Celebrating Excellence: Our Pediatric Therapy Company Named Best Employers of NC for 2023 and 2024!

Posted on July 15, 2024August 2, 2024

We are thrilled to announce that our pediatric therapy company has been recognized as one of the Best Employers of North Carolina for 2023 and 2024 by Business North Carolina! This incredible achievement is a testament to the dedication, passion, and hard work of our entire team, and it highlights our commitment to providing exceptional care and services to the children and families in our community.

A Commitment to Excellence in Pediatric Therapy

Over the past 14 years, our organization has specialized in a comprehensive range of pediatric therapy services, including occupational therapy, speech therapy, physical therapy, mental wellness and counseling, and educational services. We have recently expanded to include services for adults in the past year and a half. Our multidisciplinary approach ensures that each child receives individualized care tailored to their unique needs, fostering their development and helping them reach their full potential.

Occupational Therapy: Our skilled occupational therapists help children develop the skills they need for daily living and academic success, focusing on fine motor skills, sensory processing, and more.

Speech Therapy: Our speech-language pathologists work with children to improve their communication skills, addressing challenges related to speech, language, and social communication.

Physical Therapy: Our physical therapists are dedicated to enhancing children’s mobility, strength, development, and coordination, enabling them to participate fully in everyday activities.

Mental Wellness and Counseling: We provide a supportive environment for children and adults to explore their emotions, develop coping strategies, and improve their mental health and well-being.

Educational Services: Our educational specialists offer academic testing and tutoring support for children with learning differences, helping them thrive academically.

Serving Eastern North Carolina with Dedication and Care

With multiple locations around Eastern North Carolina, our clinic is committed to making our services accessible to families throughout the region. We also have several virtual speech-language pathologists who can serve children across all of North Carolina. We understand the importance of providing high-quality care close to home, and our convenient locations ensure that children and families can receive the support they need without extensive travel.

Recognized as a Top Employer

Being named one of the Best Employers of North Carolina for two consecutive years is an honor that reflects our dedication to creating a positive and supportive work environment for our staff. We believe that happy, fulfilled employees are the foundation of excellent patient care. Our team members are passionate about their work and committed to making a difference in the lives of the children and families we serve.

The survey conducted by DataJoe for Business North Carolina covered essential workplace topics, including organizational health, leadership, engagement, work-life balance, pay, training, benefits, and corporate social responsibility.

Looking to the Future

As we celebrate this achievement, we remain focused on our mission to provide the highest quality pediatric therapy services in Eastern North Carolina. We are continually exploring new ways to enhance our programs, support our staff, and expand our reach to better serve our community.

Thank you to our incredible team, our wonderful patients and families, and everyone who has supported us on this journey. We look forward to continuing to provide exceptional care and to being a part of your child’s growth and development for many years to come!

Visit our website or contact us today to learn more about our services and how we can support you and your child’s needs. Together, we can help every child reach their full potential!

https://businessnc.com/topping-the-list-of-north-carolinas-best-employers-2024/

Stuttering: Developmental or Disordered?

Posted on February 1, 2024January 31, 2024

Stuttering in children is a speech disorder characterized by disruptions in the natural flow of speech. Developmental stuttering is a common experience, typically emerging between the ages of 2 and 5 when children are first learning to speak fluently and developing a large repertoire of words, phrases, and sentences. While many kids experience a phase of disfluency in their normal speech development and may outgrow it, some might continue to stutter as they grow older. In this case, speech therapy may be recommended.

Causes of Stuttering in Children

The exact cause remains unclear, but it’s believed to arise from a combination of genetic, neurophysiological, and environmental factors. Children with a family history of stuttering are more likely to develop it. Some kids experience stuttering due to differences in brain structure or function related to speech production. Emotional factors like stress, pressure to communicate quickly, or a hurried environment can also increase stuttering. Stuttering occurs at the initiation of voice, which is why we typically hear disfluencies at the beginning of words and phrases.

According to Johns Hopkins Hospital, A child is more likely to stutter if he or she has:

A family history of stuttering
Stuttered for 6+ months
Other speech or language disorders
Strong emotions about stuttering or family members with fears or concerns

Types of Disfluencies

Stuttering manifests in various ways, such as repetitions (repeating sounds, syllables, or words), prolongations (elongating sounds), and blocks (inability to produce sounds). These disruptions can lead to tension and anxiety, causing the child to avoid certain words or situations where they might feel pressured to speak.

Speech Therapy for Stuttering:

Speech therapists play a crucial role in assessing, diagnosing, and treating stuttering. Here are some primary approaches utilized in speech therapy:

Speech Modification Techniques: Therapists teach children to use gentle starts to sentences, and employ smooth, relaxed breathing patterns. This helps in reducing the frequency and severity of stuttering moments. Continuous phonation, for example, is a technique where speakers learn to keep their voice on and vocal folds vibrating throughout speech.

Fluency Shaping: This technique focuses on reshaping the child’s speech patterns by teaching smoother speech movements. It involves controlled breathing, gentle voicing, and gradually increasing sentence length to enhance fluency.

Stuttering Modification: This approach concentrates on changing the child’s emotional and cognitive reactions to stuttering. It involves desensitizing the child to the fear and anxiety associated with stuttering and teaching strategies to manage and accept disfluency.

Parental Involvement: Educating parents about stuttering and how to support their child’s speech development is key to increasing the child’s success. Therapists often teach parents techniques to practice at home, creating a supportive environment for the child’s progress.

Communication Skills Training: This includes enhancing overall communication skills, like turn-taking and using pauses effectively. It helps in building the child’s confidence and reducing the pressure associated with speaking.

Long-Term Outlook

Many young children outgrow developmental stuttering; however, some might continue to stutter into adolescence and adulthood. In such cases, ongoing therapy, support groups, and strategies for managing stuttering in social and professional settings become vital.

How can Carolina Therapy Connection help?

Children who sutter often benefit from therapy from skilled Speech-Language Pathologists. Stuttering in children is a complex speech disorder that necessitates early intervention and specialized therapy. Speech therapists employ a variety of techniques focusing on speech modification, emotional support, and overall communication enhancement to help children manage and, in many cases, overcome stuttering. Family involvement and a supportive environment are fundamental in the child’s journey towards improved fluency and confidence in communication. At Carolina Therapy Connection, our treatment is highly individualized to your child’s needs. A standardized assessment will be administered to detect any disfluencies, and our therapists will work with you and your child to develop a plan for enhancing skills to build confidence across all social environments (home, school, social groups, etc). If you have any concerns or questions regarding your child’s development, call our clinic at (252) 341-9944.

By Ashley Holloway, MS, CCC-SLP, CAS

Winter Activities for All Ages!

Posted on January 15, 2024January 12, 2024

What are Some Winter Activities When the Weather is too Cold Outside?

Ever wonder what you can do to keep your Kiddo occupied and safe while providing the necessary sensory input when it’s too cold to play outside? It is recommended to take indoor breaks every 20-30 minutes when the temperature outside is between 13-30 degrees; however, some kiddos tolerate cold weather better than others. Here are some tips for activities that can be done indoors when it’s just too cold to go outside this winter!

A Fun Winter Activity: Play Board Games

This is dependent on your child’s age and skill set. If you have some board games tucked in the closet, break them out and have family fun! This will work on building your child’s reciprocal play skills, following multistep direction skills, coping skills, and emotional regulation. Check out our Amazon storefront for some of our recommended board games!

Build a Pillow/Blanket Fort

Who didn’t love making a fort under the kitchen table as a kid? Build a fort in the kitchen and living room, then place some of their favorite books, toys, and stuffed animals inside. This can be a fun way to get your kids into critical thinking mode and build their visual perceptual and motor skills!

Scavenger Hunt

Another fun winter activity is to hide some items in your house and have your kiddos find them! This can be graded according to skill level and age. For example, for a younger kiddo, have them locate items they would typically use. For older kiddos, give hints to the item they are looking for. “Find two things mom uses to stir within the kitchen (utensils)” or “Find something round and blue in your bedroom (ball).” This will work on their figure ground skills and get their body moving!

Bake/Cook

Have your kiddos help you bake/cook your favorite snack or dessert in the kitchen. Have your kiddos follow the directions given or help with the messy tasks. This can be great for our sensory-seeking kiddos and those resistant to messy play!

Dance Off!

GET MOVING with a fun dance-off! Put off some of your favorite music and have a contest to see who dances best to the song! This is a great way to work on gross motor skills, coordination, and auditory processing, and it’s just plain fun!

Watch your Favorite Movie and Act Out the Scenes.

Many kids like to watch movies; however, do you ever notice that they get bored halfway through and are on to the next thing? Get them involved with the movie. Have that pause button ready and have them act out a scene to see if they can recall what happened!

Indoor “Snowball” Fight

Do you have some extra tissue paper lying around after wrapping those Christmas presents? Make snowballs and toss them at each other! This is a great way to get kiddos moving without fear of knocking things off tables/counters and breaking things!

Keepie-uppie with Balloons

Everyone knows this one! Can we keep the balloon off of the ground? Try it! It is so much fun, works on your kiddo’s hand-eye coordination, and has less risk of damaging something in your home!

How can Carolina Therapy Help?

With winter in full swing, ask your therapist about tips/tricks to have fun indoors with adaptations specifically for your child’s sensory-related needs. A therapist at Carolina Therapy Connection can help adapt the activities listed above and give more ideas for your specific child! Also, check out our link for Amazon storefront to find fun toys/activities to make the indoors fun! Many great toy ideas and sensory-related tools can be used when your child needs to get some energy out!

I hope these tips have helped build some fun ideas for you and your family for this winter season! Stay happy, healthy, and warm!

By: Shelby Godwin, COTA/L, AC

Not Your Average Toy!

Posted on December 1, 2023December 1, 2023

Not Your Average Toy offers a transformative approach to pediatric therapy, catering to the different needs of our pediatric patients in occupational, speech, and physical therapy within our clinic. These specialized toys aren’t just playthings; they motivate children to develop essential skills like fine motor control, visual perceptual abilities, grasping techniques, following multistep directions, stimulating ‘what’ questions, fostering color and shape recognition, encouraging problem-solving, and refining hand-eye coordination. What makes these toys exceptional is their unique ability to grasp the children’s attention while integrating therapeutic goals into engaging activities tailored to each child’s journey toward progress and achievement. Check out some of our favorite “Not average toys!”

Examples of Not Your Average Toy:

Water Beads:

What sets water beads apart? Water beads stand out for their fun way of developmental skills. They offer an enjoyable sensory and messy play while enhancing color recognition and sorting abilities. These beads serve as a tool for reaching milestones. Children can play by using a spoon for scooping into a cup, counting exercises, and even hiding items like toy fish or other objects within the beads to engage both hands in a tactile search. These toys facilitate various developmental goals, from color recognition and sorting to refining fine motor skills, in-hand manipulation, bilateral coordination, and sensory play. They also stimulate counting skills and engage in figure-ground activities.

Building Blocks:

Building blocks are known for making a tower and watching it fall, but did you know that they offer various developmental opportunities? These square toys build structures with two hands, allowing a child to work towards bilateral coordination, midline crossing, and fine motor skills. Playing with blocks can also help with color recognition, shape learning, spatial orientation, and teaching concepts through block positions.

Building blocks can also help with emotional regulation. If a task is challenging or the tower does not stay quite the way intended, this is an excellent opportunity to discuss the feelings raised and allow your child to have a voice.

Puzzles:

Puzzles are a fun, versatile learning tool for children. They can help children learn about shapes and colors, expand their vocabulary, and identify different types of animals. Puzzles also help children learn to act like put in and take out. You can add a multi-step direction to make a puzzle more challenging, like putting the cow and horse puzzle pieces together in their correct spot. For more engaging questions, ask your child, “What does a cow say?” or “Where is the cow?” Puzzle helps achieve milestones that involve enhancing visual perceptual skills, grasping technique, mastering multi-step directions, and developing problem-solving abilities.

How can Carolina Therapy Connection Help?

At CTC, we are committed to supporting our families and the child’s developmental journey and helping them achieve these goals at home. Please explore our website (https://www.carolinatherapyconnection.com/) or our Amazon Storefront (https://www.amazon.com/shop/carolinatherapyconnection). These are not your average toys; they are carefully innovative toys that can help foster growth and development. To further understand these toys’ impact, ask your therapist if you can sit in during a session. By watching the interaction between the child playing and the therapist, parents can gain insights into how effective these tools can be and bring these Not Your Average Toys into their home.

By: Lauren Hodges, COTA/L, and Allison Hicks

Why Is Food Play Important For Picky Eaters?

Posted on August 17, 2023October 4, 2023

What Is Food Play?

As a child, most of our parents would tell us not to play with our food…well, sometimes playing with food is a great benefit for children.

Food play is an important sensory play activity for children with sensory defensiveness and those that are picky eaters. This type of play can be fun and a non stressful way for children to explore different foods using all of their senses. Children gain skills through play-based learning. Food play is a great opportunity for children to explore and learn about foods and over time become comfortable with interacting with the foods. Not only does food play increase exposure to different foods, it improves fine motor skills for self-feeding, imaginative play, family interaction, and increases vocabulary to help describe foods.

Food Play Activities:

Pretending to make a meal for you, their dolls or friends.
Having a tea party with dolls or parents.
Playing restaurant
Using a paint brush and paint with puree food
Using tongs to play with cooked noodles
Cutting foods with knife or a cookie cutter
Simon Says with food (placing food on different parts of the body, make it dance, make a noise, take a bite, etc.)
Making a sensory box out of cereal or dried noodles
Drawing with shaving cream, apple sauce, or pudding with their finger
Driving cars and digging through rice, beans, or dried noodles
Cutting foods into small pieces to feed to toy animals

Great Tips for Setting Up Food Play Activities:

During food play, go with the pace of the child. Do not force your child to do food play. It should be a positive and low-pressure activity. Present foods with different colors, shapes, sizes, and textures. You can present foods during food play that you would like your child to eventually eat. It is important that food play should not be engaged in the child’s regular mealtime environment. Conduct it outside, on the floor with a blanket, activity table, etc. During food play, it is okay if the child denies eating the food that is being presented. Remember the goal is to expose the child to these foods not consumption. You can model eating the foods but try not to pressure your child into eating.

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!

Teaching Kids Independence With Life Skills

Posted on July 6, 2023October 4, 2023

Chores or Life Skills?

Kiddos may ask themselves this question: Why do I have to do these chores? Here at CTC, we call chores “Life Skills” because that is simply what they are. Although not always the most preferred thing for your child to do, washing dishes, washing clothes, making the bed, vacuuming, sweeping, mopping, grocery shopping, cooking, and many more are essential life skills that are necessary when becoming an independent adult. Not only are they necessary, they are also very helpful for the development of time management skills, executive functioning, sensory regulation, and even emotional regulation.

You may be wondering how you can gauge what skills are appropriate for your child. Below is a short list of age appropriate chores to get you started based on your child’s age:

Life Skills for 2-3 years old

Picking up toys
Wiping up a mess (wiping off the counter after eating or messy play)
Putting laundry in the hamper after taking off dirty clothes

Life Skills for 4-5 years old

Making the bed (even if it is assisting you with the task!)
Starting simple meal preparation (putting thing into bowls, stirring, etc.)
Helping wash/rinse dishes

Life Skills for 6-8 years old

Feeding pets
Vacuuming, sweeping, mopping
Folding laundry/putting away own clothes

Life Skills for 9-12 years old

Prepare simple meals (heating up a hot pocket, TV dinner or oven pizza)
Taking out garbage
Cleaning areas of the home other than own bedroom (bathroom, living room, outdoor areas)
Helping make a shopping list and helping to find items in the grocery store

13-18 years – Include all listed above with increased to total independence!

So your child may be age appropriate for the tasks at hand, but what if you wonder whether they are developmentally, emotionally, physically or cognitively appropriate for the task at this age? Recently CTC held a Life Skills camp with 4 days of fun while completing tasks that increase independence within the home environment. The kiddos in this group worked on grocery shopping, meal preparation, cleaning up after themselves, household life skills, taking care of pets and plants, team work and communication. During the camp, each child was asked to review their skills and determine the toughest part of doing “chores”. The #1 answer was time management and feelings of overwhelm when presented with multiple tasks to complete. We all worked to develop either written or visual (picture) schedules for each kiddo to take home to aid in these concerns, making getting these life skills done easier and less frustrating!

Talk to your child’s occupational therapist to see if these could be options to help your child regulate their emotions, plan their time with greater efficiency and learn new skills after mastering current ones! If your kiddo struggles to complete their daily activities, call our clinic at (252) 341-9944! Your child may benefit from an occupational therapy screening or formal evaluation!

Here is 2 recipes of foods that were made during the camp:

Rice Kripsy Treats – The Original Rice Krispies Treats™ Recipe | Rice Krispies®
Soup (written by a kiddo in the camp)

Ingredients

3-4 boneless chicken thighs
1 medium onion
3 carrots, sliced
2 chicken stock boxes
1 small rice pack (boil in a bag)
1 can black beans

Add a pinch of…

Pink Himalayan Salt
Chili powder
Seasoned Salt
Black pepper
Red pepper flakes

MIX TOGETHER IN A SMALL BOWL

Steps:

Make the rice according to directions on the rice bag
As the rice is cooking, cut chicken into 1 inch cubes
Sprinkle seasoning onto chicken
Cut carrots and onion into preferred size and cook until preferred texture
Cook the chicken until done in saucepan
Once all ingredients are finished, combine with stock in a pot and boil for 2-5 minutes
Simmer for 10-15 minutes

Written By: Shelby Godwin, COTA/L, AC

We are GROWING in Goldsboro and New Bern!

Posted on April 26, 2023October 4, 2023

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!

Your Baby’s Communication: Prelinguistic Vocalization

Posted on November 3, 2022October 4, 2023

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?

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

The Vestibular System in Pediatrics

Posted on October 3, 2022October 4, 2023

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!

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.
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Helping Your Child Learn to Walk

Posted on August 2, 2022October 4, 2023

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