Category Archives: parenting

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.

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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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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

Tips for Practitioners and Specialists: Considering the Full Reality of Patients and Clients’ Lives

By: Sharon Pike, Parent Liaison & Jordyn Holliday, Communications Intern

Many parents will tell you that trips to the doctors office, specialists, etc. can sometimes make for stressful moments for children and families. When a child has complex needs, the level of stress can be increased. Once you consider factors and obstacles such as medical emergencies and other personal issues that a family may be dealing with, those appointments become tougher to make.

25_SheddJAMES.jpgIt is important for doctors and other specialists to be mindful and reevaluate the judgments they make on parents and caregivers. Before drawing conclusions on why a child may be missing appointments, it is imperative to consider the entirety of that child’s life.

Here are a few tips on how specialists can be more understanding of families:

  • Be Mindful: One important thing to remember is that in the vast majority of cases, no one is more concerned with the well-being of a child than that child’s parents and family. If there are appointments being missed or a lack of communication, there is likely a good reason behind it. Forming a solid grasp of this is a huge step in better understanding a client or patient.
  • Check for Signs: Often times, it is possible to gain a sense that something external may be happening in a child or family’s life. When you are visited by a patient or client, try to look for signals. Are there any noticeable signs of stress? Are there any patterns in appointment cancellations? Asking yourself these questions can lead to meaningful answers.
  • Appropriately Ask the Family: If you are unable to gain insight using the previous tip, think of a kind way to inquire information from the parent/caregiver. This can be done by simply asking how things have been going. By kindly asking how the child and family has been, or even asking about recent medical history, you are beginning dialogue that could help you understand the root of inconsistencies.

Acknowledging the lives of children and families outside of just the scope that you see them in as a specialist is a significant step in building better relationships with them. It’s important not to make assumptions, as they can often lead to uneasiness.

For more information on managing your child’s care and your own, connect with our parent liaisons and family services department at eastersealsdfvr.org/SocialServices.

Screen Time: What is too much?

By: Cassidy McCoy, PT

Over the past few years, computers, tablets, phones, and TV seem to have taken over. Technology has begun to change the way our children interact with each other and us. However, how much time spent on these devices is considered too much?

The American Academy of Pediatrics recently released new recommendation for children’s media use.

The recommendations include:

  • <18 months: Avoid use of screen media other than video-chatting.
  • 18 to 24 months: If you want to introduce digital media, choose high-quality programming. Also, watch it with your children to help them understand what they’re seeing.
  • 2 to 5 years: Limit your children’s screen use to 1 hour per day of high-quality programs. You should watch it with them to help them understand what they are seeing and apply it to the world around them.boy-learning-with-therapist
  • 6 and older: Place consistent limits on the time spent using media, the types of media, and make sure media does not take the place of adequate sleep, physical activity and other behaviors essential to health.

What are the potential effects of too much screen time?

  • Obesity: Too much screen time equates to more time spent in sedentary positioning resulting in decreased physical activity and weight gain. The American Academy of Pediatrics recommend for children to get at least 60 minutes of active play daily.
  • Sleep: Devices emit a blue light that mimics daylight, which stimulates you, leading to irregular sleep schedules and shorter duration of sleep with use of a device before bedtime.
  • Behavioral problems and violence: Screen time can be an effective way to calm down, but it should not be the only way they learn to calm down. Children should learn how to identify and handle strong emotions and come up with ways to manage them (such as deep breathing or problem solving)
  • Loss of social skills: Face-to-face communication or “talk time” is critical for language development. Research has shown that it’s that “back-and-forth conversation” that improves language skills—much more so than “passive” listening or one-way interaction with a screen.

What can you to to help?

  • Set time limits and expectations
  • Create “tech free zones” such a dinner table or bedrooms
  • Use screen time to promote education and development by utilizing appropriate programming.

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

New Models of Patient Care

liuBy Dr. Ingrid Liu, D.O.

Who can keep track of all this? How are the independently insured going to get medical care?

Doctors are not happy and neither are patients. I have colleagues that have decided to stop patient care completely, changing to new careers in consulting, research, entering early retirement (if that’s an option), or any number of non medical options.

Unfortunately there are only so many hours in a day and insurance plans only pay so much for each office visit (no matter how much premiums cost or how much doctors beg and plead). A physician has to see on average 30 patients/day in order to succeed. This therefore translates to 10-15 minutes per patient in a 8 hour day. This, as we know, is not good for either the physician or the patient.

When physicians spend more time with each patient, we get to know them each individually and thoroughly, allowing for better decisions and treatment plans as well as guidance on preventive measures.

wellcomemdPrimary care physicians are changing their practices to offer patients options.  I am a family medicine physician and I switched my practice to a membership model 2 years ago. This has been called concierge medicine but I prefer to call it old fashioned medical care in today’s healthcare system. By limiting the number of patients under my care, I am not only able to address more questions from the patients, but my office staff also assists with coordinating care from specialists. We also assist in navigating this complicated insurance maze.

Because the health insurance policies are so complicated, another model that now exists is called Direct Primary Care, or DPC. This type of practice charges a small membership fee and does not accept any health insurance contracts, charging patients a set fee for services, similar to a menu at a restaurant or items at the auto repair shop. There are only a few of these practices nationwide but are growing in numbers.

Especially in this election year, health care reform continues to be a hot topic and I’m not writing to express my point of view other than that change needs to happen and is happening. There is growing concern over a shortage of primary care physicians. Please ask your family physician or pediatrician how he/she is doing. You may be surprised to hear the answer. I know the question would be welcomed and appreciated (as long as there’s time during the appointment to ask it)!

Editor’s Note:
Dr. Liu has provided family medical care for thousands of patients of all ages over two decades. She is board-certified in family practice and licensed without restrictions. She currently serves on the board of Easter Seals DuPage & Fox Valley and is also a member of the Illinois Academy of Family Practice Committee on Mental Health. Dr. Liu is proficient in all aspects of primary care, but holds special interests in women’s health and travel medicine. http://www.wellcomemd.com/. Learn more about her practice in the video below.

Just Breathe

 

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

The popularity of using breathing exercises with children is on the rise.  And, with good reason, because they work! When we focus on breathing fully and deeply, we move out of our sympathetic nervous system (fight or flight) and into our parasympathetic nervous system (relaxation and receptivity).  Breathing exercises are effective for the frustrated 4-year-old, the anxious teenager, the overwhelmed parent and the stressed out teacher.  There are an abundance of fascinating studies that have found that our body posture, facial expression and breathing, send messages to our brains about how we are feeling.  Therefore, we can take control of our feelings by doing something different with our bodies.

Research has found that something as simple as mindful breathing can have the following benefits:

  1. Increase our focus
  2. Promote instant feelings of calmness
  3. Regulate our mood
  4. Increase our confidence
  5. Increase our joy

Some families find it helpful to have mindful breathing integrated into their regular routines.  For example, every time they are sitting in the car or at every trip to the bathroom they will participate in a simple breathing exercise.  Taking a few minutes at the beginning of an activity can also be an effective way to get a child in a calm, ready to learn state or to reduce stress in anxiety provoking situations.  Breathing exercises can also be an effective way of curbing a looming behavioral meltdown.

When teaching a child a breathing exercise, choose a time when the child is ready to learn.  If a child is in an anxious or frustrated state, he will have difficulty processing the directions.   Make the learning fun and multi-modal.

breathe blog
Image from theyogakids.com

Use a real object, picture or imaginative visualization to teach a breathing exercise.  I may show my little friend a stuffed bunny and ask:  “Do you know how bunnies breathe!?  A bunny takes 3 quick sniffs through its nose and then blows one deep breath through its nose.  I wonder if you could breathe like a bunny?” or “Imagine you had a balloon!  What color would your balloon be?  Let’s take a biiiiiiiig breath through our nose and blow the air out of our mouth into our balloon.  Wow, you made your balloon sooo big with those 3 big breaths!”

Here are my favorite, kid friendly, breathing exercises.

breathe blog 2

For more information on Easter Seals DuPage & Fox Valley visit our website.

7 Tips for Learning and Loving it!

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

Does helping your child with their homework ever feel like a laborious task?  These learning strategies will help you teach your child in a way that increases their understanding and retention.  Above all, these tips are meant to make the learning journey an enjoyable experience for all of those involved!

  1. Relate new information to known information.  Our brains are pattern-seeking devices.  They are always searching for associations between information being received and information already stored.  Linking new information with familiar information creates a connection that your brain will hold on to.blog
  1. Multi-Sensory involvement: the more varied experiences a child has with a new concept, the more neural pathways will be developed.  Whenever possible, teach the concept in a way that the child can experience.  If your child is learning about volcanoes, you can have them:

Role play being a volcano OR create a visual Venn Diagram comparing it to something they already know about.
volcan

  1. Active learning-the more a child is involved with the information, the more efficiently he will consolidate and recall it.  When a child passively receives information, he will understand and remember less.  Passively receiving informcloudation would be listening to a lecture or passing your eyes over the print from beginning to end in a chapter. Active learning would involve making predictions about the chapter, taking notes and discussing what was read or learned.
  1. Rhythm and Music: Rhythm and music stimulates both sides of the brain.  It activates our attention system and multiple neural pathways which facilitates memory and retrieval.   Create a song, set to a familiar tune that reviews key concepts in a curricular area.  Memorizing the 50 states, days of the week, or spelling words can all be easier when taught within a song or chant.
  2. Movement: Adding movement to an activity provides extra-sensory input and enhances attention.  Movement helps increase cognitive function while also helping children get rid of “the wiggles”.

It is also beneficial for children to have downtime for movement built into their days. Many studies have found that students who exercise do better in school.   Exercise triggers the release of a substance that enhances cognition by boosting the ability of neurons to communicate with each other. Below are some ideas to incorporate movement into learning:

  • Air writing letters
  • Playing charades to act out a history lesson
  • If the answer is correct, make a sign like a referee
  •  Jumping on the trampoline while doing math facts
  • Playing catch while reviewing information
  1. Humor– Humor wakes up the brain cells!  It also encourages attention and relieves stress.  Humor keeps learning an enjoyable experience for teachers, parents and children.  Using humor lets students have an increased feeling of safety in making an error or getting an answer wrong.  Make time for laugh breaks to keep your child alert and attentive while learning
  2. ReflectionDowntime is important to help the brain process new information and strengthen neural connections.  Have your child learn and study in small chunks of time.  Implement breaks for movement, listening to music, doodling or having a snack.

For more information on strategies for learning and about Easter Seals DuPage & Fox Valley, visit: eastersealsdfvr.org.

Teaching Your Child How to Tie Their Shoes

By: Laura Bueche MOT OTR/L

Teaching your child how to tie shoes can be frustrating for parent and child. This tricky dressing task relies on a variety of different components to work together such as: fine motor skills, bilateral hand skills, visual perceptual skills, sequencing, and attention.

Here are some easy tips and tricks I’ve picked up over the years to help your child be more successful with this tricky self-help task.

 SET UP FOR SUCCESS

Practice Off the Foot

tie a shoe

It is much easier to learn how to tie a shoe when the shoe isn’t on your foot.  You can lace up an old shoe for your child to practice on, or you can make a “learning shoe” with cardboard or an egg carton.

Different Color Laces

Buy two pairs of laces of two different colors. This will help your child with the visual perception piece. She or he will be better able to see the laces and differentiate, and avoid a tangled mess.

Visual Check List

Print out the sequence pictures from this blog to make a flip-book and follow along as you teach. This can help your child sequence through the steps.

One or Two Steps at a Time

Learning all the steps at once can be overwhelming. Read your child’s motivation and/or frustration levels to know when to push forward and when to call it a day.

Don’t Rush

Set aside time to practice. Rushing out the door is NOT the time for learning. Set aside a time to work on shoe tying when you can go at a slow and stress free pace.

Ok great! Now you are set up and ready to learn the magic formula to teach your child how to tie their shoes…

MISS LAURA’S MAGIC FORMULA

  1. Hold the laces

shoe_1

2.  Make an “X”

shoe_2

3.  What lace is on top? (blue)

shoe_3

4.  Top Lace (blue) goes through the tunnel

shoe_4

5.  Pull Tightshoe_5

6.  Make a loop

Not too big… Not too small…Not too far away

shoe_7

    7.  Blue lace goes aroouuund town

shoe_8

     8.  Drop it!

shoe_9

    9.  Thumb pushes bunny through the hole

shoe_10

   10.  Grab both bunny earsbunny

           11.  Pull tightshoe_11jpg

DONE!!

Other Tips

Elastic shoelaces

Elastic shoelaces are great because they look just like regular laces and allow your child to slip on their sneakers without untying. This can be used as a great compensatory strategy or a temporary substitute while your child is in the process of leaning to tie shoes.

Hemiplegia

Here’s a resource for kids who need a one handed alternative.

Still having trouble?

Despite your best efforts, if your child is still having difficulty, perhaps it’s worth an occupational therapy screening or evaluation to determine if there is an underlying fine motor, visual motor, bilateral coordination, or visual perceptual problem. An occupational therapist will be able to adapt this shoe tying task to better fit your individual child’s needs.

Learn more about occupational therapy and other programs at eastersealsdfvr.org.

 

 

 

 

 

Using visual schedules: A Guide for Parents

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

Using visual schedules allows your child to see what is going to be happening in their day and the order of events.  Visual schedules can be customized to meet the needs of each child.  Getting started with a visual schedule can seem overwhelming, so this blog will help you recognize if your child would benefit from a visual schedule with ideas on how to get started.

7 Benefits of visual schedules:

  1. Provides structure and predictability:  Visual schedules prepare a child for what is coming up, which can reduce anxiety. 
  2. Eases transitions: Visual schedules are helpful in easing transitions from one activity to the next.
  3. Reinforce verbal instructions: Most children process visual information better than auditory information.  Words disappear after we say them and the visuals give language a lasting component. 
  4. Supports literacy development- Consistent exposure to written words can enforce reading of sight-words and provide an opportunity to practice reading through decoding.   
  5. Supports development of executive functioning: Visual schedules enforce planning, sequencing, completing tasks independently and the natural consequences of time management.
  6. Supports conversation skills: Many childrenn have difficulty recalling and retelling previous events.  Providing the visual framework of the schedule can help kids answer open-ended questions like: “What did you do today?” or “What was your favorite activity?”
  7. Helps caregivers:  Having a plan in place can be calming for adults.  Creating a schedule helps the caregiver prepare for the day and use time effectively.

Decide on the format

Visual schedules come in all shapes and forms.  When selecting a visual schedule format, consider which would be most functional for you to use, along with what would be most beneficial for your child.  Some schedule forms take more preparation while schedules like line drawn images or written words can be done quickly and on the fly. 

  Here are some different types of visual schedules:

all+picApps on phone/tablet   Tangible pictures with Velcro Line drawing images  Written words

Decide on the length The length of the schedule will be based on your son or daughter’s needs and abilities. Some children may be able to use a whole day schedule while others will be overwhelmed by this amount of information and will need to see just one or two items at a time.

First/Then-This can be an effective format to introduce visual schedules without overwhelming the child with too much information.  It can assist a child in getting through the non-preferred first activity by seeing that next, she will get a preferred choice.

day
Part of the day with more specific activities                                              Monthly Calendar

 

 

all day .jpg
Whole day with more general activities

It is beneficial to include your child as part of the process of creating the schedule.  The slowed down, one step at a time, verbal explanations paired with visuals helps the child understand and prepare for upcoming activities.  It can also be a nice opportunity for the child to have some autonomy and make choices about what their day will look like. Don’t feel that making a schedule means that you have to rigidly follow it.  Life is unpredictable and having a change in plans is something that we all have to adapt to.  The visual schedule can be a great tool to teach your kids about flexibility.

Learn more about Easter Seals DuPage & Fox Valley resources here: https://eastersealsdfvr.org/.