By: Cindy Baranoski MS, RDN, LDN Manager of Nutritional Therapy
Maybe you heard about this in the news last week, or maybe not. Either way, trying to make sense of what we should be offering our children to drink is always a dilemma. From the moment a baby is born, the question becomes, breast milk or formula. Breast milk being the optimal choice, but that’s not always possible, so formula is available.
Children less than 12 months of age should never be offered a bottle of straight up milk, but after 1 year, it is the go to drink recommended by everyone. Juice is often offered, but it is not the same as eating the fruit or vegetable. And sometimes in infancy, prune juice is given to help with stools, but that’s not a rule. Many children do not like milk, once done with breast milk or formula, and parents begin to offer anything to help ensure their child is hydrated.
Bring in the new options available for children to drink and it can be confusing to know what is best to offer. For example, plant based milks are all the rage now for many reasons, including allergies, family preferences, cultural reasons, and last resorts for a picky eater. They are flavored, unflavored, sweetened, and unsweetened. And the selection continues to grow, including rice, almond, coconut, soy, oat, hemp, split pea, cashew, and blends to name only a few. Though these may seem like a great alternative to cows milk, each one of them can be found fortified, unfortified, with added protein, or original version. Most plant milks are going to be lacking in protein, fat, and potentially key vitamins and minerals found in cow’s milk. Diet modifications can be made to help ensure what is lacking in a plant milk can be found in other sources in the diet. But if cow’s milk cannot is not the choice for whatever reason, plant milks with diet modification can work.
Juices have changed as well, with many companies offering non sugar
sweetened fruit and/or vegetable juices. Some companies offering cold pressed
and fruit/vegetable smoothies with additives, such as greens, protein and
vitamins. Use of sweeteners such as grape juice or artificial sweeteners
replace sugar and high fructose corn syrup. Juice is not the best option for
anyone to be consuming regularly, or in quantity, when the food brings so much
more nutrition to the diet that has yet to be identified or quantified.
And then there is water, but not just tap water, but bottled water, flavored water, sweetened waters, artificially sweetened waters, vitamin boost waters, and sparkling waters. As a general guideline, plain old regular water with nothing added or changed, is the best choice.
To help, the Academy of Nutrition and Dietetics, The American Academy of Pediatric Dentistry, the American Academy of Pediatrics and the American Heart association have made some updated recommendations.
Artificially sweetened beverages
“Low-calorie” or “Zero- calorie” drinks
Toddler and flavored milks
Sugar sweetened beverages
Less than 1 year of age: Do not offer juice
1-3 years of age: 4 ounces a day or less a day
4-5 years of age: 4-6 ounces a day or less a day
1-2 years of age: 16-24 ounces of whole milk a day
2-3 years of age: 16 ounces of skim or low fat milk a day
4-5 years of age: 20 ounces of skim or low fat milk a day
6-12 months of age: 4-8 ounces a day
1-3 years of age: 8-32 ounces a day
4-5 years of age: 12-40 ounces a day
Finally, whenever something is happening out of the ordinary with any child, and there is a struggle or question of fluids, seek the advice of a Registered Dietitian Nutritionist to help guide what would be best. Looking at the child as a whole, their full diet, development, family choices, help with recommendations being made for fluids. This will ensure children receive optimal fluids, contributing to best growth and development.
By: Kelly Nesbitt, MOT, OTR/L, Occupational Therapist
Summer vacation is in full swing, along with all the stress and planning that parents feel as they try to make a great relaxing vacation for their whole family. For parents of children with disabilities, these feelings can be very overwhelming as they have to take into account how to travel efficiently and safely while accommodating their child’s needs.
To make your trips a little easier, I’ve compiled a list of resources about air travel, cruises, and US-based destinations that are perfect for a family with a child with disabilities.
TSA Cares is a national program through the Department of Homeland Security that offers one-on-one assistance navigating the airport and security for people with disabilities. Services include escort by a Passenger Support Specialist who can meet you at a specific point in a chosen airport, help with baggage through security, assist in security checks, and just be another support system navigating a chaotic environment such as an airport.
Open Taxis is a new wheelchair accessible taxi service in Chicago. It is open 24/7, so it is perfect for quick taxi rides to the airport without parking your own accessible vehicle at the airport for the entirety of your trip. You can call to prearrange a trip or call the day of the trip. You can schedule a ride by calling 855-928-1010.
Travelers Aid Chicagois a service in Chicago O’Hare that provides support and protection for “vulnerable at-risk travelers who need guidance, support, or advocacy” as well as crisis intervention for passengers with cognitive or developmental disabilities. Information desks are located in terminals throughout O’Hare.
Travelers Aid Chicago provides the option to schedule an Airport Practice Experience. You can take a “practice run” through O’Hare airport including going through security and the terminals to help children know what to expect on the actual travel day. They even have visuals to provide to families so that the child can have their own visual schedule of their trip to O’Hare.
I would especially recommend this for a child who may have Autism and/or an Anxiety disorder and has not experienced anything like flying before.
Autism on the Sea is an international organization that creates cruise experiences for children and adults with Autism, Down Syndrome, Tourrette Syndrome, Cerebral Palsy and more. These experiences are currently available on well-known cruise lines such as Royal Caribbean, Norwegian Cruises, Carnival Cruises, and Disney Cruises.
With this service, cruise members who are experienced and background checked can accompany you on the cruise and adapt activities in order to fit the special needs of your family. This organization will also collaborate with you in order to contact cruise lines to adapt your vacation to fit the dietary, physical, mental, and emotional needs of your child.
They even provide images of common used “cruise ship words” to be used as part of a child’s Picture Exchange Communication System (PECS) so that you can create a social story to prep your child for their trip.
Disney Cruises offers many special services for passengers with special needs, such as accessible suites, access to medical equipment, sharps containers, and a variety of other accommodations. Disney Cruises also offer American Sign Language (ASL) interpreters for on-board entertainment and shows. Please contact Disney Cruises 60 days before your cruise to arrange accommodations.
As Easterseals DuPage & Fox Valley is based in the western suburbs of Chicago, here are some tips for exploring the Windy City!
The Chicago Children’s Museum Play for All program offers free admission for the first 250 visitors with disabilities the second Saturday every month from 9 a.m. to 10 a.m. to experience exhibits via a private tour. You must pre-register in order to get this special offer. The museum also has sound reducing headphones, pictures for a visual schedule, and lap trays for wheelchairs so that children with disabilities can experience the museum.
Calm Waters at the Shedd Aquarium offers extended hours on selected days especially for children with disabilities. They have specially designed shows with novel sensory experiences, a “quiet room” for sensory breaks, and an app in which there is information about noise levels in different parts of the Aquarium to help you plan your trip.
Click here or call 312-939-2438 for additional information on Calm Waters at the Shedd Aquarium!
Sensory Saturday at the Field Museum:The Field Museum opens early on select Saturdays in which children with disabilities or sensory processing issues can enjoy the field museum without loud crowds as well as access to hands on experiences to learn through tactile play and exploration.
Click here or email to learn more about Sensory Saturdays at the Field Museum!
It really is the happiest place on earth. Disney World offers numerous services and accommodations for children with special needs at each of Disney’s parks.
Access to Break Areas for children who need a break from the sensory overload of Disney. You can ask any cast member to help you locate a break area.
Sensory Guides for each park’s ridesand shows that have strobe lights, scents pumped in, loud noises, have a lot of unpredictability, bumps, go fast, etc. It even lists what type of restraint is used in each ride for safety as well as how long each ride is. This guide can help families of children with special needs decide which attractions would be most enjoyable for their child. If you are planning to go to Disney, it may be helpful to show this list to your Occupational Therapist, as they can help you figure out which rides will best suit your child’s unique sensory system.
Morgan’s Wonderland in San Antonio, Texas is an amusement and waterpark that has 25 “ultra-accessible” attractions. Opened in 2010 by parents of a daughter with physical and cognitive disabilities, Morgan’s Wonderland is the world’s first theme park designed specifically for children with special needs. This unique theme park has a variety of amazing attractions such as the Sensory Village (which is a replica small town for children to engage in imaginative play), wheelchair swings, a large sand box, a musical playground, and more!
Morgan’s Inspiration Island is a waterpark addition to Morgan’s wonderland that provides an opportunity for guests with limited mobility to experience the fun of a waterpark. They have access to waterproof chairs and compressed air operated power wheelchairs so that all children can play in the water without having to worry about ruin their personal power wheelchairs.
There are also hotels that are partnered with the amusement and water park that offer discounts and accommodations to make the entirety of your trip accessible. Morgan’s Inspiration Island was listed as one of TIME Magazines 2018 “World’s Greatest Places.” Best of all? Admission for guests with disabilities is free.
The National Park Service has a list of the most wheelchair accessible hiking trails so that guests with limited mobility don’t have to miss out on the beauty of our national parks. There are wheelchair accessible hiking paths at the Grand Canyon, Sequoia, and Zion National Parks.
Whether you decide to go on a cruise, roadtrip, or fly somewhere this summer, bring up your vacation plans with your child’s therapists for further accessibility tips and sensory strategies that can make your trip more enjoyable for everyone involved. Happy travels!
The topic of tethered oral tissues or tongue/lip tie is evolving and controversial among professionals in the medical field. The controversy often stems from first diagnosis. Is it truly a tethered oral tissue? And second the remediation. Is surgery necessary or is the child able to compensate without intervention?
As a parent, I know it is a difficult decision as you want the best for your children. You want to support your child’s development without unnecessary medical procedures. My suggestion is to work with a professional who has experience in this area who can discuss these considerations and how they impact your child specifically.
When discussing considerations regarding tethered oral tissues (e.g., tongue, lip, and cheek) it is important to include these 4 components:
The conversation on whether to move forward with medical intervention should include symptomology, structures, and function. One child upon visual inspection may look to have a tethered oral tissue without any symptoms. While another child may have a tethered oral tissue that is not as visually apparent, however may have several symptoms impacting activities of daily living.
Below are interdisciplinary symptoms that could potentially be attributed to tethered oral tissues that you may want to consider:
Breastfeeding issues: Nipple pain, difficulty latching, inefficient nursing (e.g., feeding until becomes fatigued rather than full, nursing around the clock, etc.)
Lack of weight gain or growth
Difficulty moving to solid foods or won’t tolerate a variety of foods
Difficulty with cup, straw or bottle drinking
Delayed production of single words or imprecise articulation
Dentition (e.g., gap in front teeth) or malocclusion
Open mouth posture or congestion
Asymmetrical motor skills (e.g., preference for one side at young age) or Torticollis
Issues with sensory regulation, fine motor skills or vision
Coordination or balance issues
Gut Health issues or GERD
are the next steps?
It is important to find a medical professional who has experience in this area. A Pediatrician, ENT, or Dentist can diagnose a tethered oral tissue. Often a Speech-Language Pathologist or Lactation Consultant may be referred, as these professionals work closely with oral motor skills therapeutically.
If a frenectomy (i.e., surgical cut to release the
frenulum) is warranted, seek a medical professional (e.g., ENT or Dentist) who
has experience in the following:
Has knowledge and expertise in releasing
tethered oral tissues
Recommends post-surgical program (i.e., stretches,
therapeutic feedings, etc.)
Procedural experience using both scissor
and laser for best possible outcome.
By: Kelly Nesbitt, MOT, OTR/L, Occupational Therapist
Down Syndrome, or Trisomy 21, is one of the more common genetic disorders in which children are born with 3 (instead of the normal 2) copies of chromosome 21.
There are common physical characteristics of children with Down Syndrome, such as upwardly slanted eyes, short fingers, small facial features, and a flattened nasal bridge. Children with Down Syndrome also may have varying degrees of intellectual disability, may develop heart conditions, and are at risk for visual impairments. Many children with Down’s Syndrome also have low tone (meaning that their muscles have less of a “taut” quality to them, making their joints appear “loose” or “floppy”).
Because of these physical and intellectual challenges that children with Down Syndrome live with, many children with Down Syndrome receive Occupational, Physical, and Speech therapies in order to address these concerns and make them as independent as possible.
That was the very medical analysis of Down Syndrome… but if you are a parent of a child who was recently diagnosed with Down Syndrome, you are not thinking of statistics, factoids, and medical jargon. You would be thinking, “What does this mean for my child?”
While I am not a parent of a child with Down Syndrome, nor do I pretend to be the holder of all the knowledge on Down Syndrome, I’ll try to answer common questions from my perspective as a Pediatric Occupational Therapist and a person who is proud to have friends with the condition.
What services to I need to look into for my child?
Young children with a new diagnosis of Down Syndrome (under 3 years old) can qualify through Early Intervention Services through the state of Illinois. Early Intervention brings trained specialists into the home of eligible children with disabilities or delays and provides high-quality therapeutic intervention.
To start services, a parent schedules an evaluation through a Child and Family Connections provider closest to their home (featured in the link above). After the evaluator determines a child qualifies with a 30 percent delay in development in any area, or are at risk of developmental delays, he/she will set up An Individualized Family Service Plan (IFSP). The IFSP lists child and family strengths, needs, resources, priorities, and concerns. It also identifies services to be provided to your child.
Many Easterseals therapists are trained and credentialed by the State of Illinois Early Intervention System. Parents can request an Easterseals therapist when qualifying for services and speaking with the EI Case Manager.
Team members could include Developmental therapists, Occupational therapists, Physical therapists, Speech therapists, Audiologists, Social Workers, Nursing, Assistive Technology, and nutritionists, just to name a few. These therapists can help your child with global strength, communicating effectively, sensory processing issues, fine and gross motor skills, and getting around in the community.
Once a child “ages out” of Early Intervention at 3 years old, many children with Down Syndrome continue to get services as needed through schools and outpatient based clinics, such as your local Easterseals.
Why would my child with Down Syndrome need Occupational, Physical, and/or Speech therapy?
I have worked with children with Down Syndrome as an Occupational Therapist for a number of reasons and most often to address the following:
sensory processing difficulties
trouble with transitions
participating in family and school routines
access to community activities
navigating their physical environment safely
I will refer children with Down Syndrome to Physical Therapy and Speech Therapy as well. Physical Therapists can help children with Down Syndrome ambulate and have sufficient strength to be able to crawl, squat down, skip, climb stairs, propel their walkers/wheelchairs or walk.
Speech Therapists can help a child with Down Syndrome improve articulation (intelligibility of spoken language), oral motor skills for feeding and speaking, pragmatic language skills, improving receptive language skills, and accessing augmentative forms of communication (picture boards or high-tech communication devices).
Will my child be able to go to school?
Yes! Whether it’s through an Individualized Education Plan (IEP) or a 504 plan, there are federal and state laws set in place that require schools to make education accessible to children with disabilities. These plans set specific goals and help place children in the best environment at school to support their specific needs. Just because your child has Down Syndrome does not mean that they cannot have the same educational opportunities as their peers for K-12.
Can my child go to college?
College can be in the cards for your child. Click here for a list of some Illinois universities/colleges that have programs for adults with disabilities.
Do children with Down Syndrome have friends?
Certainly! Children with Down Syndrome are sweet, funny, kind, and loyal friends. There are organizations that help give kids with Down Syndrome more exposure to similar-aged peers in the context of fun outings and school events.
I am proud supporter of Best Buddies International, whose mission is “to end social, physical, and economic isolation of the 200 million people with intellectual and developmental disabilities.” Best Buddies programs at elementary, middle and high schools pair students with intellectual or developmental disabilities with a similar aged peer and facilitate friendships between them!
My involvement in Best Buddies was one of the most positive experiences of my life and helped inspire me to become an Occupational Therapist. I am still friends with my high school buddies and we regularly keep in contact, even a decade later! Want to learn more? Visit https://www.bestbuddies.org
Do people with Down Syndrome date and get married?
Absolutely! I know people with Down Syndrome who are in long-term, committed relationships. There are even dating apps to help people with disabilities find that special someone. Like all relationships, it’s important for people to set boundaries, expectations, and have mutual love and respect for one another, so why can’t people with Down Syndrome experience dating and marriage?
Can someone with Down Syndrome have a job and live alone?
Yes! There are job-training classes available through local community colleges and different companies that can lead to employment for people with Down Syndrome.
As for a living situation, people with Down Syndrome have a variety of options depending on their independence levels.
living at home with family
living at a partially-independent living facilities
living in “shared living” arrangements in which adults with Down Syndrome can share an apartment with a roommate
How can I show my support for children with Down Syndrome?
In addition to getting involved with the organizations mentioned above, the simplest way to show your support is to wear mismatched socks on World Down Syndrome Day which is March 21, 2019!
The goal of World Down Syndrome day is to raise public awareness and create a single global voice for advocating for the rights, inclusion and well being of people with Down syndrome
While it’s impossible to depict the complexities and life experiences of people with Down Syndrome as someone without the condition, I hope I gave a brief peek into what a child with Down Syndrome’s future could look like. The road ahead may seem daunting once a child receives the initial diagnosis, but parents should take comfort in knowing that there are many resources available to help during every step. The parents I work with have told me of both the amazing successes and the difficult days their child has experienced.
When it comes down to it, a child with Down Syndrome is still a child who wants the same things in life as anyone else: to be loved and accepted. So let’s show our love and acceptance of people with Down Syndrome by wearing mismatched socks on March 21!
I think that actress Lauren Potter puts it best, “Someone once told me that different isn’t bad – different is just different!”
By: Kelly Nesbitt, MOT, OTR/L, Occupational Therapist
These cold wintry months make us want to bundle up and stay indoors. It’s so hard to keep adventurous little ones entertained on a beautiful day where you can go to the park, let alone a day when you’re stuck inside. It can be especially hard for children with sensory processing difficulties to not go outside and get the necessary input their bodies need to stay calm and focused through climbing, jumping, and tactile exploration. But you don’t have to sacrifice a fun day with your toddlers and young children just because it’s freezing out!
When it comes down to it, a child will love any game in which they have special playtime with a parent or caregiver. But if you’re having a little trouble thinking of some ideas to get you started on a fun indoor day, here are a few activities for your toddler that will help them get the sensory input they crave while having a whole lot of fun!
Build a fort
Make a princess castle, bear cave, dragons lair, or just a creative hideout. You can use whatever material is around the house (cardboard boxes, blankets, pillows, comforters, sheets draped over furniture) to make a fort. Help the younger toddlers (1 year olds) assemble the fort and play games like peek-a-boo as they climb in and out of their fort.
Young toddlers can also take child-safe flashlights into their fort as part of their peek-a-boo game or to play hide and seek with parents.
Older toddlers (2-3 year olds) can help you construct the fort as a great way to express their creativity and imagination. Encourage them to play house with their dolls/stuffed animals in their own little home. Or maybe you can join in an imaginative game with them (Be a dragon that is “attacking” the castle that your valiant knight defends with pillows, be a neighbor that brings a snack to your little one’s “home,” or pretend to be the Big Bad Wolf who blows their house down and create a pillow pile for the Little Pigs to dig out of).
Benefits of the Activity: I love having kids build a fort because it gives their body tactile input (input to their skin about the texture and pressure of the pillows and blankets). Also this type of activity helps them build visual perceptual skills needed to stack pillows to get them to stay up and not fall. Finally, children get proprioceptive input (pressure into their joints and muscles as they pick up heavy pillows and push them around). OT’s frequently call this type of input “heavy work.” Proprioceptive input is calming input that helps children who are always “on the go” slow their bodies down and have a better understanding of where their bodies are in space.
Painter’s tape mazes/hopscotch
Use painter’s tape to make shapes on hardwood, tile, or linoleum floor. Older kids can pretend that the circles out of tape are stepping stones in the river that they have to jump between without falling in the water. Kids may even enjoy making a little maze on the floor that they can walk on top of. You can even make squares to make a hopscotch pattern on the floor and practice jumping and balancing on one foot. Finally, make a path on the ground to use as a road for toy cars or animals!
Benefits of the Activity: This activity helps children build gross motor skills through coordinating their body movements to jump in/out of the hopscotch squares and develop visual tracking skills as they have their cars “follow the road” in a tape maze.
Pile pillows in a laundry hamper and place a blanket underneath to make the laundry hamper slippery on hardwood, tile, or linoleum floors. Your child could then climb in and enjoy a fun sleigh or car ride as you pull them around. Make a game out of it by stopping at the “grocery store” and picking up pretend food as you pull them around. Need your child to burn off a little energy? Have them push a basket around and pick up toys or push around a sibling, if they are able to.
Benefits of the Activity: This game gives their body tactile input (as they are squished by textured pillows in the laundry hamper) and some vestibular input (movement input and understanding of where they are in space) as they are pulled around. Once again, this activity provides proprioceptive input if the child pushes the hamper around the house!
Sensory Bin Hunt
Sensory bins can be made out of just about any material and is a fun way to help your child explore different textures. Take any large Tubberware or small to medium sized storage bin and fill with whatever sensory materials you child might like exploring (uncooked bowtie pasta, macaroni, beans, and cereal are a few of my favorite not-too-messy options). Don’t want a huge mess to clean-up? Put a fitted sheet underneath the sensory bin that will catch all the little pieces that might spill out during play. That way you can just bunch up the fitted sheet and throw pieces in it away when your child is done playing. Hide little cars inside the sensory bin and help your child dig through to find it. Pretend to give Barbies a bath in this pretend bathtub, play puppies and dig to hide a bone in the bin, or just allow your kid to play with funnels, tubberware, and serving spoons in the sensory bin.
Benefits of the Activity: This activity is a great way to introduce tactile input to the hands as they feel the different shapes, sizes, and textures of the items in the sensory bin. Want to add an extra challenge that OT’s would love? Have your child close their eyes and search around the bin with their hands to find a hidden treasure. OT’s describe the ability to distinguish between the properties of different items with the skin as tactile discrimination. See if your child can feel the difference between the macaroni you filled the bin with and the pennies you hid for them! If they have their eyes open and are searching the bin for their treasures, this activity helps children develop good visual scanning skills.
Note: Children should be supervised during sensory bin play to prevent choking if children place small pieces in their mouth.
Bath time Painting
Have a fun water day indoors by playing in the tub! Encourage some creativity and early fine motor fun with fingerpaint soap or bathtub crayons that are easily washed away with water. I found fingerpaint soap at the Dollar Store or in the dollar section at Target.
Benefits of the Activity: This activity promotes tactile exploration as children feel the different textures of the fingerpaint, the temperature of the tub, the pressure of the water around their bodies, and the splashes of the water as they play. Bathtub crayons also provide a play-based opportunity to practice developing an age-appropriate grasp and fine motor development.
**Note: Children should be supervised at all times in the bathtub. Check that fingerpaint soaps are non-toxic and safe.
Use premade puppets or make your own puppets with socks. Show your young toddlers how to play with a puppet (make the puppet say “hi” or give your little one kisses). See if they can imitate what you do! Help set up a little “stage” for a puppet show by draping a sheet over 2 chairs and encourage your older toddlers to put on a show for family and friends!
Benefits of the Activity: This activity promotes imitation through play. A child’s ability to imitate actions is a function of motor planning. Motor planning is the ability of the child to have an idea of what to do, plan the steps needed to accomplish this task, and successfully execute this plan. This activity also promotes imaginative play and helps children receive tactile input as they put sock puppets over their hands and move their hands to make the puppet talk.
Food Stamps or Food Necklaces
Make stamps out of fruit and veggies and make some artwork! Help prep vegetables and fruits you have around the house by cutting them in half. Apples, potatoes, bottoms of celery stalks, and broccoli make great stamps. Set up an area where your kids can get messy (maybe roll out wrapping paper on the kitchen table or floor and place paper on top to make clean-up easy). Provide some non-toxic finger paint or maybe shaving cream with food coloring and get stamping! This activity not only helps little ones express their creativity, but it also exposes them to new foods in tactile exploration.
Older toddlers might also enjoy making food necklaces. Use yarn or other types of string and help your child string on Cheerios, Fruit Loops, or macaroni onto their necklace.
Benefits of the Activity: Not only does your child receive tactile input through the different textures of food, but it’s a perfect opportunity for your child to play with foods that they usually don’t eat (if your child hates broccoli, it’s helpful for them to just be exposed to it in a context in which they don’t have to eat it, just play with it!)
An Occupational Therapist will tell you that repeated exposures to non-preferred foods helps children become more comfortable with different foods. Finally, children who string Cheerios/Fruit Loops onto string have the opportunity to practice their fine motor skills as well as visual motor skills (can the child identify where the hole in the cereal is and thread the food onto it?)
Silly Instrument Play
Lay a blanket on the kitchen floor and lay out pots and pans. Have your little one use wooden or metal spoons to play on their instruments. (Adults may need earplugs during this game!) Join in the silliness and be the leader of a parade around the house. Sing songs with your little one and practice marching.
Benefits of the Activity: This game provides your child with proprioceptive input as they bang on pots and pans. Your child also works coordinating movements (can they swing their arms to hit the pot). Older toddlers can work on gradation, which is the ability to grade force of movements (can your child hit the pan softly so a quiet song, then hit the pan really hard to produce a loud sound?)
Obstacle Course Adventure
Make a climbing obstacle course around the house using pillows, blankets, and sofa cushions. Help your child climb a pillow mountain or make a “garbage pile” of pillows in which you can hide a toy that your child can climb around to find.
Benefits of the Activity: Similar to a fort activity, obstacle courses provide a great opportunity for tactile input as they move around the cushions and blankets and proprioceptive input as they push/pull pieces to crawl through the obstacle course. This activity also works on body awareness, the ability of the child to feel where they are in space in order to effectively move their body around obstacles. The more a child is allowed to crash and push equipment around, they develop a better sense of where their body is in space.
Pull out old clothes, hats, shoes, sunglasses, socks, and scarves from way back in your closet and have a dress-up day. Older toddlers may enjoy having a fashion or talent show in your living room.
Benefits of the Activity: Not only do kids get to use this as a way to pretend to be just like their heroes (you), they also get practice dressing skills they will need when they are older. Young toddlers may have difficulty putting on different pieces of clothing (which is pretty age-appropriate), but they can work on pulling off pieces that they are all done with playing, such as pulling off a t-shirt, socks, shoes, and pants/skirt.
Make a tent out of sheets and chairs and drag in a sleeping bag or pillows to make your tent cozy. You can bring in flashlights, story books, toys, and/or some homemade s’mores made in the oven (recipe link below). See if your little one can use their flashlight to find different pictures in the story you read to them.
Benefits of the Activity: Making a small space out of pillows and sheets creates a great opportunity for children to receive tactile input. Some children find small spaces calming because they get “squished” between pillows. Getting “squishes” is a form of deep tactile input, which is very calming for some (think of a big hug or being swaddled). If this sounds like your child, use the tent as a safe retreat in which they can bring their favorite story and get a big hug from a loved one. Finding pictures with a flashlight while reading a story promotes visual scanning. Best of all, reading a story together gives you both the perfect opportunity to bond and spend quality time together.
There are limitless activities you can do inside that can help support sensory play and help children with sensory processing difficulties get the input they need. Feel free to use the ideas above or come up with your own play ideas!
By: Laura Van Zandt, MS, OTR/L and Sarah Peabody, Physical Therapist
Play is an essential piece to optimal child development as it contributes to the cognitive, physical, social, and emotional well-being of children. Walking through the toy aisle can be overwhelming, but it is important to choose a toy that is age-appropriate, promotes healthy development, and encourages positive behavior. View our favorite holiday toy selections below!
Gifts for Infants:
Activity mat – Activity mats are great for promoting tummy time. Some have mirrors attached which helps the infant to lift his or her head up and engage in the mirror. Tummy time should start as early as possible for 3-5 minutes a couple times a day, building up the length and duration as the baby grows. Tummy time is essential to help your baby build the strength needed for rolling over, sitting up, crawling, and walking.
Black and white toys – For young infants (birth – 3 months), toys with high contrast are the most appealing, as their vision has not adapted to seeing colors yet. Around 5-6 months of age, bright and colorful toys are appropriate as infants will likely be able to see the full spectrum of colors.
Mirrors – These are a great resource for visual engagement.
Colorful rattles, O-ball, a textured toy – Toys that children can reach for and grasp are great to promote fine motor development. Toys that appeal to multiple senses are ideal for infants and promote positive sensory development. Infants enjoy exploring the feeling of new textures.
Gifts for Toddlers – The toys listed below help kids learn to understand patterns, problem solve, and develop competence and confidence.
Push toys – Ideal for the early toddler/young walking stage (bonus – with the one linked here, you can put objects into the push toy to weigh it down. Heavy work is great for building core strength!)
Blocks, LEGOS, Magnetic Sets – Open-ended toys like these can be used in a variety of ways. Kids love to take things apart and add to structures at this age, and these toys will extend into the preschool years and beyond. This is also a great way to incorporate problem solving skills and provide opportunities for adult interaction into play.
Hand puppets – These are a great way to encourage interaction and communication in the young child.
Shape Sorters and Simple Puzzles– Shape sorters and early inset puzzles are great for toddlers. Interlocking puzzles of various sizes can be a great interactive toy for learning about all kinds of things. Look for puzzles that have large knobs for younger children or those that struggle with fine motor skills. Puzzles are also great to help children develop their visual perceptual skills and become better problem solvers.
Gifts for Preschool Age Children:
Play sets – Play sets with little people, dolls, animals, etc can expand a child’s language and communication skills and help them make sense of the world by imitating adult behavior and encourages imagination.
Simple dress-up costumes – When kids play dress up, their imaginations really get to blossom. Instead of buying a specific cartoon/movie character dress up costume, buy a generic tutu or princess dress where a child can be multiple different characters all in one outfit.
Games- The nice thing about games is you can play them in a variety of ways. You don’t have to be stuck to the traditional rules. You can even use the games in pretend play. Here are just a few names of popular games used in therapy sessions: Pop the Pirate, Pop The Pig, Sneaky Snacky Squirrel, Scatterpillar, Jenga, Spot It, Hullabaloo, I Can Do That, Connect Four, Thumbs Up, Tricky Fingers, Boggle, Rush Hour, Gravity Maze, Quirkle, Blokus, Go Fish, Chutes and Ladders, and Dragon Dash.
Never forget, a trip to the museum, theater, or special exhibit is a great gift too! Experiences can never be replaced with toys and the trip will stay with a child for a long time. Capture them with your phone or camera and you can pull them out to talk about and connect on a later date.
For more ideas, visit our Amazon wishlist that shares suggestions for multiple age range and child need. Most of the toys listed can be adapted in some way or used by children of all abilities.
If shopping online, remember AmazonSmile is a website operated by Amazon with the same products, prices, and shopping features as Amazon, but the difference is that when you shop on AmazonSmile, the AmazonSmile Foundation will donate 0.5% of the purchase price of eligible products to the charitable organization of your choice. Please choose Easterseals Dupage & Fox Valley to help support our cause.
By: Laura Van Zandt, MS, OTR/L and Sarah Peabody, Physical Therapist
It’s the most wonderful time of the year! Time to decorate your home with seasonal decorations, listen to cheerful holiday music, start baking lots of yummy goodies, spend time with friends and family, and shop for the perfect holiday gifts. This time of year can bring merriment and stress! Especially when considering gift ideas for children.
If you are buying a toy for a child, it’s important to select something that is based on his/her individual need. Every child is unique. Purchasing a toy for a child with special needs involves taking into consideration the child’s unique developmental profile.
Children who lack fine motor skills often have trouble doing things with their hands, like holding a crayon, so they might enjoy toys with large knobs or big levers that will enable them to grasp them more easily. Children with social learning difficulties or sensory processing difficulties might prefer toys that offer movement or heavy work.
Children with physical disabilities might enjoy toys that have buttons and don’t require a lot of fine motor manipulation. They might also enjoy more arts and crafts that allow them to just move their arms without having to worry about holding onto something.
Choosing a toy that is age-appropriate, promotes healthy development, and encourages positive behavior works best. Use these tips below to help guide you for buying gifts for your child, a niece or nephew or other child:
General Tips for Selecting Developmental Toys for Children:
Spanning multiple age ranges
Finding a multipurpose toy that spans multiple age ranges is a great investment. Toys that are meant for several ages and stages of childhood will be kept around and cherished for a long time. For example, this Shape Sorter, can be used in late infancy as you place the shapes in and out of the box with the lid open. As your child grows into the toddler stage and enhances their fine motor skills, he or she will learn how to manipulate the shapes and place them in the appropriate spot. You can then incorporate colors, shapes, etc. all into one piece as they advance even more. Another example is magnetic letters. A child can use these at a young age to learn letters and sounds and as they grow into elementary years use them together to make words.
2. Be cautious of age recommendations
Many toys have a suggested age range based on the safety and developmental appropriateness for a child. These recommendations are based on the developmental abilities of an average child and may serve as a starting point for you when selecting a toy for your child. A toy should be challenging, but not frustrating. Likewise, if a toy is too simplistic and beyond your child’s abilities, he or she will quickly lose interest. Children learn and grow at various paces, and what might be an appropriate toy for one two-year-old child may not be for the next.
3. Promoting Exploration and Imagination
Research has found that toys that do “too much” don’t encourage children to use their imaginations. Stuffed animals that talk and sing only prompt the child to press a specific button which takes charge of the play scheme. Instead, look for a toy like blocks. Blocks can be stacked up to build a tower, knocked down by a dragon, lined up to make a city, the list goes on and on. The more your child has to problem solve and use his or her imagination, the more your child will learn through play.
4. Think, Move, and Interact
This generation loves to be entertained with screens. Instead of getting that Ipad or other video console, look for toys that provide opportunities for cooperative play that encourage the development of social skills and positive behaviors like taking turns. Board games are a great example!
5. Sensory Considerations
Toys that are tactile or visual can often help improve how a child processes the information. Music, varying textures, flashing lights, and colors can all improve the sensory appeal to your child. It is important to know the needs of your child because what is appealing for one child may be overstimulating for the next.
6. Promoting Inclusion
Toys that promote groupwork and peer interaction with other children are great to promote social skills and improve self-esteem and overall quality of life.
7. Think outside the box.
Toys don’t always have to be used in the conventional manner. For example, that food puzzle might be a little hard for your child to sit still and focus to complete, however, maybe your child would be motivated to find the pieces hidden in a tactile bin or exploring the house on a gross motor adventure to find the food. For children with physical disabilities, many battery operated toys can be adapted for switches. Check out this blog for directions and this link for purchasing battery interrupters.
If you child is younger, can you use that ring stacker to look through the circles together at each other. Or maybe the rings fit on different body parts. If your child is older, think about using the toys within movement activities.
8. Will the child make memories with it?
Giving experiences is becoming a new, more popular trend (for multiple reasons!). Taking time to explore local attractions can create long lasting memories and even new post-holiday traditions. Most businesses and even public libraries offer gift certificates to local attractions. This is a great way to really personalize a gift for your child.
Last but not least, make sure the toys are engaging and fun. Do not force a toy upon a child. If they appear not interested in a certain toy, leave it for a few days and re-introduce it at another time. Keeping the toys fun will ultimately make the learning fun for your child.
Visit this blog next week, for more of our specific toy recommendations! You can also search our previous blogs for each year’s toy recommendations like here and here. Happy Holidays! For more information on Easterseals DuPage & Fox Valley visit eastersealsdfvr.org.
Did you know October was National Augmentative and Alternative Communication (AAC) month? AAC is a specialized area of clinical services. Here at Easterseals DuPage & Fox Valley, we are very lucky to have several therapists who specialize in helping individuals find their voice through AAC. We have both Occupational Therapists (OT) and Speech-Language Pathologists (SLPs) involved in a multidisciplinary team evaluation to determine the best strategies and/or communication systems to help a child learn to communicate.
As an OT, I first became interested in AAC when I was working with a little boy with autism who received a high tech speech output device. It was amazing to see how having his new voice provided so many new opportunities for him. It helped with his overall regulation as he now had a system to share his wants, desires, and needs.
AAC looks different from person to person and varies from low tech options, light/mid tech and high tech systems. If you think your child might benefit from AAC, our team evaluative approach may be helpful. Below is more information on what each team member does to best help your child.
Many parents often have questions about whether or not a device will hinder their children’s ability to speak. This is absolutely not the case. Research demonstrates that AAC does not keep children from learning to speak. In fact, users will make gains in language AND speech because AAC helps a child connect with others, produce successful communication, and provides consistent speech models. The child I described above, went on to learn a ton of new words after he got his device! When we begin to use AAC with toddlers, it doesn’t mean we believe they are never going to talk; instead, it often means, we believe they need a way to have a meaningful connection to others through a common language which helps serve as a bridge to spoken language.
Do try and introduce forms of AAC early. Using AAC can be very helpful for a toddler who is beginning to make gestures, eye contact or sounds to communicate messages, but isn’t yet using spoken language. Often these toddlers are frustrated they can’t communicate certain thoughts and messages. Once they start to see and learn the power of communication through signs, pictures, or more formal AAC apps/devices, they begin to feel a little less frustrated.
3. Model, model, model. When using any type of AAC, we can never model enough. This means that everyone in a child’s life should use AAC too! As with all language learning, AAC is learned because those around the child speak the same language. If you think about it, early communication development (between birth – 12 months) is only modeling – caregivers communicating without any expectation while being connected with their baby using a common language. I love it when my clients bring their devices to therapy. If your child is already receiving therapy services, ask the therapist to use your child’s communication system during sessions to connect and engage with your child. When using AAC, continue to use verbal speech to model and help children understand the pictorial representation of language and develop the words.
4. When you schedule an evaluation, you will see both an occupational therapist and a speech therapist trained in AAC. Both therapists are knowledgeable in a variety of access methods such as hand access, switch scanning, and eye gaze technology. The occupational therapist will specifically look at:
the child’s overall posture and strength to allow for upper extremity (or any other extremity) use while accessing the communication system
determine optimal positioning of both the child and the device to ensure the most efficient method of access
the child’s vision, auditory, and sensory processing needs
the child’s visual and/or auditory scanning ability
the child’s visual/auditory tolerance
any adaptations to engage different sensory systems, as well as monitor for sensory overload and/or assist in sensory regulation for device access.
The speech therapist is extremely knowledgeable in the vast array of AAC communication systems and AAC strategies available. They will help determine the communication system and language page best suited to bridge the gap between the child’s receptive and expressive communication skills. The evaluations are done in a play based manner to help the child feel comfortable. And play is how children learn!
Here at Easterseals we offer a team approach for evaluating children for AAC needs. For children that could additionally benefit from AAC, we will see them for co-treats to help expand their language within play based therapy sessions.
When the child’s specific goal is to assist in overall regulation and play to support device access, then a co-treat can be extremely valuable between Occupational Therapy and Speech Therapy. OTs are trained in setting up sensory rich environments to support regulation and drive play. These activities can be very motivating for your child’s communication. There are endless opportunities to model language depending on your child’s unique development.
To learn more about Assistive Technology at Easterseals DuPage & Fox Valley, click here.
Physical therapy plays a crucial role in helping a child who is diagnosed with Down syndrome (DS) reach their highest potential. What that therapy looks like through a child’s life changes as he/she transitions from newborn to teenager. Hypotonia, weakness, cardiac and respiratory issues are some of the challenges a PT will address.
0 – 24 months: The physical therapist (PT) is one of the first healthcare professionals to work with a parent and their child to help build a strong foundation of strength and movement. Depending on the medical complications a child faces, the PT works regularly with the child to build strong muscles so he/she doesn’t develop compensation that can affect their abilities later.
The parents or caregivers will have activities to work on daily to help their child reach gross motor milestones. The child may need special braces for their feet to improve alignment so that muscles can maintain length to function efficiently.
Compression garments such as a SPIO, Benik or an abdominal binder, may be considered to aide postural alignment and respiratory function. Aquatic therapy can be beneficial if a child enjoys the water. This gives him/her an opportunity to be challenged in new and fun ways, while also building strong swimming skills and an enjoyment of water for future exercising.
2 years – 5 years: During the preschool years physical therapy continues to address higher level gross motor skills. It may be appropriate for a child to be involved in group therapy sessions where peers motivate each other, along with providing social and communication opportunities.
5 – 10 years: Throughout these years, a child involved in community-based programs could seek PT consultations. Some children may enjoy a summer PT group to build strength and confidence such as our rock climbing group. Biking can also be a great opportunity for fitness and socializing. There are several “learn to bike” programs in the community and a PT can help a child develop this skill. Many children become involved in swimming and this becomes their life long fitness.
Teenage years: Encourage physical fitness, which is important for any teenager or young adult. Hopefully as the child faces the challenges of being a teenager, they have confidence in their abilities and can continue to be a part of a sport community, like a swim team, running group, or special rec team. The child may need to check in with their PT a bit more to update home programs, as growth may affect their posture. While braces may not be needed anymore, foot inserts may be necessary to support his/her feet in the best possible position.
Most importantly, set high expectations and enjoy all the gifts children bring to families!
Most parents know it is important for children to eat a balanced diet. What exactly does a balanced diet mean? Generally, it means eating a variety of foods and getting enough of each food group. The five food groups are fruits, vegetables, grains, protein foods, and dairy. Although every food group is important, it seems as though protein foods and vegetables receive the most attention. You may be wondering why these two food groups are so important, how much of each is needed, and how to get your child to meet the recommendations. We will cover all this, but let’s start with how much food your child needs.
Protein is a key nutrient for everyone from growing babies to elite athletes. It is necessary to build, maintain, and repair tissue. We need protein to form healthy bones, muscles, cartilage, skin, and nails, as well as to make enzymes, hormones, and other chemicals. Protein foods are also important sources of nutrients such as iron, niacin, vitamin B12, vitamin B6, riboflavin, selenium, choline, phosphorous, zinc, copper, vitamin D, and Vitamin E. These vitamins and minerals offer a myriad of benefits to a growing child.
A common misconception is that protein is only found in animal-based foods, like meat. However, protein can also come from plant-based foods, like beans (example: pinto, black, kidney beans) and soy products (example: tofu, tempeh, edamame). The protein food group includes meat, poultry, seafood, beans, peas, eggs, processed soy products, nuts, and seeds. Dairy foods such as milk, cheese, yogurt, and cottage cheese will also provide your child with protein. Your child’s protein needs vary based on age, sex, and activity level. (Please see Table 1 above for recommended intake amounts.)
A serving from the protein food group, also referred to as an ounce-equivalent, is 1 ounce of meat, poultry, or fish, 1 egg, ¼ cup cooked beans or peas, ¼ cup tofu, 1 ounce of tempeh, 1 falafel patty, 2 tablespoons of hummus, 1 tablespoon of peanut butter, or ½ ounce of nuts or seeds. Please see Table 2 for common protein food portions.
Table 2. Common Portions and Servings of Protein Foods*
Common Portion and Servings
1 small steak = 3.5 to 4 servings
1 small hamburger = 2 to 3 servings
1 small chicken breast half = 3 servings
½ Cornish game hen = 4 servings
1 can of tuna, drained = 3 to 4 servings
1 salmon steak = 4 to 6 servings
A couple examples of convenient and kid-friendly protein foods are hamburger patties (examples: McDonald’s, White Castle [yes, fast food is okay]), fish sticks, chicken nuggets, Boca vegan burgers, and milk (examples: cow’s milk, Ripple milk, hemp milk). If your child prefers to drink rather than eat, try supplementing with a nutritious drink (examples: Kate Farms, Vega, Orgain, PediaSure). If your child does not eat solid foods, you can puree meat, poultry, seafood, and tofu, mash beans and peas, and provide foods like creamy nut butters, hummus, blended soups, and smooth yogurt. If your child relies on formula given through a feeding tube or drinking a supplement for most or all of his/her daily nutrition intake, s/he may be getting enough protein if s/he is consuming enough. Make sure to speak to a registered dietitian if you have any concerns about your child meeting his/her protein needs.
QUICK RECIPE: Black Bean Quesadilla*
¾ cup pico de gallo
1 can (15.5 oz) black beans (great protein source!)
½ cup shredded Colby and Monterey Jack cheese
2 tablespoons chopped cilantro
4 eight-inch flour tortillas
½ teaspoon olive oil
1. Using small-hole strainer, drain liquid from Pico de Gallo; discard liquid. Transfer leftover tomato mixture to medium bowl. Mix in black beans, cheese and cilantro until combined.
2. Divide black bean mixture evenly over half of each tortilla (about ½ cup each). Fold tortillas in half.
3. Heat large griddle or skillet over medium-high heat. Brush with oil. Place filled tortillas on griddle. Cook, carefully flipping once, until tortillas are golden brown and crisp and cheese filling melts, about 5 minutes. Cut quesadillas into wedges. Makes 8 servings.
Optional: For additional protein, add chicken or your favorite meat!
Vegetables are full of nutrients including dietary fiber, potassium, iron, vitamin A, vitamin C, vitamin K, copper, magnesium, vitamin E, vitamin B6, manganese, thiamin, niacin, and choline. These nutrients can help your child build healthy bones, heal cuts and wounds, protect against infection, support heart health, promote healthy aging, and maintain healthy eyes, skin, teeth and gums.
The vegetable food group is made up of vegetables and 100% vegetable juice. Vegetables come in a variety of forms to fit any diet. They can be raw, cooked, fresh, frozen, canned, dried/dehydrated, whole, sliced, mashed, pureed, or juiced. Please see Table 1 above for recommended intake amounts.
A serving, or cup-equivalent, from the vegetable group can be 1 cup of raw or cooked vegetables, 1 cup of vegetable juice, or 2 cups of raw leafy greens. There are some great brands out there that sell kid-friendly, veggie-containing foods. Two examples of brands are Dr. Praeger’s Purely Sensible Foods and Happy Family. Dr. Praeger’s line of foods includes a variety of “Puffs”, “Cakes”, and “Littles” (these are shaped liked stars, dinosaurs, and bears!) that are made with ingredients like broccoli, spinach, kale, and carrots. Happy Family sells everything from bars, to squeeze pouches, to puffs (some of these are also shaped like dinos!). These foods can have veggies like tomato, kale, spinach, and carrots. Their foods are appropriate for all ages, from infants to adults.
You can also try incorporating vegetables into other foods at home. Combine leafy green vegetables, celery, carrots, or beets with fruit to make a juice or smoothie. Store-bought, single serving vegetable juices and smoothies (example: Bolthouse Farms or Naked Juice) are also an option if you are on-the-go. You can also try blending pureed cooked cauliflower in mashed potatoes and mixing pureed cooked sweet potato or carrot into a cheese or pasta sauce. Blending cooked pumpkin, carrot, squash, or sweet potato into a tomato or vegetable soup can also increase your child’s vegetable intake. These ideas are also appropriate for children who do not eat solids.
If your child relies on a tube feeding formula or an oral supplement, s/he may be meeting all vitamin and mineral needs if s/he is consuming enough. If not, your child may benefit from a multivitamin. A registered dietitian can help you plan on the best way to get more nutrients into your child. If you are interested in adding blended vegetables to your child’s tube feeding regimen, a registered dietitian can also help you get started with blenderized tube feedings.
QUICK RECIPE: Pineapple and Spinach Smoothie*
2 cups pineapple
1 cup baby spinach (great way to consume veggies!)
1 cup unsweetened almond milk
1 cup ice
¼ tsp ground cinnamon
Combinepineapple, spinach, banana, almond milk, ice and cinnamon in blender. Cover; blend until smooth. Makes 2 servings.