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
  • Problemsolving: obtaining, processing, and collaborating the information needed to find a solution to a simple or complex issue

Feeding and Swallowing

Photo by AMSW Photography -Alisha Smith Watkins on Pexels.com

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.

Dealing with Sensory Overload

By: Megan Fickert, Therapy Aide

What is Sensory Overload?

Simply put, sensory overload is when one’s senses become overwhelmed to the point that a person is negatively impacted. Sensory overload can affect anyone but is particularly common among those with developmental disabilities like ADHD or autism that cause difficulty with filtering external input that other people might find perfectly tolerable.

Sensory overload can be a physically painful experience. As a small child, if I was outside and someone a block away was mowing their lawn, I would crouch low to the ground and clasp my hands over my ears. I used to run out of the bathroom in elementary school because of the automatic toilets, and to this day, I still have to cover my ears whenever I flush!

To an observer, it will often be obvious what is happening to a person experiencing sensory overload, but other times people may simply appear distracted or disengaged from their surroundings or may lash out in frustration instead.

For many disabled people, sensory overload becomes an everyday challenge. Let’s go over some ways of dealing with it.

Prevention

The ideal scenario is preventing instances of overload from happening in the first place. This means being mindful of your surroundings and planning ahead. Know how certain stimuli affect you or others. Have an escape route in mind and a way to communicate your needs. Avoid situations you know will lead to sensory overload if you can.

But of course, life doesn’t work seamlessly and there will always be unexpected scenarios that bring on overload. Here is how you can help yourself or someone else when it arises.

1. Remove Yourself

If possible, one of the quickest ways to handle overload is to remove oneself entirely. If you begin to feel overwhelmed, excuse yourself or ask someone to help you get out of the area. If you are assisting someone else, keep an eye on their reactions and give them chances to escape their environment if it seems like they have become overloaded.

Some adults and children may not have the self-awareness or communication skills to let others know they have become overloaded, so check in with them often when you are in especially stimulating or busy environments, and remember to take breaks even if sensory overload hasn’t occurred yet.

2. Block Incoming Senses

If leaving is not an option, the next best thing is to block stimuli. Wear earplugs or headphones if sound is an issue. Cover your eyes, look to the floor or even hide under a blanket to block visual input. Plug your nose to keep smells away. Have alternative clothes in case you become irritated by tags, seams or textures.

3. Ask for Help

In some cases it may be possible to ask for help. Admittedly this can be a scary task and isn’t always feasible, but some venues may be able to accommodate your needs if you speak up! Ask for the volume to be lowered or lights to be turned down, ask to be seated away from others. This is often best done as part of prevention, but sometimes it’s necessary to ask for help on the spot, too.

4. Override External Input

When it comes to sensory overload, sometimes the most overwhelming part is experiencing excess stimuli that we have no control over. To counter this, it might help to create your own stimuli to focus on instead. (Be mindful that in public scenarios, this might not be possible if it will be disruptive for others). 

Stimming, or self-stimulatory behavior, is often a natural reaction to sensory overload. If external sound is bothersome, listen to music or make sounds of your own to focus on instead! Draw a picture or focus on a specific object to drown out other visual input. Flap your hands, wiggle your toes, or stomp your feet to express control over how your body feels. Use a weighted blanket to control proprioceptive input.

Basic Sensory Overload Kit

Here is a list of some good items to keep on hand for situations when sensory overload may be expected. Because different things work for different people, make sure to customize your own kit with what works for you based on the situation and circumstances.

  • Ear protection (headphones, earplugs)
  • Eye protection (sunglasses, hats, eye masks)
  • Hand fidgets (tangles, stress balls, marble mazes, etc.)
  • Chewable fidgets (handheld or wearable “chewelry”)
  • Weight/pressure tools (blankets, vests, compression garments)

Sensory Overload Summary

Ultimately, how one deals with sensory overload will greatly depend on the individual and the situation, but these are the basics on how to help yourself or others when faced with it in daily life.

Remember that instances of overload are inevitable, but being proactive and utilizing tools at your disposal can minimize these unpleasant experiences for yourself or someone you care about.

To learn more about sensory processing disorder and how we can help, visit: https://www.easterseals.com/dfv/our-programs/sensory-processing-disorder.html

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.

Common Questions About Bilingualism

By: Joanna Nasiadka, M.S., CCC-SLP

Speech-Language Therapy strengthens children’s communication and feeding skills so they can participate fully in daily activities and achieve success. Easterseals DuPage & Fox Valley therapists have numerous years of experience in typical and atypical speech and language development and offer a fun and engaging environment for children to learn and develop their skills. We also have a number of therapists fluent in several language such as Polish (myself), Korean and Tagalog. There are often questions shared about raising a bilingual child and I wanted to discuss the many benefits and what to look for if you suspect a speech delay below.

Q1: Does bilingualism mean my child is equally proficient in two languages?

Being bilingual does not mean that the child has equal proficiency in both languages. It is common for children to have a dominant language. Children can also have a dominant language for specific contexts. For example, a child might speak English at school and communicate most effectively in English when the context is academics but might prefer to talk in their family’s native language while talking about a sport, religion, or while talking to their family members. The dominance of language fluctuates depending on the amount and nature of exposure. There are two types of bilingualism:

Simultaneous Bilingualism:

This type of bilingualism is the acquisition of 2 languages at the same time, typically before age 3.​ Early language milestones are met in typical time and manner in both languages.​

Sequential Bilingualism:

This type of bilingualism occurs when the second language is introduced AFTER 3 years old.

Photo by Stan Kedziorski-Carr

Q2: Will my child be confused if we use two languages at home?

Many studies on bilingualism have shown that using two languages does not confuse a child, even when they are young and learning two languages simultaneously.

Q3: What if my child has a language delay or disorder?

There is no evidence that using two languages confuses a typically developing child OR a child with a disability. Bilingualism can actually be beneficial for children who have disabilities, and it allows them to be active participants in their daily activities. It also allows them to have full social-emotional growth since it will enable them to communicate with family members and friends who have a shared language and culture.

Q4: Will bilingualism cause my child to have a language delay or academic difficulties? Will he or she be behind other kids?

Bilingualism does not cause language delay or disorders in children. It also does not exacerbate delays or disorders that are already present. If a child presents a disorder in one language, they will have the disorder in the second language as well. If the difficulties only arise in one language, this could be a sign of limited language proficiency.

Bilingual children develop language similarly to their monolingual peers. However, bilingual children may have lower proficiency in one of the languages until they catch up to fluent speakers.

  • Average time to achieve social proficiency (conversations, social interactions): 2-3 years
  • Average time to reach academic proficiency:  5-7 years
Photo by August de Richelieu on Pexels.com

Q5: What are some pros and cons of raising a bilingual speaker?

Q6: What is the best way to support two languages? Should I wait for my child to be proficient in one language before introducing a second one?

Photo by Alex Green on Pexels.com

The best time for a child to learn two languages to be proficient is before 3. Younger children are more likely to develop a natural accent, more likely to become proficient and achieve higher syntax levels in the long run. Therefore, there is no need to wait for your child to learn one language before introducing a new one.

Many families have found success in speaking both languages at home. Other families prefer to speak both languages and spend time reading, writing, or doing activities in each language. A very effective way to help a child learn both languages is to have one caregiver speak one language and a second caregiver speaks the other language. This choice depends on the family dynamic and your preferences.

Q7: My child started to mix the two languages together in the same sentences. Is this normal?

Using both languages or alternating between languages in the same utterance or conversation is very common for bilingual speakers and is called code-switching. Competent bilingual speakers often code-switch for many reasons, including using a word that is not present in the other language, quoting ideas, emphasizing, excluding others from conversation, showing status, or adding authority. Code-switching can happen more in certain cultures and contexts.

Code-switching does require rules to be done appropriately:

  1. Must follow the grammatical structure of both languages
  2. The word order has to make sense
Photo by Julie Hermes

Q8: How will a speech-language pathologist evaluate and treat my bilingual child with a language disorder or delay?

A speech-language therapist can help determine a speech-language disorder from a limited language proficiency by considering the sound and language rules of both languages that your child speaks. Your therapist will administer evidence-based methods of testing that are adjusted for your child’s needs as a bilingual speaker. These tests include speech-language samples, writing samples, play-based observations and assessments, standardized measures (if appropriate and adjusted), and assessments of ability to learn new skills. If your child benefits from services, treatment will focus on improving speech and language skills while supporting both languages.

Take our Free Developmental Screening

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, call us at 630.282.2022.

Understand and Boost Your Immune System

By: Manager of Nutrition Therapy, Cindy Baranoski MS, RDN, LDN

Better Immunity is Achievable

What better time than now to start building your defenses against illnesses? With coronavirus or COVID-19 here, there is a lot of fear and a feeling of helplessness to do anything. But you should know that there are things you can do to help protect yourself and your family’s health overall.

As a human we are bound to become ill, but how that illness manifests in us, how extreme are the symptoms, how long does it last, when does it go away, and can we get it again, can be under a bit of our control if we do the right things to keep our body’s immune system and defenses strong.

What Protects Us From Illness

Many components make up our defense system, some we can control and others we cannot. A human body contains trillions of microorganisms or microbes that outnumber our cells by 10 to 1. The term ‘microbiome’ refers to the genetic material all of these microbes contain, and their total genetic material is 200x more than the number of genes in a human body. Many of these microbes are pathogenic, or able to cause disease, but coexist with a human body never causing disease. Consider that two to six pounds of a 200-pound person would be bacteria!!

The immune system

Our immune system is made up of cells that perform the ‘immune response’ to foreign invaders, such as disease causing bacteria, viruses, fungi, parasites or any other foreign matter. B cells, T cells and Memory cells are all mobilized in some manner when they determine there is an antigen – a toxin or foreign substance – that has entered the body. The response is antibodies matched to an antigen, like a key in a lock, helping to neutralize or destroy the antigen.

Physical protection from foreign invaders

Our body has many physical systems in place to keep us healthy and protect us from foreign microbe invaders, or the ones living within us, from causing disease.

  • Skin – is a physical barrier, with a pH that discourages growth of organisms, and our secretions of sweat and oil can kill many bacteria.
  • Stomach – acid in the stomach can kill organisms.
  • Tears – will wash away any foreign matter and contain enzymes that kill bacteria.
  • Saliva – helps clean microbes from our teeth, tongue and oral area.
  • Respiratory tract – including our nose, which contains fine hairs to trap foreign matter, mucous lining the system to trap invaders, and cilia to sweep away trapped organisms.
  • Large intestines – contains bacteria that help keep invaders in check. This ‘gut microbiome’ makes up 70% of our immune system.
  • Bladder – urine washes away microbes from the area leading to the outside world.

What we Have Limited Control Over

Chronic noninfectious conditions, such as cancer, diabetes, hypertension, high cholesterol, heart disease, inherited genetic conditions all play a role in diminishing the defense system of the human body. Those that are most notable include the following –

Heredity – is one of the greatest factors that influence our noninfectious disease risk. Our genes play an important role in what conditions, such as diabetes, cancer, hypertension, may occur in our lives. These conditions impact our immune system, and can leave us more susceptible to disease.

Age – after 40 years of age the human body is more vulnerable to chronic diseases, though very young children whose immune systems are still developing, or those over 65, are especially vulnerable.

Environment – and the ability to have clean, sanitary living conditions is key to keeping us healthy. Though our bodies need to be exposed to microorganism to help our immune systems develop resistance. Too clean doesn’t allow our systems to recognize good and bad microbes. Additionally, conditions that include the presence of drugs, chemicals, pollutants, waste in food and water, or the absence of medical care, increase risk for disease.

Microorganisms – severity of or resistance to pose challenges as well. For some, only one cell is needed to create drastic illness in the human body. Bacteria that become resistant to antibiotics from overuse by us have mutated to be able to bypass the antibiotic’s effectiveness.

What We Have Control Over

Though we cannot see most of the microbes that cause sickness, they are there, and we can create an environment within and outside of our body that prevents them from causing illness. Stress, personal hygiene, nutrition, fitness, sleep, substance use, environment, and behaviors are all under our control.

Stress, such as what we are experiencing right now diminishes our ability to fight disease. When we are stressed our body will divert its energy away from nonessential functions to those that are essential – the Fight, Flight or Freeze response. Our blood is redirected to muscles to run or fight, breathing is faster, heart rate increases, pupils dilate, and hearing is keener, ready to take on the Sabre Tooth Tiger that generally doesn’t exist. What our body prepares to fight remains invisible, but it is prepared at all times. This leaves body functions required to exist in an unstressed state diminished in their ability.

Reducing Stress

If you’ve not already received numerous emails or suggestions from friends, there are many ways to manage your stress. Any one of these should be done with care, intent, and in such a gradual manner a snail could pass you by. Safety is key, to not create an injury or situation that will cause you more stress.

Exercise is one way, and has more than just stress reduction benefits. A workout club or gym may not be available to you, but you have so much in your home that is available!

Walk out your door for 15 minutes, turn around and come home. You’ve just walked for 30 minutes.

Turn on some fun music and simply march or walk in place for 20 minutes.

If you live in a condo or apartment building, do the stairs (taking precautions with social distancing and face masks right now.)

If you don’t have weights, you can use cans, bottles, something of weight that you can use for dumbbells.

Floor exercises that are easy, safe and you do not over do such as sit ups, leg raises, push ups. You only need to do a few, or even just one.

Yoga can be done on your own, without one piece of equipment. There are recorded and live streams of yoga all over the Internet today. As a yoga instructor, I can share that anyone can do it! Yoga is not just for bendy, flexible, skinny-legged sweaty 25-year-olds.

Chair yoga is amazingly beneficial, and is done by 85-year-olds around the globe.

Restorative yoga is one of the most relaxing forms of yoga, where you are supported by props, which increases your parasympathetic nervous system, slowing your heart and relaxing your body.

The yoga many are familiar with regular upright movement, is a wonderful stress reliever-though remembering if you’ve never done yoga, it may contribute to more stress.

And if nothing else, just laying on the floor, on your back, legs and arms out on the floor (or knees bent), known as savasna, is one of the most important poses in yoga. Lay there for 10 minutes.

Meditation may sound all “woo woo,” but it is more than just crossing your legs into a pretzel, closing your eyes and chanting ‘ommmm’. Meditation is simply anything you do to direct your mind to become focused on one thing, taking you away from this world momentarily. It reduces the physical reactions to stress mentioned above, slows your breathing, quiets your organs, increases your parasympathetic nervous system, and quiets your racing mind. The benefits of meditation are not IN the meditation, but in your body’s response when not meditating. By helping to maintain the ‘quiet’ your body should be in, your immune system can work it’s best.

Reading a book, gardening in the yard, coloring, drawing or painting, and praying are all forms of meditation.

Traditional meditation takes practice, and yes, sitting quietly, not moving, eyes closed, is what many think of. Try sitting still for 1 minute with your eyes closed. You’ve just started meditating. Now, get comfortable in a supportive seated position, and try it for 5 minutes. This is how you start to meditate with intention to do so, knowing it can only help.

Numerous meditation apps exist now, with timers, streamed and recorded meditations from 1 minute to many. Examples include:

Laughter should not be discounted by any means. Laughter is the best medicine! It can decrease stress hormones, relax muscles, and decrease pain. Ten minutes of laughter is better than any drug!

Sleep is a time when our body heals, rests, and prepares for our next day. Restful sleep is often not possible when we are stressed. 7-8 hours a day for an adult, and more for children and teens. There are many activities that can impact restful sleep, including technology, alcohol, eating before bed, and stress. Helping reduce your stress will promote restful and restorative sleep. Aim to create a bedtime routine for you and your family with no technology, eating, bright lights, noise – good sleep equals less stress, and less stress equals good sleep.

Personal Hygiene is something we take for granted. We have soap, water, tooth brushes and toothpaste, showers, baths, shampoos, hand sanitizers and hand soaps. Just so many forms of how we can keep ourselves clean on a daily basis. We forget this is not available to everyone in our area or the world. But keeping ourselves clean is something we can do, easily, by washing our hands routinely – especially now.

Improving Personal Hygiene

The greatest source of infection is our hands. We touch everything, then ourselves, transmitting to someone or us, germs and potential antigens. Wash your hands – for 20 seconds – with soap and water, between the fingers, back side of the hands, under the nails and wrists.

When you cough or sneeze, cover up! Most of the time we have on shirts, right? Pull it over your nose and mouth, use your elbow and sleeve, and if you use your hands, wash them after.

And now we have face masks. So treat your face mask like you do your underwear

only wear it if it’s clean

don’t touch it or adjust it – especially in public

don’t lend it to anyone

don’t borrow anyone’s

make sure it fits well

wash it after wearing

if it’s stained or torn, throw it away I

From A Chalkboard a Day

Nutrition is one of the key contributors to the immune system. Remember, we are built on what we consume and do with our bodies. The ingredients for a great body include what we consume, and if all we eat and drink is lacking in nutrients, then that is who we become. Under nutrition or malnutrition is not reserved exclusively for poor families and children who are skinny and wasting away. Malnutrition is found in obese individuals as well as healthy weight ones too. http://www.MyPlate.gov shared by the USDA gives a basic outline of what should be consumed for variety of all the nutrients, including Carbohydrate, Protein, Fat, Calories, Fluid and 29 known vitamins and minerals. We are what we eat! To learn more about helping a child with nutrition or feeding issues, visit: https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/nutritional-therapy.html.

Improving Nutrition 

  • A balanced diet containing of all the different food groups is the starting place. Review your family’s diet, and see if you have foods representing Fruits, Vegetables, Protein, Dairy (animal or plant), Grains (whole) as well as fat. Is there enough fluid each day? Are there vitamin/mineral supplements taken already. Are there nutritional drinks being consumed each day, and what might these be replacing or supplementing if they are used regularly. What about processed foods, high sugar, fat and salty foods that are being consumed more than they should be. Are fresh foods represented well? And is one food group consumed in a much greater quantity than it should be? You need to review your diet before you know what to change to make it better.
  • Protein is one of the most important nutrients, helping make antibodies of the immune system. We all need varying amounts of protein, but we also don’t need as much as we think we need. An average adult needs about 50 grams of protein a day, and consumes about 100 grams a day in the US. Children need less than this, yet often consume more than they need as well. Main food sources include meat, fish, poultry, egg, legumes, dairy.
  • Malnutrition and under nutrition exists in this country, and includes lack of calories and protein, but often times our society consumes more than enough of these two nutrients, however, lack many vitamins and minerals. A recent government study shows potassium, calcium, Vitamin E, C, A, D and magnesium are all less than optimal in our diets. All vitamins and minerals are ingredients of our immune system.
  • A few nutrients identified in research as key to the immune system and it’s response, that you should be sure you are receiving adequate amounts of, include the following –
    •  Zinc – found in tuna, beef, poultry, pumpkin and hemp seeds and dairy. Caution, over consumption of zinc, or taking large supplements, can interfere with copper balance in the body.
    • Selenium – found in Brazil nuts, tuna, sardines, salmon, chicken egg, brown rice.
    • Vitamin C – found in acerola extract, rose hips, camu camu, black currents, guava, lemons, limes, oranges, strawberries. Though higher doses can cause loose stools.
    • Vitamin D – does not have many great food sources. Fortified animal and plant milks will contribute when consumed in the right portions. Short periods of exposure to the sun without sunblock allows for production of Vitamin D beginning in the skin. However, with the concerns for skin cancer, sun exposure is limited. Supplementation of Vitamin D3 is the most reliable source.
  • Probiotics are beneficial for the human body. Studies have shown their benefit to the digestive tract, and ultimately the immune system, by ensuring the line of defense in the gut microbiome is balanced and working well. They are found naturally in some foods, and more common are manufactured supplements taken orally. ‘Prebiotics’ are food for the probiotics and are found naturally in our gut through consumption of fiber, but can also be found along with probiotic supplements.
    Important Note on Vitamins, Minerals and Probiotics – Taking large amounts of any supplements, or consumption in large amounts of any individual or multivitamin/mineral supplement is not advised. If you are choosing to do this for you or your child, you are directed here to speak to a physician or dietitian.

Environment and Behaviors could be discussed in so much more detail than this post can provide. But know your behaviors are under your control. What you do impacts anyone and everyone, including our world. The environment is not just something that happens, but is changed by everything we do. Being thoughtful of ourselves is so important, but if we become so self absorbed and focused in the long run, our world will become more skewed from what it should be, which ultimately comes back to our ability to be healthy in this world.

In summary
Creating a place in your world that is safe, clean, nutritive, and supportive of your immune system is totally within your reach, taking time and attention. The scary world of viruses and diseases that are out of your control can be managed, and the impact it has on health – yours, your family’s, friends, and society – is pretty significant. There is so much more, but I hope some of the thoughts and ideas mentioned here might stir you to rethinking your role in this world of immunity.

I wish you and your family the best health. For more information on our nutrition services, please visit: https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/nutritional-therapy.html.

Staying Sane while Staying Home

By: Kelly Nesbitt, MOT, OTR/L, Occupational Therapist

Response to Coronavirus (COVID-19) 

Kids are finishing up the school year, you are still going to work/working remotely, running your home, and keeping your kids entertained during their summer! All this change can be very disorienting and stressful for everyone.  I wanted to put together a list of some suggestions that are “occupational therapist-approved” to help you navigate staying sane, keeping a good routine, carving out “family time”, and receiving therapy services remotely while being stuck inside the house! 

Routines

Probably the largest disruption to all of us at this time is that all of our daily routines are completely changed! Daily routines help provide structure to our lives, whether you are a child or an adult. Research by Ruth Segal, OTD and Assistant Professor in the Department of Occupational Therapy at New York University, reports that daily routines give families as sense of identity, organization, and provide socialization opportunities (Segal, 2004). Our kids are used to having a predictable day involving school, extra curriculars, play dates, and therapy appointments which help them organize their days and have meaningful interactions with family and friends. With this change to e-learning and staying home, it’s completely understandable that kids may feel stressed, anxious, and aimless without their routines. This stress may be more exacerbated for children with Autism Spectrum Disorder (ASD). Children with ASD can be heavily reliant upon predictability and routine, which have been thrown off because of the Coronavirus. For both neurotypical and children with ASD alike, using visual schedules, timers, and social stories may be good techniques to help your child cope with a new routine. 

Visual Schedules

Visual schedules can be as complex or simple as you need; they can be simple drawings on a piece of paper, an excel spreadsheet, or printed words/pictures from an online generator. For some of my clients, they are comforted and reassured when I draw 3 pictures of activities we are going to do in OT.

Honestly, whatever works for your kid and helps them feel organized is correct.  Whatever way you decide to create a visual schedule, it’s important to build in both structured and unstructured time for your children. They should have time built in for their academic work for school as well as a few hours for play time that is completely unstructured. Some kids may want to put a sticker next to an activity they completed, erase it on the whiteboard, cross it out, or just put a checkmark next to it. The sky’s the limit! Below are some examples of visual schedules and who it may be appropriate for:  

(Written schedule with times, appropriate for older elementary children who can tell time) 

(visual picture or words, as they are able to read. You can draw your own pictures or just print some off for younger children who cannot read.)  

More resources at: Free Templates for Daily Visual Schedules 

Timers

In conjunction with visual schedules, it can be helpful to utilize timers (sandtimers, timer on the microwave, on your iPhone, etc.) to help your children keep organized. The timer you use will have to be dependent upon your own child’s level of development as well as what they personally need to feel supported. Apps you can use: 

  1. Children’s Countdown App: Great, free time app on smart phones that shows a picture countdown on the screen. The coundtown clock can be set for any amount of time and children do not need to understand how to tell time or have understanding of numbers to comprehend it.
  2. Timed It! App: App for older children in which you can put in personalized tasks in minute increments and the app will help the child count down until they need to move on to the next task.
  3. Timer on smart phone: just about all smart phones have a “clock” application in which there are capabilities for setting a timer. This would be good for older children who have a better sense of what an hour, minute, second is. Although, some younger children will understand the concept that they are only “all done” when the timer makes a sound.

Social Stories

For some children with ASD, social stories are a good way to help explain why their routine has changed or what the “story” of their day. Social stories are third person stories in which the child is the main character and different themes can be explored. Ask an Occupational or Speech therapists for help creating a social story, if needed. 

Here’s a link to example social stories and one of the final links on this page has a social story template: https://www.andnextcomesl.com/2018/07/free-social-stories-about-transitions.html.  

Reducing Stress Activities

 In this uncertain time, it’s important to have some outlets for both you and your children to decompress and still have fun together. Building in sensory activities into your daily routine will help your child remain calm and regulated throughout the day.  

Physical Activities and Heavy Work

Taking movement breaks throughout your day will help both you and your child stay sane while you are cooped up at the house.  Occupational therapists often discuss the benefits of heavy work and how this push, pull, or carry input (or proprioceptive input) to the muscles and joints has a regulating and calming affect. There are a multitude of heavy work activities you can do indoors. Such as:

  1. Build a pillow fort with blankets, pillows & stuffed animals
  2. Pull siblings on the hardwood floor while they are sitting or laying on a blanket
  3. Do animal walk races across the room (bear walk, frog hop, crab walk, etc. Make up your own silly walk!)
  4. Jumping Jacks or jump on a trampoline
  5. Pull siblings in the wagon around the block
  6. Have a wall push-up competition and find out who is the strongest in your house
  7. Play towel tug-of-war
  8. Plant flowers in the backyard or help with yard work (using little shovel, pull weeds, dig in the dirt)

My helpful tip to parents is, if the activity includes pushing, pulling, or carrying something; that’s heavy work! Get creative and come up with your own ideas!

Family Game Night/Nightly Mealtime Tradition

Keeping special family routines will be important to make sure kids feel safe and supported when everyone is kind of stressed. Set aside time in your routine where you can all sit down and have a meal together with the television off. A family tradition at my house growing up was to play “Pot Boils Over” where one member of the family starts a silly story and after a few sentences says “pot boils over” and “passes” the story-telling to another family member to add on as they please. It’s a simple game that gets all family members involved, laughing, and thinking creatively.

Another mealtime routine I have heard of, is going around and saying one thing each family member is thankful for, what the best part of their day was, share a good joke, etc. This is also a great time for families to all sit down together and have game nights. You are going to be all home together, why not build some special memories and encourage social learning. Here are a few favorite games that can be played with multiple people, for different ages:

  1. Games for younger children: Shoots and Ladders, Simon Says, Twister (help them with right and left), Follow the Leader, Go fish, Memory (match pictures by turning over cards), Jenga, Kerplunk
  2. Games for Older children: Twister, Uno (each color you play can correspond to a fun activity such as “Make up your Own Dance Move” or “Do 2 Pushups”), Clue, Scrabble and Scrabble Junior, Telestrations (like telephone, but with drawing pictures), Apples to Apples, do a 200+ piece puzzle as a family, Guess Who?

Here’s another resource with more games: Our Favorite Board Games for Kids

Unplug

I am personally feeling inundated by COVID-19 news and I can get overwhelmed quickly, so I can imagine you and your children are feeling the same. I think it’s healthy to be aware of the evolving situation and current precautions, however it’s beneficial to “unplug” every once and a while when you are at home with your kids. Your children are very perceptive and can pick up on your stress and anxiety as they read your non-verbal cues and affect. Young children especially need their parents to “co regulate,” meaning they read your affect, mood, facial expressions and adjust their own regulation accordingly. If you exude a calm, cool, collected attitude when they are anxious, this will help them calm down and feel secure.

Therefore it’s important to turn off the news at some point and focus on having quality and uninterrupted play time with your kids. Do finger painting, make a fort out of blankets, play board games, read stories by flashlight, sit together and do a puzzle or color! Even just being available to your children, not distracted by technology or work, can be extremely beneficial to your kids.

As May is Mental Health Awareness Month, the CDC also recommends to take time to pause and breath during stress. Notice How you Feel. Take Breaks. Make time to sleep and exercise. Reach out and stay connected. Seek help if you are feeling overwhelmed or feeling unsafe. If you or your child needs help, our social work team can help.

Tele-Therapy Services

COVID-19 does not have to stop your child’s progress toward their goals! Your child can still receive therapy services remotely via tele-therapy.  Tele-therapy is a unique service delivery method in which your friendly Easterseals therapist will arrange a time and will send you a link via the Microsoft Teams app. From there, you just click on the link at your pre-arranged appointment time and you can have a video call with your therapist. Your therapist can then work on therapy goals with your child with you, the parent, being the therapist’s “hands” in the session. An occupational therapist will help coach you through appropriate handling techniques, sensory strategies, exercises, fine motor activities, feeding session and more remotely!  

All our therapists adopted this technology so your child will continually receive services with minimal interruption. It is our hope to keep providing exceptional therapy services to all of our clients during this difficult time. If you have any questions or concerns regarding tele-therapy, please reach out to one of your therapists or contact us at 630.620.4433.

Also stay tuned to our blog for more resources and tips from our therapists on helping families cope with increased time at home during COVID especially during the summer.

Sources:

Easy Indoor Activities for Energetic Kids

By: Laura Donatello, PT, DPT

Update: With a stay-at-home order for all of Illinois in effect, I know parents and caregivers could use some ideas for energetic children more than ever. I updated my previous blog with some new ideas.

I know it is hard to balance the need for work and for child care at the same time, so just know you are doing your best!

Push-Pull Activities

This total body strengthening activity targets shoulder stability as a child pushes an object at or below shoulder height with straight arms, core to change direction, and lower extremities to power forward.

Push/Pull Activity Ideas:

child and laundry
Image from 3.bp.blogspot.com
  1. Hide some of your child’s favorite toys in a large open room. Have your child push a laundry basket around the room, and fill up the cart with toys. You can place toys at various heights, encouraging your child to stand on their toes, climb a couch cushion, or squat down to retrieve a toy. Pay attention to the type of flooring in the room. When using a plastic laundry basket, carpet will generally be more challenging to push against, and hardwood/tile will be easier.
  2. Have a race to see how fast he/she can push the basket to the end of the hall to retrieve a toy, and back. Races can be against siblings or parents, or be in the form of a relay race.
  3. Tie a string to the basket to make this a pulling activity.

Obstacle Course

The possibilities are endless with obstacle courses. You can encourage your child to help create, set up, and clean up the course. Maybe incorporate your child’s favorite play scheme; he/she has to navigate the course to place a puzzle piece in the puzzle, feed their favorite doll, or animal. You can add multiple activities together, or just focus on a few. There are many gross motor skills that can be incorporated such as walking, jumping, balancing on one foot, and hopping.

Obstacle Course Ideas

  1. olympics.jpgLay out couch cushions on the floor for your child to step on, jump over, or climb through. Maybe even jump from cushion to cushion.
  2. Navigate a hopscotch course made out of tape on the floor. This can be modified into many different patterns such as a few boxes in a row, column, diagonal, or in a traditional hopscotch pattern. Your child can walk, jump, or hop from square to square.
  3. Crawl or squat under a string tied across two chairs.
  4. Walk on a bubble wrap road, walk across a taped line, or both!
  5. Crumple up old newspapers and grab a laundry basket to play newspaper basketball. For a balance challenge, have your child stand on a cushion or one leg to make a basket.
  6. Cut a pool noodle into 26 pieces, put a letter of the alphabet on each piece and grab some string. Kids can practice putting words together, squat to pick up a piece, and go up on their toes to thread the noodle through the string.

Color Under the Table

Color Under the Table

Tape a piece of paper or coloring book to the underside of a kid’s table. Your child can color up from laying on the floor to work on strengthening their shoulder and trunk muscles!

Exercise Dice

Create a six-sided dice out of cardboard and tape. On each side draw or print out a picture of a different activity such as clapping, jumping jacks, running in place, jumping, heel raises, and dancing. You can also create another dice with numbers on each side to determine how many times or seconds to complete an activity for.

04_Bodhi2.jpg
Photo by Patti Mendoza

Online Resources

  1. Cosmic Kids Yoga is a website, app, and free YouTube channel where a narrator demonstrates popular yoga poses in the form of stories. Kids can follow along with the instructor on the screen as they narrate their favorite stories or movies in the form of yoga poses. You can access a free 2 week trial if you download the app, or type in “Cosmic Kids Yoga” into the YouTube search bar to access free videos!
  • Go Noodle is another great free online resource to get kids moving! The website is full of videos including dance parties, yoga sessions, and games. The resources span a variety of ages, abilities, interests, and can be interactive to include siblings.  Access Go Noodle for Families website through the link.

10 Popular Toys on Amazon Under $20

Here are some of my favorite entertaining, therapeutic toys used with a variety of ages.

  1. Beads are a great multi use toy you can take practically anywhere with your imagination.
  2. Bubbles are another perfect activity to incorporate into obstacle courses, pop in a variety of positions such as sitting or standing, or work on blowing them to control your breath. “Fubbles” are a personal favorite because they don’t spill.
  3. Paint in a Bag is a great sensory activity. Grab your favorite paint colors and squeeze them into a zip lock bag. Tape the bag to a table or the floor and watch your child be entertained with pushing the colors around.
  4. Spinning Toy is a fun way to work on gross motor and fine motor to spin the gears around the pipe.
  5. Pop Tubes are a fun, noise making, resistance toy your child can practice pulling in a variety of positions.
  6. Zoom Ball is a partner game to propel the ball along the string by moving your arms. It’s a great shoulder exercise even adults can feel the burn from!
  7. Squigz are little suckers that stick to a variety of surfaces. They’re great for sticking on mirrors and pulling off against resistance. The company Fat Brain Toys also makes Whirly Squigz that spin.
  8. Get ready to make cookies with the Melissa and Doug Slice and Bake Cookie Set. This pretend play set is the perfect toy for obstacle courses. The cookies come on a Velcro tray making this toy the perfect resistance activity. The frosting also Velcros to the cookie. Hide the cookies in an obstacle course or navigate over couch cushions to put the cookie on the tray.
  9. Top Bright Bird Feeding Game is a great fine motor activity. Play this game laying down on your side to use different muscles to feed the bird!
  10. Spike the Fine Motor Hedgehog is another great fine motor toy to pull his spikes out and push them back in.

Whatever activity you choose, be sure to have fun with it!

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

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