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Category: Physical Therapy

What is Toe Walking?

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Toe walking means that a child is walking and standing on tiptoes, and their heels do not make contact with the ground. Walking up on their toes can be a normal occurrence in children aged three and under as they continue to develop their ability to walk. Beyond that age, without any definitive medical reason, it is considered idiopathic toe walking (walking on toes without a known cause).

Toe Walking Causes

To understand, what’s not so simple about toe walking is the why behind it. There are many possible reasons that children might develop this pattern:

Developmental phase: A child occasionally walking on the balls of their feet can be part of normal development.  When children first begin walking, usually between 12-15 months of age, they often try different foot positions including walking up on their toes.  However, it is expected that typically developing children will only walk on their toes occasionally.

Neurological concern:

  • Sensory processing concerns: Children with sensory issues, including those on the Autism Spectrum related to the vestibular system, have a different awareness of their body position and feel stabilized during toe walking. The tactile system includes our sense of touch, pain, and temperature. Some studies conclude that children with differences in vestibular processing can also have tactile senses that exacerbate their toe walking. They may not like the feeling of the floor touching their feet, and toe walking minimizes this contact. Children seeking proprioceptive input toe walk because the gait prolongs stimulation of joint receptors and causes their muscles to tighten. The movement provides a calming input sensation for the child. (Williams 2010)
  • Cerebral Palsy: The most common cause of toe walking in those with cerebral palsy is spasticity, which can cause stiffness and involuntary muscle contractions in calf muscles, keeping their heels from touching the ground. Over time, without proper stretching and bracing, these muscles can become shortened, making it challenging to achieve heel contact. 

 

Idiopathic toe walking: Toe walking can occur because of an underlying anatomic or neuromuscular condition, but in most cases, toe walking is idiopathic without a discernible underlying cause. Idiopathic toe walking occurs in children between 3 and 7 years old and is more commonly seen in males than females. Idiopathic toe walking is not related to any specific diagnosis and can presenty of reasons, due to a variet including decreased stability and sensory involvement. For some families, toe walking may be a cosmetic concern, whereas it can cause pain or functional issues in other cases. (Ruzbarsky, Scher, & Dodwell, 2016)

Treatment

You may wonder how to stop toe-walking with your child. Therapeutic treatment depends on the cause, how strong of a habit it is, how tight the calf muscles have become, and what other changes have occurred in the child’s foot and ankle due to walking this way. 

Treatment can include:

  • Stretching: To improve muscle length, increase ankle mobility, and promote heel contact
  • Orthoses: Ankle-foot orthotic worn to keep the foot at a 90-degree angle and promote heel contact
  • *Turtle bracing: New bracing technique utilizing a removable, re-moldable, lightweight brace to achieve optimal ankle positioning, obtain and maintain ankle mobility, and promote heel contact
  • Serial Castings: Hard cast used to obtain and maintain a 90-degree angle at the ankle joint for extended periods (1-2 weeks at a time)
  • Night splints: Braces worn at night to keep the foot in a 90-degree angle and achieve prolonged stretch
  • Botox injections are most commonly used with those dealing with spasticity; they weaken their calf muscles and make them easier to stretch and cast.

A careful history, clinical exam, and selective diagnostic testing can be used to differentiate between different types of toe walking and determine the most appropriate treatment for each child. 

 

How Can Carolina Therapy Connection Help with Toe Walking?

Being evaluated by a Physical or Occupational Therapist can further help determine which treatment routes are appropriate for your child. Call us today at 252-341-9944 for a free screening! 

 

By: Taylor Saunders

 

Down Syndrome Awareness Month!

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October is filled with so many exciting things, the start of fall weather and holidays approaching; but did you know that October is also Down Syndrome Awareness Month? Established for over 40 years, it is a time to recognize and celebrate our friends with Down Syndrome and the amazing abilities they have!

 

What is Down Syndrome?

Down Syndrome is often called Trisomy 21, though there are actually three types: trisomy 21 (nondisjunction) which makes up 95% of cases, translocation (4%), and mosaicism (1%). It occurs in approximately 1 out of every 691 births, and more than 400,000 people are living with Down syndrome in the United States. These individuals are born with an extra copy of the 21st chromosome. They are able to work, go to school, develop meaningful relationships, make their own decisions, and participate in society however they wish! According to the National Down Syndrome Society, “Quality educational programs, a stimulating home environment, good health care, and positive support from family, friends, and the community enable people with Down Syndrome to lead fulfilling and productive lives.”

 

You are welcomed here!

Here at Carolina Therapy Connection, we are honored to serve our families who have children with Down Syndrome! One of our special friends, Hannah Hill, has made tremendous progress in her therapy. Her mother stated, “Because Hannah is very verbal, people often ask me if she has a ‘mild’ case of Down Syndrome. It’s not commonly known that there is no ‘spectrum’ of Down Syndrome! You either have it or you don’t! While the extra chromosome does impact their lives, people with Down Syndrome are unique, and have their own strengths and weaknesses. They have physical features, personality traits, abilities, challenges, interests, successes, and failures just like everyone else!”  

Hannah: Age 8

 

How can therapy help?

  • Speech therapy services provided by a speech-language pathologist reap great benefits. Many children with Down syndrome develop language later than same-age peers. Low muscle tone could also impact the ability to produce speech sounds accurately, and therapy is paramount to helping a child develop the ability to confidently and effectively communicate their thoughts, feelings, wants, and needs. SLPs can provide assistance with prelinguistic and oral-motor skills, as well!
  • Physical therapy can help a child with Down Syndrome starting at a young age to increase strength and gross motor development. From rolling and sitting, to developing an efficient walking pattern, and even participating in sports, physical therapy can make a huge difference in a child’s life. In a physical therapy session, our PT’s will focus on things such as: gross and fine motor development, balance, coordination, and age-appropriate daily living skills. 
  • Occupational therapy can assist people with Down Syndrome in learning to complete many everyday tasks. Occupational therapy will provide support specifically in three areas, motor, cognitive, and sensory integration. Specifically, an occupational therapy session may include activities that promote self-care, fine motor, play, and social skills!

 

A Total Communication Approach 

Many parents are excited to begin therapy and learn ways to promote and enhance communication for their children. According to our colleagues at the Boston Children’s Hospital Down Syndrome Program, a Total Communication Approach can be beneficial! The Total Communication Approach means using any functional means of communication; this could include: verbal speech, ASL, gestures, pictures, and/or simple or high-tech communication devices. Many children with Down syndrome are visual processors, and the goal of Total Communication is multi-sensory (i.e., visual, auditory, tactile, etc.) in order to encourage any form of expression. What are some ways to facilitate this approach at home?

  • Visual input: Pointing to objects and pictures that you are naming or describing. 
  • Use sign language for basic words (eat, want, bath, play, etc.). Research shows using signs increases understanding and offers an additional method for communication. 
  • Incorporate music into pretend play.
  • Joint book reading. Follow your child’s lead!

 

How can Carolina Therapy Connection help?

Children with Down Syndrome often benefit from therapy from skilled professionals, including speech-language pathologists, occupational therapists, and physical therapists. At Carolina Therapy Connection, our treatment is highly individualized to your child’s needs. A standardized assessment will be administered to detect any delays, and our therapists will work with you and your child to develop a plan for enhancing skills to  build confidence across all social environments (home, school, social groups, etc). If you have any concerns or questions regarding your child’s development, call our clinic at (252) 341-9944.

By Ashley Holloway, MS, CCC-SLP, CAS

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

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 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

Joann Carolina Therapy Connection Blog Greenville NC

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

All About Physical Therapy

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National Physical Therapy Month

October is National Physical Therapy Month — a time to celebrate the profession and all the ways physical therapists promote independence, increase participation, facilitate motor development and function, improve strength and endurance, enhance learning opportunities, and ease daily challenges in the lives of their patients. This month we would like to shout out our awesome physical therapists and give thanks to each them for their hard work to help kiddos and families across Eastern North Carolina. Learn more about our physical therapists by visiting our team page for Greenville HERE and for New Bern HERE.

What is physical therapy?

Physical therapy is the science of movement, how our muscles move our body, and how abnormal muscle activity may lead to movement disorders or developmental delays, birth defect, chronic illness or an injury. 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.

We offer Physical Therapy services to children birth through adolescence, with a wide variety of needs and diagnoses:

  • Autism Spectrum Disorders
  • Asperger’s Syndrome, Pervasive Developmental Disorder (PDD)
  • Attention Deficit Hyperactivity Disorder (ADD & ADHD)
  • Sensory Processing Disorder
  • Torticollis
  • Developmental Delay
  • Downs Syndrome
  • Cerebral Palsy
  • Neuromuscular Disorders

Children with neurological, orthopedic, or developmental disorders may need assistance of special equipment, customized orthotics, and/or exercises to build up motor skills.

Our team of physical therapists provide screening, assessment, consultation, and treatment in the following areas:

  • Gross and Fine Motor Development
  • Early Intervention Services
  • Balance and Coordination Skills
  • Age-Appropriate Daily Living Skills/ Self-Help Skills
  • Adaptive Equipment Purchasing and Modification
  • Wheelchair Assessments
  • Evaluations for Orthotic Devices and Equipment (AFO’s, Helmet, etc.)

In addition to the services above, we are so excited to announce that we are now offering physical therapy services at our Greenville and New Bern clinics for back pain and sports injuries!

PT for Sports Injuries

At Carolina Therapy Connection, our team of physical therapists can help your child overcome a sports injury by promoting independence, facilitating motor development and function, improving strength and endurance, and easing challenges with daily activities. We offer PT services to children ages 4 to 14 who have experienced a sports injury. We use our extensive clinical knowledge and therapeutic understanding to deliver evidence-based and innovative therapeutic interventions. Our physical therapists will work with your child to:

  • Provide an individualized treatment plan
  • Promote an efficient healing process
  • Decrease pain and inflammation
  • Regain strength and range of motion
  • Reduce recovery time for return to sport
  • Prevent future injuries

Common Sports Injuries:

  • Sprained Ankles
  • Knee Pain
  • Shin Splints
  • Foot Pain
  • Elbow Pain
  • Shoulder Pain
  • Achilles Tendonitis

Treatment we provide:

  • Tissue healing
  • Stretching and mobility exercises
  • Stability and control of movement
  • Exercises focusing on proper movement patterns
  • Sport specific performance improvement
  • Advanced agility and coordination exercises

PT for Back Pain

At Carolina Therapy Connection, our team of physical therapists can help your child overcome back pain by promoting independence, facilitating motor development and function, improving strength and endurance, and easing challenges with daily actvities. We offer PT to children ages 4 to 14 years old who are experiencing back pain. We use our extensive clinical knowledge and therapeutic understanding to deliver evidence-based and innovative therapeutic interventions. Our physical therapists will work with your child to:

  • Provide a comprehensive evaluation to assess the causes of back pain
  • Decrease pain and inflammation
  • Build muscle strength in the core
  • Restore mobility and range of motion
  • Improve posture
  • Restore their quality of life
  • Reduce the risk for further injury

Common causes of back pain:

  • Muscle weakness
  • Increased flexibility of the spine
  • Decreased flexibility leg muscles
  • Poor posture
  • Muscle strain
  • Scoliosis
  • Heavy backpacks

Treatment we provide:

  • Tissue healing
  • Stretching and mobility exercises
  • Exercises focusing on proper movement patterns
  • Tips and exercises for improved posture

If you are interested in scheduling a physical therapy evaluation for your child, call our office to get started today!

Greenville office: (252) 341-9944

New Bern office: (252) 341-9944 (EXT. 2)

Goldsboro office: (252) 814-8044

Our office staff will take all of your health insurance information and complete any authorizations or referrals that you may need. Visit our referrals page for more information HERE. Happy Physical Therapy Month

physical therapy Greenville New Bern NC Carolina Therapy Connection

Making “Sense” of Our Experiences

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The Pyramid of Learning

Pyramid Of Learning

The Pyramid of Learning was developed by Occupational Therapist Kathleen Taylor and Special Educator Maryann Trott. The Pyramid of Learning is an easy-to-understand illustration that depicts a general idea of a child’s foundational skills, and what other skills build upon those. Think about it: You can’t place stones on the top until the foundation stones are in place… every block relies on the ones underneath to be strong and stable. This pyramid explains why the sensory systems are so incredibly important to support academic learning. In other words, kids NEED routine sensory input for their bodies and their brain! Our central nervous system processes and organizes the sensory information we put into it each day. Adequate sensorimotor development for things like motor planning, postural security and body awareness are built on adequate modulation and processing of sensory information that we take in every day! Sensory input can be anything such as, smells, tastes, sounds, movements, pressure, and textures.

When a child is referred to occupational therapy, it is usually for things like attention to task, handwriting difficulties, picky eating, self-care tasks, tolerating routine changes, or school readiness skills. These functional difficulties are in the “Cognition and Intellect” categories at the top of the learning pyramid. The role of an occupational therapist is to determine underlying causes of these issues and utilize specific interventions to address them. Often times, it is hard for parents to fully understand why their child is not performing at the level at which they would like them to be. Some parents may see their child become frustrated when they are trying their best to be compliant, listen and learn, but their sensory processing abilities are hindering them. These frustrations root from the child working throughout the day just to do the simple things, the things that should be automatic and unconscious for them. This may include things like listening to the teacher, keeping their balance on the stairs, standing close to their friends in line, trying a new snack, or engaging in messy play. It all begins at the bottom of the pyramid!

Understanding Our Sensory Systems

  • Proprioception is our ability to sense the location, positioning, and movements of our body and its limbs. It allows us to navigate a crowded area without bumping into people and furniture in our path.
  • Vestibular sensation is housed in our inner ears and uses gravity to sense spatial orientation and movement. This system is responsible for maintaining balance during movement. If you or child is a victim of motion sickness, you have the vestibular system to blame!
  • Tactile sensation comes from receptors in our skin found all over the body. Tactile sensation includes sensations of pain, temperature, pressure, and textures.
  • Gustatory includes specific tastes (spicy, sweet, minty, bitter) and specific textures (crunchy, chewy, mushy). Taste also involves knowing the difference between food items and non-food items.
  • Olfactory or smells involve the ability to distinguish, detect, tolerate and object certain scents.
  • Visual includes noticing and tolerating visual patterns, colors, shapes, bright and dimmed lights and moving objects.
  • Auditory involves the ability to distinguish and tolerate loud sounds (fire alarms, sirens or loud music) and soft sounds (finger snapping, repetitive tapping, hearing others breathing).

How Sensory Processing Difficulties Affect Behavior

As a parent, it can be difficult when our children are having difficulty with negative behaviors. Let’s say that you receive a call from your child’s school reporting that they often seem distracted and don’t pay attention in class, bump into kids in the lunch line, can’t hold a pencil correctly, become upset when asked to switch from one activity to another, or melt down during circle time. Although these seem like behaviors that are caused by the child seeking attention or not getting their way, sometimes it can root from difficulty with sensory input. It is important for parents to work with an occupational therapist in determining the root of the problem. Sensory integration therapy or a sensory diet may be the key to diminishing these behaviors. Sometimes, just some simple routine changes can allow the child to regulate themselves. Regardless, it is important to have an occupational therapist on your team to help make those adjustments.

Sensory Integration

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. 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. The OT may use a sensory gym to engage the child in these repetitive and stimulating activities.

Sensory Integration Strategies 

  • Messy play – mud, dirt, water, food play, finger paints, shaving cream, bath bubbles, etc.
  • Noise cancelling headphones or ear plugs
  • Window shades or adjustable lights
  • Include your child in meal preparation process – encourage them to help whether with their hands or using cooking utensils to interact with the many food textures and smells
  • Food play – Encourage your child to interact with new foods in the most basic manner; the SOS Feeding Approach, used commonly by Occupational Therapists, encourages the following progression with new foods: See –> Touch –> Kiss –> Lick –> Taste –> Chew & Swallow. It is important to allow your child to move at their own pace and allow them to clean off hands or spit out food at any point along the continuum.
  • Sensory toys – check out Ark Therapeutic, a leading manufacturer of innovative therapy tools and special needs products! They have great sensory toys, chews and fidgets that can help your child deal with sensory overload.
  • Finger painting – also try bathtub paint to reduce mess and give child control over cleaning off their hands
  • Listening to music
  • Having a clear visual schedule posted with plenty of preparation for transitions.
  • Providing sensory breaks such as walking in circles, jumping on a mini-trampoline and sucking on sour candy.
  • For the child who needs to move a bit, you might try an inflated seated cushion or a pillow from home so they can both squirm and stay in their seat.

How can Carolina Therapy Connection help?

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, 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.). Various techniques include swinging, deep pressure therapy, which may include squeezing, rolling, etc., jumping on a trampoline, or gross motor play such as wall climbing, balance beam, etc.

Carolina Therapy Connection now has the largest and most state-of-the-art sensory gym in all of Eastern North Carolina!  Check out our 360° view of our sensory gym HERE. Our sensory gym is fully equipped with a zip-line, monkey bars, slides, scooter board ramps, ball pit, trampolines, rock climbing wall, and an expansive set of swings to offer a wide-variety of sensory experiences for each child.

If you have any questions or would like to schedule a screening for your child, call our clinic at (252) 341-9944 to learn more about what you can do and how we can help!

 

References:

Pyramid of Learning by Taylor and Trott (1991)

Amy Hathaway, OTR/L DEVELOP, LEARN, GROW

Kids First Children’s Services 

Sensory Blog

Now Offering Free Screenings!

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What is a Screening?

A screening for occupational therapy, speech-language therapy and/or physical therapy is a quick 10-15 minute discussion or observation of your child for potential areas of developmental concern. A screening may be over the phone, zoom or in person. A screening is used to determine whether your child may or may not need a formal evaluation.

What is a Formal Evaluation?

There are a variety of evaluation methods and standardized tests that are designed to assess different areas of functioning including visual-motor, visual-perception, gross motor, fine motor, sensory integration and many others. A child’s performance on each of these tests is compared with the average performance of other children in his or her age group. In addition to these tests, clinical observations are made based on discussion between the parent and the therapist. These formal evaluations allow the therapist to see your child’s current level of function, determine if services are needed, and develop client-centered goals and planning for therapy outcomes.

Everything You Need to Know About a Screenings

One of our amazing Occupational Therapist, Kelly Burton, explains everything you need to know about the screening process in the video below. If you have any questions or concerns about your child’s development or would like to set up a screening, call our clinic at 252-341-9944!

 

 

Screenings

Autism Awareness

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What is Autism Awareness Month?

In 1970, the Autism Society launched an ongoing nationwide effort to promote autism awareness and assure that all affected by autism are able to achieve the highest quality of life possible.  In 1972, the Autism Society launched the first annual National Autistic Children’s week, which evolved into Autism Acceptance Month (AAM). This April, Carolina Therapy Connection continues our efforts to spread awareness, promote acceptance, and ignite change alongside so many others across the nation.

How can I participate in doing my part?

The prevalence of Autism in the United States has risen from 1 in 125 children in 2010 to 1 in 59 in 2020. Recognizing this continued increase, the goal is to further increase awareness and global understanding about autism using support, kindness and compassion. Here are just a few ways you can participate this April:

  • Be informed – This doesn’t just mean looking up what the definition is on google or the signs/symptoms, but also learning how to interact with a person with Autism, and how to help them feel included, confident, safe and happy. Today it is becoming much more common to encounter someone with Autism and with doing the research, there would be a lot less struggle to even just say “hello.” You can view our resources page to learn more about Autism Spectrum Disorder and ways to become more educated about the diagnosis.  It is so important for the public to gain information directly from those with Autism.  Show empathy, learn their perspective and respect their voice!
  • Show your support – Use hashtags #CelebrateDifferences, #KindnessCounts, #Lightitupblue, and #WorldAutismMonth on social media. On April 2nd, 2021, wear blue to show your support. Autism Awareness month is all about making a month of kindness, towards others and yourself. We all get wrapped into the busy lives we live and forget to stop and say something kind to a coworker, friend, family member, or even a stranger. This is especially the month to be kind to those who are just a little bit different, but so special.
  • Get involved – A great way to get involved is joining in some type of program with the special needs population. These programs are all over Eastern NC and can also be found on our local resources page. Some of these programs include Special Needs sports teams, day programs for children or adults with Autism, runs or walks that may fund Autism research, and so many more. Get out and volunteer!

Autism Awareness From an Autistic Perspective

The Carolina Therapy Connection staff recently had the opportunity to hear an amazing presentation from Fiona Holler, a high school junior at John Paul II Catholic High School in Greenville, NC. Fiona explained in great detail what it has personally been like for her growing up with Autism. We look forward to looking with her more in the near future with setting up Autism support groups for kiddos and their families! Fiona is an enormous asset to the Autism community within and around Pitt County.

Here are a few points Fiona made during her presentation:

  • Neurodivergent vs Neurotypical: Neurodivergent people are those who have a differing mental or neurological function from what is considered typical (neurotypical people).
  • Sensory isn’t just a term for neurodivergent people. We all have sensory needs and we all take in sensory information through our bodies differently.
  • What is sensory pleasing to one autistic person may be completely different from another autistic person. Examples can include different lighting, specific noises, physical sensations, tastes and smells. Another really important aspect of sensory needs is that they can change. Sensory preferences are not always permanent and change more than people think! A lot of people with Autism often get frustrated when trying to communicate our sensory needs, which can often lead to things like stimming, or burnout.
  • Stimming refers to how neurodivergent individuals release and express their emotions. The misconception of stimming is that it is always a sign of stress or aggression. The truth is that stimming is used to describe a certain mechanism used to release a range of emotions, whether it be excited, sad, angry, happy, anxious, etc.
  • Masking refers to when people with Autism push down our stims and coping mechanisms in order to “blend in” with the neurotypical world. Masking doesn’t just refer to pushing down sensory pleasures, it can mean completely changing or disguising yourself as what society believes is “normal.”
  • Burnout refers to extreme tiredness and fatigue caused by masking, extreme sensory sensations, and/or the presence of extreme emotions (with and without masking).
  • Often times, a symptom of Autism is “special interests.” These are sometimes associated as a negative symptom. The term is called “special interest” because we as autistics tend to excessively fixate on a specific topic, usually much more than neurotypical people – special interests are good! Even though sometimes we need direct social cues, this doesn’t mean that sharing a special interest is wrong- it’s a matter of when it is and isn’t appropriate to share. Like stimming, these special interests often get frowned upon for how autistic people present them and or which age group the topic is meant for. This is very harmful to people with autism and can give us the wrong idea. Fiona explained that she grew up thinking she wasn’t allowed to express a special interest or stim without being labeled as incompetent.
  • A final thought: “Being autistic is very hard at times because whether we know or don’t know our diagnosis, it is easy to feel as if we don’t belong in this world of neurotypical people. We are trained to mask and hide our autism a lot of the times rather than to accept and love ourselves for who we are. I find myself knowing how to mask better than how to help myself. This is a very dangerous thing to teach our young autistic children. A lot of things about how autistic people regulate and how/what they think goes unsaid, which is why it is so important that we encourage the open conversation and genuine acceptance of autism. It’s okay to have questions about our diagnosis, just ask us kindly and we will answer the best we can. We’re people too.”

 

Tummy Time Tips

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What is Tummy Time and why is it important?

Tummy Time is one of baby’s first exercises—and the most important! It is any period of the day where the child is placed on his or her stomach to play. It is a crucial exercise for baby’s motor, visual, and sensory development. Practicing tummy time helps babies develop the muscles necessary to lift their heads and, eventually, to sit up, crawl and walk. Tummy time is not an activity for sleep! Your baby should always be awake and supervised when lying on their tummy.

Tummy time is important because it:

  • Helps prevent flat spots on the back of your baby’s head
  • Makes your baby’s head, neck and shoulder muscles stronger so they can start to sit up, crawl, and walk
  • Improves your baby’s motor skills (using muscles to move and complete an action)
  • Alleviates gas and gastrointestinal pain
  • Helps master head control
  • Exposes your baby to different sensory environments
  • Engages and promotes bonding between you and your baby

When should Tummy Time start and how long does it last?

The American Academy of Pediatrics recommends parents start tummy time early. In fact, babies born at full term with no health issues can start tummy time as soon as their first day home from the hospital. As a new born, your baby can benefit from 2-3 tummy time sessions every day, lasting around 3-5 minutes each. As they get older and become more able to tolerate tummy time, your baby should gradually practice more each day. When your baby is 3-4 months old, aim to achieve at least an hour total per day. You should continue doing this with them until they are at least 7-9 months old when they begin crawling. At this age, they will be getting the developmental benefits of tummy time while moving, and it is not as essential to have them do it, however, it is still beneficial to have your baby lying on their stomach during play.

Why doesn’t my baby like Tummy Time?

Some babies may not like the tummy time position at first, particularly when they have not yet developed the muscles to lift their head and neck. Eventually, your baby should enjoy lying on their tummy and begin to enjoy play in this position.

Tips for making tummy time more enjoyable:

  • Place yourself or a toy in reach for him or her to play with.
  • Lie on your bellies together, side-by-side or face-to-face, on a comfy surface.
  • Put your baby tummy-down on your chest while you do your sit-ups. Add some funny faces and silly noises with each rep.
  • Change locations, giving your baby a different view to look at each session.
  • Entertain your baby with colorful toys that make noises and have lights while lying on their tummy.
  • Use a pillow or folded towel under your baby’s arms to slightly elevate them when lying on their tummy.

Tummy Time Abilities

At 2 weeks your baby:

  • Using tummy-to-tummy with you, tummy down carrying positions, and lap soothing positions
  • Working towards lying on the floor on their tummy
  • May become irritated when placed on their tummy, especially on the floor

After 1 month, your baby:

  • Should attempt turn their head while lying on their stomach
  • Attempting to lift head up, even if they are unsuccessful

At 2 months, your baby:

  • Spending at least 1-2 minutes lying on their stomach without becoming upset
  • Doing most exercises on the floor
  • Tilting their head to one side (Note: ensure they are tilting their head to both sides and watch for early signs of Torticollis)

At 3 months, your baby:

  • Is beginning to put some weight in their arms, with elbows behind their shoulders
  • Gaining more head control for longer periods of time
  • Spending a total of 1 hour total each day lying on their stomach
  • Visually tracks toys and objects in front of them

At 4 months, your baby:

  • Lifting their head to a 90 degree angle and keeping it centered
  • Pushing up on their arms to bring chest off the floor
  • Lifting head and moving neck simultaneously to visually track you and toys in front of them

At 5 months, your baby:

  • Beginning to push up on hands with straight elbows
  • Starting to reach for toys placed nearby and moving/scooting forward

At 6+ months, your baby:

  • Initiates lying on tummy on their own during play
  • Reaching and grabbing toys
  • Pivoting in a circle while on their stomach
  • Rolling from their tummy to their back and vice versa
  • Prefers being on their stomach to allow for easier play, movement, and exploring

How can Carolina Therapy Connection help?

We often have parents ask us about tummy time, so our amazing physical therapist, Emily Tower, is here to help! Watch this video to learn more about how you can engage your child in tummy time. 

If you have any questions about tummy time or your child’s development, contact Carolina Therapy Connection!

  • Our email is info@carolinatherapyconnection
  • Our phone number is 252-341-9944
  • We will be happy to do a FREE screening!
Tummy Time Tips

Carolina Therapy Connection Expands to New Bern

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Carolina Therapy Connection Strives to Meet the Demand in Eastern NC

For over 10 years, Carolina Therapy Connection has embodied a vision of being the regional leader of skilled professionals providing diverse, collaborative services for children and their families. After growing from about 25 families in the first year of the practice, to over 1600 active patients today, we continue to improve the quality of life of children in Eastern North Carolina and provide support and education to parents and families.

Over the past year, our greatest challenge has been tirelessly working to meet the demands and needs of the pediatric population within our community. After becoming the first Certified Autism Center™ in Eastern N.C., it was clear that our next priority was to expand to New Bern! This realization led us to opening a new location in New Bern, North Carolina! Despite the challenges of COVID-19, our amazing team has gone above and beyond the call of duty to provide an exceptional new clinic and prepare for the needs within and around Craven County.

About Our New Bern Clinic

Our New Bern building is 2500 square foot, accommodating for 6 huge offices for our therapists and administrative staff, and a state-of-the-art sensory gym. Our New Bern team consists of Occupational Therapists, Physical Therapists, Speech-Language Pathologists, and Educational Specialists. Currently, our team specializes in Augmentative and Alternative Communication (AAC), Torticollis, Interactive Metronome, Autism Spectrum Disorder (ASD), Feeding Therapy, Sensory Processing Disorder and many others! Having an open mind to drive innovation, we believe all our clinics should be an educational resource to provide the community with direct access to the latest research and developments in pediatric habilitative and rehabilitative services.

Through demonstrated excellence in clinical, school, and home-based practice, our therapists provide screening, assessment, consultation, and treatment in the following areas at our New Bern location:

  • Sensory Integration
  • Interactive Metronome ®
  • Therapeutic Listening®
  • Handwriting Without Tears®
  • SOS Feeding Therapy ®
  • Beckman Oral Motor Approach®
  • School-Related Skills
  • Gross and Fine Motor Development
  • Early Intervention Services
  • Feeding and Oral Motor Development
  • Balance and Coordination Skills
  • Age-Appropriate Daily Living Skills/ Self-Help Skills
  • Handwriting Skills
  • Adaptive Equipment Purchasing and Modification
  • Articulation and Language Development
  • Augmentative Communication
  • Adaptive Equipment Purchasing and Modification
  • Wheelchair Assessments
  • Evaluations for Orthotic Devices and Equipment (AFO’s, Helmet, etc.)

Expanding Our Community Outreach Program

Our New Bern administrative staff and therapists have been working hard to reach out to the community to get as much viable information as possible. As we continue developing our community outreach plan for 2021, we are constantly updating our website resources page for in and around Craven County. We are also working hard to ensure that the pediatric offices, daycares and schools are aware of the services we provide.  Over the past few months, we have sent out a community survey to better understand how we can partner with with local organizations in making a way for greater resilience within our community. Amidst the struggle of COVID-19, we have also been able to reach out to multiple locations around New Bern by email, phone call, and also by delivering goodie baskets! We are so excited to be working with all these great organizations and can’t wait to see where the future takes us!

Pictures of Our New Bern Clinic

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CTC Clinic New Bern North Carolina