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Category: Autism

Teaching Kids Independence With Life Skills

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Chores or Life Skills?

Kiddos may ask themselves this question: Why do I have to do these chores? Here at CTC, we call chores “Life Skills” because that is simply what they are. Although not always the most preferred thing for your child to do, washing dishes, washing clothes, making the bed, vacuuming, sweeping, mopping, grocery shopping, cooking, and many more are essential life skills that are necessary when becoming an independent adult. Not only are they necessary, they are also very helpful for the development of time management skills, executive functioning, sensory regulation, and even emotional regulation. 

You may be wondering how you can gauge what skills are appropriate for your child. Below is a short list of age appropriate chores to get you started based on your child’s age:

Life Skills for 2-3 years old

  • Picking up toys
  • Wiping up a mess (wiping off the counter after eating or messy play)
  • Putting laundry in the hamper after taking off dirty clothes

Life Skills for 4-5 years old

  • Making the bed (even if it is assisting you with the task!)
  • Starting simple meal preparation (putting thing into bowls, stirring, etc.)
  • Helping wash/rinse dishes

Life Skills for 6-8 years old

  • Feeding pets
  • Vacuuming, sweeping, mopping
  • Folding laundry/putting away own clothes

Life Skills for 9-12 years old

  • Prepare simple meals (heating up a hot pocket, TV dinner or oven pizza)
  • Taking out garbage
  • Cleaning areas of the home other than own bedroom (bathroom, living room, outdoor areas)
  • Helping make a shopping list and helping to find items in the grocery store

13-18 years – Include all listed above with increased to total independence!

So your child may be age appropriate for the tasks at hand, but what if you wonder whether they are developmentally, emotionally, physically or cognitively appropriate for the task at this age? Recently CTC held a Life Skills camp with 4 days of fun while completing tasks that increase independence within the home environment. The kiddos in this group worked on grocery shopping, meal preparation, cleaning up after themselves, household life skills, taking care of pets and plants, team work and communication. During the camp, each child was asked to review their skills and determine the toughest part of doing “chores”. The #1 answer was time management and feelings of overwhelm when presented with multiple tasks to complete. We all worked to develop either written or visual (picture) schedules for each kiddo to take home to aid in these concerns, making getting these life skills done easier and less frustrating!

Talk to your child’s occupational therapist to see if these could be options to help your child regulate their emotions, plan their time with greater efficiency and learn new skills after mastering current ones! If your kiddo struggles to complete their daily activities, call our clinic at (252) 341-9944! Your child may benefit from an occupational therapy screening or formal evaluation!

 

 

 

 

 

 

Here is 2 recipes of foods that were made during the camp:

  1. Rice Kripsy Treats – The Original Rice Krispies Treats™ Recipe | Rice Krispies® 
  2. Soup (written by a kiddo in the camp)

Ingredients

  • 3-4 boneless chicken thighs
  • 1 medium onion
  • 3 carrots, sliced
  • 2 chicken stock boxes
  • 1 small rice pack (boil in a bag)
  • 1 can black beans

Add a pinch of…

  • Pink Himalayan Salt
  • Chili powder
  • Seasoned Salt
  • Black pepper
  • Red pepper flakes

MIX TOGETHER IN A SMALL BOWL

Steps:

  1. Make the rice according to directions on the rice bag
  2. As the rice is cooking, cut chicken into 1 inch cubes
  3. Sprinkle seasoning onto chicken
  4. Cut carrots and onion into preferred size and cook until preferred texture
  5. Cook the chicken until done in saucepan
  6. Once all ingredients are finished, combine with stock in a pot and boil for 2-5 minutes
  7. Simmer for 10-15 minutes
Written By: Shelby Godwin, COTA/L, AC 
TEACHING CHILDREN LIFE SKILLS Carolina Therapy Connection Greenville Goldsboro New Bern NC

Why Does My Child Put Everything In Their Mouth?

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What is Oral Sensory Seeking?

Oral Sensory Seeking is the constant desire or need for a child to place objects in or touch their mouth. Children who have an oral fixation usually feel the need to constantly chew or suck on something. Depending on the age of the child, this may or may not be appropriate. As a parent, this can be difficult to navigate, especially due to the risk of choking on small objects. We know it is impossible to have eyes on your child every minute and scary to feel like you need to keep everything picked up off the floor and out of reach at all times. The oral stage of development that happens from birth to 21 months involves an infant’s pleasure center being focused on the mouth and lips, which are used for sucking and feeding. This is the age when the infant puts everything in the mouth—from hands, fingers, wrists, toys, pacifiers, clothing, blankets … just about anything within hands reach. One of the first prominent objects the baby’s mouth becomes accustomed to is a mother’s breast, for milk. In this blog, we will explore some of the reasons why your child may continue seeking additional oral sensory needs when it is no longer age-appropriate and activities to help them with this behavior.

What are Oral Sensory Seeking Behaviors?

When a child chews, mouths, sucks, or bites non-edible objects and/or edible objects frequently, we will call this an oral sensory seeking behavior. It can also involve harmful behaviors like biting. Some children who are seeking out oral and tactile (touch) sensory input will bite parts of their body, such as the arms, legs, feet and hands. Although oral seeking behavior can help children regulate their bodies and emotions at times, it can also prevent children’s learning if the child is constantly looking for objects to put in their mouth, or cause harm when they bite or suck on themselves. If children are distracted by finding objects or fixated on this behavior, it can affect their ability to focus at school or on an activity at hand.

Here is a list of common oral sensory seeking behaviors:

  • Excessive or frequent licking and/or chewing of random objects or toys
  • Excessive or frequent chewing of soft items or clothing (shirt sleeves, bed sheets, blankets, stuffed animals)
  • Biting toys or people, especially when unprovoked or when overly excited
  • Chewing the inside of the cheeks or biting/sucking on lip
  • Biting nails
  • Grinding teeth
  • Stuffing mouth with food or holding food in mouth for a long period of time
  • Drooling or spitting purposefully

How Can I Help My Child With Oral Sensory Behaviors?

Although there are a variety of ways to provide oral sensory input to children in a safe way and to replace oral sensory behaviors.. no child is the same when it comes to the solution. Our occupational therapists at Carolina Therapy Connection recommend that you experiment with these activities as part of your child’s sensory diet and notice what tends to calm, alert, and/or regulate them.

Create a FREE sensory diet with this template from “Your Kids Table” HERE!

Oral Sensory Seeking – Chewing Activities

  • Chewing crunchy foods, chewy foods, gum etc.
  • Use a chewy jewelry or other sensory chew toys

  • Vibrating chew toys (for kiddos who need that extra sensory input!)

Various Activities for Sensory Input

  • Blowing bubbles or blowing up balloons
  • Suck on sour candies, lollipops, ice cubes, etc.
  • Clicking tongue
  • Drink various textures through a straw (apple cause, milkshakes, yogurt, pudding, etc.)
  • Whistles, party blowers, kazoos, harmonicas, pinwheels etc.
  • Make a bubble mountains with dish soap and water

Bubbles Oral Motor Activities

How can Carolina Therapy Connection help?

Occupational therapy addresses any barriers that affect someone’s physical, mental and emotional wellbeing, which includes sensory integration difficulties. Sensory integration refers to how your body recognizes, processes, and responds to information received by our sensory systems on an individual and combined level.This includes our traditional 5 senses, sight, touch, taste, smell, and hearing; however, we also have proprioceptive and vestibular sensory systems. Often times, oral sensory processing or seeking difficulties are paired with other sensory system difficulties. Occupational therapists use sensory integration therapy by exposing a child to sensory stimulation in a structured and organized way. The goal of sensory integration therapy is to adapt the child’s brain and nervous system to process sensory information more efficiently.

At Carolina Therapy Connection, we offer Sensory Integration Therapy and play-based treatment intervention that is specifically designed to stimulate and challenge all of the senses. Sensory Integration involves specific sensory activities (swinging, bouncing, brushing, providing oral sensory input and more) that are intended to help your child regulate his or her response to incoming sensory input. The outcome of these activities may be better focus and attention, improved behavior, and even lowered anxiety. Our therapists may work on  lowering a patient’s negative reactions to touch, help them become better aware of their body in space, and work on their ability to manage their bodies more appropriately (run and jump when it’s time to run and jump, sit and focus when it’s time to sit and focus, etc.).

Our occupational therapists will complete an initial evaluation to become familiar with your child’s strengths, weaknesses and daily routine. Following the evaluation, they will create an individualized treatment plan and goals to address any concerns with development. We take pride in making therapy enjoyable and fun for your child, so that they can be motivated to live their life to their greatest potential. If you are interested in a FREE occupational therapy screening in the Greenville, Goldsboro, or New Bern, NC areas, call us at (252) 341-9944.

Why does my child put everything in their mouth? Carolina Therapy Connection

Mealtime Tips For Your Picky Eater

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Why Is Mealtime So Important For Children?

The 3 most important things for humans to survive is: food, water and oxygen. For some parents, the concern for their kiddos health and well-being becomes heightened when they notice their kiddo isn’t eating as much food or as many types of foods as they may have at one time. Some kiddos who are referred to Occupational Therapy are considered “Picky Eaters” and others may be referred to as a “Problem Feeder”. We all know a picky eater. This is a person/kiddo who has at least 30 foods in their repertoire. Whereas a “Problem Feeder” is a person/kiddo who has less than 20 foods in their repertoire. There are many reasons this could happen such as trauma, sensory related challenges, anxiety, behavioral challenges, and more. As Occupational Therapists, we are trained to assist these kiddos by addressing these challenges which can increase their tolerance for trying new foods! Keep reading to learn more picky eater tips we have below!

So why is MEALTIME so important to assist with this?

One of the first things we will ask as OTRs or COTAs is “What does mealtime look like at home?” Some parents may say, 

“We all sit down as a family every night for dinner but we are busy or gone for breakfast and lunch”, “We are so busy that we are lucky to eat all at the same time”, or “(The child) eats all day but won’t eat the food I cook at dinner”. Of course these are just examples, but can you relate to any of them? It’s a possibility! 

Asking about mealtimes is very important to your therapist because this gives us an idea of how your child eats during the day. Kiddos need fuel to keep their bodies going. However, WHAT they are taking in and HOW/WHEN they are taking it in will make a huge difference in behavior, attention, ability to process/retain information and regulate emotions/emotional responses. To give you an idea of why the “what”, “how” and “when” are so important, I’ll follow up on the questions above.

1. “We all sit down as a family every night for dinner but we are busy or gone for breakfast and lunch”

This could be a beneficial time to incorporate feeding techniques and build interest in the foods around the table. Interest always comes before action. A child must first be interested in the food before they will interact with it. This is one reason that mealtime is so important for kiddos. It can be an opportunity to build interest in various smells, sights, and textures of foods provided by parents in a supportive and positive manner.

2. “We are so busy that we are lucky to eat all at the same time”

How can you work your schedule to have a least one meal together every other day? We understand that this busy world requires busy people to keep it going. However, when you are overwhelmed and exhausted your child may pick up on that. Children are very intuitive. Incorporating as many mealtimes as possible may assist with parent/child interaction and decreasing anxiety and overwhelming emotions in adults which can in turn make eating less stressful for a “picky eater”.

3. “(The child) eats all day but won’t eat the food I cook at dinner”

Grazing is when a kiddo eating little snacks all throughout the day. Have you ever seen a child leave a snack on the table, go play for 30 minutes, then return to finish the snack? If your child is doing this all day, it may explain why they are not eating at mealtimes. Typically, the brain lets us know when we need to refuel because the digestive system sends signals saying, “I’m empty in here!”. When grazing, a child’s brain will begin to have a hard time distinguishing when the child is hungry due to constantly having food in the digestive system. This can effect metabolism and the ability to regulate hunger. When given mealtimes, the body has time to regulate, digest and filter out what it needs for fuel. Additionally, if given processed snacks that are high in sugar or carbohydrates throughout the day, the body will begin to crave them. This can create a difficult loop to break when introducing thing like vegetables, meats and some fruits. Positive interactions at mealtimes can assist with parent/child interactions, lowering anxiety and stress levels, giving the child’s body time to process what it needs for fuel and providing learning opportunities for the sensory system. This can be a major changing factor in how your child engages with food! 

Additional Mealtime Picky Eater Tips

Picky Eater Tips #1: Don’t force foods on children

As parents, we want our children to eat a variety of foods, including vegetables, fruits and other healthy snacks to help them grow to be strong and healthy. Studies show that forcing a child to sit and eat until they have cleared their entire plate is not the best method for achieving this goal. Instead, parents should promote foods that may have not been a hit the first time around. You can model this yourself by trying a food you haven’t liked in the past, and explain that you’re giving it another chance because your tastes may have changed. We want to show kids that we are adaptable. Remember: It can take as many as 10 or more times tasting a food before a toddler’s taste buds accept it. 

Picky Eater Tips #2: Get Creative With Food Bingo

You can also put together a list of new foods for the family to try and make a game out of it—what will we try tonight? You can make it interactive and fun by doing something creative like Food Bingo. There are many free printable online similar to the image shown below. You can even make your own! Hang it on the fridge and have your child place a sticker or check off the new foods they have tried. You can even add in a reward for them getting “bingo” – a trip to their favorite place, a new toy, a play date, or something else they really enjoy!

Food Bingo

Picky Eater Tips #3: Don’t Make a Second Meal

When you serve a meal to your family and your kiddo refuses to eat it, we recommend having simple and consistent back up options, such as yogurt, a cheese, nut & fruit snack pack, apple sauce, cereal etc. It’s important for children to know that if they can not eat the meal you have prepared, they will receive the standard option – rather than the usual chicken nuggets baked quickly in the oven. We should also teach kids that a meal isn’t ruined if it comes in contact with something they don’t like. Finding an unwanted pickle on your cheeseburger will not contaminate it. Children should be encouraged to push food they don’t like off to the side, or onto another plate, or offer to share it with someone else.

Picky Eater Tips #4: Involve Your Kiddo in the Meal Prep Process

Some cooking tasks are perfect for toddlers and small children (with supervision, of course): sifting, stirring, counting ingredients, picking fresh herbs from a garden or windowsill, and “painting” on cooking oil with a pastry brush. Allowing our children to interact with the foods they are going to eat will help to promote and encourage them to try it!

Picky Eater Tips #5: Food Chaining

Once your kiddo tries a new food and that food is accepted, use what one our Occupational Therapist’s favorite pickle eater tips call “food chaining” to introduce others with similar color, flavor and texture to help expand variety in what your child will eat. Children with sensory concerns have difficulty with leaping from the types of food they are willing/able to eat. Food chaining builds a bridge to get to those foods you really want your child to eat one step at a time through links to food they’re already eating. Examples include:

  • If your child likes pumpkin pie, for example, try mashed sweet potatoes and then mashed carrots.
  • If your child loves pretzels, try veggie straws next, and then move on to baby carrots or carrot sticks. Carrots are hard, crunchy, and stick shaped, but are cold and have a different taste.
  • If your child loves French Fries, then give a try to Zucchini fries.
  • Move from cookies to Fig Newtons, to jam toast, to jam sandwich, to bread with sliced strawberries, and lastly to fresh strawberries
  • If chicken nuggets are the fan favorite, try to first change the brand of nuggets, then move to homemade chicken nuggets, then to homemade tenders, and lastly to a baked chicken breast.
  • Maybe your kiddo love goldfish crackers. Next give Cheeze Itz a try, and then move on to saltine crackers, and lastly to saltines with cheese slices.

How Can Carolina Therapy Connection Help?

In addition to utilizing the tips above at home, we know that sometimes children need an extra push to expand their food repertoire. At Carolina Therapy Connection, our occupational and speech therapists provide feeding therapy that uses a collaborative approach to work closely with you and your child to determine the source of a child’s feeding difficulties, and develop specific intervention plans to make the entire eating process easier and more enjoyable. Often times, feeding therapy happens on a weekly basis and may consist of working on difficulty with trying new foods, chewing, swallowing, sensory issues, irritability at meal time and so much more. Our goals are to broaden your child’s scope of foods, teach them the benefits of healthy eating, and develop oral motor skills needed for optimal growth and nutrition.

Our Occupational Therapists take a sensory-based feeding approach to therapy.  They focus on: oral motor skills, sensory sensitivities, progressing through food textures, and using adaptive equipment and tools to develop self-feeding skills. They also use a process called food chaining, which is a child-friendly treatment approach that helps introduce new foods while building on the child’s past successful eating experiences. In this process, the child is presented with new foods that may be similar in taste, temperature, or texture to foods the child already likes and accepts. Our occupational therapists are certified in the SOS Feeding Approach, a nationally and internationally recognized approach for assessing and treating children with feeding difficulties.

Our feeding therapists have 15-20 years of experience with children of all ages and a variety of feeding disorders. They have certifications in SOS and AEIOU approaches and significant training from around the country on feeding approaches, treatment strategies, and focused plans. We also having consistent collaboration with other professionals in the community to guarantee the best care. Call our clinic at 252-341-9944 for a free phone screening with one of our feeding therapists and schedule an evaluation today!

Blog Written By: Shelby Godwin, COTA/L, AC & Morgan Foster, MS, OTR/L

 

The #1 Tip for Parenting a Child With Special Needs

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#1 Tip for Parenting a Child With Special Needs

No matter if your child is typically developing or you have a child(ren) with special needs, we have the best parenting tip that will help you every single day! And guess what?! It’s a super easy concept! However, a challenging one to implement!  Want to know what the #1 tip for parenting your child is?

SELF CONTROL AND MANAGING YOURSELF!

All kids need a calm, loving caregiver who is present and can manage their own emotions.  Being a caregiver is STRESSFUL and when we project that stress outward, our kids pick up on that behavior and emotion and have a hard time regulating themselves.  Remember- kids observe our ACTIONS more than they listen to what we tell them.  They are watching how we react, how we respond, and how we manage ourselves.  When we set a positive example for them in our everyday lives (for example, how we react to stress, how we talk to others, how we talk about ourselves, how we handle problems, etc.), they set this as their model.  When we are out of control there is a good chance that our child(ren) will be out of control!

Other Contributing Factors

In addition to managing our own emotions and behaviors, there are many reasons why a child may display negative behaviors:

  • Lack of sleep
  • Inconsistent schedules (i.e. holiday season, summertime)
  • Lack of routine
  • Overstimulation (from their environment or other people)

Other Parent Tips and Techniques

It’s important to manage these outside influences as much as possible to help encourage better regulation in our children.  During times that we know schedules and sleep may be affected (i.e during the holidays or during the Summer), we can use the following parenting tips and techniques to help our children with self-regulation:

  • Use visual supports (visual schedules)
  • Use a social story that outlines a particular event, holiday, or season. Here are some free holiday social stories you can use to help prepare your child for unexpected events.
  • Decrease the amount of stimulation in the environment by using noise canceling headphones, a weighted blanket, and build in time for sensory breaks (deep pressure input, mindfulness, calming music, etc.).

Parenting Tips and Techniques

Our children depend on us to help regulate their emotions and behavior.  What better way to model these things for them!  Here are some easy ways to manage our own behavior and carryout the #1 tip for parenting a child with special needs:

  • Build in time throughout the week and day for your own self-care- this may be getting enough sleep each night, setting aside time in the morning before everyone wakes up to take 5-10 minutes of meditation time, setting up a workout/exercise routine, setting aside time for your own hobbies.
  • Find ways throughout your day and week to laugh and find humor in situations.  Both smiling and laughing have been studied extensively for centuries- showing laughter and smiling produce inner happiness.
  • Give up on perfection and the need to compare yourself to others on social media.  Give yourself a social media break- detoxing from social media can remove unnecessary noise and the negative emotional triggers often caused by comparing yourself to others.
  • Focus on connecting with your family and kids daily.  Spend quality time with them each day- give them a hug, go for a walk, read a book together, spend time just talking each night before bed.  If your child is non-verbal, spend quality time together by engaging with them in something they find joy in!
  • Count your blessings! Writing down what you are grateful for changes your mindset.  Instead of looking at all of the challenges in your life and the things your child has not yet mastered, focus daily on one thing that is going well or one thing they are successful at!
  • Take a look at your expectations- ask yourself- are they unrealistic?  If your child is 2 years old, can you truly expect them to sit and attend for longer than 5 minutes? The answer is NO!  If your child is non-verbal, can you expect them to communicate their wants and needs effectively? When someone does not live up to the expectations you have set in your mind- that is when you become disappointed and upset.  Do a reality check on your expectations!
  • Lastly, and most importantly, when your child is acting out or behaving in a negative way, KEEP YOUR COOL!  As a caregiver it is super easy for us to lash out, raise our voices, or “punish” our child when they are really trying to communicate something to us.  The more we are able to keep calm and maintain our own composure, the better outcome the situation will be!  When your child goes into meltdown mode, check yourself- how am I feeling, what emotions are going through me, what is my child trying to communicate, what are my actions saying to my child?.  This is tough, I know, but SO important for our children!  How we deal with stress is how they will eventually deal with stress.

So, take a deep breath, count to 10, regroup, and remember your child has big emotions and needs lots of love during this time! Managing yourself, your emotions and your own behaviors is key! When hard times occur, the parent or caregiver’s response affects the likelihood of the behavior happening again.

If you need help creating strategies for your child to help manage their daily routines, please reach out to us! We are here for you!

Blog Written By: Cindy Taylor, MS, OTR/L

Cindy Taylor

Prep Academy Program

Autism Center and Autism Resources

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CTC Continues Commitment to Serving Autism Community and Provides Resources for Families

Since becoming a Certified Autism Center™ in 2020, Carolina Therapy Connection Greenville (CTC) has built upon the certification principals by collaborating with other resources to create a stronger community. Its therapists are now going into ABA clinics to provide occupational and physical therapy services.  As part of CTC’s ongoing commitment, team members recently completed additional training through IBCCES to meet renewal requirements and ensure staff have up-to-date knowledge and resources to enhance their skill sets.  Part of Carolina Therapy Connection’s mission is to provide valuable and specific autism resources for families that will help them throughout their daily routines.

Inclusive Programs

CTC also has a Prep Academy that provides a kindergarten readiness program that integrates typically developing children as well as children on the autism spectrum into the same learning environment.  Cindy Taylor, owner of Carolina Therapy Connection Greenville said, “The team’s hope and passion is to take the knowledge of our training and provide a safe space for kiddos to begin to engage in reciprocal play, be able to tolerate various sounds, and to begin to trust their environment.”

“Families have numerous and various reasons for the  ‘why’ behind what leads them to CTC.  Part of the ‘why’ for both the families we serve as well as potential new hires, is the Certified Autism Center™ designation and the individualized therapist training that comes with that.  Families feel comfort in knowing that owner, Cindy Taylor has taken the extra step to ensure that we as therapists receive ‘a little extra something’ to assist and better serve their kiddo,” shared Stevi M. Smith, COTA/L, AAC, HR Manager at CTC Greenville. “A lot of families who come to us may have had unpleasant experiences through other venues, be it school, a daycare, or another facility. So, when families see that we take time out to learn more about their kiddos, it means a lot to them.”

About CTC

Carolina Therapy Connection is a pediatric private practice serving children birth through adolescence and the team consists of occupational therapists, physical therapists, speech language pathologists, and educational specialists. Since becoming an autism certified practice employees have shared their excitement for IBCCES’ discipline specific training and certification options!  Many staff members shared comments like, “Sometimes we attend training, it’s nice and informative, but we have to think about how it applies to us professionally. This is not the case with IBCCES’ training.  Specific treatment scenarios are given throughout the training.”

  “It’s wonderful to have long-term partnerships with dedicated teams such as the professionals at Carolina Therapy Connection Greenville. Our programs require renewal and are updated with multidisciplinary experts as well as autistic individuals to ensure we can support professionals as best practices emerge” said Myron Pincomb, IBCCES Board Chairman.

For more than 20 years, IBCCES has been the industry leader in cognitive disorder training and certification for education, healthcare, and corporate professionals around the globe. IBCCES provides evidence-based training and certification programs created in conjunction with clinical experts and autistic individuals in order to provide professionals better understanding of how to communicate and interact with individuals with cognitive differences or sensory needs, industry best practices, and the latest research in these areas.

IBCCES also created CertifiedAutismCenter.com, as a free online resource for parents that lists certified locations and professionals. Each organization listed on the site has met Certified Autism Center™ (CAC) requirements.

About IBCCES

Delivering The Global Standard For Training and Certification in The Field of Cognitive Disorders – IBCCES provides a series of certifications that empower professionals to be leaders in their field and improve the outcomes for the individuals they serve. These programs are the only training and certification programs endorsed by the largest grassroots autism organization in the world, The Autism Society of America, and recognized around the world as the leading benchmark for training and certification in the areas of autism and other cognitive disorders.

Autism centerAutism center greenville, nc

Autism Center

The Vestibular System in Pediatrics

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What is the Vestibular System?

Vesti-what?!? The vestibular system is made up of the inner ear, vestibulocochlear nerve that communicates between the inner ear and brain, parts of the brainstem, and cortical areas in the brain. The vestibular system responds to head movements like when you nod your head “yes”, shake your head “no”, or tip your head to shake the water out of your ears. It also responds to movements like when you move forward or backwards when you’re sledding, move up and down like when you’re jumping, or when you spin around in circles. Overall the vestibular system helps you figure out where you are in space as you move around your environment so that you can… 

  • Maintain your gaze on a target while moving your head (vestibulo-ocular reflex)
  • Maintain postural control or balance
  • Orient yourself to your environment
  • React appropriately to your surroundings
  • Avoid falls

Check out this helpful resource from Integrated Learning Strategies, who breaks down the vestibular system as an internal GPS system for the body!

Vestibular Therapy Carolina Therapy Connection

What is vestibular dysfunction?

Vestibular dysfunction may be attributed to deficits or impairments of the inner ear, vestibulocochlear nerve, brain, or brainstem. As adults we may notice difficulties with our vestibular system due to symptoms like dizziness, vertigo, trouble keeping objects in focus while moving our head, or changes in our balance. Children who have vestibular concerns may not realize that they are dizzy or that movement of letters when reading is atypical if they have always experienced these symptoms. This can make diagnosing vestibular concerns hard and can often times be mistaken for other issues (learning disabilities, behavior problems etc.) due to a child’s inability to explain the symptoms they are experiencing.

Migraines, Benign Paroxysmal Vertigo of Childhood (BPVC), and Traumatic Brain Injuries are the most common causes of childhood vertigo. Ocular disorders, inner ear malformations, labyrinthitis (inflammation of the inner ear), and neuritis (inflammation of the vestibulocochlear nerve) are also common causes.

As a parent, here are a few signs and symptoms to watch for regarding vestibular dysfunction:

  • Head tilted to the side
  • Easily stressed, anxious, or upset with quick changes in movement or being on unstable, uneven, or taller surfaces
  • Nausea and vomiting
  • Imbalance or frequent falls
  • Vertigo or dizziness
  • Reduced cognitive performance
  • Decreased consciousness or arousal
  • Poor spatial awareness, navigation, or orientation
  • Ringing in ears
  • Spontaneous and involuntary eye movements
  • Motion/car sickness
  • Constant need for movement or taking unsafe risks for various positional changes or movement patterns

What should you do if your child is experiencing vestibular dysfuntion?

First and foremost, consult your child’s pediatrician to discuss your concerns. You may be referred to a neurologist for further evaluation and recommendations. If your child’s pediatrician or neurologist determines that your child would benefit from Physical or Occupational Therapy treatment, your child may be referred for an initial OT and/or PT evaluation.

How can a pediatric occupational therapist or physical therapist help with vestibular concerns?

  • During the initial evaluation your therapist may…
    • Assess how your child’s eye move in a variety of situations
    • Screen for abnormal eye movements
    • Assess your child’s visual acuity
    • Test your child’s balance while static or standing still, as well as their dynamic balance while on a variety of surfaces, while they are moving, or while they are performing a task
    • Assess how your child responds to various positional changes and movement patterns
    • Assess for seeking or avoidance behaviors of various positional changes or movements
  • During treatment your therapist may…
    • Use balance beams, obstacle courses, balance boards, single leg stance activities, etc. to challenge and improve your child’s balance.
    • Use stair training, climbing a rockwall or ladder, standing on a platform swing, etc. to address gravitational sensitivities and challenge balance at various heights.
    • Use swinging, spinning, rolling in a foam cylinder, sliding down slide, riding on a scooter board, etc. to help strengthen your child’s vestibular system. These activities will also potentially help delay the onset or reduce the severity of your child’s dizziness.
    • Use specific activities involving movement of their eyes and head to strengthen their vestibular system.

If you have concerns about your child’s vestibular function, motor development, sensory difficulties or anything else, call Carolina Therapy Connection at 252-341-9944 or email us at info@carolinatherapyconnection.com to get started today! We accept all major insurances and would love to help your family and kiddo maximize their independence and potential to grow healthy and strong!

Blog Written By: Joann Flaherty, PT, DPT and Jessica Reynalds OTD, OTR/L

References:

  • Casselbrant ML, Villardo RJ, Mandel EM. Balance and otitis media with effusion. Int J Audiol. 2008;47(9):584-589.
  • Christy, J., Beam, M., Mueller, G., & Rine, R. (2019). Just Screen It!! (Part 2): Developmental Disability, Vestibular Deficit, or Both?. Presentation, APTA Combined Sections Meeting.
  • Christy, J., & Rine, R. (2019). Just Screen It!! (Part 1): Developmental Disability, Vestibular Deficit, or Both?. Presentation, APTA Combined Sections Meeting.
  • Lin, C. (2019). Vestibular Rehabilitation Intervention. Presentation, East Carolina University.
  • Salami, A., Dellepiane, M., Mora, R., Taborelli, G., & Jankowska, B. (2006). Electronystagmography finding in children with peripheral and central vestibular disorders.International Journal of Pediatric Otorhinolaryngology, 70(1), 13-18. doi:10.1016/j.ijporl.2005.05.001
  • Wiener-Vacher, S. R. (2008). Vestibular disorders in children. International Journal of Audiology, 47(9), 578-583. doi:10.1080/14992020802334358
Pediatric Vestibular Therapy Greenville, NC Carolina Therapy Connection

All About Occupational Therapy

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What is Occupational Therapy? 

The main goal of OT is to increase quality of life so that the client can continue to participate in their personal interests as well as take care of their own needs. Through therapeutic use of self, a strong relationship of trust is built between client and therapist that will help the client to grow in skills leading to increased independence. Occupational therapists improve, rehabilitate, or maintain individuals’ performance to complete everyday occupations (IADLs & ADLs).

What is the role of an Occupational Therapist?

As an occupational therapy assistant, working in the pediatric setting, it is my responsibility to implement activities and tasks that will improve my clients ability to perform at an age-appropriate level. In this setting, you will commonly see OTs working on improving age-appropriate grasp and legibility with handwriting, sensory processing, oral motor skills for feeding, core strengthening for postural control, hand strengthening to increase fine motor skills, visual motor/perceptual skills for copying shapes and or letters.

What are IADLs?

IADL’s stands for Instrumental Activities of Daily Living that involve your home and community. Below is a list of different IADLs an individual may complete regularly.

  • Care of others
  • Care of pets
  • Communication management
  • Driving and community mobility
  • Financial management
  • Health management and maintenance
  • Housekeeping
  • Food preparation
  • Religious and spiritual activities
  • Shopping

What are ADLs?

ADL’s stands for Activities of Daily Living and are basic self-are tasks an individual engages in daily.

  • Bathing
  • Grooming
  • Toileting
  • Dressing
  • Feeding
  • Transfers
  • Abulation

How Can OT Benefit Children? 

Occupational therapy can benefit children of all ages with a variety of needs and diagnoses including:

At CTC, our occupational therapist provides screenings, assessments, consultations, and treatment for those concerned about: 

  • Cognitive skills
  • Gross & fine motor skills
  • Self-care tasks
  • Self-feeding tasks
  • Sensory processing
  • Visual processing & perception
  • Social skills

How can Carolina Therapy Connection help?

Our occupational therapists will complete an initial evaluation to become familiar with your child’s strengths, weaknesses and daily routine. Following the evaluation, they will create an individualized treatment plan and goals to address any concerns with development. We take pride in making therapy enjoyable and fun for your child, so that they can be motivated to live their life to their greatest potential.

We use evidence-based treatment approaches including:

If you have questions regarding your child’s development or want to learn more about occupational therapy, call our clinic today at 252-341-9944 or visit our referrals page HERE. We provide services in Greenville, Goldsboro and New Bern, North Carolina. One of our licensed and board certified therapists will be happy to provide you with a FREE developmental screening today! We can’t wait to begin this journey with your family!

Blog Written By: Lacey Smith, COTA/L 

Should My Child Be Using a Visual Schedule?

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What is a visual schedule?

As adults, many of us live by our planners. We gain satisfaction from marking off our to-do lists and being organized with our daily activities. Children are better able to learn, grow and adapt to changes using this same strategy! Although there are many types of visual schedules, they all typically contain images, symbols, photos and/or words to better communicate a task or activity. Depending on your child’s age and specific needs, their visual schedule may contain activities by the minute, hour, day or week. For example, if your child requires more structure, they may use a visual schedule that uses “first, next, then” language to communicate activities for the next few minutes. If your child requires less structure with their daily activities, their visual schedule may list tasks by hour for an entire day. Check out these examples below!

 

Carolina Therapy Connection Visual Schedule Example Autism

Carolina Therapy Connection Visual Schedule Example

What are the benefits of a visual schedule?

Visual schedules are a powerful tool that can help kids perform complex tasks, organize their day, or follow a routine. Here are a list of benefits that result from using visual schedules:

  • Visual schedules provide structure and predictability. Has your child ever become upset because they didn’t want to complete a task or weren’t expecting an upcoming activity? Visual schedules provide a consistent reminder of what activity is next and can show a reward that follows a non-preferred activity. For example, if your child doesn’t like bath time, they can use their visual schedule to understand they will get to watch their favorite TV show following their bath.
  • Visual schedules encourage independence. Once your child becomes comfortable with using their schedule, they can help create it and plan for each day. It will also allow them to select preferred activities or rewards between non-preferred activities. When a child helps create their own schedule, the sense of independence promotes completing activities without being asked to do so.
  • Visual schedules reduce negative behaviors and meltdowns. When kids know in advance what’s happening, it can help them feel more in control and at ease. If there is a change in their routine, they can plan and prepare themselves for that change.
  • Visual schedules work with your child’s visual strengths. Although visual schedules can use words, pictures and symbols often times create ease for reading a visual schedule. You can also use pictures that are specific to your child’s household or routine. For example, you can use a picture of their favorite book using your phone camera instead of a generic or cartoon book.
  • Visual schedules teach a variety of skills during childhood development. Visual supports open the doors of communication, increasing your child’s ability to interact with his or her surroundings. Creating and utilizing visual schedules promote visual motor skills, fine motor skills, organization, positive self-esteem, decision making, and a wide variety of executive functioning skills.
  • Visual schedules can be used for more than just sequencing activities. You can use visual prompts similar to visual schedules to break down one task into steps. For example, if your child has difficulty with sequencing the steps of toileting, they can use a chart similar to the one below provided by A Day In Our Shoes.

Carolina Therapy Connection Visual Schedules Autism Greenville NC

Tips For Implementing a Visual Schedule With Your Child

  • Before using the visual schedule, ensure that your child understands the purpose of it and how to use it.
  • The schedule needs to be manageable. Start with a small schedule that only contains a few tasks and uses language such as “first, then” or “first, next, then.”
  • Mix preferred activities with non-preferred ones. This helps to motivate children to persevere through non-preferred activities.
  • Personalize the schedule with their favorite characters or colors. Use pictures of your child’s specific toys or items in the household. If your child is able, let them help create it!
  • Cue your child to use the schedule or ask them to check it when they begin an activity. Repetition is key!
  • If your child gets satisfaction from marking off completed activities, place a check box beside each task.
  • Use these instructions for tips on creating your own visual schedule at home.
  • This awesome resource from A Day In Our Shoes has plenty of FREE visual schedules you can print from the comfort of your home.

How can Carolina Therapy Connection help?

At Carolina Therapy Connection, we offer pediatric occupational therapy to addresses concerns with things such as self-care skills, including feeding, bathing, and dressing; fine motor skills, including writing, tying shoes, and picking up small objects; neuromotor development; and sensory integration. Our occupational therapists can work with your child and family to ensure they are using the right type of visual schedule for their routine and help them create the perfect one just for them! Our experienced therapists can help your child use a visual schedule in the clinic, as well as carryover of using them in the home or school. As our team of specialists work to help your child reach their goals, you will begin to see remarkable changes in their skills and abilities. More importantly, you will see the happiness, confidence and sense of independence this brings to your child, and the peace of mind this brings to your family.

If you have any questions regarding visual schedules or your child’s development, call Carolina Therapy Connection at 252-341-9944 to speak with one of our occupational therapists! We currently offer occupational therapy, physical therapy and speech therapy in Greenville, Goldsboro and New Bern, NC. 

 

Carolina Therapy Connection Autism Visual Schedule Greenville NC

Helping Children Develop Self-Care Skills

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What are types of self-care skills?

As children learn and grow, they have a drive to be independent and do things on their own. One area that an occupational therapist address in childhood development are their activities of daily living (ADLs), also known as self-care skills. Self-care skills are skills that are required to manage a person’s basic needs including:

  • Brushing teeth
  • Dressing (upper/lower body dressing, zippers, belts, shoe tying)
  • Bathing
  • Grooming (brushing/styling hair, nail cutting)
  • Self-feeding
  • Toileting

What are the building blocks necessary for self-care skills?

  • Executive functioning skills (i.e. attention, sequencing, initiation of task)
  • Fine motor skills (hand & finger strength, object manipulation)
  • Receptive & expressive language (comprehension and alternative forms of communication to communicate wants, needs, thoughts and ideas)
  • Sensory processing (tolerating sensory stimulation in the environment, such as grooming or dressing tasks for tactile processing)
  • Coordination & motor planning (moving body through space in a functional way)

What age should my child be able to engage in self-care tasks?

It is important to understand that all children develop at their own pace and that is okay! Remember — there is no penalty for being cautious about your growing child, and if there is a problem acting early can make all the difference. Self care skills are the every day practice of the foundations skills for academic performance and not just life skills. According to the CDC and American Academy of Pediatrics, below are a few of the developmental milestones pertaining to self-care skills in early childhood development.

6-12 months

  • Drinking from a cup
  • Holding a bottle or cup independently
  • Using tongue to move food around mouth
  • Feeding self small crackers or other small pieces of food

1-2 years

  • Settling themselves to sleep at night or during the day
  • Attempting to brush teeth
  • Removing own socks
  • Cooperating with dressing by extending an arm or leg

2-3 years

  • Using toilet with assistance and having daytime control
  • Attempting to manipulate large buttons
  • Distinguishing between urination and bowel movements, and names them correctly
  • Using a napkin to wipe face and hands
  • Feeding self simple meals using a fork or spoon
  • Taking socks and shoes off

3-4 years

  • Unbuttoning and buttoning large buttons
  • Feeding self without difficulty
  • Tolerating different clothing textures, seams, tags etc
  • Toileting independently
  • Brushing teeth independently or with supervision only
  • Dressing and undressing self (only requiring assistance with laces, buttons, and other fasteners in awkward places)

4-5 years

  • Choosing weather appropriate clothes
  • Dressing self independently
  • Attempting to bathe and groom with supervision only

5-6 years

  • Dressing independently
  • Able to manage morning and night time routine with supervision only
  • Settling independently for sleep
  • Able to manipulate more difficult fasteners and tie shoes

6-7 years

  • Showering or taking a bath independently
  • Independently toileting during the day and at night
  • Preparing simple meals (i.e. cereal)
  • Independent grooming (combing hair, brushing teeth, flossing)

7-8 years

  • Showering independently
  • Taking on more responsibilities (i.e. chores)
  • Preparing simple meals and helping with more complex meals (i.e. making a sandwich, using the microwave, spreading condiments, pouring from a larger container into a cup)
  • Interest in taking on more complex grooming tasks – nail cutting, tolerating hair cuts, styling hair

How can an occupational therapist help address self-care difficulties?

Create a routine: Developing a consistent routine with a child can help them know what is expected of them and when to complete their self-care tasks throughout the day. Creating a routine may require a visual schedule or reward chart, something that an occupational therapist can help your child and family plan, develop, and implement in the home!

Improve fine motor skills: Almost all self-care skills require adequate fine motor skills, such as brushing teeth, using utensils, buttons, zippers, tying shoes, and more! An occupational therapist can help improve your child’s fine motor skills to increase independence of their self-care tasks.

Sensory integration: some children may have difficulty tolerating grooming or dressing tasks which can indicate a challenge with tactile processing. They may also have difficulty with tolerating hair cuts, nail cutting, or teeth brushing. Seeing an OT to address these sensory processing concerns can help your child to improve their ability to register and tolerate tactile input to improve their ability to complete these self-care tasks using a variety of treatment strategies.

Adaptation & modification of tools and the environment: An occupational therapist can recommend different types of adaptive equipment (i.e. button hook, weighted utensils, shoe horn, etc.) to help increase independence in self-care skills. They may also get creative by providing tips for adapting the environment to promote independence in the home.

Executive functioning skills & attention to task:  If your child has difficulty with their higher level cognitive skills then self-care may be difficult. Seeing an OT could be helpful by implementing and utilizing a variety of treatment strategies for increasing attention, initiation of tasks, sequencing steps of an activity and more!

Caregiver/parent training: An occupational therapist may be able to provide tips and strategies to parents in the home for carryover of self-care skills into daily routine.

How can Carolina Therapy Connection help?

Through demonstrated excellence in clinical, school, and home-based practice, Carolina Therapy Connection’s occupational therapists provide screening, assessment, consultation, and treatment to children having difficulty with a wide variety of needs, including difficulty with self-care skills. We believe it is critical to make therapy as fun and motivating as possible by celebrating the small victories as well as major achievements. We have a strong focus on helping your child develop the skills appropriate to their age and current stage of development. We also use a holistic approach and evidence-based practices to help your child develop and grow to their greatest potential. If your child is having difficulty with any of the skills discussed above, call our clinic today at 252-341-9944 for a FREE occupational therapy screening! We currently provide occupational therapy services in Greenville, Goldsboro and New Bern, NC!

References

Holland, B. (2017, February 14). Top 10 ways occupational therapy can help children with self-care. Chicago Occupational Therapy. Retrieved November 2, 2021, from https://chicagooccupationaltherapy.com/articles/top-10-ways-occupational-therapy-can-help-children-with-self-care/.

Admin, K. S. W. (2016, November 27). Self care skills. Kid Sense Child Development. Retrieved November 2, 2021, from https://childdevelopment.com.au/areas-of-concern/self-care/self-care-skills/.

Centers for Disease Control and Prevention. (2021, January 22). CDC’s Developmental Milestones. Centers for Disease Control and Prevention. Retrieved November 2, 2021, from https://www.cdc.gov/ncbddd/actearly/milestones/index.html.

 

Carolina Therapy Connection Occupational Therapy Greenville, Goldsboro, New Bern North Carolina Help with Self-care skills

Alternative & Complementary ADHD Treatments

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What is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common disorders among children. Per the American Psychiatric Association, many ADHD symptoms, such as high activity levels, difficulty remaining still for long periods of time and limited attention spans, are common to young children in general. The difference in children with ADHD is that their hyperactivity and inattention are noticeably greater than expected for their age and cause distress and/or problems functioning at home, at school or with friends.

ADHD Treatment

ADHD is commonly treated with medication and these medications are effective and for 80% of kids with the disorder. Some children benefit from their medication, in addition to other treatment strategies, while others are able to manage their routine with solely medication. Many parents worry about side affects of ADHD medication and are willing to try other options prior to taking the pharmaceutical route. Regardless of your decision for your child, as a parent, we understand that this can be a challenging time! An occupational therapist at Carolina Therapy Connection may be able to help your child by directly addressing these skills:

  • Organization
  • Physical Coordination
  • Controlling energy levels
  • Ability to do everyday tasks: organize their backpack, make their bed, complete morning or nightly routine, feeding etc.
  • Maintain attention to tasks
  • Time management

Carolina Therapy Connection discusses several alternative and complementary treatments for ADHD that we specialize in below.

Sensory Integration Therapy

    • Many children with ADHD also suffer from sensory processing disorder, a neurological underpinning that contributes to their ability to pay attention or focus.  Normally, we process and adapt to sensory stimulation in our daily environment. But children with ADHD are unable to adjust, and instead might be so distracted and bothered by a sound or movement in the classroom, for instance, that they cannot pay attention to the teacher.
    • Development of a sensory diet and home education program focusing on self-modulation and self-regulation skills
    • Use of our brand new, 3000sq. ft. sensory gym to elicit a variety of adaptive responses to help improve attention and sensory modulation 
      • Focus specifically on deep pressure/proprioceptive feedback and vestibular feedback.

Interactive Metronome (IM) Treatment Modality

    • Developed in the early 1990s, the Interactive Metronome treatment modality is a computer-based program that has children complete physical exercises in certain pre-determined rhythms, relying on a concept called “neurotiming” to improve a child’s focus, coordination, processing speed, and working memory.
    • The program requires the user to synchronize a range of hand and foot exercises with a precise computer-generated tone heard through headphones. A child tries to match the rhythmic beat with repetitive motor actions. An auditory-visual guidance system gives immediate feedback, measured in milliseconds, and keeps score. Over time (a typical course of treatment lasts 15 to 20 sessions), IM improves the brain’s sense of timing through exercise and practice — which, in turn, is thought to improve a wide range of other cognitive skills.
    • The principle behind both Interactive Metronome (neurotiming)  has been studied for more than 10 years. Most of the results have been positive: a 2011 study, focusing on 54 students in grades 2 through 8, found that, after training with Interactive Metronome for 20 sessions, participants’ reading and math skills improved by an average of 20 percent. Common ADHD trouble spots like attention levels, listening ability, and emotional control improved, too — by an average of 30 percent.
    • Another study, from 2012, compared traditional reading intervention methods with an interactive metronome program. Results indicated that children who practiced with the metronome program — in addition to the traditional reading intervention methods — had greater gains in reading skills than did the children who used traditional methods alone.
    • The Interactive Metronome training helps to facilitate a number of capacities, including attention, motor control, and selected academic skills, in children with ADHD.
    • Treatment with the Interactive Metronome is incorporated into a comprehensive occupational therapy treatment program and is covered by all insurances. 

Therapeutic Listening Program

    • Therapeutic Listening is an evidence-based form of music and sound therapy that assists people with many things such as sensory integration, poor attention and communication, and social skill deficits.  The music or sounds delivered to the individual through the headphones have been electronically modified and altered so that they stimulate the proper area of the central nervous system or brain.
    • In Therapeutic Listening therapy, an individual listens to a 30-minute session of music on specialized headphones twice a day no less than 3 hours apart from each other. While listening to music during the 30-minute session, the individual is usually engaging in behaviors that are intended to help them practice the skill of which they are wanting to improve. It can be done at home or in a therapeutic setting with our VitaLinks trained therapists.
    • Therapeutic Listening music can be altered in a way to stimulate the part of the brain that is responsible for attention, focus and hyperactivity. There have been numerous case studies to validate the efficacy of Therapeutic Listening to improve attention and focus.

Mindfulness Training

    • Occupational therapists work to help children “ground” themselves in their routines by using mindfulness techniques that help avoid and manage the stress that comes with feeling out of control.

Zones of Regulation

    • The Zones of Regulation is a curriculum geared toward helping students gain skills in consciously regulating their actions, which in turn leads to increased control and problem solving skills for kids with difficulty controlling impulsive behaviors.
    • The curriculum includes learning activities to help clients recognize when they are in the different zones (states of arousal) as well as lessons on how to use self-regulation strategies or tools to regulate the zone they are in.
    • Calming techniques and thinking strategies are explored along with sensory diet supports so students have a toolbox of strategies from which they can choose to help self-regulate.
    • To further explore the concept of self-regulation, clients gain an increased vocabulary of emotional terms, skills in reading facial expressions, perspective on how others see and react to their behavior, insight about events that trigger their behavior, and problem-solving skills. Executive functioning skills are addressed in order to increase flexible thinking, awareness of impulse control, and understanding the big picture.

If you have any questions regarding these treatments or your child’s development, call our clinic at 252-341-9944 and we will be glad to get you talking with one of our occupational therapists! Looking for more ADHD resources? Visit our resources page for ADHD HERE.

Carolina Therapy Connection ADHD Treatments Greenville, New Bern, Goldsboro NC