Why OT?: Destigmatizing the Need for Therapy

“Why was my child recommended for occupational therapy, they don’t have a job!” You might have many questions if your child has completed an occupational therapy evaluation and was recommended to receive occupational therapy services. What does this mean, exactly?

What is occupational therapy?

The term “occupational” does not refer to one’s employment, in this instance. Occupationscan be defined as activities that support the health, well-being, and development of an individual (American Occupational Therapy Association, 2014). An occupational therapist’s job is to increase the engagement and participation in meaningful daily activities that support your child’s learning, growing, and most of all, fun! There are a wide variety of circumstances that may affect your child’s optimal engagement in day-to-day activities at home, at school, or in the community.

How is occupational therapy going to help my child?

The benefit of occupational therapy is that practitioners are equipped for focusing therapy on a widevariety of skills required in your child’s daily life, such as:

  • Fine motor skills
    • Your child uses fine motor skills to write their name on their school work and to tie their shoes before heading out to play!
  • Visual motor skills
    • Your child utilizes visual motor skills when playing catch in the park and to copy written work from the chalkboard in the classroom.
  • Self-help skills
    • Self-help skills help get your child out the door in the morning! Your child needs to eat, get dressed, and use the bathroom to start their day.
  • Gross motor skills
    • Gross motor skills are required to walk to the front door and down the stairs safely to begin your child’s commute to school.
  • Sensory processing and regulation
    • Your child’s body is constantly processing sensory information in their environment to attend to and enjoy their world.
  • Executive functioning skills
    • When recalling the steps of their favorite family board game and following their teacher’s instructions, they are using their executive functioning skills, i.e., working memory, sequencing, and problem solving.
  • Social interaction skills
    • Your child utilizes their social interaction skills to make new friends and keep familiar ones.

What does it mean if my child was recommended occupational therapy?

Receiving a recommendation for therapy can be difficult and may bring about many questions and concerns regarding your child. Common concerns after receiving a recommendation for your child to receive therapy are “Will my child be singled-out from their peers?” or “Will my child always need therapy?”  When your child receives a recommendation for therapy, it does not necessarily mean that there is something wrong. A recommendation for occupational therapy does mean that a trained therapist has noted suspected concerns that warrant further evaluation. As an occupational therapist, many times I am asked, “Do you work with children with disabilities?” and my answer is, “Yes I do, but not exclusively!” Just as pediatric occupational therapists work on a wide variety of skills, we also work with a wide variety within the pediatric population. An occupational therapist will utilize a holistic approach to empower your child and your family so they can live their life to the fullest in their daily routines, school activities, and excitement within the community.

Questions or concerns?

If you have questions or concerns about your child’s engagement in meaningful daily activities, please contact us at info@playworkschicago.com or 773-332-9439.

Reagan Lockwood, MOT, OTR/L
Occupational Therapist

Reference: American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain & process (3rd ed.). American Journal of Occupational Therapy, 68(Suppl. 1), S1–S48. http://dx.doi.org/10.5014/ajot.2014.682006

Photo Credit: Photo by Thiago Cerqueira on Unsplash

Co-Treatment 101: What is it? And is it right for my child?

Co-treatment, or sometimes referred to as a co-treat, refers to when two different disciplines provide treatment for one child at the same time. For example, the speech-language pathologist and occupational therapist work together to implement both of their goals into one therapy session. Co-treating can be any combination of therapists, including developmental therapists, occupational therapists, physical therapists, speech-language pathologists, social workers, nutritionists, or any of the other members on your child’s therapy team.

When it comes to therapy, doesn’t more equal better?

Not necessarily. There is no one-size-fits-all recommendation for therapy frequency and is entirely dependent on the needs of your child. Some children benefit from multiple sessions of the same discipline to provide intense focus on specific goals, while others may benefit from a combined therapeutic approach. When an increase in therapy is recommended, it is best to consider both individual and co-treatment sessions.

What are the benefits of a co-treatment session?

There are many reasons why your team of therapists may recommend a co-treatment for your child. Below are just a few:

  • Co-treatments with OT or PT
    • When sensory regulation support is needed in order to attend to therapy activities
    • Gross motor activities may increase your child’s verbal output
    • Postural support may increase your child’s success in various therapy activities
  • Co-treatments with DT or SW
    • Behavioral strategies may be easier implemented with two trained therapists to support your child’s needs
    • Your child requires additional support to establish early developmental milestones prior to focusing on more complex therapy tasks
  • Co-treatments with SLP
    • When your child demonstrates a receptive language (comprehension) delay and benefits from modified cues for therapy directions
    • Appropriate language models can be implemented into structured tasks to increase verbalizations
  • General benefits
    • Therapists are able to brainstorm new therapeutic strategies and modify approaches in real-timeto see what works best for your child
    • Your child is already receiving multiple therapies per week and may become fatigued with additional sessions

How do I know if a co-treatment session is right for my child?

The first step is to talk to your current team of therapists to review your child’s individual goals. Depending on their needs, you and your team will be able to decide if a co-treatment session would be beneficial for your child. If you do decide upon a co-treatment, discuss the therapy plan prior to implementation to make sure that your child is not being placed under too many demands. A successful co-treatment will use basic principles of resource allocation to guide therapy – basically, your child only has so many resources to spend on one difficult task at a time, so they should not be challenged in both discipline areas during the same task (i.e. working on both speech therapy and occupational therapy goals while playing with one toy). This most likely will be asking too much of your child and will often cause them to be unsuccessful with both goals.

Questions or concerns?

If you have questions or concerns about implementing a co-treatment session for your child, please contact us at info@playworkschicago.com or 773-332-9439.

Autumn Smith, MS, CCC-SLP
Director of Speech-Language Services

Photo Credit:rawpixel.com

Speech Therapy: Debunked

Most people have had some exposure or connection to speech and language therapy, whether it was for themselves, a friend, or a family member. It could be that your child has recently been recommended speech therapy and you are not sure what this will entail. In this blog, I hope to debunk a few common misconceptions regarding speech and language therapy, as well as provide a brief overview of the field of pediatric speech-language pathology.

Common Myths and Misconceptions: Debunked
While it may look to the outside world that we are simply playing with toys and games, there is a method to this play-based madness. Our job is to find out what motivates your child and use it to target their therapy goals. When your child is a toddler, this might mean making a cow jump over a barn. While that isfun, your speech therapist may be working on improving your child’s engagement and ability to imitate play-actions, which will hopefully lead them to imitating sounds and words. A population that is often thought of when discussing speech therapy are those with disfluencies, or those who stutter. This is true but is a small percentage of children worked with for a general speech therapist. Articulation therapy is another familiar area, as many of my friends remember being pulled-out of class to play Candyland and work on speech sounds as a child.  Although I do own Candyland and use it semi-regularly, there is so much more we, as speech-language pathologists, do to help improve your child’s communication skills.

What is speech and language therapy?

Variety is the spice of life, and as speech therapists, we get a good taste of this! Speech therapists have a broad scope of practice when it comes to the pediatric population. Below are a few of the most common areas a speech therapist might help your child with.

  • Articulation/Phonology:The actual sounds your child makes to create words.
  • Motor planning:Your child’s ability to plan and execute the fine motor movements required to speak in words, phrases and conversation.
  • Language:The words and phrases your child both usesand understands.
  • Feeding:This involves oral-motors skills like sucking, chewing and swallowing. Also, the sensory processing of different textures, tastes and consistencies.
  • Voice:Your child’s vocal quality. Is it appropriate for a child their age and size or is it breathy or hoarse?
  • Fluency:The way your child’s speech flows.
  • Pragmatics:Your child’s social communication skills, such as making eye-contact, initiating communication with peers, and taking conversational turns.
  • Advocacy: Your child could benefit from additional therapies that you may not be aware of. Your speech therapist can help advocate for your child to ensure they get the best possible care from a qualified team of providers, if necessary.

If your child is demonstrating difficulty in one or many of the areas above, consider contacting one of our speech-language therapists.

Questions or concerns?

If you have questions or concerns about your child’s communication or feeding skills, please contact us at info@playworkschicago.com or 773-332-9439.

Ana Thrall Burgoon, M.S., CCC – SLP 
Speech-Language Pathologist

Photo Credit: Photo by Leo Rivas on Unsplash

What Toys Are Best For My Child?

As a walk down any toy aisle will tell you, there are many types of toys for all ages of children.  Most will indicate on the packaging what age they are geared toward (“for ages 2+”), but how do you know which toys will provide the best developmental opportunities for your child?

Choose toys that are open-ended.

Get the most bang for your buck by choosing toys that can be adapted as your child grows. For example, blocks are great for infants to bang together to practice cause and effect, as well as bringing their hands to the midline, a great exercise for the brain. Toddlers can begin to stack blocks for fine motor development. They can also use blocks to encourage imaginative play by pretending they are cars driving across the floor or as a telephone to call a loved one! Preschool children can use blocks to build more elaborate structures with playmates to encourage social skills and negotiating conflict. Blocks also enhance dramatic play and can be used to create a house for stuffed animals, a storefront for a restaurant, or bridge to connect people, things, and ideas.

Adapt “toys” you already have.

Parents joke that children often prefer the box the toy came in to the actual toy. Go with it! Let your creativity loose and find new purpose for items in your house. What about that mesh loofa? It makes a great sensory experience for infants, and it is easy for them to grasp as their hand-eye coordination is developing. It also makes a safe option for toddlers to throw and kick around the house. What about using it in paint for a unique texture on paper? Or add it your play with a doll or stuffed animal and practice the bath time routine.  The possibilities are endless!

Don’t forget your child’s favorite toy: You!

Playtime is not necessarily about the type of toy, but how it is used in relation with the caregiver. As caregivers, our schedules are packed, but even just a few moments of playing peek-a-boo your infants or singing a rousing rendition of “Wheels on the Bus,” with your toddler, complete with motions, will help your child’s brain develop synapse connections as they learn about the world around them. Point out your eyes, nose, etc.during bath time with your little one or try playing I-Spy in the car on the way to the store with your preschooler. Your child learns best in the context of a loving relationship with you, so go ahead, have a tickle-fest in the middle of that toy aisle and take advantage of the most priceless toy your child could have! You!

Questions or concerns?

If you have questions or concerns about developmentally appropriate toys, please contact us at info@playworkschicago.com or 773-332-9439.

Becky Clark, MS, DT
Developmental Therapist

Reference: Cook, R. E., Sparks, S. N. (2008).  The art and practice of home visiting. Baltimore, MD: Paul H. Brooks Publishing Co.

Photo by Susan Holt Simpsonon unsplash.com

Early Intervention Initial Evaluation: What to Expect

Making the call to Early Intervention (EI) can be the daunting first step in addressing developmental concerns for your child. What comes next? PlayWorks Therapy’s Director of Developmental Therapy, Kim Shlaes, explains what to expect during an Illinois Early Intervention initial evaluation.

Service Coordinator
After a referral is made for your child, a service coordinator is assigned to your case. The service coordinator:

  • Is the point of contact for you and your family to help guide you through the EI process.
  • Is responsible for conducting an intake meeting to collect all the needed information and paperwork to set up an initial evaluation.
  • Coordinates the evaluation and ongoing services, should your child qualify.
  • Is responsible for writing and updating the Individualized Family Service Plan (IFSP) based on recommendations made by providers during their initial evaluation, goals you and your family have for your child, and assessments while in EI.
  • Is responsible for informing a family of their rights while in EI.
  • Helps facilitate the transition from EI as the child ages out of the program at three years old.

Initial Evaluation
Next, your service coordinator organizes a team of at least two credentialed evaluators. The evaluation team is selected based on developmental concerns you have for your child. An evaluation team typically has a combination of the following: developmental therapist, occupational therapist, physical therapist, and/or speech and language pathologist. Other providers, such as social workers, nutritionists, interpreters, and others are added to an evaluation team as needed.

The initial evaluation typically takes about one hour to complete. A parent/guardian is required to attend the evaluation. A typical evaluation follows the following routine:

  • Review reasons for the referral to EI, including parental and pediatrician concerns.
  • Review the child’s birth and medical history. The evaluators will also ask questions about your child’s milestones, their social history (including who your child lives with, who cares for your child during the day, any languages your child is exposed to), and your child’s opportunities to socialize with other children.
  • The evaluators take turns playing with your child.
  • The evaluators ask you several questions about your child’s development (i.e. how your child completes “self-help” skills such as eating and dressing, how they socialize with other children, how they communicate with you, how they process sensory information, etc.).
  • Evaluators then score their assessments and make recommendations for ongoing therapy or additional evaluations. If your child qualifies for services, you and the evaluators write discipline specific goals for your child, based on what your family wants to target while in EI. This part of the evaluation is the “IFSP meeting”.

What comes next?
Should you decide to move forward with Early Intervention services, your service coordinator organizes a team of credentialed therapists to provide service to your child. These therapists contact you directly to schedule your child’s therapy sessions, which are held in a natural environment for your child, most commonly your home or their school/daycare. Services typically begin within a few weeks of the initial evaluation.

Questions or concerns?
If you have questions or concerns about your child’s development or the Early Intervention process, please contact us at info@playworkschicago.com or 773-332-9439.

Kimberly Shlaes, MAT, DT
Director of Developmental Therapy Services

Photo Credit: willingness.com.mt/types-of-play-therapy/

What to Choose? Self-Feeding Tools for Babies and Toddlers

If you’ve ever browsed the grocery store aisles looking for the perfect cup or utensil set for your child, you may have quickly found yourself overwhelmed with all of the options. With the wide variety of choices available nowadays, it’s hard to determine the best item to for your child. There is no “one size fits all” approach to finding a transition cup and/or feeding utensil that is right for your child, and it may take some trial and error to determine the best fit. However, throughout my time as a speech-language pathologist and feeding therapist, I’ve found some tools to be particularly useful as a child develops his or her eating and drinking skills.

I’ve heard sippy cups are bad? What cup should I choose?

I’ve had many parents tell me that they’ve heard that sippy cups are “bad” and that they’d like a better option for their child. While I don’t label all sippy cups as “bad” (and feel that they are a necessary option for some children with specific feeding needs), research has proven that use of sippy cups can lead to tooth decay, oral motor delays, and speech and swallowing delays. For more information, please see a recent blog post by one of PlayWorks Therapy’s speech language pathologists: http://playworkschicago.com/blog/page/3/

Straw cups and free flow cups are a great alternative to sippy cups. Here are some cups that I have found particularly beneficial for children from all feeding backgrounds:

  • Straw cups: There are a wide variety of straw cups on the market that are specific to babies and toddlers. Some of my favorites include the Nuby No-Spill Sports Sipper(a great option for transitioning from bottles to cups!) and Phillips Avent Straw Cup; however, there are several similar options on the market that work just as well. If your child hasn’t quite grasped the concept of straws yet, the Honey Bear Straw Cupis a great introduction to straw drinking.
  • Spoutless sippy cups: Commonly referred to as the 360 Cup, this no-spill cup is a great tool to teach the oral motor and swallowing skills necessary for drinking from an open cup. Munchin Miracle 360 Trainerand Playtex Spoutless 360 Cupare both great options.

I want my child to use utensils, but he can’t quite grasp a spoon or fork yet. What should I do?

Children learn to eat with their hands, and this is a goodthing! It’s important for children to be exposed to the sensory properties of food, and eating with their hands is the best way to do so. However, there comes a time when it’s appropriate for a child to use a utensil to feed himself. When children aren’t able to successfully use a fork or spoon, I like to incorporate some of the following:

  • Dippers: Dippers are similar to a spoon, except they have no spoon bowl. Children use dippers by dipping the utensil in a thick puree and bringing the dipper to their mouth. This teaches the motor skills necessary for using utensils without requiring as much coordination. Some of my favorite dippers include Numnum Pre-Spoon Goo-tensilsand ChooMee Starter Spoons.
  • Curved spoons: Curved spoons are another good option for children who have difficulty handling typical spoons. Curved spoons are made to match a baby’s natural grasp. Many have shorter, thicker handles which make the spoons easier to maneuver. Playtex Curve Infant Spoonsare a great option!
  • Child size spoons and forks: While I don’t have any particular brand of spoons and forks that I prefer, children learning to self-feed will have more control when using small utensils. Additionally, utensils with a wider handle will be easier for children to grip.

What can I do if my child is demonstrating feeding difficulties?

If your child is demonstrating difficulties transitioning away from the bottle and/or tolerating an age-appropriate diet, consider contacting one of our feeding therapists, who can provide your family with helpful tips and tricks to increase your child’s independence as they transition to the world of self-feeding.

Questions or concerns?

If you have questions or concerns about your child’s feeding skills, please contact us at info@playworkschicago.com or 773-332-9439.

Sarah Lydon, MA, CCC-SLP
Speech-Language Pathologist

Photo Credit: Hal Gatewood via unsplash.com

** Disclaimer: We are not affiliated, associated, endorsed by, or in any way officially connected, with any of the products listed in this blog.

Boom, Bang, Chirp: the Sounds of Summer and the Auditory System

Summertime is filled with distinct noises, like that of a fire engine in the Fourth of July parade, fireworks exploding in the sky, or the steady hum of crickets chirping in the yard. For some children, these sounds can be quite stressful. Like the other sensory systems (touch, taste, smell, sight, etc), your child’s sense of hearing, or their auditory system, takes in information, processes it, and produces an external response. Sometimes, this information isn’t processed correctly. In these cases, your child may demonstrate hypersensitivity or hyposensitivity to sound, and those fun summertime activities become a source of anxiety for your little one.

What is hypersensitivity?
If your child seems to overreact to everyday sounds or seems easily distracted by noise that you are able to tune out, she is demonstrating auditory hypersensitivity. Your child may experience an intense fear of mechanical items with “whirring” sounds, such as vacuum cleaners, hand dryers or flushing toilets in public restrooms, blender, hairdryer, and coffee grinder. She may overreact to unexpected sounds by covering her ears or crying. She may seem to be overly tuned in to background noise in the environment, such as the fan spinning or the clock ticking.

What is hyposensitivity?
If your child seems to enjoy loud noises in his environment, demonstrates difficulty figuring out where a sound is coming from (localizing), and/or has difficulty figuring out what a sound is (distinguishing), he is demonstrating auditory hyposensitivity. Your child may constantly create noises with his mouth throughout the day. He may prefer to keep the television very loud, but become upset when others speak loudly. He may have difficulty hearing and responding when his name is called, especially from another room.

What causes these kinds of sensory auditory dysfunction?
The stapedius is a middle ear muscle that contracts in response to loud noise in order to protect the small hair follicles on our inner ears. Scientists say that sensory-based auditory issues may be due to a poorly-functioning stapedius. The middle and inner ear muscle systems are also important in the function of other sensory structures, such as the vestibular system – which determines your child’s equilibrium and balance.

What can I do?
If your child is demonstrating some of the behaviors above, consider contacting one of our occupational therapists, who can provide your family with helpful tips and tricks to minimize distraction, utilize noise-cancelling items, work through difficult school-based tasks, and more! If your child is demonstrating difficulty with language interpretation, difficulty learning to read, and/or a speech delay that are accompanied with the symptoms listed above, he may be experiencing Auditory Processing Disorder (APD). APD is dysfunction in the brain’s ability to translate sounds. An audiologist can help identify the issue and provide suggestions for next steps.

Questions or concerns?
If you have questions or concerns about your child’s responses to noise, please contact us at info@playworkschicago.com or 773-332-9439.

Jen Brown, MS, OTR/L
Director of Occupational Therapy Services

Reference: Dodd, George. (2002). Distinguishing sound from noise- the significance of attention and noise sensitivity. The Journal of the Acoustical Society of America 112, 2243. 25 October 2002. https://doi.org/10.1121/1.4778910

Challenging Behaviors: Considering the What and Why

Throughout children’s lives, there may be periods of time where their behaviors seem to be challenging and difficult to manage. When looking at these behaviors, it is important to consider what purpose the behavior is serving and why the behavior is happening. While is it typical for young children to have tantrums and use occasional aggression, it becomes challenging when these behaviors are continued repeated patterns that:

  • Interfere with a child’s learning, development, and success
  • Interfere with a child’s ability to engage in positive interactions with peers and adults
  • Is harmful to the child, peers, or adults
  • Is overall challenging to manage

Examples of common challenging behaviors that are reported in young children include aggression (biting, hitting, pushing). In looking at these behaviors, it is important for caregivers to first look at the purposes of these behaviors. Is the child engaging in these behaviors to get a reaction (behavioral response) or are they trying to seek input to their bodies (sensory response)? Below are examples of the behaviors seen through both behavioral and sensory lenses:

After caregivers figure out the purposes of the behaviors, it is important to match the consequences accordingly. For example, if the concerns have a behavior response, the consequence should be behavior based. If the concerns have a sensory response, the consequence should be sensory based. Below are examples of consequences from each perspective.

It is important for the child’s caregivers (e.g. parents, teachers, nanny, etc.) to be on the same page when it comes to giving consequences. When children receive constant responses from all caregivers, the higher the changes are of the challenging behaviors decreasing.

Brittany Hill, MS, MSW, LCSW, DT
Licensed Clinical Social Worker
Developmental Therapist

The Benefits of Parent Involvement in Early Intervention

What is your role as a parent in your child’s therapy sessions?

As a parent of a child who is receiving Early Intervention services, you may wonder what your role is during your child’s therapy sessions. Will the therapist be working one-on-one with your child? Will you be observing the session? Or will you be actively participating?

Parents are key to the success of therapy, no matter the goals being targeted. As a parent your involvement and insight are essential for your child to make progress towards their developmental goals.  For this reason, it is recommended that parents take an active role in therapy sessions. Your child’s therapist will model and teach you strategies and techniques for achieving your child’s specific goals. These strategies can then be carried over into your child’s daily routines and activities. You will see the best outcomes when the strategies provided during therapy sessions are embedded into your child’s everyday routines, as this will provide your child with frequent and natural learning opportunities to practice the skills introduced.

Benefits of parent involvement:

  • Parents are a child’s first teacher and children will learn the most from the people who know them best!
  • Parents interact with their children everyday and offer frequent learning opportunities for their children.
  • Children generalize learned skills when they are embedded into every day routines, such as mealtime, bath time, bedtime, and play

The impact of ongoing parent involvement

As a parent you will be able to provide your child’s therapist with important information that will help with setting specific goals for therapy and how best to implement strategies for reaching those goals based on your family’s daily routines and activities. You will take an active role throughout the therapy process by reporting changes that you see in your child and subsequently working with your child’s therapist to determine what the next steps will be. As a parent you will be able to take the strategies provided during therapy sessions and incorporate them into your child’s every day activities, which will allow frequent learning opportunities for your child. You are your child’s first and best teacher and your involvement makes all the difference!

If you have any questions or concerns about joining your child’s therapy sessions, talk with your ongoing therapist to discuss a plan for getting involved. For further information on parent involvement, please contact us at info@playworkschicago.comor 773-332-9439.

Claire Kakenmaster, MS, CCC-SLP
Speech Language Pathologist

Photo Credit

Why is Play Important?

Play is a natural and important part of development that begins in early childhood. Children learn to connect with and understand their world through their play. Play contributes to cognitive, social-emotional, motor, and language growth in young children. Children learn through toys and people how to explore, discover, and play.

Sensory Exploration (3 to 6 months): A child explores an object texture by using their senses. They will put an object in their hands, mouth, or visually watching the object as a caregiver is displaying it to them. This is when a child is learning how to comprehend new experiences.

Relational Play (9 to 12 months): This is when a child use two different but related objects. For example, a child will bring a brush to a doll’s head.

Functional Play (12 to 15 months): This is when a child plays with an object according to how it works. For example, cups are for drinking or cars are for pushing.

Symbolic Play (15 to 18 months): A child is using an object for something else. For example, a child may use a block as a phone, or a straw as a toothbrush. A child can also use realistic props such as, pretend food to engage in symbolic play with realistic props.

Imaginative Play (24 to 30 months): This is when a child is starting to process their environment through play. For example, a child may act out a visit to the doctor’s office or pretend to have a birthday party.

The different stages of play help support the meeting of developmental milestones. Encouraging play in your child’s day will allow these play stages to naturally form. Playing and interacting with your child from the beginning of birth will help you encourage these developmental milestones to flourish. In each stage of play, children are learning how to interact with others in their environment. They are learning how to manipulate toys, move around the room to access activities they are interested in, how to problem solve, and how to share their ideas through communication. Play skills develop as a child develops. As a child’s understanding of the world and how it works develops so do their interests in toys and in social interactions with their caregivers and peers.

Rachel Weiser, MS, DT
Developmental Therapist

Resources:

http://pediatrics.aappublications.org/content/119/1/182

http://www.earlychildhoodnews.com/earlychildhood/article_view.aspx?ArticleID=240

https://www.naeyc.org/resources/topics/play