Speech-Language Pathology Scope of Service

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

What does Speech Therapy Include?

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

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

Learn more about our speech services here.

Speech

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

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

Language

Photo by Keira Burton on Pexels.com

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

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

Fluency

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

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

Voice

Photo by Stan Kedziorski-Carr

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

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

Resonance

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

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

Auditory Habilitation

Photo by Christine Carroll

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

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

Learn more about our audiology services here.

Cognitive-Communication Disorders

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

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

Feeding and Swallowing

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

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

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

Learn more about our feeding clinic here.

Augmentative and Assistive Technology

Photo by Michael Vanko

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

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

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

Speech-Language Therapy at Easterseals DuPage & Fox Valley

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

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

It’s Summer!  Let’s Go Ride A Bike! 

By: Josephine Hipolito, Physical Therapist

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

Things to Consider When Starting

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

 Teaching Children Pedaling:  

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

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

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

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

Balance Bike Versus a Bike with Training Wheels 

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

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

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

 Biking with Training Wheels

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

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

Keep an eye out for the following:  

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

Tips to Use a Balance Bike

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

Steps to Help Children Ride a Standard Bike 

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

Biking From a Complete Stop  

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

Cycling Benefits

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

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

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

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

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

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



Formula Concerns & Availability

Summary of formula resources and availability from manufactures.

by: Easterseals DuPage & Fox Valley Nutrition Team

Given the shortage of formula in the country (a combination of supply chain issues and product recalls), we know many families are looking to us for help. We understand the ability to feed your child shouldn’t be a concern. For many, this is a scary and anxious time. It has been hard during our nutrition evaluations to recommend any specific type of formula, as the availability is hard to control. A can today may not be available the next time you need it. No one should be without the nutrition they need, and we are here for you.

To help, we have talked with all of our formula contacts to give you resources to find formula and recommendations. We did our best to get you access and an insider view on what steps you can take. Scroll to the manufacturer you need for QR codes, guides to switch formula and more.

We know that manufacturers and legislators are doing everything possible to make more options available. But it will still take 6-8 weeks to get availability at a more comfortable level. In the meantime, please only take what you need for a week or two. Leave formula, especially specialty formula for children with allergies, on the shelf for those that truly need it. And please don’t dilute formula to make it last longer. This results in a lack of nutrition and not enough calories for infants. This can have serious consequences, such as increase risk of seizure.

Finally, please be cautious with recipes that are floating around to make your own baby formula, without consulting with a medical professional first. Many homemade recipes contain ingredients that are not safe for young infants, are low in calories, and are not nutritionally complete. Feeding a baby homemade formula can cause problems with growth and nutritional deficiencies.

About Formula & Brands

Just like adults, babies need protein, fat, and carbohydrates in their diet. Infant formulas sometimes differ in which specific proteins, fats, and carbohydrates they feature. Breast milk has two protein sources: whey and casein. Some infant formulas have both of these proteins, while others only have whey. All meet the FDA’s requirements. Similarly, infant formulas can differ in the type of fat they use. All infant formulas sold in the U.S., whether they are name-brand or store-brand, must meet the FDA’s standards to ensure proper nutrition for your baby.

Generic or store brand infant formulas are very similar to national brands. They even use similar marketing terms, including:

  • Advantage = Advance
  • Gentle = Gentlease
  • Sensitivity = Sensitive
  • Tender = Gentle

Most store-brand baby formulas contain DHA and ARA, prebiotics, and nucleotides, just like brand-name infant formulas. Almost all—including store brands made for Walmart (Parent’s Choice), Target (up & up), Walgreens (Well Beginnings), and Kroger (Comforts for Baby), etc.—are made by the same manufacturer: Perrigo Nutritionals. Read more from verywellfamily.

Some children have no issues with transitioning to a new formula, while others may need a little time to adjust. For some children, new adjustments to their diet may cause gastrointestinal (GI) changes. If you need support for your baby’s allergies, constipation or other emerging GI issues, please contact a pediatric dietician for support.

Due to the shortage, now may be the time to move a toddler or older child off of formula and transition to another option. We know this change can be scary. But many families have found this has been a needed push with a beneficial outcome.

See below for a formula comparison chart that you can use to find comparable formulas if your usual brand is sold out. Again, generic brands are perfectly okay to feed your baby.

From Feed to Succeed LLC

Online Support

The support from communities to help those in need of formula is so heartwarming. Consider reaching out to friends and family to help find formula for your baby as they shop. Purchasing donor breast milk from your local milk bank, may be an option. While there is a high demand they are also experiencing more donations of extra milk. One such resource is the Mothers’ Milk Bank of the Western Great Lakes.

Use caution with milk sharing or buying milk over the internet from places other than an official milk bank as these may contain contaminants. If someone is offering extra formula they no longer need, please be sure the formula is not expired and has been stored in a temperature controlled location (i.e. not in a garage).

Instacart is a helpful resource that shows where formula is on shelves. You don’t have to shop on Instacart, but use as a locater in your area.

Community Facebook groups like local Mom Groups, parenting groups and more can help share tips or resources for formula. Chicagoland Formula Finders is a recent and helpful resource for many.

Formula Availability

Scroll down to find more information from Enfamil, Gerber, Kate Farms, Nutricia, Similac and WIC programs (alphabetized).

Enfamil

Enfamil.com has a store locater that is updated three times a day. They also share this qr code and product comparison chart below.

Nutramigen is an extensively hydrolysed formula for the dietary management of infants with mild to moderate cow’s milk allergy. It is hypoallergenic, which means it has been specially formulated to not cause allergic reactions in most infants with cow’s milk allergy. This formula has been more available at this time, but please only purchase if necessary.

At Reckitt/MJN, we see this as a very serious issue, because we understand the responsibility we have in making the single source of nutrition for so many infants, therefore can be no short cuts for this vulnerable population. Our manufacturing facilities are operating 24/7. This has allowed us to supply 30% more product to market YTD, which allows us to provide formula to an additional 200,000 babies per month since the Abbott recall occurred.

It is important to note our manufacturing is near pharmaceutical grade and quality and safety are paramount. Our goal is to get as many feedings to shelf as possible, but our highest priority are those mothers and infants in the WIC program as they are the most vulnerable in our society. Where Abbott can no longer meet their commitments, we are filling the gap as much as we can.

We’re continually looking for more ways to increase supply, while ensuring the highest levels of safety and quality. We’re also working closely with President Biden, the FDA, and the USDA to expedite approval for us to use a factory outside of the U.S., access key ingredients, and make it easier to ensure the most vulnerable babies have access to the formula they need. We know parents and caregivers are concerned about formula supply on the shelves, we are working with our retail partners to support limiting purchases to 1- week supply per household and always recommend buying formula from a reputable source.

This is the highest priority for us as a company and the entire industry. We are confident that by working together and remaining focused on this problem, we will solve it, ensuring that parents and infants have access to the nutrition that they need.

Helping Hand for Special Kids Program

This program can help with a one time gift of formula in cases of financial assistance or multiple births. With help from a medical professional or one of our dieticians, choose from one of the three applicable programs. Offer is limited to one formula gift per household, per birth. Programs and offers subject to change without notice. Only parents and/or legal guardians who meet offer qualifications are eligible. View the program application.

Gerber

While we are a small player in the U.S. infant formula market, we are absolutely committed to doing everything we can to help get parents and caregivers the formula they need so their babies can thrive. We have significantly increased the amount of our infant formula available to consumers by ramping up production and accelerating general product availability to retailers and online, as well as in hospitals for those most vulnerable. We are also working through our Parent Resource Center, website, social media and industry groups to help make sure essential information is available for those parents and caregivers seeking it.

Demand for Gerber formula has increased due to a national infant formula shortage. This increased demand may result in some temporary out of stock issues at certain stores. Each retailer has the best estimate of when specific products will be on their shelves. For information about which retailers in your area carry Gerber formula, you can visit https://www.gerber.com/shop-by-product/formula.

While individual stores may be temporarily out of stock, it should return soon, or you can order from our website.

Our Parent Resource Center is available 24/7 to help parents with any feeding queries, including help in finding our formulas and suggesting recommended alternatives, as it is generally okay to switch routine infant formula brands (800-4-GERBER). If an infant is on a specialty formula for a medical condition or for treatment of allergy, switching infant formula should be discussed with your health care provider before doing so.

Kate Farms

We understand that patients, caregivers, and healthcare professionals are pressed to find alternatives. Kate Farms formulas may be a solution for patients affected by the Abbott recall. Our formulas are only for children one and up, but could be appropriate for kiddos aging out of an infant formula including those who are appropriate for a peptide challenge and were formerly on an amino acid product. Below are a a few crosswalk tools which show which Kate Farms products would be considered “equivalent”, and we have a dedicated out of stock webpage here:  https://www.katefarms.com/customer-service/out-of-stock-support/.

The Nutritional Applications Pediatric Formulas is also a helpful resource to show what may be appropriate by disease state.  The pediatric transition guide is also helpful for tube fed patients. Learn more about transitioning to a new formula with this guide in partnership with a Registered Dietician.

Kate Farms formulas:          

  • Indicated for ages 1 and up
  • No common allergens. Do not contain milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, or soybeans —but are not tested to be hypoallergenic
  • Unlike powdered formulas, Kate Farms formulas use aseptic processing and are commercially sterile
  • Offer pediatric peptide formulas made with organic hydrolyzed pea protein (HCPCS B4161) and pediatric standard formulas made with organic intact pea protein (HCPCS B4160)— not amino acid or elemental
  • Nutritionally complete, taste great, and designed for oral or tube feeding (flow smoothly through tubes down to 6.5 Fr)
  • Eligible for insurance coverage: Medicare, Medicaid, private plans, and select WIC* programs
  • Samples arrive within two days to healthcare offices or patient homes at the request of a healthcare professional. Visit katefarms.com/samples.

Kate Farms formulas are broadly eligible for insurance. Your home medical supplier will check your coverage and ship Kate Farms to you. Or you can purchase any one of our formulas online with free 2-day shipping at katefarms.com.

Nutricia

We offer nutritional solutions that positively impact the health from early life and onwards into old age.

  1. Nutricia Navigator contains information on the service which can investigate coverage options and locate DMEs or pharmacies in their area that may have product available. 
  2. Neocate.com.  Always provides updated information on ordering directly from Nutricia. Parents can enter in their email addresses to receive a notification when it is back in stock at Nutricia.
  3. Walgreens.com.  They will indicate if they have availability in any store.  If they see it is available, you can call the store first before going. 

Similac

For families whose babies require specialty, metabolic formulas, the FDA recently informed Abbott Nutrition that the agency has no objection to releasing urgent, life-sustaining supplies of certain specialty and metabolic formulas on a case-by-case basis. Abbott has established a request line for patients and caregivers seeking access to their specialty formulas: 1-800-881-0876.

We know that our recent recall caused additional stress and anxiety in an already challenging situation of a global supply shortage. We are working hard to help moms, dads and caregivers get the high-quality nutrition they need for their babies.

Abbott is working closely with the FDA to restart operations at the Sturgis, Mich., facility. We continue to make progress on corrective actions and will be implementing additional actions as we work toward addressing items related to the recent recall. In the meantime, we are working to increase the supply of infant formula by prioritizing infant formula production at our facilities that provide product to the U.S. market.

Below is a QR code that is updated regularly to show availability of infant formulas at different large box stores. More will be available in the next few weeks.

WIC

We have a special obligation to WIC families. About one-half of babies born in Illinois participate in WIC in the first year of their lives. We will continue to do everything possible to safeguard their development and access to safe, nutritious formula.”

said IDHS Secretary Grace B. Hou

The state of Illinois is taking a series of steps in response to the current, nationwide infant formula shortage. Senate unanimously passed the House’s bill to add flexibility to WIC benefits. The federal nutrition program for women, infants, and children is the largest infant formula buyer in the country — making up about half of all formula purchases. The approved legislation would waive the contract requirements for emergencies (like during a formula shortage), and allow mothers to purchase other formulas available without having to pay out of pocket.

In coordination with the USDA Food & Nutrition Service, Illinois retailers are being encouraged to set aside formula for low-income families enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children program.

The Illinois Department of Human Services has also trained caseworkers to assist families with formula questions. The IDHS Help Line at 1-800-843-6154.T he Help Line is designed for Supplemental Nutrition Assistance Program and WIC customers primarily but is open to all residents of Illinois. Read more here.

For more information on our Feeding Clinic, nutrition and feeding services, visit: https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/nutrition-therapy.html.

2021 Holiday Gift Guide

By: Citlaly Gonzalez Psy.D Clinical Psychologist

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

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

Family Time at Home

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

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

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

The Tricky Spots

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

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

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

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

The classics

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

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

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

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

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

Let’s not forget the caregiver

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

The best gift for your child . . .

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

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

Amazon Wishlists

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

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

Keeping Children with Disabilities Safe in a Digital World

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

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

Make your home network safe.

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

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

Teach your child how to behave online.

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

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

Provide resources and support.

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

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

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

Common Questions About Bilingualism

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

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

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

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

Simultaneous Bilingualism:

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

Sequential Bilingualism:

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

Photo by Stan Kedziorski-Carr

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

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

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

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

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

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

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

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

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

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

Photo by Alex Green on Pexels.com

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

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

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

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

Code-switching does require rules to be done appropriately:

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

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

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

Take our Free Developmental Screening

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

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

Prepare Your Child for Kindergarten During the Covid-19 Pandemic

By: Katie Kwiatek, Pre-Kindergarten Teacher at The Lily Garden Child Care

Will your child be five years old before September 1st, 2020? If so, get ready to send them off to kindergarten this Fall!

But, wait!

Since schools and day cares have closed, I’m afraid my child will have a tough time transitioning back to a school setting. What skills do they need in order to be kindergarten ready? There are so many new procedures for children to learn too! How can I help?!

Here’s what you can do to prepare your little one!

Create a daily schedule that mirrors the average school day.

It can be a rough transition from quarantine life to a school schedule. It’s so easy to fall in to the habit of staying in pajamas all day, being a couch potato, eating right when you feel hungry, etc. Once your child goes back to school, they will have to follow a schedule of: when to eat, when to play outside, when to sit still, when to be silly, and when to be serious. For everybody’s sake, create a structured schedule for the typical work week and keep weekends open and fun!


To mirror your child’s average school day, contact the teacher! They’ll be more than happy to send you an outline of a typical day. Make sure to keep your schedule consistent! Children need structure and consistency! They like to know what comes next and what is expected of them. If your child tends to feel nervous/anxious, having a consistent schedule will help ease them. Let your child know before you implement a new schedule- explain the new routine, make a chart together! Here is a resource for parents about creating structure and rules.

For all children’s success in this current pandemic, practice wearing masks at home and getting comfortable with wearing them for extended amounts of time. Practice frequent, good hand washing and reminders to limit touching of their face. We know this is easier said than done! Check back on our blog and social media for upcoming tips and resources around mask/face coverings and remote learning.

This is a challenging time for families and it is hard to know what the school environment and year will be like for your child. With some careful preparations and conversations, your child can have success. By sharing a positive attitude surrounding school, the new rules and the big change to Kindergarten for your child, it will help him/her feel ready to learn and ease some anxiety.

Work on social and emotional skills at home. 

Social and emotional skills are a key ingredient for kindergarten readiness. Your child needs to learn how to express and cope with their emotions appropriately and form healthy relationships with their peers and grown-ups. How can you work on social and emotional skills at home? Its very simple! Do your best to keep your own emotions in check and talk, talk, TALK!

Remember, your child is always observing your behavior. Think out loud, show them your thought process when you’re upset. When your child is upset, describe their face & body language, label the emotion, and provide a solution,  “I see your body is tense and your eyebrows are drawn. You are frustrated. Lets take 2 deep breaths and do 3 hand squeezes together.”  While reading a book or watching a TV show, describe the characters and ask questions, “That man is yelling at that girl and his face is red. He is very angry. How do you think she feels?”


Here is a resource about building social & emotional skills at home:
https://www.naeyc.org/our-work/families/building-social-emotional-skills-at-home


Click this link for a list of books about emotions:
https://www.pre-kpages.com/books-emotions-preschool/

Encourage your child to be independent! 

Being independent and having self-help skills is another key ingredient for kindergarten readiness. Your child will likely be in a classroom with over 20 students and 1 teacher and keeping distance between each other. This requires your child to be as independent as possible.

 

Here is a resource about self-help skills:
https://childdevelopment.com.au/areas-of-concern/self-care/self-care-skills/

Click this link for the self-help development chart:
https://childdevelopment.com.au/resources/child-development-charts/self-care-developmental-chart/

To promote independence and improve self-help skills at home, work on these tasks:

  • Picking out clothes for the day
  • Getting undressed and dressed independently
  • Putting dirty clothes in a laundry basket
  • Brushing teeth & hair
  • Take off & put on shoes
  • Put on a jacket and zip/button it up
  • 100% bathroom independent (potty trained & wipe independently)
  • Properly wash hands
  • Hang up a jacket & a backpack on a hook

Allow boredom 

Why do you want your child to be bored? From boredom comes imagination and creativity! Its essential for every child to have a lively imagination, to think outside of the box, and to express themselves creatively. They’ll be able to carry this trait through school to adulthood. Keep your child’s imagination alive! Provide them with art materials and encourage open-ended art, have them express themselves through music with pots & pans (put on headphones if you’re working from home 😉), encourage them to create puppets and put on a puppet show! Even chores can provide great lessons in executive functioning.

Here is a parent resource to fire up your child’s imagination:
https://www.parenting.com/activities/kids/10-easy-ways-to-fire-your-childs-imagination-21354373/

Make learning fun!

Each kindergarten has different standards and academic requirements prior to starting. Contact your local school district to get more information. Typically, your child should be able to copy upper & lowercase letters, recognize some-most letters, know numbers 1-10, classify objects by shape & size, and be able to use scissors & glue with ease.

Here is a resource of more skills your child should know:
https://www.scholastic.com/parents/school-success/school-life/grade-by-grade/preparing-kindergarten.html

With many kindergarten screenings cancelled this summer, you can use the Easterseals FREE child development screening tool, the Ages & Stages Questionnaire, to help measure and keep track of your child’s growth and development. This is a great tool to provide your teacher and child’s doctor on areas they may need assistance to grow.

Take a free development screening. askeasterseals.com

How to make learning fun?

Create a pretend classroom for your child to play teacher and you play student! This area can serve as your child’s remote learning area too. This is an opportunity to grow your child’s love of learning. Give them assorted classroom materials: clipboards, pencils, paper, books, alphabet & number cards (use whatever you can find in the house or find free printables online). Are there certain letters, numbers, or shapes they have trouble with? Don’t focus so much on worksheets- instead find fun hands-on activities!

Click this link for letter activities:
https://www.pre-kpages.com/alphabet/
Click this link for number games & activities:
https://www.pre-kpages.com/counting-games-activities-preschoolers/
Click this link for shape activities:
https://www.pre-kpages.com/shapes-activities-preschoolers/

We know how agonizing the decisions for the next school year are for your family. If your child receives school therapy services, is unable to wear a mask, or if remote learning is not an option for your family, it can feel especially challenging. Whatever decision you make, we are here to support you. Contact our Social Services team for support and resources at socialservices@eastersealsdfvr.org. We will have more information on our blog around these important subjects in the months ahead.

We remain committed to providing the highest quality services to improve the lives of children and those who love and care for them. We understand that a child’s needs to succeed look different for each family. For over 75 years, our clinical team has provided individualized therapy plans to best achieve a child’s goals and support healthy families. This pandemic only solidifies our commitment. Let us know how we can help you in the comments.

Understand and Boost Your Immune System

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

Better Immunity is Achievable

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

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

What Protects Us From Illness

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

The immune system

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

Physical protection from foreign invaders

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

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

What we Have Limited Control Over

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

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

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

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

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

What We Have Control Over

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

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

Reducing Stress

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Improving Personal Hygiene

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

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

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

only wear it if it’s clean

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

don’t lend it to anyone

don’t borrow anyone’s

make sure it fits well

wash it after wearing

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

From A Chalkboard a Day

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

Improving Nutrition 

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

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

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

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

Short Stories to Explain the Coronavirus to Children

By: Yvonne D. Anderson, LCSW, CADC, CODP II, Bilingual Licensed Clinical Social Worker

The current pandemic of the novel coronavirus (COVID-19) is a difficult time for everyone and leaves a lot of unanswered questions, especially for children. The following short stories are great resources to bring some clarity and comfort to young children while their normal routines are disrupted. The stories below vary in length and detail ranging from very short to slightly more detailed. I hope you find a story or two that will be helpful for your specific child’s needs!

Caroline Conquers her Corona Fears

By: Kellie Camelford, Krystal Vaughn, & Erin Dugan

This short story answers some of the many questions young children may be having about Covid-19 and why their normal routines are so different. A simple breakdown of social distancing and safety procedures are talked about to help young children understand why certain actions are in place. Overall the story is informative, positive, easy to read, and is a great resource to calm uncertainty and confusion for children. When printed out, the book doubles as a coloring book and includes a page for parent’s and children to write out a simple schedule.

Story Link: https://alliedhealth.lsuhsc.edu/clinics/docs/CarolineConquersherCoronoaFears31820.pdf

Coronavirus: A book for children

By: Elizabeth Jenner, Kate Wilson & Nia Roberts

What is the coronavirus, and why is everyone talking about it?

Engagingly illustrated by Axel Scheffler, this approachable and timely book helps answer these questions and many more, providing children aged 5-10 and their parents with clear and accessible explanations about COVID-19 and its effects – both from a health perspective and the impact it has on a family’s day-to-day life.

With input from expert consultant Professor Graham Medley of the London School of Hygiene & Tropical Medicine, as well as advice from teachers and child psychologists, this is a practical and informative resource to help explain the changes we are currently all experiencing.

Story Link: https://nosycrow.com/wp-content/uploads/2020/04/Coronavirus-A-Book-for-Children.pdf

Dave the Dog is Worried About Coronavirus

By: Nurse Dotty

A book for children about coronavirus that aims to give information without fear.

With everything that is going on at the moment; big changes to children’s routines and lots of stories on the news it can be a really scary time for children.

This book opens up the conversation about coronavirus and some of the things they might be hearing about it and provide truthful information in a reassuring and child friendly manner.

Story Link: https://nursedottybooks.files.wordpress.com/2020/03/dave-the-dog-coronavirus-1-1.pdf

Hello! My name is Corona Virus

By: Manuela Molina

Summary from the author: I have created this short book to support and reassure our children, under the age of 7, regarding COVID-19. This book is an invitation for families to discuss the full range of emotions arising from the current situation. It is important to point out that this resource does not seek to be a source of scientific information, but rather a tool based on fantasy. My recommendation is to print this material so children can draw on it. Remember that emotions are processed through repetitive play and stories read multiple times. Share COVIBOOK and help ease kiddo’s anxiety all over the world. 

Story Link: https://660919d3-b85b-43c3-a3ad-3de6a9d37099.filesusr.com/ugd/64c685_0a595408de2e4bfcbf1539dcf6ba4b89.pdf

I’d rather go out!

By: Deborah Woods

This short illustrated story highlights the use of imagination as a means of dealing with stressful times.

Story Link: https://www.magneticmoms.com/userfiles/481350/file/I%20would%20rather%20go%20out%20story%20(2).pdf

My Hero is You

This book was a project developed by the Inter-Agency Standing Committee Reference Group on Mental Health and Psychosocial Support in Emergency Settings (IASC MHPSS RG). The project was supported by global, regional and country based experts from Member Agencies of the IASC MHPSS RG, in addition to parents, caregivers, teach-ers and children in 104 countries. A global survey was distributed in Arabic, English, Italian, French and Spanish to assess children’s mental health and psychosocial needs during the COVID-19 outbreak. A framework of topics to be addressed through the story was developed using the survey results. The book was shared through storytelling to children in several countries affected by COVID-19. Feedback from children, parents and caregivers was then used to review and update the story.

Over 1,700 children, parents, caregivers and teachers from around the world took the time to share how they were coping with the COVID-19 pandemic. A big thank you to these children, their parents, caregivers and teachers for completing the surveys and influencing this story. This is a story developed for and by children around the world.

Story Link: https://interagencystandingcommittee.org/system/files/2020-04/My%20Hero%20is%20You%2C%20Storybook%20for%20Children%20on%20COVID-19.pdf

Also, please don’t hesitate to reach out to anyone in our Social Services department if you and/ or your family need support, resources, etc. We are happy to help. Our staff completes comprehensive assessments to pinpoint what a child and family need to be able to succeed. Working with the entire family, our staff can identify each child’s unique strengths and challenges and then tailor a treatment plan to meet those needs.

Our Social Work and Counseling services can help children and their families learn to grow together. Contact us at socialservices@eastersealsdfvr.org or 630.620.4433.

Staying Sane while Staying Home

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

Response to Coronavirus (COVID-19) 

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

Routines

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

Visual Schedules

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

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

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

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

More resources at: Free Templates for Daily Visual Schedules 

Timers

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

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

Social Stories

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

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

Reducing Stress Activities

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

Physical Activities and Heavy Work

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

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

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

Family Game Night/Nightly Mealtime Tradition

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

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

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

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

Unplug

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

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

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

Tele-Therapy Services

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

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

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

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