Speech-Language Pathology Scope of Service

By: Anne O’Dowd, Pediatric Speech-Language Pathologist, CF-SLP

What does Speech Therapy Include?

Perhaps your child or another child you know is referred to see a speech-language pathologist from their doctor. When you think about the areas a speech-language pathologist treats, it is easy to assume we work only in the areas of speech and language, as our title implies. This is a common misconception.

In fact, our field is much larger than our title offers it to be. To provide a better view of the areas we treat, below is an extensive list of our scope or service delivery areas. A speech pathologist can help a child in nine key development needs. Please note that this list is not exhaustive, not all service delivery areas are offered at Easterseals DuPage & Fox Valley, and individual speech-language pathologists can specialize in one or several areas. Areas in which we practice vary in development, some continuing to evolve (e.g., literacy) and others emerging.

Learn more about our speech services here.

Speech

Speech refers to the production of speech sounds, individually and in words. Children produce several typical speech errors that decrease over the first few years of life, resulting in adult-like speech. Intelligibility, how well an outside listener without context can understand an individual’s speech, is one quick tool we can use to measure speech development. Below are some examples of the service delivery areas we treat regarding speech:

• Articulation: errors in individual speech sounds
• Phonological: errors that follow rule-based, predictable patterns (e.g., phonological processes of stopping, final consonant deletion, or weak syllable deletion)
• Motor planning and execution: developmental or acquired disorders at a motor/neurological level characterized by difficulty producing consistent, predictable speech patterns

Language

Photo by Keira Burton on Pexels.com

Language refers to expressing and comprehending words through multiple modalities, including speech, writing, reading, speech-generating devices, picture symbols, and gestures. We use language for various intents, including sharing ideas and ensuring our needs are met. Below are some examples of the service delivery areas we treat regarding language:

• Phonology: system of speech sounds and how we combine them to make meaningful words
• Morphology: use of word forms to create new words
• Syntax: combining words to create grammatically correct sentence structures
• Semantics: appropriate use and identification of word meanings
• Pragmatics: social aspects of communication and language use
• Literacy: spelling, reading, writing
• Prelinguistic communication: (e.g., intentionality, communicative signaling, joint attention)
• Paralinguistic communication: (e.g., body language, signs, gestures)

Fluency

Fluency refers to the rhythm of our speech. Typical speech is characterized by occasional disfluent moments (e.g., pauses and repetitions), although a higher frequency of these may be a cause for concern. Below are some examples of the service delivery areas we treat regarding fluency:

• Stuttering: disfluencies in speech, including repetitions, blocks, and prolongations
• Cluttering: abnormally fast and/or irregular rate of speech

Voice

Photo by Stan Kedziorski-Carr

Voice refers to the quality, pitch, and volume of an individual’s voice. A voice disorder is present when one or more of these voice qualities are perceived as different or inappropriate for an individual’s gender, age, culture, and geographic location. Causes for variation in voice can be organic (e.g., structural changes due to aging, vocal fold paralysis) or functional (e.g., vocal fatigue). Below are some examples of the service delivery areas we treat regarding voice:

• Pitch: how “high” or “low” one’s voice is
• Loudness: the volume of one’s voice
• Alaryngeal speech: speech production utilizing a substitute for the vocal folds in the larynx

Resonance

Resonance in speech refers to the production of a filtered sound, beginning at the vocal folds. The sound travels through the pharynx and oral and nasal cavity. As it passes through, it is filtered and enhanced based on the shape and/or size of an individual’s vocal tract. Below are some examples of the service delivery areas we treat regarding resonance:

• Hypo- and hypernasality: not enough or too much sound energy in the nasal cavity
• Cul-de-sac resonance: when sound energy is “trapped” in the oral, nasal, or pharyngeal cavity due to an obstruction

Auditory Habilitation

Photo by Christine Carroll

Typically, when discussing the pediatric population, Auditory Habilitation instead of rehabilitation is used as rehabilitation refers to restoring a skill that was lost. Often, a young child who presents with hearing loss or is Deaf has not yet developed age-appropriate auditory skills and therefore is not restoring the skill. Below are some examples of the service delivery areas we treat regarding aural habilitation/rehabilitation:

• Auditory processing: comprehension and interpretation of auditory information
• Speech, language, communication, and listening skills: as affected by deafness, hearing loss

Learn more about our audiology services here.

Cognitive-Communication Disorders

Speech-language pathologists also provide services for individuals with Cognitive-Communication Disorders.  In the pediatric population, the most common etiologies for cognitive-communication disorders are autism spectrum disorder, cerebral palsy, developmental delay, and traumatic brain injury. Below are some examples of the service delivery areas we treat regarding cognitive communication:

• Executive functioning: includes working memory, inhibitory control, and cognitive flexibility
• Attention: ability to attend to someone or something
• Memory: includes episodic, semantic, procedural, short-term and working, sensory, and prospective memory
• Problem–solving: obtaining, processing, and collaborating the information needed to find a solution to a simple or complex issue

Feeding and Swallowing

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Feeding and swallowing refer to how individuals transport food and drink from their environment into their bodies. Speech-language pathologists are involved in the parts of this process that involve the mouth, pharynx, and esophagus. We collaborate with other specialists, such as nutritionists, occupational therapists, and gastroenterologists, to meet each child’s individual feeding and swallowing needs. Below are some examples of the service delivery areas we treat regarding feeding and swallowing:

• Oral, pharyngeal, and esophageal phase of swallow: components of the swallow that occur in the mouth, pharynx, and esophagus; abnormal swallow can occur in one or multiple phases
• Atypical eating: (e.g., food refusal, food sensitivity, negative physiological response)

Learn more about our feeding clinic here.

Augmentative and Assistive Technology

Photo by Michael Vanko

Augmentative and Assistive Communication (AAC) includes all forms of communication that are used to supplement or replace oral speech to express thoughts, needs, wants and ideas. AAC allows children to communicate more easily and, in doing so, reduces frustrations for the individual and his or her family. There are several forms of AAC ranging from light tech to high tech. Below are some examples of the service delivery areas we provide in AT services:

• Diagnostic Therapy – working with a child to explore access methods that are consistent and least restrictive to a robust communication system
• Assistive Tech/ Speech Therapy – building language skills and learning how to operate the communication system to be able to express wants and needs
• Customization of systems – setting up, maintaining, or generalizing communication systems to all environments
• Consultations – may work with other providers/school team members to ensure consistency of aided language partners
• Parent training – provide parents the tools to implement operations of communication systems and to be a language model

Learn more about our Assistive Technology (AT) and Augmentative and Alternative Communication (AAC) services here.

Speech-Language Therapy at Easterseals DuPage & Fox Valley

If you are concerned about your child’s language or other development, take our free online developmental screening tool for children birth to age five. The Ages and Stages Questionnaire (ASQ) will showcase your child’s developmental milestones while uncovering any potential delays. Learn more at askeasterseals.com. 

To learn more about Speech Language services at Easterseals DuPage & Fox Valley, click here or call us at 630.282.2022.

Books to Improve Mental Health

By: Dr. Citlaly Gonzalez, Clinical Psychologist

Winter weather and a week off of school, what better time to cozy up with a nice pile of books? There is something magical about the world that is waiting inside a book and the places and times you can travel to, the feelings they evoke, and the things we can learn.  

As a psychologist, the opportunity to blend my appreciation for each person’s story and my love of reading has been an incredible thing.  In my work in our Autism Diagnostic Clinic, my job is to include a recommendation to support each child’s development. I find that including a list of book recommendations with each report has been a fun way for parents to support their child’s needs.  

When presented with the opportunity to write a blog about books I would recommend from a mental health lens, I jumped at the chance, but where to start? Books about feelings? Books on tough topics? My favorite children’s books? One blog post can’t cover them all (but maybe a part II or part III can try), so we’ll focus on the magic of reading with your child and what it can do to support connection, increase understanding of feelings and tough situations, and support the child’s sense of self.  

Books on Feelings 

There are so many books about feelings out there! It’s a beautiful thing. It’s best to start with feelings books at your child’s level. This could include introducing basic feelings concepts or stories with more complex social situations. Here are some of my go-to books!  

• For the youngest readers and those whose attention is best supported by simple books try the Feelings Book and Glad Monster, Sad Monster, both of which introduce feelings paired with bright illustrations. Lots of Feelings on the other hand uses photographs for children who might benefit from more realistic representations.  
• In the Boy with Big, Big Feelings, a little boy wonders why he has a “big, giant heart in a world that’s so heavy and kind, where all of the feelings under the sun feel as if they were made to be mine.” He learns that it’s okay to have big feelings and that it can even help us understand and connect with others!   
• A Whole Bunch of Feelings has been a favorite in our house. Each page has a brief introduction to a different feeling paired with an activity or question for discussion. We read a page at breakfast and made it part of our normal routine showing that any time is a good time to talk about our feelings.
• We usually followed up with one page from Breathe like a Bear for a quiet moment of meditation before we get our day started. See the theme, little moments, scheduled regularly, make for some big impact!  
• Think of who and what your child responds to, like their favorite characters. If you have a dinosaur lover, the “How do Dinosaurs” series might be a great place to start. Superhero lovers might be most interested in a book with their favorite characters, Super Heroes Have Feelings Too (DC Super Heroes).

Books on Tough Topics 

Our therapy team is often asked for book recommendations to talk about tough topics. We welcome opportunities to connect families with books that can help them navigate hard discussions. If you are going through a challenging moment, feel free to reach out to your therapist or our mental health team for book recommendations. Your local library may also provide a wealth of resources!  

Photo: Topics to Talk About display at the Berwyn Public Library 

• Books on Making mistakes: For the kids who can’t stand to make a mistake try The Girl Who Never Made Mistakes. Pair it with a conversation about the times you’ve made a mistake and how you recovered. Social-emotional learning happens when children are provided opportunities and models. 
• A Garbage Can Day–  talks about the feelings and choices that come with a rough day. Written by a local therapist and a teacher, this book is paired with a board game for reading and play.  
• When Sadness is at your Door personifies the feeling of sadness, making it easier for younger children to talk about what it feels like for them. It doesn’t look to resolve the problem or make the feeling go away, but to provide language to discuss it, ideas to cope, and reassurance that it is okay to feel deeply.  

• We are often asked for books on grief, change, and loss:  A Memory Box looks at grief from a child’s perspective and suggests an activity to do to keep the person present. The Invisible String uses a more subtle approach and looks at separation, both temporary and permanent, providing language to use when children really miss someone and wished they could be closer. The Fall of Freddie the Leaf is a more abstract book that discusses change through the framework of fear moving toward acceptance. It’s a classic book and good for all ages.  
• It’s not just “therapy books” that can be useful! Sometimes just regular books can open the door to conversation. Alexander and the Terrible, Horrible, No Good, Very Bad Day was a favorite in my home growing up. When one of us was having a bad day, my mom would ask if we were feeling a bit like Alexander. It allowed us to externalize the feeling and provided a touch of humor.   

Books to celebrate your child  

There are tough moments and there are beautiful moments and all of them deserve space and attention. At Easterseals we are dedicated to celebrating each child and their many skills, talents, and unique way of being. The following are some of my favorite books to celebrate children from a strengths-based frame.  (Bonus: These are some of my favorite gifts for my children’s classrooms as a gentle reminder that there are so many ways kids share their gifts!) 

• All the Ways to Be Smart: this beautiful book celebrates the many ways children share their gifts. It’s an important reminder that every child has strengths, and it is our job and joy to find and honor them.  
• All Kids are Good Kids: this simple board book was inspired by a child I saw in our clinic. Her frequent and unexpected behavior led to her belief that she was “bad.” Children (and adults!) don’t always make the best choice, but no child is ever bad, this book reminds us that all kids are good kids. Try these books from the same series too: All Kinds of Kindness, Love Makes a Family 
• I Know a Lot: Another great book to remind kids (and the grown-ups around them) that there are so many important things our kids know, things that matter, things they learn by playing and exploring the world around them. (These books are from the same series too: I am So Brave).  

Books to Support Connection 

• The Rabbit Listened: This is one of my very favorite books for parents to read to their children. Read more about why in this powerful blog written by Natalie Donald, an Easterseals social worker. At its core, the Rabbit Listened gently reminds us that in order to help, we need to first listen. I like to invite parents to identify which animal they think they’re being (Unsurprisingly, I am a chicken. I want to talk talk talk about it all).  Read it with your child and try to see which one you are, and lean in to listen to which one your child best responds to, knowing it can change across situations, moods, and needs.  
• Mama do you love me: This simple board book tells the story of a little girl with a big imagination who wonders what would happen if she did all the things she knew she wasn’t supposed to do. Each time, her mama assures her that some things might make her angry, surprised, or scared, but that no matter what she would still love her, because of who she is.  

The Book You Write Together 

The most important book you read might be the one you write together. How you write it, is up to you and your child.  

• Not all of us can keep up with baby books but we can all keep up with a quick note. I’d like to introduce you to the “My Child Can” journal. Whether it’s in a beautiful notebook, the margins of your planner, or the not-quite-a-book notes app on your phone, the “My Child Can” is a running list of all the milestones and little moments that make you smile. It might be “my child told me they have a best friend” or “My child learned to spell his name.” In this work, we spend a lot of time asking about the things children can’t do (yet), but this journal can be an important reminder of all the things your child can do. You may also choose to work with your child to teach them to do the same and focus on all the beautiful things they can do using an affirmation book. 
• Shared art journal (Draw with Mom): For kids who have started writing and drawing, I love a shared art journal (Draw with Dad). Keep the pressure low and the journal accessible and watch the communication blossom. Some days may be just a scribble or a funny picture while other days might include a more meaningful note, all of it helps support an open line of communication  

Reading is Wellness

Simply reading with your child is the best, no matter what book your reading, the connection between parent/guardian and child, language exposure, and of course the introduction to new themes all have the potential for so many benefits for wellness.

Our Mental Health team often receives requests for books on various themes which we happily oblige. We have recommendations for books on learning about feelings, grief, potty training, divorce, sharing a diagnosis, and more. We have another blog post with recommendations on best children books on disability. We have those recommendations and lots more! But here is my biggest tip, read these books before you think you need them. Have them accessible. Read about all abilities, cultures, and a wide range of challenges and situations. Normalize talking to your child about life challenges, feelings, and tough topics. This way, when a situation of their own comes up, they know it’s okay to talk about it. They will be less resistant to reading about it. They will be more prepared to handle it.  

An added reminder for the parents of children who haven’t yet discovered the magic of books –kids don’t always start out loving books. There was a long stretch of time with my own children when it looked like I was reading to myself or the dog, but I knew that even while running around the room, they were listening. Hearing the stories, exposing them to language, and even the rhythmic reading of toddler books are way to support both connection and reading.

As a bonus recommendation for the kids who are still learning to appreciate books, I love to recommend the Indestructible series and any book with interactive components or buttons. Kids are always taking in pieces from the world around them, whether it’s the words you are reading or the fact that you are sitting, present with them.  

So, if you are looking for a final gift to complete “the something you want, something you need, something you wear and something you read” I hope this list helps you find a new book to add under the tree, a book to quietly add to your library for “just in case” or even a simple surprise for an any day moment to have with your child. 

About Easterseals DuPage & Fox Valley

For additional information on services for children with disabilities, visit: https://www.easterseals.com/dfv/programs-and-services/. The Easterseals’ Mental Health & Family Support team strives to provide children and families with the mental health support they need to help thrive and empower one another. Our work helps caregivers and children experience more joyful interactions through attunement and connection. For more information on our services, contact us at socialservices@eastersealsdfvr.org.

It’s Summer! Let’s Go Ride A Bike!

By: Josephine Hipolito, Physical Therapist

Summertime is approaching, and around this time, caregivers often ask me to work on bike riding with their kids as one of their goals. As an avid cyclist, it’s one of my favorite things to teach because of the joy and freedom children feel when they learn to ride. Let’s start with a few tips on teaching children bike riding.

Things to Consider When Starting

1. Determine whether the child knows how to pedal.  If they do, skip the next section and go to the balance section to work on the balance aspect of bike riding .
2.  Remember you don’t have to follow this step by step. It’s more of a guide to see where your child is in the bike riding process and then proceed.

 Teaching Children Pedaling:  

1. Start with teaching “Air Cycling.” Most kids don’t understand the concept of extending one leg while the opposite leg is relaxed if they have never pedaled before. Their usual instinct if you tell them to push with their legs is to have both legs push simultaneously, so they usually get stuck when on a tricycle.
   
2. To practice the motion of pedaling, place your hands at the bottom of their feet and tell them to push against it on their bent leg. Use a little resistance when you do this. On a tricycle, kids often stop pedaling and move backward when they encounter resistance, so you want them to get used to resistance.

3. Once they master air cycling, start them on a tricycle with a pedal block (a device that holds their feet on the pedals) or strap their feet on the pedals using an ace wrap or velcro straps. Children usually tend to over-push with their feet at first, so their feet slip off the pedals. Wrapping their feet will keep them on the pedals. You can also get commercially available pedal straps like this one.

4. Once they master the pedal block, take off the straps so they can learn to control their leg movement and keep their feet on the pedals.

5. Make sure they master pedaling with a tricycle so that it becomes second nature to them when they graduate to a bicycle.

Balance Bike Versus a Bike with Training Wheels 

I often tell families ready to progress their children from a tricycle to a bike, to start with a balance bike. A balance bike is simply a bike without pedals where children use their legs instead of pedals to move.

Skip the step of learning with training wheels because children can get dependent on leaning on them for balance. The Balance Bike enables the child to learn to find their center of balance on their own  

NOTE: Not everyone will be able to get a balance bike and a bike with training wheels, so I recommend taking the training wheels AND the pedals off of a bike to convert it to a balance bike. 

 Biking with Training Wheels

The problem with a bike with training wheels is the braking system.  They use coaster brakes which means pedaling backward to activate the brakes. 

Kids tend to start pedaling backward when they encounter resistance which activates the brakes. It’s always difficult for kids with motor planning issues to figure this out. That’s why you ensure they master the pedaling part of bike riding before moving on.

Keep an eye out for the following:  

1. Some kids tend to push with their legs while pulling on the handlebars, which causes the bikes to turn – as a PT, this signals to me that they need core strengthening 
2. Some kids will over push with their legs causing them to slip backward on the bike seat – I put a dycem (non-slip pad) or tie a theraband on the seat to prevent this .

 Tips to Use a Balance Bike 

1. Start with having the child walk with their legs while sitting on the saddle. See if they have the control to keep the bike from tipping or even recognize that the bike is tipped while they are riding it. They need to integrate this part. Children with body awareness issues will not even recognize that they are tilted when propelling a balance bike.
2. Watch out for kids who walk the bikes, but they are standing and not sitting on the seat. I sometimes use an ace wrap to secure their pelvis on the seat to prevent this 
3. Once they master keeping the bike upright, work on gliding .
4. Gliding – have them take three steps: 1, 2, 3, then bring their feet up to glide. Challenge them and ask them to see how far they can glide before they put their feet down.
5. I sometimes use floor markings like chalk on the surface to mark a certain point. Children can work on balancing better if they have a visual cue on how far to glide.
6. Once a child can glide for 10-20 feet consistently, I move them to a bike with two wheels (or put the pedals back on the bike).

Steps to Help Children Ride a Standard Bike 

1. Work in a parking lot of a school or a park early in the morning so that it will be empty and there are no distractions – avoid the sidewalks or hallways because the child needs to worry about staying within the confines of the space (it can become too stressful for them).
2. Try to find a parking lot with a little downward incline to help them get a little momentum to balance.
3. Let your child walk the bike out to the parking lot while holding the handlebar. This way, they learn to handle the bike and how to motor plan to keep it balanced.
4. Work on pedaling forward first.  Worry about turns later.
5. Have a gait belt (or Dad’s belt) around their trunk, so you have something to grab onto when they are riding (if they are not using a bike with a parent’s handle).
6. Give them a little push to start them up – they will usually start slow because they are apprehensive but what children don’t realize yet is they need momentum to be able to balance.  
7. Give them frequent breaks, and maybe bring a snack, as bike riding can be stressful while learning. Let them know that they have to do 2-3 laps then they can take a break. Break for 1-2 mins, get a drink or snacks, then return to bike riding. Use a timer so they know break time is over when it rings. This way, they may be more cooperative when they know they have a break.
8. Once they master going straight, you can work on turning – put cones on each end of the parking lot and ask them to turn around the cones. This way, they can practice tight turns.
9. Once they master turning,  work on tighter areas (e.g. a hallway, sidewalk) to narrow their space.  
10. Once they master tight areas, work on going up inclines.

Biking From a Complete Stop  

1. Determine the child’s balance leg – it’s usually the first leg they put down when they stop.  
2. Once that’s determined, the balance leg is the leg that will stay on the ground and will be pushing to get the bike going.  The other leg goes on the pedal (pedal leg).  
3. Teach the child to position the pedal (pedal leg side) in front of their shin so they can easily put their foot on it.  
4. Ask them to have the balance leg push on the ground while the pedal leg is pushing down on the pedal to start the bike .

Cycling Benefits

I hope this blog has been helpful wherever your child is on their cycling journey! Teaching children to cycle has numerous benefits to their development, including improving motor skills, strength and balance. It’s also a fun exercise that can be enjoyed with a sibling or friend!

if you ever have concerns about your child’s mobility, strength, or motor skills, Easterseals DuPage & Fox Valley is here to help! Learn more about our physical therapy services by visiting:
https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/physical-therapy.

We also invite your family to join our annual Bike for the Kids in Elgin!

Cyclists of all ages and abilities are welcome to ride distances ranging from 12 miles – 50 miles or join us in reaching a 100-mile goal throughout the summer on the Strava app. Adapted bikes and trailers are welcome. All ages and abilities are encouraged to participate.

We are excited to take this ride to the Fox River Trail and celebrate together at Festival Park in Elgin with food, refreshment, entertainment and more!

Learn more and register here: https://www.givegab.com/campaigns/bikeforthekids2022

Positioning and Mobility Clinic Overview

By: Allie Katsiris, PT, DPT

What Does the Mobility Clinic Do?

The Positioning and Mobility Clinic at Easterseals provides a comprehensive evaluation of a child’s adaptive equipment needs. It is a collaborative clinic consisting of a physical therapist (PT) and an assistive technology professional (ATP) from a durable medical equipment vendor. Of course, the child and their family members are also valued members of the team. The two vendors that attend clinics at Easterseals are Numotion and National Seating and Mobility. There are a lot of options for seating and mobility devices available on the market, so the PT and ATP will utilize their knowledge, experience, and expertise to recommend the most appropriate equipment for your child.

The Process

At the initial evaluation, the PT and ATP will complete a comprehensive evaluation of the child including assessment of posture, range of motion, functional mobility skills, home assessment, and child/caregiver goals. Recommended mobility equipment may include: adaptive strollers, manual wheelchairs, power wheelchairs, or power assist wheelchairs. The clinician will also assess the need for specialized car seats or adaptive bathing equipment.

Following the initial evaluation, the PT will write a letter of medical necessity for the device. This letter will be sent to the child’s physician to be reviewed and signed. The vendor will submit the order and the letter to this insurance company for approval. Once approved, the device is ordered then delivered to the child. The PT and ATP work closely upon delivery to ensure the child is positioned appropriately and that the family understands all features for safe and effective use of the device. We recommended yearly rechecks to ensure that the device continues to properly support the child.

Home and Environmental Factors we Consider

There are many factors that are considered when deciding on a mobility device. In addition to evaluating postural alignment and medical history, the team will ask about your child’s current mobility skills and goals. We will consult with primary therapists as needed to best understand your child’s abilities, functional goals, and endurance level in order to best recommend a mobility device. The team will also ask about your child’s home and school environments. Some considerations include: whether your home has stairs, location of the child’s bedroom/bathroom, and width of doorways.

It is important that the child be able to utilize recommended equipment in all environments to promote his/her best alignment and independence. Another important factor in recommending a mobility device is how the child is transported. Do you drive a compact car or SUV? Do you have an adapted vehicle? Does your child ride the school bus? The answer to these questions will help guide to whether a folding or non-folding option and transit accessories are required. Due to insurance limitations and expectations that mobility equipment will last 5-10 years, it is important that all of these factors, growth, and future needs are considered in order for the equipment to support the child for years to come.

Quick facts about the various types of equipment:

Adaptive Strollers:

• Provide support for children who have decreased postural control, endurance, or safety in the community.
• They are typically lighter weight than wheelchairs and fold more easily.
• There are some limits to the customization of these devices.

Manual wheelchairs:

• Provide postural support for children who walk with limited endurance or who are unable to walk.
• A child can push/ move this device independently.
• There are folding and non-folding options.
• Can be customized to fit a child’s needs.

Tilt in Space wheelchairs:

• Provide postural support and can tilt backward for rest breaks or medical needs.
• Children are dependent on caregivers to propel the device.
• There are folding and non-folding options; although they tend to be bulkier than manual wheelchairs.
• Can be customized to fit a child’s needs.

Power wheelchairs:

• Provide postural support and power control
• Can be operated by the child.
• These are unable to fold so the family should consider home and car accessibility.
• Can be customized to fit a child’s needs.

How to Get Started

At Easterseals DuPage and Fox Valley, we appreciate the importance of providing children with a safe means of mobility. This allows children better access to their communities and increases overall participation with their family and peers. We also recognize that the equipment ordering process can be overwhelming, so we are here to support you and help your child obtain the equipment he/she needs to thrive! Please contact us to schedule an appointment: 630-282-2023 or click here to learn more.

2021 Holiday Gift Guide

By: Citlaly Gonzalez Psy.D Clinical Psychologist

Winter brings chillier temperatures, twinkling lights, extra family time and the opportunity for holiday shopping and gift-giving. There are many gift guides out there. Big City Readers put together this one that includes toys to support learning and development, and sensory play and of course books!  There’s this one by Buzzfeed for kids with endless energy. Easterseals DuPage & Fox Valley offers something unique- a holiday gift guide carefully curated with the needs of our families in mind and offered through the lens of mental health and wellness for the whole family.

Many of the links included in this guide take you to Amazon, so add Easterseals DuPage & Fox Valley as your selected charity through smile.amazon.com and get ready to shop!

Family Time at Home

The old adage your presence is the best present is never truer than during the holidays. This is a great time to think of ways to spend time together during the winter months and look toward ways to create memories throughout the year. Board games bring the family together and there are many great options for even the youngest children. Worried about the meltdowns that happen when a child is still learning to lose graciously? Stick with cooperative games such as those by Peaceable Kingdom. The Race to the Treasure is in heavy rotation in the Social Services department as is Monkey Around, a non-competitive game that includes gross motor play, imitation, vocabulary, and social-emotional skills through a card game that prompts players to do movements together.

There’s no rule that therapy games have to stay in the therapy room. Consider adding some Social Services classics to your own toybox at home and normalize talking about mental health. These Kimochis provide a cute way to talk about feelings and Create a Story cards support sequencing and story-telling. To support calm feelings this card deck introduces mindfulness while this expandable breathing ball brings deep breathing to life.

Winter is long so think of games that keep you moving indoors. Painter’s tape in the multi-color pack is great for creating homemade obstacle courses with little equipment. Add in stepping stones, wobble boards, a figure-eight balance beam, or even tunnels and ball pits to level up the fun indoors.

The Tricky Spots

Not every routine at home brings smiles to children and caregivers. But what if we could provide some tools to support these “tricky spots?” What if we could identify toys that we could integrate into daily routines and incorporate them in ways that help? Think of what part of the day feels challenging and add in some gifts to help make those tasks feel more exciting or run more smoothly.

Bath-time: Put together a Bath bin to make bath time more appealing. “Time for bath” and “Time to choose a bath toy” have a different ring to them. Consider bath crayons, bath paint, bath bombs, bath confetti, color drops, glow-sticks, –any of which would make great stocking stuffers, or you can choose something like this interactive set that lights up and has music parts or a bath-time basketball hoop.

Bedtime: Help create a calm environment and support a healthy bedtime routine with these recommendations that might make your child look forward to bedtime! Create a soothing and distraction-free environment with this bed tent or try a light projector such as this one that creates dinosaur images on the ceiling, this huggable turtle, or this brave bear with his flashlight and book.

Mealtimes: Take some of the struggles out of mealtimes with some of these fun gifts. Which food to try next? Depends on the spinner or the order of this path or these fun plates that are sure to make meals fun.  You can also help promote self-help skills and independence with gifts that help your child participate in cooking –not to mention the gift of time and memories made together in the kitchen. Both of these wooden knife and wooden knife set are safe for most novice chefs whereas this one might be more appropriate for children who are ready to use a real knife that is still child-safe.

The classics

It would be remiss to make a holiday gift guide without mentioning “the classics” –open-ended toys, art supplies, and books. Here are some Easterseals Dupage & Fox Valley favorites:

Must-Have-Toys: Dolls and dollhouses, blocks, and play food are the play trifecta. If you have these, your play kit is complete! Dolls are great for both boys and girls and help foster pretend play, teach routines, and promote caregiving. Melissa & Doug has a beautiful wooden one while Woodzies offers an option at a lower price point. (Hint: Woodzies have a lot of other settings you can add like the school set to help your child share and tell you about their day). There are many options for play food, with Melissa & Doug offering a wide variety of beautiful sets, some that invite “cutting” or with Velcro pieces to assemble. Speaking of building, blocks are always a hit! Whether it’s Legos, wooden blocks, or a fun option like these, blocks are a great open-ended toy that provides endless possibilities for creative play.

Art: Art provides not only the opportunity to create but also to connect and express thoughts, feelings, and experiences. Some favorites include Crayola Slick Sticks which provide rich color with minimal pressure, perfect for toddler hands and those with motor challenges and Sharing journals such as this one provide a great way to connect with your children through art.

Books: Every book has its perks and particular uses and reasons to recommend it. Poke-a-dot books help support pointing and the Indestructible book series is perfect for children still learning to be gentle with books. Two of my all-time favorite books are The Rabbit Listened which reminds us to stop and listen to what children really need and All the Ways to Be Smart which celebrates the many ways kids learn, play, and explore. Remember, books are not just bound paper, they’re the promise of time spent together bonding and reading with your child.

We have a wonderful library at Easterseals and a carefully curated book list. Ask your therapist for recommendations or contact the Social Services Team. Two favorite resources for book recommendations are Miss Beth and her team at Big City Readers and Kido.

Let’s not forget the caregiver

While the focus of the holidays is often on the children, let’s not forget the gift of a healthy, happy, and well-taken care of parent. I recently saw a post of Mothercould (highly recommend for ideas of activities and sensory play!) where Myriam, the blogger, shared the idea of a gift basket she made for herself for self-care following the birth of her youngest daughter. What an amazing idea! So, this last recommendation is to put together some of your own favorites. Your favorite snacks, gift cards for your favorite store (who doesn’t love a solo trip to Target?), and a note to remember to take care of yourself this holiday season and into the new year.

The best gift for your child . . .

Of course, the focus of any gift should be the recipient and what brings them joy. You are the expert on your child and what they like most! Grant yourself the permission to fill their stocking with the Guaranteed Wins! Confession: my child’s stocking includes a bottle of eczema cream because he loves this part of our nightly routine and a wooden McDonalds food set –a Frankenmixture of trendy wooden toys and the food parents don’t always want to admit their kids love. Those items aren’t likely to be found on anyone else’s gift guide, but they are things I know will bring a smile to his face and will be immediately put to use, and that makes them good gifts!

To determine the best gifts for your child, think of the parts of your day where you could use some support and choose a gift that will grant it. Reflect on your favorite routines and memories with your child and consider ways to incorporate these into your gift. Consider how the gifts you select will be used in a way that supports your family’s health and happiness and above all the time you share together.

Amazon Wishlists

While you complete your holiday shopping, don’t forget to checkout at smile.amazon.com with Easterseals DuPage & Fox Valley as your selected charity. You can also take a look at our wishlists for therapist and teacher requested items to send to our centers. Both efforts on Amazon can provide year-round support of our services and programs. The featured items make great developmental toys and gift ideas for children of all ages too. Thank you for supporting us this holiday!

• Villa Park Wishlist
  • Features pretend play toys, art supplies, bubbles and baby and toddler toys
• Elgin Wishlist
  • Features books, movement and baby toys for use in therapy
• Naperville Wishlist
  • Features board games and sensory materials to use in therapy
• Lily Garden Wishlist
  • Features kinetic sand, paint and playdoh supplies, fidget toys and more for our infant, toddler, preschool, and pre-k classrooms.

Keeping Children with Disabilities Safe in a Digital World

By: Yvonne D. Anderson, LCSW, CADC, CODP II

All parents want to protect their children. And all children are vulnerable online, whether they’re using email or chatting on social media sites. When your child has a disability or developmental delay, those protective instincts switch into high gear. Identifying potential threats online is more challenging than, for instance, spotting a danger on the playground. Additionally, many children with disabilities struggle with reading social cues, managing emotions/ behavior, and making judgment calls about others. As a result, they are at a higher risk for cyberbullying and online victimization. As a parent or caregiver, you are your child’s first line of defense. Use the following guidelines to navigate the online world and keep your child safe.

Make your home network safe.

Avoidance is the best policy when it comes to sexual content, violent images, online predators, malware, and cyberbullying on the Internet.

• Increase your security. Use updated virus protection and other safety measures, such as firewalls, to protect your computer from hackers and other cyberattacks.
• Make it public. Keep smart phones, iPads, and computers in shared places where it’s easy for you to monitor online behavior.
• Filter content. Install filters to block unapproved websites and images.
• Set up parental controls. Limits can be set in multiple ways, such as through your internet or mobile service provider, directly on the device itself, and through site-specific services, including YouTube, Netflix, and Facebook.
• Use child-friendly browsers. Some browsers are designed specifically to allow young Internet users to explore and learn without coming across offensive or dangerous content.
• Review the browsing history regularly.
• Disable location-tagging. A GPS-enabled smartphone or computer can reveal your child’s location through online posts and uploaded photos.

Photo by Dzenina Lukac on Pexels.com

Teach your child how to behave online.

Educating your child about appropriate online behavior is vital if you want to keep her safe no matter where she accesses the Internet.

• Establish ground rules. Identify what is OK to do online and what activities are prohibited. When it comes to content, use the same guidelines that you employ for television viewing: if they can’t watch it on TV, they shouldn’t look it up online either.
• Teach your child that information shared on the Internet becomes and stays public forever.
• Review information that should not be shared. Help your child understand what types of information are unsafe to share online, such as their full name, address, phone number, school, or other images/ information that could help someone identify them. To help your child remember, post a “Do Not Share” list by the computer or on the device.
• Explain the limits to online relationships. Emphasize that it is okay to say “No” to requests for personal information, photos, money, and joining social media networks.
• Be smart about emails. Let your child know how dangerous it can be to open an email or attachment from someone they don’t know. Reinforce the importance of checking with you or another trusted adult if they get a message that they’re unsure about.
• Encourage your child not to delete messages. Tell them to save anything that they’re not sure about, doesn’t feel right, or seems hurtful. Set aside time to review the messages together.
• Explain cyberbullying, predatory behavior, and sexting. Although it may feel uncomfortable to talk about, your children can’t protect themselves from what they don’t know about. Rehearse “what to do if…” scenarios.

Photo by Julia M Cameron on Pexels.com

Provide resources and support.

Children also need to know how to identify when someone else is behaving inappropriately online and what to do about it.

• Use online tools. Websites such as InternetMatters.org or NetSmartz.org provide a wealth of resources for both parents and children. InternetMatters is a resource hub specifically designed for children with additional learning needs and their families. These sites offer tools help children learn about online dangers using role-playing, pictures, and other strategies. NetSmartz resources also include the SymbolStix safety pledge, a visual online safety contract designed with support from the National Autism Association.
• Encourage them to trust their gut. Teach your children to be skeptical and listen to their own instincts. Use role-play to practice recognizing and responding to several different scenarios your child may encounter online.
• Give them a lifeline. Make sure your children know that you and other trusted adults are available for them if they run across something online that makes them uncomfortable. Even if they’ve done something they shouldn’t have, it’s important for them to be able to reach out to adults they can rely on.
• Find safe online spaces. Seek out social networks and peer support that are focused on activities and interactions that match your child’s interests and developmental level.
• Be curious and ask questions. Find out what websites your child likes to visit. Have they ever seen something online that made them feel sad, scared, or confused? What would they do if they saw something online that made them uncomfortable?
• Connect with your child by learning how to use the technology and social media that s/he is using. Ask them to show you how it works and specifically how they use it.

Photo by Ketut Subiyanto on Pexels.com

Reach out to Easterseals’ Social Services team for more ideas about how to support your child’s social and emotional development. You can contact us at socialservices@eastersealsdfvr.org.

How Speech-Language and Occupational Therapies Work Together

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

Young 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.

If 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. 

Motivation Comes From Seeing Your Future Self

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

We all have a range in abilities of executive functioning.  Kids and adults alike can struggle with organization, memory, focus, managing time, initiating a task and completing a task.

Being able to visualize the future is an imperative skill for moving from event to event and showing up on time with the needed materials.

Some of our kids who struggle with executive functioning may seem distracted, disorganized and struggling to keep up with the pace of the day.

Additionally, some of these kids can be perceived as being unmotivated.   They might be smart kids that simply don’t appear driven to work up to their potential.  Executive functioning guru, Sarah Ward, asserts that these kids have difficulty imagining their future emotions.  They don’t intuitively imagine what they will feel like or what they will look like when they complete a task or achieve a goal.

What I need to look like now.                                   So that I can look like this later.

We want kids to be able to see the future, say the future, feel the future and plan for the future.  So how can we facilitate this skill of ‘future imagery thinking’?

• Have your child make an image by helping them talk through the following:
  • What will the environment look like?
  • Who else do you see being there?
  • What will I look like?
  • What will I feel like?

• Ask questions that encourage future imagery thinking.
  • Ask:  “When you walk into class tomorrow, what do you see yourself handing to your teacher?”
    • Instead of:  “What do you have for homework tonight?”
  • Ask: “What would you look like if you were standing by the door, ready to leave for soccer?”
    • Instead of: “Go get ready for soccer.”

Making a mental movie of the future requires us to actively think through the necessary steps in order to complete a task.  It enables us to envision and play a ‘dry run’ of a task without the risk of error.  Seeing the future helps us to persist through the present challenge in order to achieve our goals.

To learn more about Easter Seals DuPage and Fox Valley programs, visit eastersealsdfvr.org.

 

Featured image by: Lauren Sims

Occupational Therapist Recommended iPad Apps

By: Laura Bueche, MOT OTR/L

No one can deny the powers of the iPad. The back lit animations, sound effects and interactive games make apps a great tool for kids to learn. Kids and adults are drawn to the technology?

The American Academy of Pediatrics (AAP) recommends limiting the amount of screen time a child has to “high-quality content.” They recommend children and teens should engage with entertainment media for no more than one or two hours per day and that television and other entertainment media should be avoided for infants and children under age 2.

But what games or content are high-quality? As a pediatric occupational therapist, I use iPad apps during therapy as a therapeutic tool to help kid’s develop skills.  Below are my favorite quality iPad apps.

Fine Motor Skills

 

Dexteria By: Binary Labs, Inc.
Price: $3.99

Dexteria turns your iOS device into a therapeutic tool that improves fine motor skills and handwriting readiness in children and adults.

Dexteria Jr. By: BinaryLabs, Inc.
Price: $2.99

Set of hand and finger exercises to develop fine motor skills and handwriting readiness. The activities are specially designed for kids age 2-6.

Dot to Dot Numbers and Letters Lite By: Apps in My Pocket Ltd By Apps in My Pocket Ltd
Price: Free

Trace through dot-to-dot puzzles for visual motor skills and visual tracking.

Bugs and Buttons By: Little Bit Studio, LLC.
Price: $2.99

18 mini-games and activities that make learning fun. Count colorful buttons, recycle with marching ants or dainty ladybugs, recognize letters, solve bug mazes, and more!

 

Letter and Number Formation

 

Letter School By: Letterschool Enabling Learning B.V.
Price: $4.99

Play to learn how to write all letters of the alphabet: abc – xyz and the numbers 1-10 with LetterSchool.

Letter Workbook Home Edition By: BigCleaverLearning
Price: Free

Letter Workbook is an interactive educational app which teaches toddlers and children how to form and write letters. Through the simple, interactive guide children will learn how to write their ABC, improve vocabulary and have fun along the way!

My First Number Trace By: Neutre
Price: $1.99

Easy tracing for little fingers. Trace letters 1-10.

iWriteWords By: gdiplus
Price: $2.99

iWriteWords teaches your child handwriting while playing a fun and entertaining game.

 

Visual Perception

Little Things By: KLICKTOCK
Price: $2.99

An innovative seek and find game. Search colorful collages built from thousands of little things. Randomized searches ensure a different game each time you play.

Rush Hour Free By: Thinkfun Inc.
Price: Free

The original sliding block Traffic Jam puzzle, works on visual perception, problem solving, and attention.

 

Visual Attention Therapy By: Tactus Therapy Solutions Ltd. Price: $9.99

Visual Attention Therapy helps brain injury and stroke survivors, as well as struggling students, to improve scanning abilities. It also helps rehab professionals to assess for neglect and provide more efficient and effective therapy for attention deficits.

Cause and Effect Apps

Peekaboo Forrest, Barn, or Fridge By: Night & Day Studios, Inc.
Price: $1.99

If you see something moving, tap on it to find out who it is!

Ilovefireworks lite By: Fireworks Games

Price: Free

Create beautiful fireworks display by easy tap operation! Touch on the screen, you immediately see breath taking fireworks in 3D graphics and real sounds.

Touch of Music By: gamegou

Price: Free

Enjoy the freedom to play songs at your own beat while never missing a note.

 

Self Care Skills 

IdoHygiene By: C.E.T – THE CENTER FOR EDUCATIONAL TECHNOLOGY
Price: Free

Learn the most common personal hygiene daily activities (teeth brushing, shampooing , hand washing, toilet training, taking a shower , public bathroom, etc.)

T-Rex Toothbrush Timer By: PCAppDev Limited
Price: $0.99

Encourage your kids to brush their own teeth properly by following Dino brush his teeth!!

To learn more about Occupational Therapy at Easter Seals DuPage & Fox Valley visit eastersealsdfvr.org.

A Checklist for this Year’s IEP

By: Sharon Pike, Family Services Parent Liaison

As one of the Parent Liaisons at Easter Seals DuPage & Fox Valley, I have experienced many years of not only my own children’s IEP’s, but countless families from our centers.   Here are some strategies that have helped our families feel like a true member of the team and confident that this year’s IEP is a well written plan that will meet their child’s needs.

Prepare for the meeting

1. Make a list of your child’s strengths and needs. Bring it with you to review during the meeting to insure they are covering things that are important to your child’s success in school. Think about and write down strategies that work at home and with your private therapist to share with the staff.
2. Know what the law requires. Section 614 of the Individuals with Disabilities Education Act (IDEA) sets out the process and elements of what needs to be explored to develop and revise and IEP.  States and local school districts add their own policies on top of what is required under the federal law. That being said it doesn’t mean you need to know the letter of the law.   Bottom line… the more you know and understand the easier the process is.
3. Never attend this meeting alone. It’s important that you and your spouse attend if possible.  If not then ask a grandparent or a friend. Their role is to be support for you and another set of ears!  Often at these meetings we can get stuck on something one member of the staff said and miss important information.  Make sure you inform the school that you are bringing someone with.
4. Start the meeting with a positive statement about your child even if you’ve had a difficult period there is ALWAYS something positive to say… he has the best smile, she is caring and kind, he loves other children!
5. When talking to the team, focus on your child’s needs and NOT your wants! Take the I out of IEP. Avoid, I want him to work on, I want her to be in this class, I think she needs….  Rephrase everything. He needs to have these supports in order to be successful. She needs to have sensory break before being expected to do table top activities, as it helps her focus.  The goal of special education is to meet the child’s needs, not the needs of us parents.
6. Placement is not the first decision. This is determined after the team has decided what services and supports are needed.  This is hard; as it is often the first thing you want to know!
7. Trust your gut. If a piece of the IEP doesn’t feel right, and you can’t reach an agreement with the school, make sure it is documented that you do not agree.  Remember, just because you disagree doesn’t mean it will be changed.  The whole team has to agree to change it.  But I always say, ask for the moon and hope for the stars!
   
8. Think about your child’s future! Aim HIGH.  Don’t wait until high school to start planning for what your child can do as an adult.  Every skill your child achieves in elementary school will help him or her be an independent adult.
9. Establish a clear and reasonable communication plan with the school and your child’s teacher. Stick to the plan.  You and the school are partners in your child’s development and learning.
10. Remember the IEP is a fluid document and can be amended at any time by requesting another IEP meeting.

After the IEP meeting

Pat yourself on the back for another successful IEP under your belt.

Easter Seals DuPage & Fox Valley Family Services provide information, education and support that address the concerns and stressors which may accompany having a child with special needs.  Our parent liaisons are highly trained parents of children with special needs.  They provide parents and caregivers with support from the unique perspective of someone “who has been there” in both informal one-on-one and group settings. For more resources and information click here.