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Category: Greenville

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 in**@***********************on.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

Helping Your Child Learn to Walk

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Concerns About Your Child’s Ability to Walk

Are you concerned that your child hasn’t started walking yet? Development and achievement of motor milestones happens at a pace unique to each child. However, if your child has not yet started walking independently by 18 months it may be time to reach out to your local Physical Therapist for an evaluation. The Centers for Disease Control and Prevention (CDC) acknowledges that these walking-related physical milestones are typically met by age 1:

  • pulling up to stand
  • walking while holding on to furniture
  • may be taking a few independent steps
  • standing holding on and may stand alone

Delayed walking can occur for a variety of reasons – core weakness, lower extremity weakness, vestibular dysfunction, gravitational sensitivities, impairments in the motor plan or coordination for walking, and balance deficits to name a few. During a Physical Therapy evaluation we will assess your child’s strength, movement of their extremities and trunk, and balance. We will also screen for any neurological and vestibular concerns, as well as keep an eye out for any sensory involvement or gravitational sensitivities.

How can you begin helping your child learn to walk?

Here are some activity ideas that may be used by your Physical Therapist and that you can try at home to jump start those unsupported steps and help your child walk:

    1. Activities to promote weight shifting between lower extremities, as well as single leg stance balance needed for unsupported walking. Cruising laterally (side to side), across corners, around corners, and pivoting between surfaces. This can be done at a horizontal surface (i.e. coffee table or couch) or a vertical surface (wall, window, mirror, etc.). As your child masters pivoting between two surfaces, increase the distance between the surfaces to promote unsupported standing and stepping to reach the other side.
    2. While standing supported at the couch, coffee table, wall, window, etc. offload one of your child’s lower extremities. You can prop their foot on a pillow, stool, etc. or simply hold their foot up off the ground. As your child masters this while standing supported, try while they are standing unsupported and interacting with a toy with both hands. Shift their weight over one leg while stabilizing their knee on that side. Lift their other leg to prop on a stool, pillow, your leg, or simply hold their foot off the ground.
    3. Supported walking for increased duration and distance. You can start by having your child walk while holding your hands. Progress them from holding 2 hands to just holding 1 hand. Move from holding hands up, overhead to holding hands, forearms, or elbows at shoulder height. They can also engage in supportive walking using a walker/push-toy. Note: Always provide supervision when having your child use a push walker/toy. It is recommended to only use push toys and NOT a walker that your baby has to be physically placed inside of. 
    4. Walking while standing in a small hula hoop/ring to promote reduced support and more variable support. Have your child hold on to the ring with both hands while you support the front or back of the ring. As they master this, wean away your support.
    5. Walking while holding a toy (ring, action figure, etc.) to promote walking with less support and eventually no support. Walk with your child while holding the toy together. As your child’s confidence increases, wean away your hold on the toy to promote walking with less support.
    6. Supported walking with a rubber band or hair tie to promote walking with more variable support. If your child will maintain a grasp on a rubber band or hair tie, try walking with them while holding the rubber band or hair tie together.
    7. Supported walking (hand hold or upper extremity support on a wall) while stepping over uneven surfaces (i.e. a pillow of blankets, couch cushions, pillows, etc.).
    8. Initiating unsupported stepping. Situate your child in standing with their back against the wall. Stand in front of your child and hold out an incentivizing toy, food, etc. to promote weight shift forward away from the wall, transition into unsupported standing, and progression to unsupported steps forward to reach you.

How can Carolina Therapy Connection help your child learn to walk?

Pediatric physical therapy promotes independence, increases participation, facilitates motor development and function, improves strength and endurance, enhances learning opportunities, and eases challenges with daily caregiving. When developmental progress is brought into question, it can be difficult for a parent. We know there is nothing as stressful as seeing other children advance quicker than your child, leaving them left behind as they develop at a slower pace than expected. It is important to understand that slower does not mean never! In fact, there are many late walkers who are able to overcome the delay and catch up with other children their age without concern.

If you have concerns about your child’s ability to walk, motor development or anything else, call Carolina Therapy Connection at 252-341-9944 or email us at in**@***********************on.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

Joann Carolina Therapy Connection Blog Greenville NC

Helping your child learn to walk Carolina Therapy Connection Greenville and New Bern NC

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 

Does My Child Need a Sensory Diet?

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What is a Sensory Diet?

As a COTA, during my first visit with a family for Occupational Therapy Services I am looking for and asking about ways to develop a sensory diet for home, school and/or community use.

I often get the question, “What is a Sensory Diet?”

A Sensory Diet is a personalized, organized plan that provides sensory input activities that a person needs to regulate their body throughout the day.

What does it mean to “regulate”?

Sensory regulation is easier to understand once you understand how your senses impact your body. The five senses known to most people are taste, touch, smell, sight and sound. Some people are unaware that you also have two other senses: vestibular and proprioceptive. The Vestibular System is responsible for regulating spacial orientation and providing the brain with information about movement and head position so that our body’s can coordinate movements appropriately. The Proprioceptive System helps regulate body movement by providing our brain with information about force provided primarily through our joints and muscles. Now we have seven systems to look at! To understand more about children’s sensory systems, how they affect learning and sensory integration therapy, read our blog: “Making Sense of Our Experiences.”Vestibular System Carolina Therapy ConnectionProprioceptive System Carolina Therapy Connection

What can be addressed with a sensory diet?

Jumping, crashing and or falling on purpose could look like a kiddo is being too rough or is clumsy. We want to figure out why this is happening. Could this be that the kiddo’s body is not confident about where it is in space, which is regulated by the vestibular system? Could this be because the kiddo’s body is considered “under responsive”? This means simply that this kiddo’s body may not register textures or body movements on the same scale as yours or mine. They would be considered UNDER responsive because their body is always looking for MORE sensory input. If their sensory system is not regulated, it will most likely cause them to try to find ways to do that on their own. This may come out in excessive jumping, movement, crashing into things, falling on purpose, touching everything nearby, etc. This can be frustrating and scary for a parent because the last thing you want is to see your kiddo hurt!

What sensory diet look like on a day-to-day basis?

This is where a sensory diet comes into play. A sensory diet will be comprised of special exercises that are specific to your child’s age, physical and cognitive capabilities. We will also look at your schedule for the day and what items you have at your availability. This does not necessarily mean that you will need 3-4 hours of strength training with your kiddo or a gym with equipment to complete these tasks. It can as simple as using the own body in appropriate ways to provide the input needed! For example, if you are out in the community and see a lot of high energy movements coming from your kiddo, try bunny hopping all the way down the isle at the store or have them help you care bags of groceries, etc. At home, depending on the child’s age and abilities, helping with household chores such and carrying the laundry basket, vacuuming, wiping down the table after dinner, etc. Input can also be provided by drinking thick liquids like milkshakes through a straw, eating crunchy foods/snacks and chewing gum. These simple activities provide the child with the gross motor movement, deep pressure through the joints/muscles, heavy work (as long as it’s appropriate for the age) and the confidence of knowing that they CAN feel regulated!

How can Carolina Therapy Connection help?

Each sensory diet will be very specific to each child, so it is important that you stick with it and consult with your Occupational Therapy Practitioner before making significant changes or if it does not produce the outcomes you are expecting. Please also remember that this change does not happen over night, so please don’t be discouraged if there is not an immediate change. Think of it like a weight loss diet. You cannot expect to eat healthy and exercise for one day and reach the outcomes you want. It takes work and dedication on all parts! The important element here is that the child, with your help as parents, learns helpful and appropriate strategies to regulate their body. This will help in so many more areas such as; school performance, attention, behaviorally, emotionally, etc.

Please talk to your Occupational Therapy Practitioner about a Sensory Diet today or call our clinic at 252-341-9944 to get started!

Written by: Shelby Godwin, COTA/L, AC

Shelby Godwin Occupational Therapy Assistant Carolina Therapy Connection Sensory Diet Goldsboro NC

Image References: Tools to GrowOT

Does My Child’s Pencil Grasp Matter?

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Does the way children hold their pencil really matter?

If you have a pencil handy, pick it up and notice how you hold it. Which fingers does the pencil rest between how are you supporting it? How much pressure do you use when you write? Does it really make a difference in your handwriting? The answer is YES, it does matter! How you hold your pencil really does make a difference—and it will also impact your writing. Your pencil grasp is directly related to handwriting speed and legibility, as having a mature grasp is more efficient and less tiring on your hands (Schwellnus, et al., 2012). Having a mature grasp also directly correlates with fine motor skills and your ability to manipulate other things (i.e. tying your shoes, picking up small objects, flossing, zipping up your jacket, using a fork or spoon).

Handwriting is essential for academic success and a foundation for efficient writing lies in how the child holds their pencil and the order in which letters are formed. It is important to address these concerns as early as possible. After the age of 8, changing grasp and formation patterns is difficult, but not impossible.

What are the stages of pencil grasp development?

There are several stages of pencil grasp development needed to develop a functional grasp that can be used to write efficiently and legibly. Each stage is important and helps to develop different muscles in the hand. Children typically develop control over the larger muscles of the trunk and arms before developing the smaller muscles of the hands. This is why grasp changes over time. Not all children will use all of these grasps during their fine motor development. Some children will use more than one grasp at an age as their skills develop and change. However, they should develop a functional mature grasp similar to the tripod grasp listed below.

 

Palmer grasp/Fisted grasp: typically develops between 12-18 months.

Palmer grasp/Fisted pencil grasp Carolina Therapy Connection Greenville NC

Digital pronate grasp: typically develops at 2-3 years.

Digital Pronated Pencil Grasp Carolina Therapy Connection Greenville, NC

5 finger grasp: typically develops between 3-4 years

5 Finger Pencil Grasp Carolina Therapy Connection, North Carolina

Four finger/quadrapod grasp: typically develops at 3.5-4 years

Four finger/quadrapod pencil grasp: Carolina Therapy Connection Greenville, NC

Tripod grasp: typically develops at 5-6 years

Tripod Pencil Grasp: Occupational Therapy Carolina Therapy Connection Greenville, NC

What is letter formation?

Handwriting is a complex process that involves many skills and body functions to work in a precise manner. Letter formation refers to the order in which each line segment is produced to make a single letter. Children should learn to form letters from top to bottom and from left to right. The order in which letters are formed either aids or interferes with efficient, legible writing.

Proper Letter Formation Carolina Therapy Connection Greenville NC

Why is proper letter formation important?

  • Children who have poor letter formation usually do not enjoy handwriting and/or the process takes longer than they would like.
  • Proper letter formation increases handwriting legibility, speed and accuracy.
  • Without the proper order of formation, letters are being ‘drawn’ more than formed and handwriting suffers.
  • Teaching proper letter formation can help to limit letter reversals such as b and d.
  • Practicing proper letter formation teaches higher cognitive skills ( i.e. working memory, sequencing, self-monitoring).

It’s important to note that every child’s handwriting style and process of learning is different and THAT IS OKAY! Our occupational therapists use a child-centered approach to help your kiddo become confident in their abilities while making handwriting FUN! If you are concerned about how your child forms letters or holds their pencil, an occupational therapist should evaluate your child. The therapist will determine if there are any skill or strength deficits and formulate a plan that is individualized for your child’s unique needs.

 

Written by: Amanda Easter, MS, OTR/L, CAS

Amanda Easter Blog - Does My Child's Pencil Grasp Matter? Occupational Therapy Greenville NC

References

Schwellnus, H., Carnahan, H., Kushki, A., Polatajko, H., Missiuna, C., & Chau, T. (2012). Effect of pencil grasp on the speed and legibility of handwriting in children. American Journal of Occupational Therapy, 66: 718–726.

Pencil Grasp Carolina Therapy Connection Greenville NC

Optimizing Therapy Progress

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Competence Brings Confidence

When we begin treatment with a new patient, or we begin working on a new skill at home as a parent, we often become so excited about the goal, or the end game, that we forget about all the small steps we should take to get there. Over the past 20 years working with children and families as an SLP and raising my own children I have learned that we need to celebrate the small steps in life and for therapy progress.

At some point I started telling parents of preschoolers and early elementary students, “Competence brings confidence!”

Your child might learn a very small step toward their goal in a therapy session. This small step should bring a lot of excitement, praise, and chances to “show it off” at home. These chances are growing your child’s confidence in their abilities. Those chances are giving neural connections a chance to form. Those chances are reinforcing new motor patterns. Being competent in a new skill, no matter how small, brings confidence! Confidence gives us the drive and the will to keep working hard and keep going. It keeps us excited in our pursuit to learn something new or difficult and optimizes therapy progress.

Focus on the Small Steps for Big Victories

Often parents and practitioners focus too much on the end goal.  Young children do not even know what the end goal is. We need to celebrate each very small step along the way.

With the confidence your child has from practicing a seemingly small skill at home, they come to therapy ready to move on and add more new skills. They will have the skill they have become so good at in their tool belt, and add to it! They might have started making a speech sound with confidence in isolation. When they are confident with that skill because they have shown it off many times, they will be ready to move on to making that sound in words.

In the opposite scenario we might spend time working on the small skills, try to speed along, and forget to give praise and practice at each step. We are focused on the end goal, for example, clear speech. All along your child or patient might practice and never realize all the small gains because we forget to praise them with small steps or have them show off their small steps. In this scenario, opportunities to practice important building blocks are missed. Opportunities to build confidence are missed, and ultimately the pace of progress is slower.

In the end, learning the “end goal” should have felt like many moments of satisfaction and praise to finally reach where we wanted the child to be.  It should not feel like many moments of trying and not {quite} getting there and being corrected over and over until we {finally} get good enough.

Incidentally, this works for grown ups too! If you are trying to learn something new, give yourself some grace. Focus on a small step you have mastered and practice it or show it off many times, and then move on. In the long run, you will be smarter and stronger for building competence in the small steps all along, and you will be more confident with your goal when you get there!

Optimizing Therapy Progress at Carolina Therapy Connection

The key to success is realizing that our large or end goals aren’t going to happen overnight, in the next week or maybe even the next year, but this is okay. We tend to take the present moment for granted – it seems insignificant, and we believe the little things we do in the moment are not changing us. At Carolina Therapy Connection, we believe in a culture that embraces the small victories for your family! Each time your child has milestone achievement, we will find a way to celebrate. We believe it is critical to make therapy as fun and motivating as possible by celebrating the small victories as well as major achievements. After all, when children enjoy what they are doing, who they are with and the environment they are in, anything is possible! If your family has concerns regarding your child’s development or goals you would like to achieve, call us at 252-341-9944. We would love to help you and make you a part of our CTC family and culture. 

 

Written by: Susan Hill, MS, CCC-SLP

Optimizing Therapy Progress Susan Hill SLP Greenville New Bern Goldsboro NC

 

 

 

 

 

 

 

 

 

Optimizing Therapy Progress Greenville NC Pediatric occupational speech and physical therapy written by Susan Hill

Phonological Patterns

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What are phonological patterns?

So your child’s speech-language pathologist says your child presents with phonological patterns…What does that mean? Phonological patterns are “patterns of sound errors that typically developing children use to simplify speech as they are learning to talk” (Hanks, 2013). Children often demonstrate difficulty coordinating their lips, tongue, teeth, palate, and jaw for intelligible speech. There are many different patterns that your child may demonstrate.

What is a phonological disorder?

A phonological disorder is when a pattern persists past what is considered “normal” for their age. For example, if your 4 year old still uses the phonological process of “reduplication” (saying, “wawa” for “water”) that would be considered delayed since most children stop using that process by the time they turn 3 (Hanks, 2013).

Typically, if your child is exhibiting several phonological patterns, their speech is difficult to understand or “unintelligible”. You, as a parent, may understand what they are saying because you are familiar with these speech sound patterns; however, other family members and peers demonstrate difficulty understanding your child.

As described above, a speech sound disorder is considered a phonological disorder when:

  1. Phonological processes persist beyond the typical age of development.
  2. Phonological processes are used that are not seen in typical development
  3. A child is highly unintelligible due to the excessive use of phonological processes

 

Phonological Patterns Carolina Therapy Connection Greenville NC Speech Therapy

What are common phonological patterns and what do they mean?

Assimilation: when one sound becomes the same or similar to other sounds in the same word

  • Age of Elimination: 3 years
  • Example: “I want a pip” when they meant to say “I want a sip” (the “s” becomes like the “p” at the end of the word)

Final Consonant Deletion: when a child drops off or doesn’t produce the last sound at the end of a word

  • Age of Elimination: 3 years
  • Example: “Look at the bow!” for “look at the boat!”

Devoicing: when a child produces a voiceless sound instead of the voiced sound

  • Age of Elimination: 3 years
  • Example: “Where is my back?” For “Where is my bag?”

Voicing: when a child produces a voiced sound for a voiceless sound

  • Age of Elimination: 3 years
  • Example: “I want more bees” for “I want more peas”

Stopping: when a child stops the airflow needed to produce a sound and substitutes it with another sound

  • Age of Elimination: 3-5 years
  • Example: “my two” for “my shoe”

Fronting: when a child substitutes sounds that they should be making in the back of the mouth with sounds towards the front of the mouth

  • Age of Elimination: 3.5 years
  • Example: “Daddy’s tea” for “Daddy’s key” (substituting “t” for “k”)

Cluster Reduction: when a child drops off or deletes one of the consonants in a “cluster”

  • Age of Elimination: 4 years
  • Example: “I see a nail” for “I see a snail”

Weak Syllable Deletion: when a child drops off or doesn’t say one of the syllables within a word

  • Age of Elimination: 4 years
  • Example: “I want a nana” for “I want a banana”

Deaffrication: when a child doesn’t produce the pressure sound in a combined sound

  • Age of Elimination: 4 years
  • Example: “I want ships” for “I want chips” (ch -> sh and j -> zh)

Gliding: when a child substitutes the “l” and “r” sounds for the “y” and “w” sounds

  • Age of Elimination: 5 years
  • Example: “The apple is wed” for “The apple is red”

*Examples and explanations are referenced from Adventures in Speech Pathology

How can Carolina Therapy Connection help?

This is a lot of information that can be overwhelming for a parent trying to help their child. We know that you want the best for your kiddo and we want to help! Our team of pediatric speech therapists provide screening, assessment, consultation, and treatment to help children overcome communication obstacles. Call Carolina Therapy Connection at 252-341-9944 to speak with one of our skilled and knowledgable speech-language pathologists. They can evaluate your child’s communication patterns, further explain phonological processes, and discuss the best treatment interventions for your family.

 

Written by: Brandi Ayscue, MS, CCC-SLP, CAS

Brandi Ayscue Phonological Patterns Blog Carolina Therapy Connection Greenville NC Speech Therapy

 

Phonological Patterns Carolina Therapy Connection Greenville New Bern NC Speech Therapy

Importance of Developmental Reflexes

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What are developmental reflexes?

A reflex is an automatic and instantaneous response to a sensory stimulus. Remember when you were a child at the doctor’s office and they tapped your knee with a small mallet to check if your leg kicked upwards? You didn’t decide to kick your leg, it just kicked. There are many types of reflexes like this one and almost all of us have them. In fact, we’re born with most of them. The reflexes we are born with are called primitive reflexes and the ones we develop during the first years of life are called integrated reflexes. From infancy, reflexes are vitally important for proper development of the brain, nervous system, body and sensory systems. Some reflexes are meant to stay with us our whole lives. Others are designed to be dormant after their function is fulfilled – also called integration. Check out this awesome resource from Tools to Grow to learn more about specific reflexes and how they impact a child’s function during their daily life.

What are primitive reflexes?

Primitive reflexes are present at birth and should be integrated by 12 months to two years of age. Reflexes are the basis of our nervous system and our ability to move. Reflexes are automatic movements that happen without conscious thought that help us to survive, search for food, seek protection, avoid danger, and to walk.  Reflexes originate in the brain stem, which is the area of the brain responsible for survival. If these reflexes are not integrated, the body stays in “survival” and “stress” mode which can cause difficulty with concentration, anxiety, poor behavior, deficits in coordination, and poor performance in developmental skills and school tasks. There are many risk factors for retained primitive reflexes including, but not limited to, the following: multiple births, prematurity, c-sections, lack of tummy time, higher instances of alcohol and drug abuse, and poor awareness of developmental stages. 

What are integrated reflexes?

Integrated reflexes are important for developing motor control. A child needs motor control to maintain proper posture at a desk in school, ride a bike, read a book, cross midline, write, and get dressed. A child with integrated reflexes has normal movement patterns to complete these functional tasks at home and at school. A child with unintegrated reflexes could benefit from skilled reflex integration therapy which will essentially train a child’s brain by establishing an efficient movement pattern that supports higher level motor skills or cognitive tasks.

How do you know whether or not your child has integrated these reflexes? 

There are many common areas of difficulty that may suggest a retained reflex including the following:

  • “Bouncing” Child: Constantly moving, can’t sit still on a chair, hyperactive
  • “Noodle” Child: Leans on everything, rests head on table
  • “Shirt Chewers”: Constantly chewing on shirts or pencils, and touches everything
  • “Emotional Child”: Challenges with regulating emotions, easily frustrated or upset, difficulty with utilizing age appropriate coping strategies to calm body 
  • School Performance Challenges: difficulty with reading, handwriting, language/speech, poor sitting balance and immature grasp on writing utensils
  • Coordination Challenges: Chronic body aches, poor endurance, fatigue, muscle weakness, poor concentration, fidgeting, disorganization

What does treatment look like?

Once your Occupational Therapist suspects a retained reflex, he/she will educate the caregiver on the importance of carryover for treatment recommendations. Caregivers play an important role in seeing progression in their child’s everyday activities. It is typically recommended that the child completes a set of tailored exercises to meet your child’s needs, 5-10 minutes per day, for 30 consecutive days in order to see any progress. Your therapist may recommended a reward or sticker chart in order to keep your child motivated towards an end goal. Progress can be noted short term and over 9-12 months. In addition to exercises, your Occupational Therapist will make recommendations for modifications in the school and home environments which may include changing positioning during school work, movement breaks, sensory techniques, relaxation techniques, decreasing auditory and visual stimulation, and organizational skills, just to name a few!

In order to determine whether your child would benefit from direct treatment for Reflex Integration, it is recommended that your child be evaluated or screened by an Occupational Therapist at Carolina Therapy Connection. Give us a call at 252-341-9944 today to schedule your FREE occupational therapy screening with one of our experienced and knowledgable OT’s. 

Importance of Developmental Reflexes Carolina Therapy Connection Greenville NC

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