“Aspire has been the biggest blessing in having an infant with a disability. I've been encouraged as a parent and been able to learn so much to help our child.”  Research shows that more learning and development occurs in a child’s first three years than at any other time in their lives. Children grow and develop new skills quickly, so it is critical for your child with developmental delays or disabilities that the correct plan of care is in place from the beginning in order to set your child up for success and provide them with optimal care to prevent any further delays. The Birth to 3 Program is a federally mandated Early Intervention program to support families of children under the age of 3 with developmental delays or disabilities. While Birth to 3 is a great program, it does have its short-comings, and additional outpatient services should be considered in most cases. Once enrolled in Birth to 3, your team will help to develop an Individual Family Service Plan (IFSP) which could include special education services; physical, occupational, speech therapy; or service coordination. The services you receive—including in what way, how often, and how long—are based on the individual goals and outcomes of the child. It’s important to realize that all activities in the IFSP are provided to your family using Wisconsin’s Birth to 3 Program coaching approach where the early intervention practitioner is a coach rather than a direct therapy provider. This means that the therapist will verbally direct you, as a parent, how to play, move, or position your child instead of providing consistent, hands-on treatment. While the coaching-only model is a great approach for some parents, others may feel that they need more frequent help, or that their current plan is just not working. It is important to advocate for your child and communicate clearly to your team when things aren’t working as they should. Furthermore, since Birth to 3 is a federally funded program, there are numerous children who receive services in each county. In order to serve so many children, we have observed that in general, more than one discipline will not be appointed for the same child unless there is extreme need. In most cases there is a “main” therapist who provides the most necessary services and receives guidance from other disciplines, providing that education on their behalf. For example, if your child’s main challenge is speaking - but your child is also developmentally delayed and not walking - a speech therapist will be the primary therapist and provide education from the physical therapist on the child’s treatment team. Most families do not realize they can supplement Birth to 3 with other services. In a recent survey asking current families who participated in Birth to 3, 100% of responses stated they had no idea that they could supplement their therapy with outpatient services and were given no additional support or resources to help navigate the next steps. One family said, “I felt like I was supported in getting help with Birth to 3, but then kind of thrown out into the world to find additional services on my own.”  At Aspire, we feel that it is important to provide high-quality, hands-on intervention to your child during this crucial period of early development. We aim to incorporate parents into each session, and ensure that you are confident with the education that we provide, giving you ample time to practice and ask questions during our sessions. We evaluate your child and develop a plan of care that suits your individual needs and create a treatment plan that allows us to adapt our care depending on where your child is. Weekly appointments give us the opportunity to make frequent changes as your child develops and masters new skills to maximize their potential.
Don’t just take our word for it. Here is what some parents have said about our services: “While our (Birth to 3) OT was amazing, having you in our lives made me realize we should have taken on actual PT much sooner. Thank you for everything, you help give me so much more confidence as a mom than you probably realize and we are so thankful for you! ” “Aspire has been the biggest blessing in having an infant with a disability. I've been encouraged as a parent and been able to learn so much to help our child.” If your child is under 3, and…
...call Aspire for a free screening! Aspire accepts all local major insurance plans, Medicaid, and offers private pay options. We also offer FREE consultations and screenings in person or by phone. Call us at (608) 556-6120 or email info@aspirewisconsin.com for more information!  Photo by Meru Bi from Pexels Sensory processing is our body’s ability to receive, understand, and organize incoming information from our world.² This information could be how something feels, what it looks like, how you are moving your body, what something tastes like, or the feeling of your bladder being full. Once this kind of information is received by our central nervous system, we typically have some type of physical, mental, or emotional reaction to it.
When these reactions interfere with our ability to successfully participate in the world around us, we call this sensory processing disorder. The neurological process that allows us to organize our sensations for use is called sensory integration.² Certain people might process sensory information faster or slower, or more or less than others. This can cause us to either avoid or seek out certain sensory experiences to help our body feel ‘just right’. You may have heard about the body’s 5 senses, but there are actually 8! They are responsible for receiving different types of sensory input and sending that information to the brain to be processed.³ These senses include:
The way we process all of this information can greatly influence our ability to engage in purposeful behavior and daily occupations like brushing our hair, taking a shower, going to the bathroom, or socializing with our peers.¹ For more information on each of the specific sensory systems, ask your therapist for more guidance or grab a sensory-specific handout or see the back of this handout for book recommendations. What now? If your child’s sensory processing hasn’t yet been addressed in therapy but some of the things in this handout sound familiar, bring it up to your therapist and see what they think. A comprehensive evaluation of the child’s sensory processing abilities completed by an experienced therapist will be important in determining which specific senses need to be addressed to help you and your child learn more about what their body needs in order to meaningfully participate in daily activities. We are here to support you in finding a routine that is best for your child, and are dedicated to developing an individualized plan for each family! -Your Aspire Therapy Family Book Recommendations: The Out of Sync Child by Carol Stock Kranowitz Sensational Kids by Lucy Jane Miller The Out of Sync Child Grows Up by Carol Stock Kranowitz Too Loud, Too Bright, Too Fast, Too Tight by Sharon Heller References
 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 |
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