Category Archives: parenting

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/.

Stir Crazy Kids: How to Stay Active this Winter

By: Laura Bueche, Occupational Therapist

Daniel_Alessandra_T

Oh the weather outside is frightful, and we are going crazy indoors. Just because there is snow and ice on the ground, does not mean your child’s arousal level is any lower.  On the contrary, it’s probably reaching a boiling point and you are looking for ways to get your kids the sensory stimulation and gross motor activity their little bodies are craving.

Getting your kids up and moving has a lot of benefits. The Department of Agriculture’s Dietary Guidelines for Americans recommends that children and adolescents engage in at least 60 minutes of moderate to vigorous physical activity on most days of the week, preferably daily. As an occupational therapist, I love physical activity because of the regulating aspects of proprioceptive input*, as well as development of coordination skills and strengthening opportunities.

*Proprioceptive input are sensations from joints, muscles and connective tissues that underlie body awareness. Input can be obtained by lifting, pushing, and pulling heavy objects, including one’s own weight. For example, climbing on a jungle gym, swinging across monkey bars, or pulling a wagon.

15_Brady PembrokeWhy is it helpful? Providing your child with more proprioceptive input throughout the day can help them:

  • Tolerate sensations and situations that are challenging
  • Regulate emotions, alertness and increase attention span
  • Reduce unwanted sensory seeking and sensory avoiding behaviors
  • Handle transitions with less stress (sensorysmarts.com)

For more information about sensory processing check out the post, How Sensitive is Too Sensitive?

In these bitter winter months, it is difficult to get your kids the physical
activity they need. Here are just a few ideas for indoor activities to give you and your family a much-needed break from being stuck at home.

Ideas for Local Indoor Activities

Ideas if You Can’t Leave the House

There is a crazy blizzard outside, what can I do with what I have at home? Here are some ideas to get kids some movement breaks when stuck indoors:

  • Build a furniture fort by pushing and pulling furniture and cushions from around the house.
  • Make an obstacle course by army crawling, jumping and doing jumping jacks to get to the finish line in record time.
  • The floor is hot lava! We all know this favorite.
  • Animal walk relay races: bear walk, crab walk, wheelbarrow, and penguin waddle across the room to roll the die of a board game or get stickers for a craft project.
  • Jump and crash into a pillow pile or onto the bed.
  • Jump rope with rhymes and songs.
  • Squeeze, squish, and smash Play-Doh.
  • Use a scooter, tricycle, or scooter board to propel through the house.
  • Squish your kids in a pillow pile; making sandwiches.
  • Swing your toddler in a blanket between you and another adult.
  • Push a vacuum or mop, collect the garbage, wipe down the table, load the laundry, and push the laundry basket.Cooper

The Best Developmental Toys for Toddlers

By: Bridget Hobbs, PT, DPT

Perhaps you have a toddler’s birthday coming up or with (I can’t believe I’m saying this) the holidays just around the corner, you may be thinking about finding gifts for the little ones in your lives.  As a pediatric physical therapist, I often get asked about best toys for development.  Since I have a soon-to-be toddler at home, and because this age can sometimes be difficult to buy for (past rattles but not quite to the Barbie stage), I thought I’d share the best toys to encourage their development.

Blocks: Toy blocks might not be as sparkly or fancy as the tech-geared toys on the market.  However, they have stood the test of time for a reason.  Dating back to Piaget, numerous studies have proven the positive effects of block play with math skills later in life.  An author of a recent study that was published in the journal Child Dblocks2evelopment states “Research in the science of learning has shown that experiences like block building and puzzle play can improve children’s spatial skills and that these skills support complex mathematical problem solving in middle and high school,” explains Brian N. Verdine, one of the studies’ authors. You can read more of the study here. 

Play kitchen: I love a play kitchen not just for the imagination and sequencing aspect of preparing a meal, putting it on aplay kitchen plate and serving it to others, but for the gross motor benefits as well.  As seen below in the picture, there are many different levels to a play kitchen.  A child has to stand up to get a plate, squat down to put a pretend pie in the oven and walk side to side to put things in the sink.  All of these are dynamic movements that help to incorporate balance, stability and agility and helps toddlers build their confidence while navigating their environment.

Sound puzzles: Puzzles give little ones a jump on hand-eye coordination, help develop grasp as well as sequencing skills.  A bonus is the sound puzzles that make a sound, such as a helicopter motor or a cow mooing.  These puzzles teach cause and effect and can help TakeThreePhotography_05202010-62develop early sound development.

Small table and chairs: Children this age want to start coloring, drawing and delighting in their masterpieces.  An ideal chair for a little one would be one that helps their feet be firmly planted, with their hips and knees at 90 degree angles.

Shape sorters and stackers:  Shape sorters help a child with discriminating between different shapes, and figuring out how things fit together (think early engineering skills).  Shape sorters are a great way to encourage problem solving skills starting at a young age. Stackers, such as the cups shown below, assist a child with important concepts of placing things into a container and taking them out again.  shape stackers

Ride-On Toys: Try to avoid the expensive ‘power wheels’ type of toys that lose their battery after a week and take up loads of space in your house or garage.   A classic ride on toy will last riding toyyears or decades and will provide your child with balance and strengthening through propelling the toy and coordination through steering.

Often it’s the simplest, tried and true toys that are the best for child development.  So, if you recognize toys in the store that you had a kid, it’s likely that they are good for your child’s learning and motor development.   All of these toys listed above are enjoyable, educational and affordable.   They assist with gross and fine motor skills, language development and social engagement.

For more information about Easter Seals DuPage & Fox Valley please visit EasterSealsDFVR.org.

Nutrition for Your Children

By, Cindy Baranoski, MS, RDN, LDN

Although March is National Nutrition Month, and March 11 is Registered Dietitian Nutritionist Day, every day of the year is a nutrition celebration.

We eNNM_Logo_2015_hires_lg_r1at, drink, or are fed every day, throughout the day, in order for us to survive, grow and thrive. As adults we tend for forget just how important nutrition is for us, unless we are diagnosed with a nutrition related disease, such as diabetes, heart disease or cancer. For children, however, nutrition is the key ingredient in helping them grow and develop into the best they can be.

At Easter Seals DuPage & Fox Valley, parents are learning more and more just how important nutrition is to their child at a very young age, and these parents are becoming very proactive in this area, to the benefit of everyone involved in their child’s world.

Most people have a difficult time even knowing where to begin. Nutrition is a degree that can be earned at all levels, including doctorate degrees. Although the detail and level of understanding to receive a degree is pretty huge, it doesn’t’ take a degree to provide good nutrition for yourself or your child.

How can you even begin to delve into this science of nutrition? Start by keeping it simple. The government has done a lot of research, and MyPlate is one of the easiest websites to find daily food plans, menus, recipes, tips for nutrition, videos, games and more.

myplate_green

MyPlate is the easiest way to know how much food to eat in a day for optimal nutrition. It’s divided into food groups, and one of the easiest tools on this site is the Daily Food Plan. Depending on your child’s age, or if you know a calorie level you are trying to aim for, it will give guidelines on how much to eat from each food group to achieve this goal.

Another resource on MyPlate, is SuperTracker. This resource is easy to use and you can put information into it for analysis of nutrition for you or anyone in your family. It’s not completely accurate, but it is helpful to determine how many calories, protein, vitamins and minerals were included in that diet.

Infants and Toddlers

If your child is an infant, there are limited tools available that tell you what they are supposed to eat or drink every day. However, if you go to Gerber you have an opportunity to access general information or create menus specific for your child.

gerber

Based on your child’s developmental level, they may need to only drink formula or breast milk, or they might be ready to start solid foods. Gerber’s website tools are helpful because they are based on development, and not necessarily ages. The website is geared for Gerber products, but the menu system can really be helpful to see 7 days of what your child could be eating or drinking, how many times in the day and how to keep their diet balanced.

Top Ten List  For Nutrition for Children Over 1 Year of Age

  1. Keep your child on a schedule as much as possible.
  2. Do not allow your child to graze through the day. Most children eat 4-6 meals and snacks each day.
  3. If not an infant, offer three meals and 2-3 snacks a day, with 2-3 hours of time separating each of these eating times.
  4. Offer water between all meals and snacks.
  5. Ensure supported seating with mealtimes; the body should be at 90 degrees at the ankles, knees and hips. Be sure they
    Photo by McKenzie Burbach
    Photo by McKenzie Burbach

    don’t fall to the sides in a chair – it should provide support in all directions. The table or tray of their chair should be at a level their shoulders are not too high up and fatigue.

  6. Offer a source of protein, vegetable, fruit, grain and dairy at each meal. If they are an infant, this is not a rule.
  7. Meals are for nutrition, snacks are for extra food or drink, or an opportunity to practice more challenging foods.
  8. Be sure your child is stooling each day. Stools should be soft, easy to pass. Urine should be clear or light in color and often through the day.
  9. A good indication your child is receiving enough to eat and drink in the day is how well they sleep at night.
  10. When in doubt, speak to your child’s doctor or consult with a dietitian with who has skills with children.

Find a Dietitian in your area at Eat Right.org.

For more information about Easter Seals DuPage & Fox Valley please visit EasterSealsDFVR.org.