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All Things Speech Therapy at CTC

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Happy Better Hearing and Speech Month!

Better Hearing and Speech Month (BHSM) was founded in 1927, by the American Speech-Language-Hearing Association (ASHA). The aim of Better Speech and Hearing Month is to raise awareness around both speech and hearing problems while encouraging people to take a look at their own speech and hearing and to make a change if there is a problem. Developing strong communication skills is one of the most important elements to socializing and creating relationships. Communicating can be difficult for children with speech and/or language disorders, causing frustration and isolation. A Speech-Language Pathologist helps children overcome communication obstacles, and this month we are giving a huge shout out to our amazing speech therapists at Carolina Therapy Connection! We also want to highlight all the areas that our speech therapists specialize in and treat on a daily basis in our clinics.

What is Speech Therapy?

Speech therapy is the assessment and treatment of communication problems and speech disorders. Your child may need speech therapy if they have difficulty with speech/articulation (pronouncing sounds or words) or using words to communicate. Because the muscles and structures used for speech (such as lips, tongue, teeth, palate and throat) are also used in eating, a speech and language pathologist may also help with feeding and swallowing difficulties, also known as dysphagia.

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

  • Early Intervention Services
  • Feeding and Oral Motor Development
  • Articulation/Phonological Disorders and Delays
  • Language Disorders and Delays
  • Motor-Based Speech Disorders including Childhood Apraxia of Speech (CAS)
  • Fluency Disorders
  • Hearing screenings available with Speech/Language Evaluations
  • Augmentative and Alternative Communication (AAC) Evaluations

What is a Speech Sound Disorder?

A speech sound disorder is a term to describe difficulty producing or articulating speech sounds, including difficulties with perception, motor production, or phonological representation of sounds. Children develop speech sounds at different rates, though most follow the same general pattern of development. Functional speech sound disorders are common, and can be divided into 2 general categories: articulation and phonology. If a child is slower in producing age-appropriate speech sounds, they may have an articulation or phonological delay. Articulation disorders focus on errors including distortions and substitutions in production of individual speech sounds. Phonological disorders focus on rule-based errors or phonological processes that affect more than one sound.

What are general signs of a Speech Sound Disorder?

According to the American Speech Language and Hearing Association (ASHA), signs of symptoms of a speech sound disorder include:

  • Omissions/deletions—certain sounds are omitted or deleted (e.g., “cu” for “cup” and “poon” for “spoon”)
  • Substitutions—one or more sounds are substituted, which may result in loss of phonemic contrast (e.g., “thing” for “sing” and “wabbit” for “rabbit”)
  • Additions—one or more extra sounds are added or inserted into a word (e.g., “buhlack” for “black”)
  • Distortions—sounds are altered or changed (e.g., a lateral “s”)
  • Syllable-level errors—weak syllables are deleted (e.g., “tephone” for “telephone”)

Children generally develop articulatory precision of sounds at the following ages: 

  • 2 years old: P
  • 3 years old: B, T, D, K, G, M, N, NG, F, H, Y, W
  • 4 years old: V, S, Z, SH, CH, J, L
  • 5 years old: TH (voiced “THem”) R
  • 6 years old: TH (voiceless “paTH”)

What is Apraxia?

Childhood Apraxia of Speech (CAS) is a motor-speech disorder that impacts a child’s ability to perform the motor movements required to produce speech sounds. Children with CAS have more difficulty planning a specific series of movements of the tongue, lips, jaw and palate that are necessary for intelligible speech. As opposed to a true developmental speech delay when the child is following the “typical” path of childhood speech development, children with CAS may exhibit vowel distortions, inconsistent errors, and inconsistent voicing.

What is a Language Disorder?

A language disorder is a term to describe difficulty understanding the message that is coming from others (receptive language) and difficulty relaying their message or information to others (expressive language). Children learn language all the same way, though they do not always learn at the same time. Children with language disorders can have difficulties understanding and/or using written language, spoken language, or both. Also, language disorders differ from  speech sound disorders. A speech sound disorder is characterized by difficulties making sounds, whereas with a language disorder, a child can make the sounds but exhibit difficulty using them to communicate. Learning a second language does not contribute to a language disorder. If your child has a learning disorder, they will exhibit difficulties in both languages.

What are the general signs of a language disorder?

According the the American Speech and Language Association (ASHA), signs and/or symptoms of a Language Disorder are as follows:

  • Birth to 3 years: Not smiling or engaging/playing with others
  • 4-7 months: Not babbling
  • 7-12 months: Producing/making only a few sounds; not using gestures (smiling, waving, blowing kisses, etc.)
  • 7 months – 2 years: Difficulty understanding what others are saying
  • 12-18 months: Saying only a few words
  • 1.5 years – 2 years old: Not putting two words together
  • 2 years old: Saying fewer than 50 words
  • 2-3 years old: Difficulty playing and talking with other children

Preschool Age

Children may have difficulty understanding what is being said to them. Some signs they may exhibit include: 

  • Understanding meaning behind gestures, like shrugging or nodding
  • Pointing to objects or pictures
  • Following directions
  • Answering questions

Children may have difficulty talking/communicating. Some signs they may exhibit include: 

  • Naming objects
  • Asking questions
  • Using gestures
  • Putting words together to form sentences
  • Learning songs/rhymes
  • Knowing how to start and keep a conversation flowing

What is a Fluency Disorder?

It’s normal to catch yourself using disfluencies while talking to a friend, such as saying “um” or repeating a word a couple of times. However, a fluency disorder is characterized by the excess presence of disfluencies, which significantly interferes with one’s ability to communicate with others. The most common type of fluency disorders is stuttering. Stuttering includes speech behaviors such as sound/word repetition, prolongation of sounds, and difficulty initiating a sound/word. People who stutter may also have physical and emotional/psychological symptoms.

What are the signs of a fluency disorder?

The signs of stuttering include:

  • Whole word repetitions (e.g., “My-my-my-my friend is here.”)
  • Sound/syllable repetitions (e.g., “That’s my d-d-d-dog.”)
  • Prolongation of sounds (e.g., “Ssssssssssssstop it!“)
  • Blocking, which is when a person who stutters is trying to initiate a word but no sound comes out
  • Body movements (e.g., fist clenching, leg tapping, head nodding)

Stuttering can also result in secondary psychological, emotional, and social symptoms such as social anxiety, decreased self-confidence, and avoidance of social situations.

How do I know my child needs a fluency evaluation?

It’s developmentally normal for children to experience more sound and word repetitions when they are between 2-3 years old, since their language is rapidly expanding and their brains are trying to keep up with all the new information. However, it is important to seek an evaluation from a licensed speech-language pathologist if your child is experiencing frequent disfluencies and presents with one or more of the following factors:

  • There is a family history of stuttering
  • The child is demonstrating negative social, emotional, or behavioral reactions to stuttering events
  • The child is experiencing physical tension (hard blinking, fist clenching, etc.) during a stuttering event
  • Stuttering events are impacting the child’s ability to effectively communicate
  • Other articulation or language delays are present

At Carolina Therapy Connection, our pediatric speech therapists will demonstrate and provide you and your child with education and strategies that:

  • Enhance and/or modify your child’s fluency
  • Reduce overall tension that causes stuttering
  • Minimize or prevent negative reactions to stuttering
  • Help your child advocate for their speech needs

How can Carolina Therapy Connection help?

At Carolina Therapy Connection, our treatment for language, speech sound and fluency disorders are highly individualized to your child’s needs. A standardized assessment will be administered to detect any delays or errors within all realms of speech and language compared to same-age peer norms. Our speech therapists will work with you and your child to develop a plan for enhancing their speech and build confidence across all social environments (home, school, social groups, etc). If you have any concerns or questions regarding your child’s speech or language, call our clinic at (252) 341-9944 for a complimentary speech therapy screening. This screening will determine if your child would benefit from a formal evaluation.

Speech Therapy at Carolina Therapy Connection Greenville, Goldsboro, New Bern NC

We are GROWING in Goldsboro and New Bern!

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Our Expansion in New Bern & Goldsboro, NC

Carolina Therapy Connection has been providing services in Goldsboro, NC for over 3 years and in New Bern, NC for just over 2 years. As the need for services in the Wayne and Craven County communities grow, we want to do the same! After a lot of thought, prayer, planning and time, we are excited to announce our next expansion journey! Our goal with expanding our services and clinic spaces in Goldsboro and New Bern are to offer skilled therapy to MORE families in need, decrease wait times for evaluations and treatment, develop state-of-the-art facilities with the latest equipment, and continue carrying out our mission to offer families a warm and supportive environment where they can learn about their child’s developmental needs and how to nurture their child’s capacity to succeed.

New Bern Expansion

Our current New Bern building is 2,500 square feet, which means we will TRIPLE in size to 7,000 square feet when we move into our new building! The new clinic space is also on 2.5 acres of land, which leaves ample opportunity for outdoor treatment areas, playground equipment, and MORE! Our New Bern clinic location will provide Speech Therapy, Physical Therapy, Occupational Therapy, Mental Wellness and Counseling Services, community events (Teen Hangout Nights, Parent Support Groups etc) AND summer camps! We will have a much larger sensory gym with more fine motor rooms, physical therapy and speech therapy treatment spaces, and kitchen areas for feeding therapy. We are beginning the process of renovating the inside of the building, cleaning up the outdoor areas, and purchasing new equipment and furniture to fill the space. We are hoping to move in to the new building and begin providing services there in August, 2023! We will provide updates as we work through this process! The address is of the new clinic is 609 McCarthy Blvd., New Bern, NC 28562.

 

 

Goldsboro Expansion

We currently rent a small space in Goldsboro, providing occupational therapy services only. After we move into our new building there, we will TRIPLE in size and provide occupational therapy AND speech-language therapy! This space will entail multiple speech therapy rooms, fine motor rooms and a sensory gym with new equipment! Our new address in Goldsboro will be 1308 Wayne Memorial Dr. Suite C, Goldsboro, NC 27534. We are planning to begin providing services at our new address in late May, 2023! We will keep you updated on this process as we prepare for move-in. If you are currently receiving speech therapy services in Greenville, but would like to switch over to Goldsboro, call us at (252) 341-9944 and our staff members will be glad to help you!

 

 

Give us a call at (252) 341-9944 OR email us at info@carolinatherapyconnection.com if you have ANY questions or concerns about our moving process or would like to switch services to one of our New Bern or Goldsboro clinics! We are so excited to bring you alongside this new chapter with us!

 

New Bern and Goldsboro NC Expansion Carolina Therapy Connection

Our NEW Mental Wellness and Counseling Services

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Mental Wellness and Counseling Services at Carolina Therapy Connection

Carolina Therapy Connection is SO excited to begin providing Mental Wellness and Counseling Services! Do you ever feel like everyday is similar to jumping on the hamster wheel?! You expend all your energy day after day and it leaves you feeling empty, anxious, and overwhelmed. Whether you are a parent/caregiver, teen trying to navigate the world, or just someone that feels anxious and overloaded by life’s expectations, our licensed clinicians are here to come alongside you and help you to reach your fullest potential. We believe through the power of relationship and the therapeutic alliance, you possess the tools to navigate all of the road blocks and stepping stones in your life. Our hope is that you walk away from each session feeling heard and valued and the skills you are able to tap into will help alleviate some of those feelings of overwhelm.

What clinical approaches are used within our Mental Wellness and Counseling services?

Our services cover a wide range of interventions aimed at improving a child, teen, and family’s overall emotional well-being. These include:

Client-Centered Therapy

The concept of client centered therapy might seem obvious — after all, almost all kinds of humanistic counseling essentially focus on the client. However, what sets this type of therapy apart, is that it centers the client in a more positive and inclusive manner, providing deeper insight into the adversity they are facing, while also maximizing their ability to resolve it on their own. Many professionals use this ‘talk therapy’ as a support process that encourages positive change within the client. Client centered therapy was developed originally in the early 1930s with the ideology that no other person’s ideas or advice could be as valid as the particular individual’s experience, and that exploring those experiences in a supportive, nonjudgemental environment is necessary in order to achieve a positive therapy experience. It emphasizes that the client’s experience is just as valid as a professional’s insight, and therefore the two parties in the therapeutic relationship should be viewed as equals.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CPT) is an evidenced-based psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness. Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications. (American Psychological Association, 2017).

CBT is based on several core principles, including: 

  1. Psychological problems are based, in part, on faulty or unhelpful ways of thinking.
  2. Psychological problems are based, in part, on learned patterns of unhelpful behavior.
  3. People suffering from psychological problems can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives.

CBT treatment usually involves efforts to change thinking patterns by:

  1. Learning to recognize one’s thoughts that create problems, and to reevaluate them in light of reality.
  2. Gaining a better understanding of our behavior and emotions.
  3. Using problem solving skills to cope with various situations.
  4. Learning to develop a greater sense and empowerment of our own abilities.

CBT treatment also usually involves efforts to change behavioral patterns. These strategies might include:

  1. Facing fears rather than avoiding them.
  2. Using role play to prepare for real-life situations.
  3. Learning to calm and relax one’s mind and body.

Dialectical Behavior Therapy (DBT)

DPT is a research-based practice that uses the skills and strategies balanced in terms of acceptance and change (University of Washington, Dialectical Behavior Therapy). The four skills modules include two sets of acceptance-oriented skills (mindfulness and distress tolerance) and two sets of change-oriented skills (emotion regulation and interpersonal effectiveness).

  • Mindfulness: the practice of being fully aware and present in this one moment
  • Distress Tolerance: how to tolerate pain in difficult situations, not to change it
  • Interpersonal Effectiveness: how to ask for what you want and say no while maintaining self-respect and relationships with others
  • Emotion Regulation: how to decrease vulnerability to painful emotions and change emotions that you want to change

Mindfulness Therapy 

Mindfulness therapy incorporates awareness of thoughts, emotions, feelings, surroundings, and situations into a person’s everyday life. It involves conversations with professionals that help a person develop greater awareness of their thoughts and the world around them. This increased awareness helps them avoid destructive or automatic responses or habits.

Who can receive Mental Wellness and Counseling services?

We will be accepting ALL AGES (not just kiddos!) for these services – so we encourage family and caregiver counseling too! You do not have to be a current or previous patient at Carolina Therapy Connection to receive these services.

Infant & Toddlers (Birth – 5 years old)

  • Attachment issues
  • Tantrums & Aggression
  • Excessive fear, worry or sadness
  • Does not respond to comfort when in distress
  • Lack of interest in peers

Early Childhood (6 years old – 12 years old)

  • Bullying
  • Social anxiety
  • Low self-esteem
  • Pressures of academia
  • Life changes (new schools, location or traumatic events)
  • Changes in family structure and dynamics
  • Physical aggression, defiance and lack of empathy for others

Teens, Adolescents & Young Adults (13 years old – 20+ years old)

  • Depression
  • Anxiety
  • Lack of interest in activities
  • Difficulty concentrating or focusing
  • Difficulty sleeping and completing daily routine
  • Irritability and impulse control

Families & Caregivers

  • Anxiety & depression common among members of the household
  • Difficulty with finding parenting strategies
  • Constant arguments
  • Grief and loss
  • Recent or past traumatic events
  • Adjustments to life changes (i.e. divorce, new members of the household, changes in location)

Who will provide our Mental Wellness and Counseling services?

Meghan Respess Licensed Clinical Social Worker Carolina Therapy Connection

 

Everyone meet Meghan Respess, MSW, LCSW – Carolina Therapy Connection’s FIRST Licensed Clinical Social Worker!

Meghan has 11 years of professional work experience in the mental wellness and counseling field. Meghan graduated from East Carolina University in 2006 with a Family and Community Services degree. She worked in community mental health with both children and adults for several years before returning to East Carolina University to obtain a Masters in Social Work. She graduated in 2011 and then pursued her LCSW. She has experience helping clients with stress and anxiety, parenting issues, motivation, self esteem, confidence, & depression. She also works with children and adults who deal with anger and impulse control. Meghan strives to create an open and safe environment where thoughts and feelings can be shared without fear of judgment.

How will services be provided and what insurance is accepted?

Our Mental Wellness and Counseling services will be provided virtually (tele-therapy platform) OR in-person at our Greenville clinic location. It will consist of individual or family counseling. We will only be accepting Private Insurance and Private Pay only for now. We are in the process of getting credentialed with Medicaid for our counseling services and will keep you updated on when that insurance option is available!

How do I start get started with Mental Wellness and Counseling services?

Getting started is EASY! If you are interested in our mental wellness and counseling services, call or email us to get started today! Our referral coordinator will help answer any questions you may have and make the process as easy as possible for you!

References

APA Div. 12 (Society of Clinical Psychology). (2017, July). What is cognitive behavioral therapy? American Psychological Association. Retrieved February 7, 2023, from https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral

American Psychiatric Association (1998). Gold Award: Integrating dialectical behavior therapy into a community mental health program. Psychiatric Services, 49(10). 1338–1340.

University of Washington. (n.d.). Dialectical Behavior Therapy. Behavioral Research Therapy Clinics. Retrieved February 7, 2023, from https://depts.washington.edu/uwbrtc/about-us/dialectical-behavior-therapy/

Counseling services Greenville NC

Mealtime Tips For Your Picky Eater

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Why Is Mealtime So Important For Children?

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

So why is MEALTIME so important to assist with this?

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

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

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

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

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

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

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

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

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

Additional Mealtime Picky Eater Tips

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

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

Picky Eater Tips #2: Get Creative With Food Bingo

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

Food Bingo

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

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

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

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

Picky Eater Tips #5: Food Chaining

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

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

How Can Carolina Therapy Connection Help?

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

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

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

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

 

The #1 Tip for Parenting a Child With Special Needs

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#1 Tip for Parenting a Child With Special Needs

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

SELF CONTROL AND MANAGING YOURSELF!

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

Other Contributing Factors

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

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

Other Parent Tips and Techniques

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

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

Parenting Tips and Techniques

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

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

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

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

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

Cindy Taylor

Prep Academy Program

Autism Center and Autism Resources

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

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

Inclusive Programs

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

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

About CTC

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

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

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

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

About IBCCES

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

Autism centerAutism center greenville, nc

Autism Center

Your Baby’s Communication: Prelinguistic Vocalization

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What can I expect before my baby begins talking?

Your baby’s first form of communication will be nonverbal and happens soon after birth. Your may baby grimace, cry, or squirm to express a range of emotions and physical needs, from fear and hunger to frustration and sensory overload. Oftentimes, parents learn to listen and interpret their baby’s different cries, coos and babbles. Many parents wonder when their baby will begin using words, imitate them, laugh and form a variety of other communication methods to express how they are feeling. A very important part of language development is the prelinguistic stage, which is the stage that is characterized by vocalizations before language begins. So for starters, what is language? How does it develop during a baby’s first year of life?

Language is when we use and organize sounds and words to convey meaning. Language development is considered a continuum, and there is not an abrupt shift from babbling to talking. There is an overlap between all stages of language development. Every child is different in the way they learn and grow; however there are many exciting milestones to watch for as your baby explores their environment in the first few months of life. Continue reading to learn more about the prelinguistic stage, how you can interact with your child during this stage, and how Carolina Therapy Connection can help your child reach their full potential!

What can I expect from my baby during the prelinguistic vocalizations stage?

Carolina Therapy Connection Prelinguistic Behaviors

 

1: Reflexive and Vegetative

  • Occurs birth – 2 months
  • Reflexive sounds (crying, coughs, burps)
  • Cries that mean different things (hunger, pain, etc.)

2: Cooing and Laughter

  • Occurs 2 – 4 months
  • Vowel like sounds
  • Squeals

3: Vocal Play

  • Occurs 4 – 6 months
  • Longer vowel like sounds
  • Some consonant sounds
  • Changes in pitch and loudness

4: Canonical Babbling

This stage is when babies may start to imitate what they hear! This is a fun time to sit and play with your babies and babble to them and see if they imitate!

  • Occurs around 6 months – until first words
  • Reduplicated or strings of identical syllables: “mamamama” “babababa”
  • Variegated or strings of varying consonants and vowels: “madagama”

5: Jargon

During this stage, it will seem like your baby is trying to tell you a story. They may look at you and make facial expressions and use hand movements. This is a fun time to encourage them and engage with them in conversation. Check out this awesome resource from Reading Rockets for Tips and Activities to Encourage Speech & Language Development!

  • Occurs around 10 months or older
  • This stage overlaps with first words
  • Strings of babbling
  • Paired with eye contact, gestures, and adult like intonation

Why does the prelinguistic stage matter?

Research indicates that babbling correlates to later language development. Greater babbling complexity and a variety of sounds used positively indicate greater language growth. Delayed babbling may be an indicator for speech/language delays. If you notice that your child is not babbling by 10 months of age, it may be beneficial to consult with a Speech Language Pathologist. While this is not the only factor, it can be helpful when looking at your child’s overall development.

How can Carolina Therapy Connection help?

There is so much new information and research these days that can be overwhelming for a parent. At Carolina Therapy Connection, our team of pediatric speech therapists are licensed professionals who are trained to help children with any communication difficulties. We know that developing strong communication skills is one of the most important elements to socializing and creating relationships.

Our knowledgable and experienced team of SLP’s provide screenings, assessments, consultations, and treatment to children birth through 21 years old. If you have any questions about your child’s development or would like to set up a FREE screening with one of our speech language pathologists to determine the need for an evaluation, call our clinic at 252-341-9944 to speak with one of our staff members. 

Meet the Author

Kayla Hudson Prelinguistic Communication Carolina Therapy Connection Speech Therapist

Carolina Therapy Connection Prelinguistic Communication Blog Greenville, New Bern, Goldsboro North Carolina Speech Therapy

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 Occupational Therapy

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What is Occupational Therapy? 

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

What is the role of an Occupational Therapist?

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

What are IADLs?

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

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

What are ADLs?

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

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

How Can OT Benefit Children? 

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

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

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

How can Carolina Therapy Connection help?

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

We use evidence-based treatment approaches including:

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

Blog Written By: Lacey Smith, COTA/L