 Autism has become a more commonly recognized diagnosis by parents, teachers, and the general population. Autism is known to be a disorder characterized by social-interaction difficulties. Often, children on the Autism spectrum receive speech and occupational therapy services to help them improve their social interaction skills. While these services can make significant changes in the lives of these children, it is important to understand the role of physical therapy in treating kids on the spectrum. Research has shown that common motor skill deficits in children on the spectrum include general gross motor delays, gait (walking) abnormalities, impaired balance, and coordination difficulties with motor planning and execution.
A new research article published in the Pediatric Physical Therapy Journal’s July 2018 journal titled “Relationships Between Gross Motor Skills and Social Function in Young Boys with Autism Spectrum Disorders” has suggested a link between social skills and motor skills of young children with autism. Specifically, if a child has impairments to social function, they often have impaired balance and object manipulation. One explanation the researchers found for these findings is that when children have difficulty maintaining stability, they must use many physical and mental resources to maintain and upright position, leaving fewer mental resources available for social engagement. The ability to throw or kick a ball to a person or a target requires the use of visual feedback as well as understanding and predicting social responses from others. It is possible that overall ball skills are related to social function due to the social nature of these activities. However, it is important to recognize that gross motor ability may also be related to other areas of development- thus making physical therapy evaluation a critical component for treating children with Autism. Being able to communicate and interact with peers is an important life skill that can help children as they grow and to be able to interact within the community. Let’s help make sure these children with Autism are getting the help they need. Improving these children’s motor skills may be the key missing to helping them improve their social skills and their overall participation. An evaluation can be done by one of Aspire's licensed physical therapists. Our physical therapists will determine if your child could benefit from ongoing physical therapy or how to help incorporate activities into your daily schedule that will help them improve their motor skills, stability, and overall coordination. Contact Aspire for more information. Dr. Angela Kloiber is a licensed Physical Therapist with Aspire Therapy  April is Autism Awareness Month! As there are so many “puzzle pieces” to the Autism Spectrum, books have been a very successful and positive resource for helping family members learn about their changing lives, children understand autism and providing education to those wanting to learn more.
The books below can help you make a connection to your own life and lead to a positive outcome of either helping your own child, yourself or others around you. Check them out! For Teens/Adults: Look Me in the Eye - John Elder Robinson John Elder Robinson was diagnosed with Asperger’s syndrome in his 40’s. He uses this book to discuss the struggles he faced as a child, into adulthood, and the struggles he faces after diagnosis. This book focuses on the difficulty he had to create relationships and interact socially. It provides readers with an idea of how treatment has evolved over the years and the many different approaches that have been used to assist individuals on the spectrum. John is a standing testament of how facing challenges and learning to adapt using different strategies can lead to great success. A Different Kind of Boy - Dan Mont This book is written by the father of a boy who is autistic. He writes about the positive and negative emotions he has experienced through raising a child on the spectrum. Dan also dives into the impact autism has on his family and challenges with navigating the educational system. Thinking in Pictures - Dr. Temple Grandin Temple Grandin does an excellent job showing the evolution of treatment and medical professionals throughout the years. She reviews her life’s struggles and how the treatment she received as a child would be different than treatment available today. In a Different Key: The Story of Autism - John Donvan & Caren Zucker This book tells the story of autism from the first ever diagnosis to modern day. Focus is placed primarily on its controversies and struggles that families face. This is a great read thats main point made is “difference rather than disability.” For Kids: The Survival Guide for Kids with an Autism Spectrum Disorder (and their parents) This is an informative and highly positive book that offers kids on the spectrum knowledge for understanding their diagnosis and finding strategies to help them cope in their own individual way. This book is a 5th grade reading level and is targeted toward children ages 9-13. The Girl Who Thought in Pictures: The Story of Dr. Temple Grandin - Julia Finley Mosca, Daniel Rieley (Illustrations) This picture book tell children the amazing story of Temple Grandin’s life. Her love for animals and how she relates her diagnosis is a significant piece of this story. Your child will learn about scientists and their unique lives and characteristics. We’re Amazing 1 2 3: A Story About Friendship and Autism This Big Golden Book uses Sesame Street characters to teach children about being a friend to everyone, despite their differences. Sesame Street introduces Julia, a character with autism. Elmo introduces Julia to friends and explains how to be a friend to those who cannot speak and who may do things a little differently! Everybody is Different - Fiona Bleach This book is written for siblings of children on the spectrum. This is a concept that is often looked over so this book allows for brothers and sisters to learn basic terms, characteristics of autism and provides suggestions for making family life more positive for all. Rachel Petersen is a licensed speech-language pathologist with Aspire.  April is OT month and occupational therapists around the US are rejoicing. Finally, a month to bring attention to our amazing profession! Finally, a month for us to bring light to what we can help others do! Finally, a month to self-reflect on what it is that we actually do so that we can accurately describe our job in 10 words or less... After close to 15 years of being an OT, I still stumble when explaining what I do on a daily basis.
Occupations are activities and roles that bring meaning to your life. A child’s occupations include play, play, and more play. When a child is old enough, occupations might also include student, athlete, musician, and hobbyist. Occupational therapists assist kids and families in building the skills needed and modifying the environment for a child to be successful in his/her occupations. A child learns first and foremost through play -- it is the window into their world. Pediatric OTs start here to build relationships with a child and to help build the needed social, motor, behavioral, and neurological skills to be able to play. We assist kids and families by improving and working with a child’s sensory processing system to help him be able to tolerate the world around them. We help to improve vestibular processing so that her world stops spinning, auditory processing so that everything isn’t too loud for him, and proprioceptive processing so that she doesn’t use too much force when interacting with her friends. Occupational therapists also work closely with kids and their families to help improve mealtime and other daily living skills. Whether it be a picky eater, a child who over-stuffs, or has difficulty simply sitting at the dinner table, we can help. We can work with kids to increase independence with dressing, bathing, brushing teeth, combing hair, and even toilet training! Once the foundational skills of play, daily living, and basic self-regulation skills are achieved, occupational therapists can also help with more complex skill development. OTs can help with handwriting, fine motor skills (cutting, coloring, gluing), visual motor skills (puzzles, tying shoes, stacking blocks), organizing homework and locker spaces, even driving (although we at Aspire haven’t been trained in this just yet). Our occupational therapists work with each individual child and family to assess where your child is at. We discuss what areas of difficulty we might be able to assist with. We work together to help improve your child’s and whole family’s ability to function. If you think your child and your family might benefit from working with one of our occupational therapists, please contact Aspire for a free consultation today! Laura McBain is a licensed Occupational Therapist and member of the American Occupational Therapy Association (AOTA).  Have you seen the hit ABC TV show Speechless? If not, check out Season 1 on Amazon for a humorous sneak peak into the life of the DiMeo family. Young actor Micah Fowler who has cerebral palsy, portrays JJ a teenager with CP. JJ is non-verbal and utilizes a communication device as well as a power wheelchair for mobility. Check it out and you may find yourself relating to some of the challenges and humors you face as a parent of a child with differing abilities and differing disabilities.
Approximately 10,000 babies born in the United States each year will develop Cerebral Palsy. It is the most common motor disability in children in the United States. It is caused by brain damage that often occurs during pregnancy or shortly after birth. The cause of Cerebral Palsy is unknown 80% of the time. In time, hopefully, research will help identify the cause of Cerebral Palsy for each individual. Cerebral Palsy can affect a person’s posture, balance, and ability to move, communicate, eat, sleep, and learn. However, the level of severity and combinations of these symptoms can vary for each person. One person may have hand weakness and struggle to tie their shoes or button their shirt. Another person may have little control over their movement and require assistance for everything from getting in and out of bed to shifting their weight. Yet another individual may have weakness in their mouth and jaw making it challenging to coordinate swallowing or speaking. Although Cerebral Palsy is a permanent life-long condition, symptoms can improve over time with the help of physical, occupational and speech therapies in addition to other medical specialties. Dr. Angela Kloiber is a licensed Physical Therapist with Aspire Therapy As promised- part two- school aged kids and adaptive footwear! If you missed the first post on shoes for babies and toddlers, check it out here.  School-Age Shoes The most important thing I can stress for kids this age is that the shoes fit! I know shoes are expensive and you can never guess when that next growth spurt will happen, but ill-fitting shoes can lead to falls and injuries! Start good habits now. Flip flops and shoes like Crocs while easy to slip on, do not give your feet the proper shock absorption they need nor do they support the arch of the foot. Look for shoes and sandals that have a secure back. Feet fatigue quicker without a back on the shoe as the toes have to constantly grip your shoes to keep them on. In addition to overworking tiny muscles in your feet, shoes without backs typically do not have great arch support. At this age and into adulthood, it is important to have supportive shoes with good shock absorption. Shoes with good support will help your child continue to have a strong arch, and reduce their risk of pain and dysfunction later in life, including plantar fasciitis and achilles tendonitis. All shoes should have less than a one inch heel. Check out some favorite brands below: Keen, See Kai Run, Stride Rite, GoPlae, or Nike, Adidas, New Balance, etc with a good fit!  Adaptive Footwear Does your child wear KAFOs, AFOs, SMOS, UCBLs? Sometimes finding a shoe that will fit your child’s orthotic can be tricky and the rules and recommendations are a little different. Your child will be getting good arch support from their orthotic, so a shoe’s arch support is less important. Your child likely needs a lightweight shoe in order to conserve their energy when walking. Look for shoes than come in a size ‘wide’ and remember to remove the manufacturer’s cushion insert to give your child’s orthotic a bit more room. A higher profile shoe, such as a high top, will help ensure your child’s heel stays inside the shoe while using their foot orthosis. Only wear an orthotic on one foot? Check out Nordstrom- they will sell two different sized shoes as a pair- just for this reason! Some recommendations of shoes that often fit foot orthotics include: New Balance 574 (comes in wides and small sizes!) GoPlae (order with extra long straps) Converse Chuck Taylor (try with elastic shoe laces) Converse Chuck Taylor All Stary Easy Slip High Top Sneaker (the entire heel flips down!) Nike FlyEase Billy FootWear Stride Rite (some styles come in wides and extra wides!) Braces
School aged kids can make braces trickier for the simple reason they typically have an opinion about what they are wearing! They want to be “cool and fashionable.” They don’t want to stand out. If you have a child who is self conscious of their braces- talk with your therapist. They may have some ideas as to which shoes will “disguise” the braces better and can help with building self confidence skills! Dr. Angela Kloiber is a licensed Physical Therapist (and shoe connoisseur) with Aspire Therapy  One of the most common conversations I have with parents is regarding shoes for their child. There are so many choices and the always-challenging balance of cuteness, cost, and functionality. Hopefully this will help you pick the perfect pair of shoes and you can learn WHY your child’s shoes are so important! As always, if you have any questions regarding shoes, ask your therapist! What your child needs in a shoe will depend on their current skills, activities, and where they are in their physical development- thus this is going to be a two part post. First lets cover babies and toddlers. Next we will cover school aged kids and adaptive footwear. Babies’ bones, especially those in their feet, have lots of cartilage on the ends of them that have not yet calcified into rigid bone. As children grow, a larger percentage of the cartilage is transformed into bone. This is partially why the recommendation for adults’ shoes is different from that of a children. Pre- walking shoes:
If your baby is still crawling or just starting pulling to stand, the only purpose of shoes is to keep their feet warm and protected (outside). Shoes should be so flexible that they could be easily crumpled up into the palm of your hand. Check out three of my favorite brands below. Momobaby, Robeez, Skidders baby booties Toddler Shoes: Your baby is now walking, hooray, but hold off on shoes for a bit. Stick to the pre-walking shoes for just a little longer! Your child is just figuring out his/her balance. Letting your child feel the floor with his/her feet will help them develop and master their balance. Consider a tight rope walker. They are often bare foot or have “pre-walking” shoes on as they balance their way across a rope. You child is going through the same challenges with their first steps. Your child is likely not walking around the grocery store doing errands with you, and is likely mainly practicing his or her walking skills in the house or the backyard. Pre-walkers will still give them the protection they need while allowing their balance skills to develop. Once your child begins to look steady on their feet, it is time to look for shoes to mainly use outside. Indoor, barefoot continues to be the best choice as it allows the child’s natural arches and muscles in their feet to develop. Toddler shoes should have flat heels and be flexible. You should be able to bend the shoe in half and twist the shoe. The goal of the shoe is to protect their foot, but still allow the foot to be flexible! These are some of my favorite brands: Skidders kids shoes, Pediped, Stride Rite, GoPlae Coming next: Shoes for School-Age Kids and Adaptive Footwear Dr. Angela Kloiber is a licensed Physical Therapist (and shoe connoisseur) with Aspire Therapy  What can I do as a parent to help my child succeed in speech therapy?
The best thing to do is incorporate what is done in therapy into your home environment. However, many parents feel like they don’t have the time to work with their child on specific activities given by your therapist. Perhaps it is a challenge to dedicate time for articulation drills with your child. Instead, you can point out specific words used in your environment that have the targeted sounds. Produce the target sounds louder in words to point out the sound. Have your child repeat you and encourage the correct production. It is okay if they don’t produce it correctly on the first try. Reward your child for trying by simply saying “good try”. Always stay positive! Your child will be more willing to try if you reward them for their effort. How can language skills be incorporated into my home environment? Language encompasses many different aspects, and your child’s development goes through many stages. One important thing to remember is always stay one step ahead of your child. For example, if your child is not using words yet, have your child use sign language, imitate words, or give your child two choices to encourage spontaneous single words. Always build off of your child’s language. If your child is using two-word phrases, encourage three-word phrases by modeling three-or-more-word phrases and have your child imitate the phrases. Older children may use many words to communicate, however, they may have a hard time processing information. With older children, it is great to explain why you do things. For example, imagine one parent has had a hard day at work and has told your child they cannot play right now. Take the opportunity to describe the parent’s body language (posture, eyes, etc.) and explain, “I don’t think she wants to play right now because she is tired. Maybe ask her later after she has time to rest.” If another person did not respond the way your child wanted them to respond due to your child’s behavior, be sure to explain why this occurred. Help your child repair the communication if it broke down. Carry-over of therapy skills to the home is very important. There are lots of simple ways you can incorporate your child’s specific goals into your environment without having to do a ton of work. Just ask your treating therapist for a few recommendations and new ideas! Always remember to allow time for your child to be a child too! Everyone needs a break at times. There is such a thing as too much work! Incorporate carry-over activities based on how your child responds. If your child needs a break, allow him/her to have one! Kelly Benson is a licensed Speech-Language Pathologist with Aspire Therapy  The holidays are here! That means time spent celebrating with family and friends. Many of us will travel. Others will have visitors. Let’s face it- the holiday schedule is a challenge for all!
Yes, we are therapists who preach most of the year about home exercise programs, homework, and the need for consistency. However, we are also humans. Many of us are parents as well. And sometimes it is important to hear from the therapists who preach it the most, it is OK if you miss your routine on a day! So as the schedule gets busy, life happens, and there are simply not enough hours in the day to get it all done, do not be too hard on yourself. You are an amazing parent and you are good enough! Being a parent is hard. Being a parent during the holiday season is even harder, and being a parent to a child with additional needs is extra, extra hard. Enjoy the time with your children and family this holiday season! No one day of missed homework will, ‘make or break,’ your child. We will all be back on schedule before you know it and your children will continue to learn and grow! Happy Holidays from Aspire! Dr. Angela Kloiber is a licensed Physical Therapist with Aspire Therapy  Did you know that getting your kids involved in holiday baking could help them meet their therapy goals? Whether it’s OT, PT, or Speech, helping out in the kitchen can be full of benefits for little ones. Plus it’s great time to spend together as a family! Tips to make holiday baking with your kids successful:
If your child is younger and/or needs more supervision, have them help with basic steps such as pouring ingredients from cups (with your help if necessary), stirring, etc. This is great practice for both gross and fine motor skills. If your child is older and/or more independent, you can ask for their help with measuring and following multiple step directions using a recipe. This is great for speech and language comprehension!  Image: Kari Shea In addition, interacting with new foods of any kind can be helpful for kids who are picky eaters or have sensory sensitivities. Make it fun! Set aside some extra ingredients and let kids experience messy play and mix them by hand (if this makes you squirm, just remember - it’s about exploration! You don’t have to use this in your finished baking product). Or, if your child is hesitant about different textures, gently encourage them to stick just one finger in and then tell them how proud of them you are! Expand conversational skills by talking about the qualities of the ingredients (what color is flour? Is it wet or dry? Light or heavy?).
Decorating can be a fun final step that further bolsters fine motor skills and creativity, whether it’s selecting sprinkles or spreading frosting. Finally, celebrate all the hard work with getting to taste the finished product! Don’t force your child to eat if they’re still feeling skeptical, but rest assured that all the fun interactions with food you’ve just facilitated are building blocks towards becoming a confident and adventurous eater. And if you’re worried about allergies or simply don’t want to give your kids too much sugar, there are plenty of healthy and alternative holiday recipes out there to fit every family’s needs (just a Google search away). Happy holidays from Aspire! Melanie Sard is a licensed Occupational Therapist with Aspire Therapy.  The holiday season is right around the corner! Before you know it, Black Friday, Small Business Saturday, and Cyber Monday will be here.
Need gift ideas for your kids? Your Aspire therapist has some great ideas - ask them! You can also check out the AblePlay Toy Guide. It has some great toy ideas for kids of ALL abilities. Check out their toy guide ideas for your child. |
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