Tag Archives: family

Protein and Vegetables: What’s the Big Deal?

By: Nutrition Graduate Student, Cristal Medina and Pediatric Nutrition Therapist Cindy Baranoski MS, RDN, LDN

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.

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Protein

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.

leafy greensA 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*

Protein Food Common Portion and Servings  
Meats 1 small steak = 3.5 to 4 servings
1 small hamburger = 2 to 3 servings
Poultry 1 small chicken breast half = 3 servings
½ Cornish game hen = 4 servings
Seafood 1 can of tuna, drained = 3 to 4 servings
1 salmon steak = 4 to 6 servings
Eggs 3 egg whites = 2 servings
3 egg yolks = 1 ounce-equivalent
Nuts and Seeds 1 ounce of nuts or seeds = 2 servings
2 tablespoons peanut butter = 2 servings
Beans and Peas ½ cup cooked beans (example: pinto, black, or kidney) or peas = 2 servings

1 cup split pea soup = 2 servings
1 cup lentil soup = 2 servings
1 cup bean soup = 2 servings
1 soy or bean burger patty = 2 servings

2 tablespoons of hummus = 1 serving

*Adapted from https://www.choosemyplate.gov/protein-foods

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*

INGREDIENTS

  •  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

DIRECTIONS

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!

*Adapted from: https://choosemyplate-prod.azureedge.net/sites/default/files/misc/GOYAcookbook-EN-HealthyTastyAffordableLatinCooking.pdf

Vegetables

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.

spinach
Dr. Praeger’s Food

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*

INGREDIENTS

  •  2 cups pineapple
  • 1 cup baby spinach (great way to consume veggies!)
  • 1 banana
  • 1 cup unsweetened almond milk
  • 1 cup ice
  • ¼ tsp ground cinnamon

DIRECTIONS

  1. Combine pineapple, spinach, banana, almond milk, ice and cinnamon in blender. Cover; blend until smooth. Makes 2 servings.

*Adapted from: http://www.dole.com/recipes/p/Pineapple-Pit-Stop-Smoothie

To learn more about nutrition therapy through Easter Seals DuPage & Fox Valley, please visit eastersealsdfvr.org/nutrition.

 

References:

  1. https://health.gov/dietaryguidelines/2015/guidelines/
  2. https://www.choosemyplate.gov
  3. http://www.dole.com/en/recipes
  4. https://drpraegers.com/
  5. https://happyfamilybrands.com/

 

 

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How Speech-Language and Occupational Therapies Work Together

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

Ryan - webYoung children go through many developmental stages before they begin talking. One of the first stages of development is shared attention. In a baby, shared attention looks like the baby turning her head toward mom when she hears mom’s voice or a baby looking into dad’s eyes when dad talks to the baby. As children get a little older, shared attention looks like mom holding up a toy, the child looking at the toy, then looking back at mom and smiling. The next step in developing shared attention is dad looking at or pointing to a toy, the child looks where dad looks or points, then he looks back to dad. These steps towards developing shared attention typically happen within the first 12 months of a child’s life.

When a young child reaches a stage of shared attention where they can follow a caregiver’s point and they can shift their gaze between the caregiver and the object, they start to develop back-and-forth communication. At first, this looks like a child reaching for an object to tell the caregiver “I want that.”

As back-and-forth communication with gestures continues to develop, the child starts to vocalize. In the beginning, these vocalizations are mostly babbling. As parents talk back when the child babbles, these vocalizations turn into jargon where a child sounds like they are speaking in sentences but not actually saying words. Some parents comment that it sounds like the child is speaking in another language. Over time, the child’s vocalizations are shaped into short, simple words, such as mama, dada, and baba for bottle. Children with speech delays often demonstrate limited shared attention. Working to develop strong shared attention will help a child learning to communicate.

One challenge for some children with speech delays is that they need to maintain a calm, regulated state so that they are available for interactions and can share attention with another person. Read more about self-regulation from OT Maureen here.

15_JJAzariahIf a child is focused on seeking sensory input, they may not have the ability to focus on social interactions, developing shared attention and speech with caregivers. Occupational therapy can help figure out activities and ways we can include these activities in everyday life so that a child can remain in a calm, regulated state so that she is available for social interactions. This may look like a child with limited eye contact running away and looking back to see if you are chasing him or a child who is quiet asking for “more” when you stop pushing the swing.

When a child stays regulated for longer periods of time, she will be available for interactions so that she can continue to develop strong shared attention, and move on to using gestures and speech to communicate. By working together, speech-language therapists and occupational therapists can help a family find activities, such as climbing, playing chase, swinging, and swimming  or others that help a child with speech delays stay regulated and available to develop shared attention and communication skills.

To learn more about speech-language and multi-discipline therapy at Easterseals DuPage & Fox Valley visit: http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/speech-language-therapy.html. 

Back to School Organization

By: Laura Van Zandt, MS, OTR/L

With many of our children returning back to school, I thought this would be a good time to review some strategies to help with school organization. Kids need organization skills in order to function during their school day as well as to get their homework done efficiently at home. If your child struggles with a messy desk, overstuffed backpack, keeping homework and classroom assignments organized, or lost and missing parent/teacher communication slips then hopefully you can find some tips and tricks in this blog. Remember every child is different and what works well for you or another child may not necessarily work well for your own child.backpack

  • Most importantly develop routines and stick to them as closely as possible. Some children might benefit from additional support to help learn the routine such as checklists, picture schedules, and/or social stories. Younger children might also benefit from turning the routine into a fun song.
  • Create backpack organization systems. Look for backpacks that offer multiple compartments to denote separate spaces. A backpack with at least two compartments is highly recommended. Use a zippered pouch (clear is the best) for pencils, erasers, calculators, etc. in the backpack.
    1. Please check out my previous post on backpack safety.
  • Place a laminated checklist clipped to your child’s backpack zipper that lists what needs to be brought home each day. This one from Understood.org is great. 
  • Go through the backpack on a regular basis with your child until he/she gets the hang of keeping it organized. Gradually give your child more responsibility and continue to check in even when you have turned in all the responsibility to your child.
  • Create a simple schoolwork folder system. A simple 2 pocket folder often works best. Use a bright sticker to place on one side for “KEEP AT HOME” and another bright sticker for the opposite pocket for “BRING BACK”. If your children are older, you can create a color coded system that corresponds to each class. Books and notebooks can use prefabricated book covers or you can use colored paper to create book covers in a variety of colors.
folder
Picture from caffeinatedconclusions.blogspot
  • Depending on the age of your child you might start to create a really good binder system. The best ones have a locking rig. Some binders have a clear plastic cover which can be used to create large labels on the outside for different subjects (if you are using a different binder for each subject) or you can use it to hold assignment sheets.
    1. If you are going to start a binder system, then you should invest in a few more organization assistants. Things like subject dividers, a zippered pencil pouch, sheet protectors, two pocket three-hold punched folders, and a portable three-hold punch are really helpful. You can organize each subject section the same. Label each subject divider tab and then include an empty sheet protector immediately behind for important handouts. Behind the sheet protector you can include a folder which follows the same simple schoolwork folder system idea above.
    2. A different option could also be to continue to use the subject divers, zippered pencil pouch, sheet protectors, two pocket three-hold punched folders, and a portable three-hold punch; however, instead of using the simple schoolwork folder system idea above with the two pocket folders, you can create one global folder that is in front of the binder where your child put homework for each class in front. At the end of the day, when at home, you can then sit with your child and help organize their homework when completed back into each individual subject folder.

pencil org..jpg

  • Some children might do also better with an accordion file based system. One suggestion for organized would be using the front section to keep your child’s homework planner or global two-pocket folder homework folder. Each additional pocket would be labelled with the different subjects and might include a separate pad of paper for that subject. I like to avoid loose sheets of paper as much as possible with an accordion system as I find they tend to slide down.
  • Create an organization system for lockers. Some children like to create a container system where they use separate containers for different belongings which are labeled with pictures on the outside to know what goes inside each bin. You can also add a picture to the locker for a visual cue for where each item belongs which the locker to further help keep things organized. Shelves are also helpful to better divide the space.
    1. lockerTo help you and your child determine the most logical and efficient way to organize the locker and backpack, here are some helpful questions (source: The Organized Student)
    2. What is your child’s schedule like? If the schedule is consistent, you can probably just separate the locker into two sections, morning and afternoon. If it changes every day, you might want to organize differently
    3. What extracurricular activities does your child participate in and what supplies/equipment is needed?
    4. Does your child keep supplies and equipment in a locker at school or do they travel back/forth between school and home on a regular basis?
    5. How many books is your child required to keep track of throughout the day
    6. Does your child’s school offer a second set of textbooks on loan?
    7. What type of storage and accessories does the locker already contain?
    8. Does your child have time to go back to his/her locker between classes?

 

  • Create a homework station at home. Include all necessary school supplies such as pencils, pens, crayons, markers, glue, scissors, paper, etc. You can use everyday items (mason jars, muffin tin) to help organize items. Containers available at any office/home good are great ways to help organize. You can attach labels made from a label marker or also just use post-its and adhere using clear tape. Every item has its own place and it is easy to spot. Ask your child’s school if it is possible to get a second set of textbooks to eliminate the need to bring books back and forth between school and home. Mark off spaces for items like books and pencil box using painter’s tape. If your child is older, you might think about creating a “desktop file box” which is described in a lot more detailed in The Organized Student book.

 

  • Help your child learn to breakdown assignments into manageable chunks. One example includes folding worksheets into sections that can be completed before moving onto the next section.
  • Invest in some telling time systems. It is often helpful to breakdown into the concept of telling time, daily time, weekly time, and monthly time. I prefer to use analog’s watches or timers for this as you can see the passage of time which is missing from digital systems. When first learning to tell time and gauge time, create from fun activities to experiment with by guessing how long it will take and then compare guess to actual. It might be useful to have several timers. One for the global amount of time your child/you think he/she needs to complete the assignments and an individual one to break down individual assignments into manageable chunks and to add a spot for a quick break. If you can find an analog clock that also allows for a quick glance to see the time digitally, that might also help.clock
  • Finally, if you have read any of our previous posts on executive functions or attended our executive function client group, then you might be familiar with the group Cognitive Connections. They developed an app that allows users to create a time marker to get ready for work, a timer marker to check in during work, and a marker when the work is planned to end. There are tones activities when the time reaches each marker. This could also be a good choice for some children.
  • The key to any organization system is be flexible to your child’s unique organizational style and needs as well as be consistent and offer check-ins until your child has mastered the system. Even when your child has mastered the system, continue to offer periodic support.References and Helpful Resources:

Comparing School & Clinic Speech Services

By: Valerie Heneghan, M.A. CCC-SLP/L
Speech Department Manager

 As a speech-language pathologist who has worked both in school-based and clinical settings, I am often asked questions about the difference between these two settings. Overall, they work together! I’ll explain more.

School-based setting

Qualifications

girls on desk looking at notebook
Photo by Pixabay on Pexels.com

Schools have entrance and exit criteria for qualifying children for speech services derived by their district or state. Using formal assessment protocols, children may need to demonstrate a deficit of a pre-set standard deviation before they are eligible for services.  There is usually a wide range of differences from district to district, so it is difficult to predict qualification criteria prior to the evaluation.

Services:

School services can treat children with language, articulation, pragmatic (i.e., social), and voice/fluency disorders to make educational progress. These services may be delivered in a variety of ways including one-on-one, group setting, or push-in to the classroom.

A Clinic-based setting (like at Easterseals DuPage & Fox Valley)

Qualifications

Clinics typically do not have pre-set qualification criteria as they are not regulated by state or governing bodies.  Clinicians will qualify children for services based on clinical judgement using both formal and informal assessment procedures. Coverage for these services however may be dependent on the child’s insurance and/or may be an out of pocket expense.

Services

speech therapist.jpgClinics may be able to provide more specialized, intensive, or varied skilled services based on functional and/or medical necessity. Often these services are delivered on a one-on-one setting in the clinic, however additional options may be available.

Easterseals

At Easterseals DuPage & Fox Valley , we offer a variety of service delivery models including: one-on-one therapy, community base therapy (groups), co-treatment with multiple services, tele-therapy services in addition to providing services in our clinic, homes, and through our daycare setting.

We deliver a wide range of speech-language services cultivated by upholding ongoing continued education/ certifications, state of the art equipment, and collaboration with multidisciplinary teams.  Our speech-language services work to strengthen children’s communication and feeding skills so that they can participate fully in daily activities and achieve success.

Our speech-language therapy services address functional communication, language expression/comprehension, pragmatics, speech-sound production, voice, fluency, oral motor, and feeding skills. Areas of specialization include but are not limited to the following:

  1. The Voice Box: A Motor Speech Lab, focuses on improving articulation, voice and resonance skills through cutting edge and innovative technology.
  2. Oralfacial Myology addresses disorders of the muscles and functions of the mouth and face. These may address tongue thrust, dental malocclusions, breathing, speech, swallowing, and chewing.
  3. Feeding services seek to ensure safety and adequate consumption of a varied diet. Treatment may address feeding issues related towards chronic diseases or syndromes, disorders of oral motor structure or development, growth disorders, failure to thrive or obesity, tube feedings, food allergies and sensitivities, gastrointestinal disorders, neurological conditions, constipation, diarrhea, sensory-related or Autism Spectrum Disorder-related feeding difficulties.

Voice Box Photo 3Our services continue to expand to meet the needs of the current populations that we serve.  Additional initiatives that we have been growing this year include: tongue/lip ties, auditory processing, and Spell-Links for improving spelling and reading comprehension.

I see value in both school and clinical settings!  I often encourage families that I work with, to consider both options based on the needs of the child.  Our therapists work with other disciplines like our Occupational Therapy, Physical Therapy, Audiology or Nutrition teams. We make sure to consult and involve all medical professionals and school therapists that work with a child, to  review goals and achieve maximal outcomes. To learn more about Speech-Language services at Easterseals DuPage & Fox Valley visit http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/speech-language-therapy.html.

Routines and Why They Can Help

By: Laura Van Zandt, MS, OTR/L

Routines are very important for all children, but they can be particularly important for children with developmental delays. Routines help provide a sense of certainty and security for children by offering them a predictable pattern that allows them to know what to expect, which will result in less frustration as well as fewer tantrums or meltdowns.

Certain routines are almost universal, such as morning and bedtime routines, but others may exist for specific circumstances or stages of life, such as your family’s weekend morning or school or summer routine.

A great place to start a routine is having a set bedtime. The American Academy of Pediatrics recommends that children ages 3-5 should get 10-13 hours of sleep a day (including naps) and children ages 6-12 should get 9-12 hours of sleep each night. The benefits of getting enough sleep are numerous and include mental/physical health, attention, memory, learning, behavior, and more. The AAP also recommends no screen time 30 minutes prior to bed, no electronics in children’s bedrooms, and having a set bedtime routine.

Setting up a bedtime routine:

Ryan - web
Photo from Take Three Photography

Bedtime routines can be anything you want them to be, as long as they are familiar and predictable. For my infant son, he takes a bath every other day. After his bath (or mom and dad quiet playtime on non-bath days), he gets a nice massage and we read a couple goodnight books. When he shows us signs of being tired, we turn off the bedside lamp, swaddle, and turn on the white noise machine.

This routine is something I hope to keep as he gets older. For an older child, you can do a similar routine but you will need to add in time for personal hygiene and perhaps next day activities such as pick out your clothes, pack your backpack, etc. You can use a similar routine for naps, except they would just be shorter.

Aside from bedtime, morning routines, can also be beneficial. Some families have different weekday and weekend morning routines, but other children may need to have one routine that stays the same regardless of the day.

Mealtime can also present an important routine. An easy place to start is to try to have meals around the same time each day. I know this isn’t always possible- but getting as close to a specific time each day can be beneficial and having everyone sit together to eat.

Additionally, having chores to do in family routines helps children develop a sense of responsibility and some basic skills, like the ability to manage time. These are skills children can use for later in life that you can begin at a young age. One great example is singing the “clean up” song when it’s time to finish an activity and move onto something different.

“Clean up clean up
everybody everywhere.
Clean up clean up
everybody do your share.

Clean up clean up
everybody everywhere.
Clean up clean up
everybody do your share.”

Routines can also be great for teaching personal hygiene. Ever heard a parent sing the ABC song while their child washes their hands? This is just one great example.

Here are some tips if you are looking to introduce routines into your daily life:

  1. Only change one part of the day at a time.

2. Come up with your basic non-negotiables and then give your children some                    choices (bedtime stories together or separate?).

3. Make a poster with the routine, including photos in the right order, to allow for              self-monitoring. In a good routine, everyone understands their roles, knows what              they need to do and sees their roles as reasonable and fair.blog_visual

4. Follow the same routine every single day for at least one month, after which it will         become habit and your older kids should be able to keep themselves on schedule for         the easy routines.

Establishing routines has lots of great benefits that can help both you and your child develop scheduling abilities, and increase the likelihood that your family will have a smooth day.

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

Understanding the Grieving Process for Parents of Special Needs Children

By: Sharon Pike & Cara Long, Parent Liaisons

It’s graduation season! We love seeing and hearing about the accomplishments of each graduate and their hard work! But for some parents, seeing their child’s peers reach graduation or other milestones, can trigger many emotions, especially if their child has a developmental delay or disability. For some children, these milestones will come much later or maybe not at all.  We hope to give you a greater understanding of the process families experience in coming to terms with a child with a developmental delay or disability. We speak from experience as we each have a beautiful young woman with a disability.

Sharon & Alison 2.jpgFirst, after the birth of a child with special needs, the diagnosis or incident that changes their child, parents will grieve the loss of the “perfect baby”, they’ve dreamed about. They grieve the dream, not the child.

Dr. Ken Moses is a psychologist who has devoted himself to helping people deal with crisis, trauma and loss. He describes it beautifully and accurately, “Parents generate core level dreams for their children even before the child is born.  Disability shatters those dreams. Grieving is the process where by parents separate from those shattered dreams and begin creating new dreams.”

He also says “few would argue that facing the devastating and continuing loss of having a child with a disability is among the most painful experiences that a person can confront. To separate from a lost dream, one must experience and share denial, anxiety, fear, guilt, depression and anger in whatever order or manner the feelings surface.” You can read more in The Impact of Childhood Disability: The Parent’s Struggle.

20110926 EasterSealsFashions (65 of 98)
Photo from Rich Howe

We recognize that for many parents this is their first experience with a disability and it unfortunately takes time to gain the insight needed. We want to help you work through the states of grief Dr. Moses mentions, so you aren’t stuck in a certain stage and can see the great potential in your child. This potential might be different than you imagined, but is still a wonderful journey.

We agree with Dr. Moses that the process takes time and honestly never really ends.  We learn to reshape our dreams with the help of the professionals we surround ourselves with. But grieving is the only way we can move on.  The parents who resist this process, become worse not better in response to the loss of the dream.

Below are Dr. Moses states of grief that you may be familiar with but need to recognize and move through them on this journey:

shockDenial/Shock

  • This stage gives parents the chance to “feel it” and start to find support and ways to navigate this new world they’ve been dropped into.
  • It buys time needed to blunt the initial impact, to discover inner strengths, find resources.

Anxiety

  • With the loss of a dream, parents are forced to change
  • Anxiety mobilizes the energy needed to make these changes

Fear

  • This stage speak to itself! The questions come “Will he walk, Will she talk,” “Will he go to college or marry?”

Depression

  • This stage is one that parents can feel repeatedly over the years and it’s depths can be simple sadness to deep, long lasting depression that needs medical intervention.

anger

Pain/Guilt

  • This stage also gives parents the chance to “feel it” to “question it” and ask themselves “What did I do to cause it?” “Why did my body fail?”

Anger

  • This stage parent ask,”Why me, why not you?”
  • A parent’s sense of justice is challenged
  • Their anger is often directed at someone or something (child, medical professional, or spouse)

Acknowledgement and Hope

  • Parents have come to grips with the fact, this is life and with modifications they can still live the dreams they had for their child and family.
  • They learn that there is always Hope.

This journey is reflected in this poem from a parent of a child with autism.

What You Should Know About My Child
by Brian Rubin 

Remember that he is, first of all, my child.
Let me see him smiling in his sleep.
And let me think how handsome he is.
Help me not lose sight of my son
In the sight of his limitations.

I know that you care for my child,
And that you work hard with him.
I need your expertise to help him become All that he is capable of being.
You need my help in understanding who he really is.
And in the following through at home
With things that are important.

Remember though, that you send him home at night,
And have weekends off and paid vacations.
Let me have the luxury of having a vacation…
Sometimes physically, sometimes emotionally.
For  a day… a week… a month..
Without your judging me.
I will be there for him when you are long gone.

I love my child with an intensity that
You can only imagine.
If on a given day, I am tired or cross with him,
Listen to me.
Lighten my burden.
Do not judge me.

Celebrate with me.
Rejoice in who he is and who he will become.
But forgive me if, from time to time,
I shed a tear…
For who he might have been.

renee

This journey is hard and can be isolating, especially for parents of babies with challenges.  But you are not alone. We are here to support families through this process. We can be your sounding board and help find whatever resources you need. To learn more about our family services, click here.

Easy Indoor Activities for Energetic Kids

By: Laura Donatello, PT, DPT

When heavy rain and snow hit, it leaves kids indoors for the day with a lot of energy to burn. While playing in the snow and rain can be fun, freezing temperatures and wet, icy conditions have us stuck inside. Instead of reaching for the remote or the Ipad, here are some fun activities you can do with your child to satisfy their energetic needs.

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:

  1. child and laundry
    Image from 3.bp.blogspot.com

    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.

Exercise Dice

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Photo by Patti Mendoza

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.

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

Easter Seals DuPage & Fox Valley enables infants, children, and adults with disabilities to achieve their maximum independence, and to provide support for the families who love and care for them. If you have questions on your child’s development and need an evaluation, contact us at 630.282.2022.

 

Is My Child Delayed?

By: Cassidy McCoy PT, DPT

It can often be challenging to determine whether or not your child is delayed. Some children may not exhibit difficulties in all areas, or the signs may be subtle. Common signs of a gross motor delay include but are not limited to: difficulty using both sides symmetrically, inability to sit independently between 6 and 9 months, and inability to independently walk between 12 and 18 months. However, not all signs of delay are as apparent as others.

15_Brady PembrokeOther signs that your child may have a physical delay, particularly with school aged children, is their ability to keep up with their peers. These children may appear clumsy on the playground, or stay away from obstacles that are difficult, such as climbing walls and monkey bars, or parents may receive reports their child is having difficulty with activities in P.E. class. Also, the child may be less motivated, or outright refuse, to be an active participant in extracurricular sports.

What should a parent or caregiver do if they think a child is delayed?

  1. Schedule an evaluation.

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Pediatric physical therapists utilize standardized assessments to accurately determine if a child is developmentally delayed. These assessments include all aspects of gross motor development including strength, balance, and gross motor skills. The resultant score of the assessments is able to provide the parent with information including the percent of delay and the age equivalent. This allows for the parents, child, and therapist to determine an appropriate, individualized plan of care and direction for treatment. The standardized assessments are also a way to show improvement following an episode of care.

  1. If you have any questions or are unsure if your child is delayed, use available resources to help.

mttfc comMake the First Five Count is Easter Seals FREE online child development screening tool to help measure and keep track of your child’s growth and development.

Take the ASQ-3 to look at key developmental areas: communication, gross motor, fine motor, problem solving and personal social skills. You will be asked to answer questions about things your child can and cannot do.

Take the ASQ SE-2 for a more in depth look at a child’s social and emotional skills. This survey includes questions about your child’s ability to calm down, take direction, follow rules, follow daily routine, demonstrate feelings and interact with others.

Also the CDC offers a developmental checklist that takes you through 2-months-old to 5-years-old. This checklists offers an easy to read guide if parents are concern that their child is delayed. They also offer a Milestone Tracker Mobile App for Apple and Android phones.

By detecting developmental delays early, you have the power to change lives and educational outcomes for children! If delays are identified, Easter Seals DuPage & Fox Valley can offer the support needed to be school-ready and build a foundation for a lifetime of learning. Learn more at eastersealsdfvr.org. 

Through my Parenting Eyes

By: Theresa Forthofer, CEO & President of Easter Seals DuPage & Fox Valley

While I am the President and CEO of Easter Seals DuPage & Fox Valley, I also happen to be the mother of three children.  Two of my children have Myotonic Muscular Dystrophy and Autism. My oldest, Ryan, was diagnosed when he was 7 years old.  He is now 24 years old. My youngest was diagnosed with the Congenital form of Muscular Dystrophy within days of his birth and he is now 18.

forthofer family

Having two boys with Muscular Dystrophy, meant lots of doctor visits and hours of therapy every week.  Throughout the years we had several different therapists and we liked them all.  They were all very nice and the boys were making progress.  Therefore, we assumed everything was great and the boys were doing the best they could.  Looking back, I sincerely wish I knew then, what I know now.  While they were progressing, they were not reaching their full potential.

I may be biased, but what I have learned since becoming President and CEO isn’t as significant as what I have learned about raising two boys with disabilities.  I share my story to help at least one other family find their child’s true potential.

For nearly 7 years, my son had (unsuccessfully) worked on putting his shoes and socks on independently.  His Early Intervention therapist worked on it, his private therapists from a nearby clinic worked on it, and his school therapists worked on it.  Over and over again we were told, he doesn’t have the strength.

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Photo by Alexi Procopos

However, when I came to Easter Seals, I asked about Occupational Therapy for Justin.  I wanted him to put his shoes and socks on independently.  In just two sessions, his therapist asked me what our next goal was because he was putting his shoes and socks on independently.  I didn’t believe her and made her show me.  He did it and is still doing it!  His therapist explained it was a motor planning issue not a strength issue for Justin.  For years, I dreaded leaving the house because putting his shoes and socks on became something to battle over. Now those days are long behind us.  No more excuses for being late!

Occupational therapy worked so well, I signed Justin up for the feeding clinic.  At 12 years old, he weighed 40 pounds and we had tried everything.  We saw an endocrinologist, feeding therapists, nutritionists, etc.  The best solution was growth hormones, but Myotonic Dystrophy has cardiac complications, so this was not advised.

After attending the feeding clinic and starting a few relatively small changes, he gained 10 pounds in three months – 25% of his body weight!  He will likely always be small for his age, but we wish it hadn’t taken us so long to figure out these needs and find the experts at Easter Seals.  They imagined a future beyond what we had been told to expect by other professionals and without any limitations.

leadership meetingI hear these same stories like mine, nearly every week.  Children who have been seen for years and aren’t reaching their fullest potential.  When they find their way to Easter Seals DuPage & Fox Valley they often can’t believe what they have missed out on.  The progress their children are making so quickly surprises their families, their doctors and sometimes even us.

If you are looking for a therapy center or therapist for your child, here are the top 10 questions to ask:

  1. Is the center CARF Accredited and have a Medical Advisory Board?
  2. Is the center directly affiliated with any major research hospital systems?
  3. Who are your primary referral sources?
  4. What are the published results of your satisfaction survey and where can I find them?
  5. Is the therapist NDT (Neuro-Developmental Treatment) trained?
  6. What diagnoses has the therapist personally treated?
  7. What is the average level of experience of the therapists at the center?
  8. How many children do you treat annually?
  9. What training do you receive on a regular basis?
  10. How do you support parents and siblings?

As parents, we all want the absolute best for our kids. I found it here at Easter Seals and you can too!

Easter Seals DuPage & Fox Valley is a CARF accredited facility with a medical advisory board and affiliations with University of Chicago, University of Illinois at Chicago, Northwestern University and RIC (Shirley Ryan Ability Lab). With 87 therapists and professional staff with an average tenure of 19 years, the majority of therapists are NDT trained and are required to receive on-going training. The therapists are specialized in many specific areas including feeding, motor, sensory needs and more.

Easter Seals serves more than 1,000 families a week with locations in Naperville, Villa Park and Elgin.  Through an annual client survey, 99% of families report satisfaction with the services they receive and 98% of families report progress. The parent liaisons and social workers on staff provide support and family activities for all members of the family. Learn more at eastersealsdfvr.org. 

What is a “Sensory Diet”?

By: Laura Van Zandt, OTR/L

A “sensory diet” is a treatment strategy occupational therapists use to help children learn to process and understand sensory information from their environment and their own body to more effectively interact within the environment and with others. The term sensory diet was first coined and originated by occupational therapist, Patricia Wilbarger. A sensory diet is meant to be individualized to the child so that the activities provided are a ‘just-right’ challenge for the child. The “just right” challenge is defined as “a challenge that is on the edge of competency and engages the drive for mastery.”

A sensory diet is not too hard, yet not too easy. An effective sensory diet should include a wide variety of activities within the child’s day that provide a variety of sensory input for play and learning. An effective sensory diet should also be a collaboration with the client, family, and caretakers.

Occupational therapists often use the analogy of comparing a sensory diet to a balanced food diet to help parents and caretakers understand we need a variety of activities that feed all our sensory systems to allow them to work well together. Just like a well-balanced diet is often tailored to our individual bodies for different nutritional needs at different points in our lives, a sensory diet is an ongoing list of activities that is established over time and modified as needed to help address the imbalance in the child’s sensory processing abilities or as the environment changes and the demands shift.

A sensory diet is designed to help keep the child calm and organized via activities that based on a child’s preferences which then helps them to be able to learn, attend, and fulfill social expectations. As a child learns to remain calm and organized, they learn to better self-regulate and hopefully move from depending more on others to being more independent in managing their sensory needs. The goal of any sensory diet is to help overtime retrain your child’s brain to process sensory information in a more typical way so that can perform at their own unique best.

Each child has a unique set of sensory needs. Generally, if a child is more sensory seeking, they may benefit from adding more movement and stimulation that includes heavy work as well as other sensory stimulation (e.g. tastes, colors, smells) to help achieve a calm, organized more focused state so they are not constantly on the go looking for input. If a child is more sensory avoiding, they may also benefit from heavy work but may need it more graded and introduced slowly over time. The child may benefit more from activities that focus on reducing sensory input and breaking tools that allow them to limit information from their environment. One of the trickiest aspects of developing and implementing any sensory diet, is beginning to recognize your child’s signs and signals as well as starting to recognize when your child is over-reacting, shutting down, or under-reacting and adjusting the sensory input so your child remains just right and able to function.

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When occupational therapists provide ideas for a sensory diet, they keep in mind several different guiding principles:

  • Frequency of input: The frequency of need varies for each child and should be guided by observations of the child before and after each activity.
  • Intensity and duration of input: How much time you spend on each activity and how much sensory input (e.g. how much weight to use to push/carry/drag/lift, how loud to play the music, what type of tactile media to present, how much tactile media to present, etc.) is directly related to the child and how the child is doing not only on a specific day but also at a specific moment in time.
  • Timing of activities: Sensory diet activities are meant to be proactive and are best used before as well as during activities that are known to be tricky to the child.

    For example, if you know sitting for a mealtime is difficult for your child, you might want to help prep your child’s body and sensory system prior to sitting down. These activities should be tailored to your child; however, heavy work activities that actively require the child to use their muscles to push, pull, carry, drag, climb, bury, dig, suck, etc. are usually beneficial to many children. Sitting for a mealtime is a very complex sensory activity that involves all your sensory systems working together. You can try prepping your child’s sensory system prior to sitting down by re-arranging the chairs around the table and cleaning the table with spray bottles and towels to dry. You can try exploring different options for their chair- maybe your child might do well with a move-n-sit cushion or having a band around the legs of their chair to kick against. Your child might be bothered by the sounds of other people chewing their food and might benefit from noise cancellation headphones. Your child might be bothered by the sights of all the different foods or by all the foods touching each other. There are many different ideas and strategies to help both of those difficulties.

Your occupational therapist may ask you to become the detective and create a daily log of behavioral changes. You are your child’s best advocate and are the best expert in your child’s abilities and areas of growth. By creating a log of activities and your child’s responses to activities over the course of different days and different times, you can help better curtail some of the trial and error process that is inherent within any sensory diet due to our own individuality.

The sensory diet activity that might have worked well for another child with a similar difficulty, may not necessarily work for your child. The various times of the day and different environments may be work better for certain activities. Not all strategies work all the time. It is important to keep track of all the different activities your child responds positively to, so that you can create variety and have more than one strategy to help your child.

With help from an occupational therapist, your child can develop the ability to process sensory information in an adaptive manner and learn strategies to help him or her cope with everyday experiences. Learn more about our program. 

Resources:

  • Shiela Frick and Julia Wilbarger – “Creating Effective Performance, Precision, and Power in Treatment and Sensory Diets”
  • The Out of Sync ChildThe Out of Sync Child Has Fun, Growing an In-Sync Child by Carol Stock Kranowitz
  • childdevelopment.com