s tube feeding regimen, a registered dietitian can also help you get started with blenderized tube feedings.

QUICK RECIPE: Pineapple and Spinach Smoothie*

INGREDIENTS

  •  2 cups pineapple
  • 1 cup baby spinach (great way to consume veggies!)
  • 1 banana
  • 1 cup unsweetened almond milk
  • 1 cup ice
  • ¼ tsp ground cinnamon

DIRECTIONS

  1. Combine pineapple, spinach, banana, almond milk, ice and cinnamon in blender. Cover; blend until smooth. Makes 2 servings.

*Adapted from: http://www.dole.com/recipes/p/Pineapple-Pit-Stop-Smoothie

To learn more about nutrition therapy through Easter Seals DuPage & Fox Valley, please visit eastersealsdfvr.org/nutrition.

 

References:

  1. https://health.gov/dietaryguidelines/2015/guidelines/
  2. https://www.choosemyplate.gov
  3. http://www.dole.com/en/recipes
  4. https://drpraegers.com/
  5. https://happyfamilybrands.com/

 

 

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How Speech-Language and Occupational Therapies Work Together

By: Danielle Maglinte, MAT, MS, CCC-SLP

Ryan - webYoung children go through many developmental stages before they begin talking. One of the first stages of development is shared attention. In a baby, shared attention looks like the baby turning her head toward mom when she hears mom’s voice or a baby looking into dad’s eyes when dad talks to the baby. As children get a little older, shared attention looks like mom holding up a toy, the child looking at the toy, then looking back at mom and smiling. The next step in developing shared attention is dad looking at or pointing to a toy, the child looks where dad looks or points, then he looks back to dad. These steps towards developing shared attention typically happen within the first 12 months of a child’s life.

When a young child reaches a stage of shared attention where they can follow a caregiver’s point and they can shift their gaze between the caregiver and the object, they start to develop back-and-forth communication. At first, this looks like a child reaching for an object to tell the caregiver “I want that.”

As back-and-forth communication with gestures continues to develop, the child starts to vocalize. In the beginning, these vocalizations are mostly babbling. As parents talk back when the child babbles, these vocalizations turn into jargon where a child sounds like they are speaking in sentences but not actually saying words. Some parents comment that it sounds like the child is speaking in another language. Over time, the child’s vocalizations are shaped into short, simple words, such as mama, dada, and baba for bottle. Children with speech delays often demonstrate limited shared attention. Working to develop strong shared attention will help a child learning to communicate.

One challenge for some children with speech delays is that they need to maintain a calm, regulated state so that they are available for interactions and can share attention with another person. Read more about self-regulation from OT Maureen here.

15_JJAzariahIf a child is focused on seeking sensory input, they may not have the ability to focus on social interactions, developing shared attention and speech with caregivers. Occupational therapy can help figure out activities and ways we can include these activities in everyday life so that a child can remain in a calm, regulated state so that she is available for social interactions. This may look like a child with limited eye contact running away and looking back to see if you are chasing him or a child who is quiet asking for “more” when you stop pushing the swing.

When a child stays regulated for longer periods of time, she will be available for interactions so that she can continue to develop strong shared attention, and move on to using gestures and speech to communicate. By working together, speech-language therapists and occupational therapists can help a family find activities, such as climbing, playing chase, swinging, and swimming  or others that help a child with speech delays stay regulated and available to develop shared attention and communication skills.

To learn more about speech-language and multi-discipline therapy at Easterseals DuPage & Fox Valley visit: http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/speech-language-therapy.html. 

Back to School Organization

By: Laura Van Zandt, MS, OTR/L

With many of our children returning back to school, I thought this would be a good time to review some strategies to help with school organization. Kids need organization skills in order to function during their school day as well as to get their homework done efficiently at home. If your child struggles with a messy desk, overstuffed backpack, keeping homework and classroom assignments organized, or lost and missing parent/teacher communication slips then hopefully you can find some tips and tricks in this blog. Remember every child is different and what works well for you or another child may not necessarily work well for your own child.backpack

  • Most importantly develop routines and stick to them as closely as possible. Some children might benefit from additional support to help learn the routine such as checklists, picture schedules, and/or social stories. Younger children might also benefit from turning the routine into a fun song.
  • Create backpack organization systems. Look for backpacks that offer multiple compartments to denote separate spaces. A backpack with at least two compartments is highly recommended. Use a zippered pouch (clear is the best) for pencils, erasers, calculators, etc. in the backpack.
    1. Please check out my previous post on backpack safety.
  • Place a laminated checklist clipped to your child’s backpack zipper that lists what needs to be brought home each day. This one from Understood.org is great. 
  • Go through the backpack on a regular basis with your child until he/she gets the hang of keeping it organized. Gradually give your child more responsibility and continue to check in even when you have turned in all the responsibility to your child.
  • Create a simple schoolwork folder system. A simple 2 pocket folder often works best. Use a bright sticker to place on one side for “KEEP AT HOME” and another bright sticker for the opposite pocket for “BRING BACK”. If your children are older, you can create a color coded system that corresponds to each class. Books and notebooks can use prefabricated book covers or you can use colored paper to create book covers in a variety of colors.
folder
Picture from caffeinatedconclusions.blogspot
  • Depending on the age of your child you might start to create a really good binder system. The best ones have a locking rig. Some binders have a clear plastic cover which can be used to create large labels on the outside for different subjects (if you are using a different binder for each subject) or you can use it to hold assignment sheets.
    1. If you are going to start a binder system, then you should invest in a few more organization assistants. Things like subject dividers, a zippered pencil pouch, sheet protectors, two pocket three-hold punched folders, and a portable three-hold punch are really helpful. You can organize each subject section the same. Label each subject divider tab and then include an empty sheet protector immediately behind for important handouts. Behind the sheet protector you can include a folder which follows the same simple schoolwork folder system idea above.
    2. A different option could also be to continue to use the subject divers, zippered pencil pouch, sheet protectors, two pocket three-hold punched folders, and a portable three-hold punch; however, instead of using the simple schoolwork folder system idea above with the two pocket folders, you can create one global folder that is in front of the binder where your child put homework for each class in front. At the end of the day, when at home, you can then sit with your child and help organize their homework when completed back into each individual subject folder.

pencil org..jpg

  • Some children might do also better with an accordion file based system. One suggestion for organized would be using the front section to keep your child’s homework planner or global two-pocket folder homework folder. Each additional pocket would be labelled with the different subjects and might include a separate pad of paper for that subject. I like to avoid loose sheets of paper as much as possible with an accordion system as I find they tend to slide down.
  • Create an organization system for lockers. Some children like to create a container system where they use separate containers for different belongings which are labeled with pictures on the outside to know what goes inside each bin. You can also add a picture to the locker for a visual cue for where each item belongs which the locker to further help keep things organized. Shelves are also helpful to better divide the space.
    1. lockerTo help you and your child determine the most logical and efficient way to organize the locker and backpack, here are some helpful questions (source: The Organized Student)
    2. What is your child’s schedule like? If the schedule is consistent, you can probably just separate the locker into two sections, morning and afternoon. If it changes every day, you might want to organize differently
    3. What extracurricular activities does your child participate in and what supplies/equipment is needed?
    4. Does your child keep supplies and equipment in a locker at school or do they travel back/forth between school and home on a regular basis?
    5. How many books is your child required to keep track of throughout the day
    6. Does your child’s school offer a second set of textbooks on loan?
    7. What type of storage and accessories does the locker already contain?
    8. Does your child have time to go back to his/her locker between classes?

 

  • Create a homework station at home. Include all necessary school supplies such as pencils, pens, crayons, markers, glue, scissors, paper, etc. You can use everyday items (mason jars, muffin tin) to help organize items. Containers available at any office/home good are great ways to help organize. You can attach labels made from a label marker or also just use post-its and adhere using clear tape. Every item has its own place and it is easy to spot. Ask your child’s school if it is possible to get a second set of textbooks to eliminate the need to bring books back and forth between school and home. Mark off spaces for items like books and pencil box using painter’s tape. If your child is older, you might think about creating a “desktop file box” which is described in a lot more detailed in The Organized Student book.

 

  • Help your child learn to breakdown assignments into manageable chunks. One example includes folding worksheets into sections that can be completed before moving onto the next section.
  • Invest in some telling time systems. It is often helpful to breakdown into the concept of telling time, daily time, weekly time, and monthly time. I prefer to use analog’s watches or timers for this as you can see the passage of time which is missing from digital systems. When first learning to tell time and gauge time, create from fun activities to experiment with by guessing how long it will take and then compare guess to actual. It might be useful to have several timers. One for the global amount of time your child/you think he/she needs to complete the assignments and an individual one to break down individual assignments into manageable chunks and to add a spot for a quick break. If you can find an analog clock that also allows for a quick glance to see the time digitally, that might also help.clock
  • Finally, if you have read any of our previous posts on executive functions or attended our executive function client group, then you might be familiar with the group Cognitive Connections. They developed an app that allows users to create a time marker to get ready for work, a timer marker to check in during work, and a marker when the work is planned to end. There are tones activities when the time reaches each marker. This could also be a good choice for some children.
  • The key to any organization system is be flexible to your child’s unique organizational style and needs as well as be consistent and offer check-ins until your child has mastered the system. Even when your child has mastered the system, continue to offer periodic support.References and Helpful Resources:

Comparing School & Clinic Speech Services

By: Valerie Heneghan, M.A. CCC-SLP/L
Speech Department Manager

 As a speech-language pathologist who has worked both in school-based and clinical settings, I am often asked questions about the difference between these two settings. Overall, they work together! I’ll explain more.

School-based setting

Qualifications

girls on desk looking at notebook
Photo by Pixabay on Pexels.com

Schools have entrance and exit criteria for qualifying children for speech services derived by their district or state. Using formal assessment protocols, children may need to demonstrate a deficit of a pre-set standard deviation before they are eligible for services.  There is usually a wide range of differences from district to district, so it is difficult to predict qualification criteria prior to the evaluation.

Services:

School services can treat children with language, articulation, pragmatic (i.e., social), and voice/fluency disorders to make educational progress. These services may be delivered in a variety of ways including one-on-one, group setting, or push-in to the classroom.

A Clinic-based setting (like at Easterseals DuPage & Fox Valley)

Qualifications

Clinics typically do not have pre-set qualification criteria as they are not regulated by state or governing bodies.  Clinicians will qualify children for services based on clinical judgement using both formal and informal assessment procedures. Coverage for these services however may be dependent on the child’s insurance and/or may be an out of pocket expense.

Services

speech therapist.jpgClinics may be able to provide more specialized, intensive, or varied skilled services based on functional and/or medical necessity. Often these services are delivered on a one-on-one setting in the clinic, however additional options may be available.

Easterseals

At Easterseals DuPage & Fox Valley , we offer a variety of service delivery models including: one-on-one therapy, community base therapy (groups), co-treatment with multiple services, tele-therapy services in addition to providing services in our clinic, homes, and through our daycare setting.

We deliver a wide range of speech-language services cultivated by upholding ongoing continued education/ certifications, state of the art equipment, and collaboration with multidisciplinary teams.  Our speech-language services work to strengthen children’s communication and feeding skills so that they can participate fully in daily activities and achieve success.

Our speech-language therapy services address functional communication, language expression/comprehension, pragmatics, speech-sound production, voice, fluency, oral motor, and feeding skills. Areas of specialization include but are not limited to the following:

  1. The Voice Box: A Motor Speech Lab, focuses on improving articulation, voice and resonance skills through cutting edge and innovative technology.
  2. Oralfacial Myology addresses disorders of the muscles and functions of the mouth and face. These may address tongue thrust, dental malocclusions, breathing, speech, swallowing, and chewing.
  3. Feeding services seek to ensure safety and adequate consumption of a varied diet. Treatment may address feeding issues related towards chronic diseases or syndromes, disorders of oral motor structure or development, growth disorders, failure to thrive or obesity, tube feedings, food allergies and sensitivities, gastrointestinal disorders, neurological conditions, constipation, diarrhea, sensory-related or Autism Spectrum Disorder-related feeding difficulties.

Voice Box Photo 3Our services continue to expand to meet the needs of the current populations that we serve.  Additional initiatives that we have been growing this year include: tongue/lip ties, auditory processing, and Spell-Links for improving spelling and reading comprehension.

I see value in both school and clinical settings!  I often encourage families that I work with, to consider both options based on the needs of the child.  Our therapists work with other disciplines like our Occupational Therapy, Physical Therapy, Audiology or Nutrition teams. We make sure to consult and involve all medical professionals and school therapists that work with a child, to  review goals and achieve maximal outcomes. To learn more about Speech-Language services at Easterseals DuPage & Fox Valley visit http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/speech-language-therapy.html.

Audiology Intervention for Children with Down Syndrome

By: Karyn Voels Malesevic, AuD, CCC-A, Manager of Audiology and Family Services

Children who have Down Syndrome can often have hearing loss, so a therapy center that also has an Audiology Department onsite can make coordinating care easier. Their hearing loss may range from permanent and needing hearing aids to having frequent middle ear infections and require consistent hearing tests.

According to the research article Understanding Hearing and Hearing Loss in Children with Down Syndrome, “Children with Down Syndrome are at a greater risk for permanent and transient hearing loss as compared with their typically developing peers. Long-term consequences of late or failed diagnosis, particularly in this population, can significantly affect quality of life, including school performance, speech and language, behavioral challenges, community engagement, and safety. Therefore, ongoing audiologic monitoring and otologic management is highly recommended for this group into adulthood.”
hearing2

Easterseals DuPage & Fox Valley has Audiologists in our Elgin and Villa Park centers who are experts at working with children that may have been considered “difficult to test” by other clinics.

We are able to fit hearing aids and make repairs and earmolds on children and adults through state programs such as Early lntervention, Medicaid, DSCC, ORS, and via private insurance or private pay options with very competitive pricing.

At Easterseals we work with the local educational Audiologists, who serve children with hearing loss that are in school. That work allows for cohesive coordination between school testing and any hearing aid or other specialized services that may be needed at an outside clinic.

We are also proud that we can continue to see the children in our care as they grow up into adulthood via our audiology clinics.

For more information on our hearing services, visit eastersealsdfvr.org/hearing.

 

Routines and Why They Can Help

By: Laura Van Zandt, MS, OTR/L

Routines are very important for all children, but they can be particularly important for children with developmental delays. Routines help provide a sense of certainty and security for children by offering them a predictable pattern that allows them to know what to expect, which will result in less frustration as well as fewer tantrums or meltdowns.

Certain routines are almost universal, such as morning and bedtime routines, but others may exist for specific circumstances or stages of life, such as your family’s weekend morning or school or summer routine.

A great place to start a routine is having a set bedtime. The American Academy of Pediatrics recommends that children ages 3-5 should get 10-13 hours of sleep a day (including naps) and children ages 6-12 should get 9-12 hours of sleep each night. The benefits of getting enough sleep are numerous and include mental/physical health, attention, memory, learning, behavior, and more. The AAP also recommends no screen time 30 minutes prior to bed, no electronics in children’s bedrooms, and having a set bedtime routine.

Setting up a bedtime routine:

Ryan - web
Photo from Take Three Photography

Bedtime routines can be anything you want them to be, as long as they are familiar and predictable. For my infant son, he takes a bath every other day. After his bath (or mom and dad quiet playtime on non-bath days), he gets a nice massage and we read a couple goodnight books. When he shows us signs of being tired, we turn off the bedside lamp, swaddle, and turn on the white noise machine.

This routine is something I hope to keep as he gets older. For an older child, you can do a similar routine but you will need to add in time for personal hygiene and perhaps next day activities such as pick out your clothes, pack your backpack, etc. You can use a similar routine for naps, except they would just be shorter.

Aside from bedtime, morning routines, can also be beneficial. Some families have different weekday and weekend morning routines, but other children may need to have one routine that stays the same regardless of the day.

Mealtime can also present an important routine. An easy place to start is to try to have meals around the same time each day. I know this isn’t always possible- but getting as close to a specific time each day can be beneficial and having everyone sit together to eat.

Additionally, having chores to do in family routines helps children develop a sense of responsibility and some basic skills, like the ability to manage time. These are skills children can use for later in life that you can begin at a young age. One great example is singing the “clean up” song when it’s time to finish an activity and move onto something different.

“Clean up clean up
everybody everywhere.
Clean up clean up
everybody do your share.

Clean up clean up
everybody everywhere.
Clean up clean up
everybody do your share.”

Routines can also be great for teaching personal hygiene. Ever heard a parent sing the ABC song while their child washes their hands? This is just one great example.

Here are some tips if you are looking to introduce routines into your daily life:

  1. Only change one part of the day at a time.

2. Come up with your basic non-negotiables and then give your children some                    choices (bedtime stories together or separate?).

3. Make a poster with the routine, including photos in the right order, to allow for              self-monitoring. In a good routine, everyone understands their roles, knows what              they need to do and sees their roles as reasonable and fair.blog_visual

4. Follow the same routine every single day for at least one month, after which it will         become habit and your older kids should be able to keep themselves on schedule for         the easy routines.

Establishing routines has lots of great benefits that can help both you and your child develop scheduling abilities, and increase the likelihood that your family will have a smooth day.

For more information on Easterseals DuPage & Fox Valley, visit eastersealsdfvr.org. 

Pretend Play Activities

By: Laura Bueche MOT OTR/L

26_Jack and Kathleen

Pretend play is an important piece of development. It promotes social skills, cognitive flexibility, imagination, language, and helps kids process the world around them. When your child participates in pretend play, they are learning the social and emotional roles of life in a fun, hands-on manner. It can stimulate creativity and help them grow to be more comfortable with themselves and the role they play in their everyday lives.

Included below is a list of potential pretend play scenarios to get your creative parent ideas flowing:

Doctor: This is a great pretend game to teach your kids about responsibility, while encouraging them to be proud of “taking care” of someone else!

Kitchen/restaurant/coffee shop/ ice cream shop: This is a great way to help your children learn about food and nutrition, and get them interested in what goes in their bodies and how it fuels their energy.

Grocery store: Another fun way to help them learn about nutrition, while also helping them improve math skills by counting and setting prices for different items being “sold”.

Animal shop/vet: A fun hands-on approach to learn about animals and the important role they play in many peoples lives

Airport: This is a great way to help children understand the different means of transportation and travel people utilize, especially if they have never gone anywhere far from home

Beach vacation: Similar to playing airport, this can help kids understand about travel and the vast and different climates many people live in, especially if your family does not live near a beach.

Brownie Miliana2.jpg

Baby bath time/ feeding baby/ baby diaper/ baby bed time:

Similar to playing Doctor, this is a great way for kids to foster an interest in responsibility and taking care of others, while also boosting their confidence in discovering their helpful abilities!

Camping adventure: This is a way to improve kids outdoor skills, while teaching them about nature and the environment they live in.

Pirate treasure map adventure: This is a fun way to get kids creativity flowing and help them learn about adventures they can take and create in their mind

Haunted house: This can be as scary or safe as your child is comfortable with, and can allow them to explore and set boundaries in their mind for what makes him/her comfortable

Dress up/fashion show:

dress up

This is a fun way to let kids try on a new role for size, and to help give them the experience of “walking in other peoples shoes”

Police man/woman: Similar to playing dress up, this gives kids the impression of what kind of jobs people in their community hold

Gardening/ making mud soup/ building sand castles: A very hands-on way to explore nature and learn about the plants and trees they see everyday

Making toy/Lego cities: This allows kids to be totally free-spirited in constructing what they think a fun space to live/play in would be.LEGO Run Pre-Party 029.JPG

Making puppets/puppet theater: This is a healthy and fun way for kids to express their emotions and feelings, while also allowing them to explore new emotions they may not be familiarized with yet.

Firefighter: Identical to playing police officer, this allows children to try out the role of what a firefighter does for their community.

Pretty mixed race girl and Caucasian boy pretending to be superh

Super hero/ defeat bad guys and save good guys:

This helps kids understand right from wrong and the values you as a family have, while also helping them feel good about the choices they make.

Tea party: This is a fun way for kids to make up their own rules and find out what it means to be “in charge” of a dining situation

Post office: Kids can learn about roles in their community and better understand a job they see people enact daily.

Car washplaying carwash.jpgPerfect for a summer day, playing car wash can show your kids real life chores in a positive way, while also making for a fun water activity.

Fishing boat: This is a great way to get your kids to explore nature in their minds, as well as understand a fun hobby many people enjoy.

Santa’s work shop: If you and your family celebrate Christmas, this is a wonderful way to introduce the holiday to your children and help them understand the tradition of Santa Clause and what that means to your family.

Farmer: Similar to playing police officer or firefighter, this can help children understand a job people either in or out of their community hold, while also helping them develop a healthy relationship with food and animals.

 

Doll house: This is a great way to get your children interested in how a household runs and the work it takes to sustain a healthy lifestyle, as well as be a fun outlet for them to get creative and cultivate different personalities and traits for each doll.

23a_Brady_and_Cooper_CoulterRace track/ train tracks:

Similar to playing airport, this helps demonstrate to children the different means of transportation available to them, as well as foster a desire to explore and travel

Many of these pretend activities/games include props, but always feel free to encourage your children to use their imagination and create props in their mind or with another item in your house, especially if the props are not readily available to you.

From one mom to another: Early Intervention tips

By: Laura Van Zandt, MS, OTR/L

Having a newborn baby can be just as equally thrilling as it can be equally exhausting. Adjusting back to home life can be overwhelming at times as you are healing and beginning to learn all about your new bundle of joy. Understanding that all newborn babies are very different from each other, here are five tips that I found helpful as both a new mom and pediatric occupational therapist:

  1. First and foremost remember to breathe and smile. This time of your life is both wonderful and stressful. Deep breathing has been proven to be very beneficial. The many benefits include a reduction in stress and blood pressure. Deep breathing releases natural “free-good” hormones in our body. Learning a few techniques and tuning into your body for just a few moments can help. If you can force a smile on your face. A smile can be enough sometimes to turn any situation into something to find humor within.

    will2
    Try calming breaths while giving your infant a massage.
  2. Use your tribe and forget as much as possible about modesty. Your tribe, or your support team, doesn’t care what you look like or that you haven’t showered in several days. They love you for who you are and not anything else. Those first weeks can be challenging, especially if you have a children with medical needs. Let them help so you can a little rest to keep yourself going strong.
  3. Talk to yourself. It might feel funny at first but it can help. It doesn’t matter what you say. I often find myself talking about anything and everything- the plan for the day, what is happening right now, about my son’s family, etc. The added benefit of talking to yourself is your child also gets to hear your voice.
  4. Try to develop routines early. It’s really hard the first weeks adjusting and even thinking about routines. I’m not even sure most newborns have routines aside from eat, sleep, and diaper changes; however, if you can try to establish some routines it will help your sanity and also help your newborn develop. For my little one, we try to follow a little routine of eat, quiet alert/play if he stays awake, and sleep. I try to use similar songs and even sing the same song over and over when he is trying to sleep. You can even plan to take a stroller walk around the block the same time every day. Having routines help signal to our bodies a sense of calmness and can provide a little bit of organization when things are crazy.
  5. baby sleeping on white cotton
    Photo by Pixabay on Pexels.com

    Sensory strategies can be your best friend. Some ideas include the use of auditory input such as white noise, talking softly, or singing, movement and swings, and deep pressure or swaddling. It was crazy what a little bit of white noise did for my son. It was enough to calm and quiet him. Now I use it at bedtime to help him get back into a deeper sleep. I use one with a timer so it doesn’t run continuously. I also talk a lot to my son. It was amazing how fast he learned to recognize my voice and respond to a calm voice, if he wasn’t too upset. I was never someone who spoke aloud but now I found myself telling him all kinds of things. I think the soft melody of my voice must have some calming property for him. Also deep pressure and movement can help a newborn in those early months. When a newborn enters this world they are in a position called physiological flexion which they slowly work out of over the next month or two. Swaddling provides physical boundaries much like the womb which allows your child to feel secure. When they wiggle within the swaddle believe it or not they are learning very early about where their body is in relation to this great big world they entered. Along with swaddling you can also try massage. Infant massage has shown to be a wonderful bonding time for newborns are their parents. Movement is the next sensory strategy. I was very lucky my son loved his swing from the very beginning. I don’t know if this had anything to do with how much I moved around on my job, but back and forth movement is one of the best ways to help calm a child. Rocking chairs and swings can be your best friend.

If you find this newborn phase to be very difficult or think you child may not be reaching his/her milestones, talk with your pediatrician and schedule an evaluation. Many parents find physical, speech, occupational or nutritional therapy for short or long periods provide much needed support and growth for their infants. Learn more at eastersealsdfvr.org. 

 

 

Understanding the Grieving Process for Parents of Special Needs Children

By: Sharon Pike & Cara Long, Parent Liaisons

It’s graduation season! We love seeing and hearing about the accomplishments of each graduate and their hard work! But for some parents, seeing their child’s peers reach graduation or other milestones, can trigger many emotions, especially if their child has a developmental delay or disability. For some children, these milestones will come much later or maybe not at all.  We hope to give you a greater understanding of the process families experience in coming to terms with a child with a developmental delay or disability. We speak from experience as we each have a beautiful young woman with a disability.

Sharon & Alison 2.jpgFirst, after the birth of a child with special needs, the diagnosis or incident that changes their child, parents will grieve the loss of the “perfect baby”, they’ve dreamed about. They grieve the dream, not the child.

Dr. Ken Moses is a psychologist who has devoted himself to helping people deal with crisis, trauma and loss. He describes it beautifully and accurately, “Parents generate core level dreams for their children even before the child is born.  Disability shatters those dreams. Grieving is the process where by parents separate from those shattered dreams and begin creating new dreams.”

He also says “few would argue that facing the devastating and continuing loss of having a child with a disability is among the most painful experiences that a person can confront. To separate from a lost dream, one must experience and share denial, anxiety, fear, guilt, depression and anger in whatever order or manner the feelings surface.” You can read more in The Impact of Childhood Disability: The Parent’s Struggle.

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Photo from Rich Howe

We recognize that for many parents this is their first experience with a disability and it unfortunately takes time to gain the insight needed. We want to help you work through the states of grief Dr. Moses mentions, so you aren’t stuck in a certain stage and can see the great potential in your child. This potential might be different than you imagined, but is still a wonderful journey.

We agree with Dr. Moses that the process takes time and honestly never really ends.  We learn to reshape our dreams with the help of the professionals we surround ourselves with. But grieving is the only way we can move on.  The parents who resist this process, become worse not better in response to the loss of the dream.

Below are Dr. Moses states of grief that you may be familiar with but need to recognize and move through them on this journey:

shockDenial/Shock

  • This stage gives parents the chance to “feel it” and start to find support and ways to navigate this new world they’ve been dropped into.
  • It buys time needed to blunt the initial impact, to discover inner strengths, find resources.

Anxiety

  • With the loss of a dream, parents are forced to change
  • Anxiety mobilizes the energy needed to make these changes

Fear

  • This stage speak to itself! The questions come “Will he walk, Will she talk,” “Will he go to college or marry?”

Depression

  • This stage is one that parents can feel repeatedly over the years and it’s depths can be simple sadness to deep, long lasting depression that needs medical intervention.

anger

Pain/Guilt

  • This stage also gives parents the chance to “feel it” to “question it” and ask themselves “What did I do to cause it?” “Why did my body fail?”

Anger

  • This stage parent ask,”Why me, why not you?”
  • A parent’s sense of justice is challenged
  • Their anger is often directed at someone or something (child, medical professional, or spouse)

Acknowledgement and Hope

  • Parents have come to grips with the fact, this is life and with modifications they can still live the dreams they had for their child and family.
  • They learn that there is always Hope.

This journey is reflected in this poem from a parent of a child with autism.

What You Should Know About My Child
by Brian Rubin 

Remember that he is, first of all, my child.
Let me see him smiling in his sleep.
And let me think how handsome he is.
Help me not lose sight of my son
In the sight of his limitations.

I know that you care for my child,
And that you work hard with him.
I need your expertise to help him become All that he is capable of being.
You need my help in understanding who he really is.
And in the following through at home
With things that are important.

Remember though, that you send him home at night,
And have weekends off and paid vacations.
Let me have the luxury of having a vacation…
Sometimes physically, sometimes emotionally.
For  a day… a week… a month..
Without your judging me.
I will be there for him when you are long gone.

I love my child with an intensity that
You can only imagine.
If on a given day, I am tired or cross with him,
Listen to me.
Lighten my burden.
Do not judge me.

Celebrate with me.
Rejoice in who he is and who he will become.
But forgive me if, from time to time,
I shed a tear…
For who he might have been.

renee

This journey is hard and can be isolating, especially for parents of babies with challenges.  But you are not alone. We are here to support families through this process. We can be your sounding board and help find whatever resources you need. To learn more about our family services, click here.

5 Tips for Keeping Hearing Aids on Babies/Toddlers

By: Beth Rosales, Au.D, CCC-A.

hearing1

As both an audiologist and a mother of 2 young children who wear hearing aids, I definitely understand that keeping hearing aids on your child can be a very difficult task. Young children and babies seem to love to get their hands on those hearing aids and pull them right out of their ears! I often hear from parents of babies and toddlers that they have tried to keep the hearing aids on their child, but it seems impossible. As a result the child doesn’t wear the hearing aids regularly, which means he or she is not hearing very well most of the time, and this will likely delay oral speech and language development.

When 2 of my boys ended up needing hearing aids, I knew I had to do everything I could to keep their hearing aids on their ears when they were awake. Well, I can say from personal experience that the struggle is very real when it comes to keeping hearing aids on young babies and children, but utilizing some helpful tools and tips can make it a lot easier.

Tip #1 – Pilot hats

Baby nico on swingThis is best for babies up to 18 months old or so. I fell in love with pilot hats and here’s why you should too. Not only are they cute, but they will make your life so much easier!! For my boys, pilot hats worked better than anything else when they were very young. The pilot hats should be lightweight and ideally have mesh sides or very thin material that will not block the sound from entering the microphones of the hearing aids. It’s important to get a pilot hat that fits well. If it is too loose, then it will be too easy for your little one to get his hands under the hat.

Here are some great places to get pilot hats that work well with hearing aids:

  • LilNells: https://www.etsy.com/shop/LilNells  My personal favorite shop! The hats fit my sons very well, and she makes them with snap closures, as well as ties. I love the snap closure because they are harder for toddlers to undo (tie up closures can work too, but tie closures are easier for kids to play with and untie). The shop owner also has options with mesh sides available and unlined (thin) hats, both of which are good for hearing aids. She is great at making custom orders, so if you see a hat you like that doesn’t have mesh sides, send her a message to see if she can make it with mesh sides, or if you have an idea or color you’d like, just send her a message to see if it is possible. Hats cost about $15 – $18.
  • Anchor Your Hearing shop: etsy.com/shop/AnchorYourHearing. These hats come with mesh sides which are very breathable so there won’t be too much material covering the microphones of the hearing aids. You can email the owner of the shop through etsy with any questions about orders, sizes, etc. Hats cost about $15-$18.
  • Emmifaye shop: etsy.com/shop/emmifaye. Another etsy shop that sells pilot hats for hearing aids with mesh sides. Cost per hat is about $12.
  • Hanna Anderson hannaandersson.com. These hats are also an option ($14 for the Pilot Cap – not the “winter” pilot caps which are lined, but rather the regular pilot caps which are thinner, not lined, and less expensive than the winter hats).
  • Silkawear silkawear.com. Cost is about $28 per hat.

Tip #2 – Crochet type of Headbands

baby headbandIf pilot hats don’t work, but your child tolerates wearing headbands well, then consider trying crochet type of headbands (worn over the ear, somewhat like the mesh pilot hats). Some patients have found that tight fitting, crochet type of headbands are useful to hold the hearing aids on and these can sometimes be found at stores like Target or Walmart. They can also be found online at stores or on etsy.com.

Tip #3 – Toupee Tape

toupee tape.jpgHooray for toupee tape! Some children benefit from using toupee tape on the behind-the-ear part of the hearing aid. I use this on my 4-year-old son’s hearing aids when he has gymnastics class! It helps stop his hearing aids from flopping off his ears. This is basically like 2-sided tape that you can use on skin. You can cut the tape into a small square or rectangle to fit onto the hearing aid. Place the tape on the behind-the-ear hearing aid, and then tape it to the child’s head since it is meant for skin contact. Some people have found this helpful to use along with the hats or headbands. My 4-year-old no longer needs a pilot hat, so this is a nice solution for when he is doing sports activities. You likely need to replace the toupee tape daily or whenever you take the hearing aids off your child and then put them back on him. Toupee tape can be purchased at places like Sally’s Beauty Supply (local stores carry this). www.sallybeauty.com.

Tip #4 – Otoclips

octoclips.jpg

I love otoclips! Otoclips are helpful in preventing the loss of hearing aids when a child pulls them off. An otoclip is attached to the hearing aid and it has a cord and clip that is attached the child’s clothing so that if the child pulls the hearing aid off, it will be hanging from the cord attached to the clothing.

Here are some websites that sell otoclips:

  • Westone: www.westone.com. Search for “otoclip” and if your child wears one hearing aid, he will need “monaural” and if your child has 2 hearing aids, he will need “binaural”.
  • ADCO Hearing: http://www.adcohearing.com/. Website offers a very large variety of tools for hearing aids and hearing loss, including otoclips (under “hearing aid supplies”, “clips and loss protection”).
  • The Bebop Shop (etsy.com): https://www.etsy.com/shop/thebebopshop. Very cute otoclip options, as well as some matching hair clips.

For additional tips and resources, visit Hearinglikeme.com. 

Tip #5 – Positive attitude

Have a positive attitude about your child’s hearing aids! Young children pick up on how their parents feel about things. Remember, hearing aids are a very good thing. Hearing aids will help your child hear speech and other sounds that they otherwise would not detect. This will help your child develop oral speech and language skills. So if oral communication is what you want for your child, then hearing aids will help them move toward reaching this goal. Hearing aids are wonderful things!

For more information on hearing services for children or adults, visit eastersealsdfvr.org/hearing.