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Why Is My Child Picky About Clothing?

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Is your child picky about clothing? It is common for children to have a favorite shirt, blanket, or pants, but what if they refuse to wear anything besides their one outfit of choice? In the pediatric world of occupational therapy, we often work with children who cannot tolerate wearing various clothing items. We have seen the stress of dressing tasks for children and their caregivers. The intended purpose of this blog is to educate parents on why a child may be sensitive to clothing and point caregivers in the right direction to address these concerns.

Why is My Child Picky About Their Clothing?

Every child processes sensory information differently. Children who demonstrate intolerance to various clothing textures may often have sensory sensitivities to tactile (touch) information, also known as tactile defensiveness. This indicates that the neurons responsible for processing tactile information have lower neurological thresholds, meaning more sensory information reaches their brain quicker, which can cause children to become overwhelmed by the stimulus. This results in heightened responses (ex., Crying, screaming, itching) when a child is prompted to wear clothing that feels uncomfortable to them. Another underlying reason for tactile sensitivities can be connected to retained primitive reflexes. Retained primitive reflexes often contribute to a child’s hypersensitivity to general sensory information and can make clothing items with tags or tight waistbands challenging to wear. 

When Should I Be Concerned About My Child’s Intolerance for Clothing?

It can be hard to discern when a child’s intolerance to clothing is a behavioral or sensory concern. A child who doesn’t “like” to wear a particular clothing item or texture is very different from a child who physically cannot tolerate certain textures. True sensory concerns will present with consistent behaviors across settings. For example, a child with true tactile defensiveness will have difficulty wearing a non-preferred clothing item at home or daycare. Additionally, consulting a professional is not customarily warranted if their limited clothing items do not impact a child’s performance and participation in meaningful activities. However, if a child’s clothing sensitivities are impacting their meaningful activities, then it may be beneficial to talk with a pediatric occupational therapist to determine what options or strategies are appropriate. An example could be a child who wants to play soccer but cannot tolerate wearing soccer cleats or sneakers and, therefore, refuses to play. Another example would be a child or adolescent who refuses to wear clothing to match the temperature outside, such as refusing to wear gloves or mittens in the middle of winter.

Strategies to Expand A Child’s Wardrobe

  • Keep a diary/log:
    • Children will normally demonstrate a pattern of behaviors to show caregivers what types of clothing are uncomfortable. It will be essential to keep a log of what items/fabrics are preferred to limit the child’s discomfort when presented with new clothing items to try on. 
  • Present sensory-friendly clothing:
    • There are common characteristics of clothing that can be aversive to children with tactile defensiveness. For these reasons, we have provided a list of clothing items that are often more tolerable for sensory-sensitive children:
      • Clothing without seams
      • Clothing without tags
      • Loose fitting clothing
      • Soft/smooth fabric
      • Breathable clothing: avoid clothing that holds moisture
  • Invite them into the process:
    • Providing the child with autonomy in choosing their clothing will help remove feelings of stress that surround dressing activities. One way to do this is to take them shopping and ask them what clothing they want. Depending on the child’s comfort level, it can also be beneficial to have them choose a variety of clothing to try on and have a “fashion show” in the dressing room.

 

What Other Concerns Can arise with Children Being Picky About Clothing, and How Can Carolina Therapy Connection Help?

Tactile defensiveness does not only impact a child’s ability to tolerate various clothing items. Typical areas of difficulty for tactilely defensive children include, but are not limited to, difficulty with hair brushing/washing, hair cuts, tooth brushing, nail clipping, and bathing. If your child has difficulty tolerating any of the above activities, then it may be beneficial to meet with a pediatric occupational therapist to discuss the best care plan for the child. Call our clinic at (252) 341-9944! Your child may benefit from an occupational therapy screening or formal evaluation!

 

By: Emily Britt

 

Spring Activities For All Ages!

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Join us as we welcome spring!

As the world outside bursts into color and warmth, it’s the perfect time to dive into some fun activities that celebrate the season. We’ve put together a bunch of excellent OT spring activities for all ages that you can do that are fun and help you learn and grow.

From making yummy flower-shaped snacks to crafting bird feeders and sensory bottles, there’s something for everyone to enjoy. Whether you’re a parent looking for fun OT activities with your kids at home or a teacher searching for exciting activities, you’ve come to the right place!

Join us as we explore the wonders of spring through activities that work on our fine motor skills and try new foods! Let’s make this season even more remarkable by having a blast with these therapeutic activities.

Spring Activities: Flower Snacks: 

This fun and creative activity works on fine motor skills, food play, and meal preparation skills. It is also a great way to introduce healthy snacks into your child’s diet. 

  • Beet slices flower snack– Use a flower-shaped cookie cutter to cut beet slices (or other soft fruit/veggies: pineapple, apples, thin potatoes…)
  • Mandarin orange flower– Peel an orange and open one end.  Add celery for a stem.
  • Orange with flair–  Add a grape tomato to the center of your orange to add a little color.  Other fruits could also be arranged into a flower shape: apple, pear, and banana slices would work.
  • Dried cranberry mini flowers– Arrange cranberries (or raisins) into petal shapes.  Add chickpeas for a center to each flower.
  • Tulip cucumbers– Cut a jagged line into cucumber slices.  Add a piece of the peel for stems for each flower.
  • Flower art–  Get the kids involved in this one!  Provide carrots, broccoli, red peppers, and grape tomatoes, and create a flower design as a family.  Enjoy!

Paint With Flowers: 

This is an easy and cheap activity to complete at home that only requires paint, paper or plate, and flowers. Use the flower as a brush and press it into the paint, then paint away!

Oral Motor Exercise With Plastic Easter Eggs: 

This is a fun activity to incorporate into your routine before feeding. Adding oral motor exercises provides sensory input and “wakes up” the muscles of the mouth. Give your child a straw and ask them to blow into the straw to push easter eggs toward a target. 

Spring Animal Walks: 

This is a fun gross motor activity that can be done in the home or outside. Have your child bunny hop, bear walk, frog jump, and snake slither from one side to the other. You can even have an animal race to see who gets to the finish line first!

Homemade Bird Feeders: 

This is a great activity to improve executive functioning skills and bilateral coordination skills. You will need toilet paper rolls, peanut butter, birdseed, and spreading tools. Spread the peanut butter on the toilet paper, roll it in the birdseed, and hang it up outside!

Spring Themed Sensory Bottle: 

Sensory bottles can provide a calming sensory experience to children by focusing on the different moving objects inside. All you need is 4 ounces of clear glue, warm water, hot glue (to seal the lid), a bottle, and any desired spring-themed objects to put inside (glitter, small toy animals, flowers, etc.). 

 

Syncing Success: A Better Way to Manage ADHD Without Medication

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Attention Deficit Hyperactivity Disorder (ADHD) poses unique challenges for individuals of all ages, affecting their ability to focus, organize tasks, and regulate impulses. While traditional interventions often involve medications and behavioral therapy, a groundbreaking approach has emerged in recent years – the use of the Interactive Metronome (IM) as an innovative tool for managing ADHD symptoms. In this blog, we’ll explore the relationship between Interactive Metronome and ADHD, shedding light on how this rhythmic training can make a significant difference in the lives of those navigating the complexities of ADHD.

 

Understanding ADHD and its Challenges

 

ADHD is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity. Individuals with ADHD may find it challenging to sustain attention, complete tasks, and regulate their behavior, impacting academic, professional, and personal aspects of their lives. Traditional treatment approaches often involve a combination of medications and behavioral therapy, but the search for non-invasive, complementary interventions has led to exploring innovative tools like the Interactive Metronome.

 

Interactive Metronome and ADHD: A Rhythmic Approach

 

The Interactive Metronome operates on the principle that precise timing and rhythmic synchronization can positively influence neural pathways related to attention, coordination, and executive functions. Here’s how IM is making waves in the realm of ADHD management:

 

  1. Enhanced Attention and Focus: IM exercises require participants to match their movements to a rhythmic beat with millisecond accuracy. This process engages the brain’s attention and timing centers, fostering sustained attention and focus improvements, essential components for managing ADHD symptoms.

 

  1. Improved Executive Functions: ADHD often involves challenges with executive functions like working memory, organization, and impulse control. The structured nature of IM exercises helps strengthen these cognitive processes, providing individuals with practical skills to navigate daily tasks more effectively.

 

  1. Sensory Integration: The combination of auditory and visual cues in IM promotes sensory integration, a critical factor in ADHD management. Individuals can develop better self-regulation and coordination by syncing sensory information with motor responses.

 

  1. Individualized Treatment Plans: Therapists at Carolina Therapy Connection can tailor IM programs to address the specific needs and challenges of individuals with ADHD. The customizable nature of IM allows for a personalized approach, ensuring that the training aligns with each participant’s unique cognitive and motor profile.

 

Real-life Success Stories 

 

The impact of Interactive Metronome on ADHD management is not just theoretical – there is a growing body of research-based evidence supporting its effectiveness. Many individuals undergoing occupational therapy at Carolina Therapy Connection have reported significant improvements in attention, impulse control, and overall quality of life after incorporating IM into their ADHD treatment plan.

 

In the evolving landscape of ADHD management, the Interactive Metronome stands out as a promising avenue for individuals seeking alternative and complementary approaches. By tapping into the power of rhythmic synchronization and precise timing, IM offers a dynamic and engaging method to address the core challenges associated with ADHD. It’s not just about keeping time; it’s about syncing success despite ADHD’s unique challenges.  Our Occupational Therapists and Certified Occupational Therapy Assistants at Carolina Therapy Connection are certified in the Interactive Metronome. They can utilize this as an essential part of a child’s treatment plan.  The Interactive Metronome can be used as a standalone treatment, but we see the best results when incorporated into diverse therapeutic programs.

 

 

Call us today to learn more about the Interactive Metronome and whether your child would benefit from this amazing therapeutic intervention!

 

What is Toe Walking?

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

Toe Walking Causes

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

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

Neurological concern:

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

 

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

Treatment

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

Treatment can include:

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

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

 

How Can Carolina Therapy Connection Help with Toe Walking?

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

 

By: Taylor Saunders

 

Stuttering: Developmental or Disordered?

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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

 

 

Navigating Neurodivergence

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How Occupational Therapy Helps Different Brains

Occupational therapy has long been recognized as a vital therapy for providing neurodiverse individuals with the tools and strategies to lead fulfilling lives. In recent years, the focus on neurodivergent occupational therapy has gained momentum, emphasizing the unique needs and strengths of individuals with neurological differences. This blog aims to explore the transformative role of occupational therapy in supporting neurodivergent individuals on their journey toward independence, empowerment, and a higher quality of life.

 

Understanding Occupational Therapy for Neurodiverse Individuals

Occupational therapy helps neurodiverse individuals by helping them discover who they are, what they can contribute to society, and how they can live their best life.  We start by making a personalized plan with the individual on how to make their life easier for them. 

 

Taking Care of the Whole Person With Occupational Therapy 

Occupational therapy looks at everything – the body, the brain, feelings, and even how someone experiences the world around them. It’s important to consider an individual’s life’s physical, cognitive, emotional, and sensory aspects.  Together with the individual and caregivers, occupational therapists take a holistic approach to help figure out what areas of their lives are challenging and what are their strengths.

 

Making Senses Work Better

It’s common for neurodiverse individuals to have differences in how they experience sensations in their world- they may feel sensitive to things like touch or sounds. Occupational therapists work to identify sensory sensitivities or challenges and implement strategies to regulate and adapt to different sensory inputs. For example- working with the individual to develop adaptive strategies for sensitivities related to food textures and picky eating. Occupational therapists can help progress through different food textures using various techniques that first start with foods the individual can tolerate and eat frequently.  Then, we start adding foods that are similar in texture, color, size, etc.  

 

Skill Development and Independence

Occupational therapy helps learn practical life skills, social skills, and executive functioning abilities.  It could be learning how to tie shoelaces or even making friends. It’s essential to take a strength-based approach to help build trust, confidence, and independence with daily tasks that allow them to engage in meaningful activities.  A strength-based approach is when an occupational therapist builds upon a person’s strengths instead of focusing on their weaknesses.

 

Family and Community Involvement

Families and friends are essential in the therapeutic process, too! Occupational therapists work with families to implement strategies at home and collaborate with community organizations and schools to create supportive spaces for neurodivergent individuals.

 

Technology and Innovation in Therapy

It’s common for a neurodiverse individual to process information differently than we expect; therefore, it is important to utilize various interactive tools and technology to enhance the therapeutic experience and cater to individual needs. Many apps and digital devices are available to help create independence in daily tasks.  Occupational therapists look at ways to support learning through apps, games, and other devices.

 

How Can Carolina Therapy Connection Help With Neurodiverse Individuals?

At Carolina Therapy Connection, all of our therapists are neurodiversity-affirming.  They recognize that neurodivergence is not an illness or disability that needs to be corrected or fixed. They recognize that neurodiverse individuals come with their own set of strengths that can be fostered. Occupational therapy can have a transformative impact in empowering individuals to overcome challenges, embrace their strengths, and lead fulfilling lives.  At Carolina Therapy Connection, we believe it’s all about making sure everyone, no matter how their brain works, can be a part of the fun and excitement in life!

 

 

 

Hearing Loss in Children

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About 2 to 3 out of every 1,000 children in the United States are born with a detectable level of hearing loss in one or both ears! Hearing loss can occur gradually over time and parents may not even realize their children have it. Children may simply adjust to the changes in their hearing and not realize they are missing out on important speech sounds and words. 

What is a hearing screening? 

Pediatric Audiology 101: Your Child's Hearing Health

A hearing screening is frequently used to check a person’s ability to detect the loudness and pitch of sounds. You can either “pass” or “fail” the screening. If your child passes and there are no other concerns, then you can continue with your child’s regularly scheduled hearing screenings. If your child “fails”, or if you have other concerns about their hearing, then an appointment for more in-depth testing may be necessary to see if there is a hearing loss and what treatment options are best to help support your child. These hearing screenings can help identify people who may need a more thorough hearing evaluation that can be completed by medical personnel such as ENTs or audiologists. Pediatric hearing screenings may take place in early intervention, school audiology, medical, and/or home settings. 

How can I tell if my child has hearing loss? 

  • Difficulty recognizing familiar voices
  • Delayed or absent speech sounds (not making cooing noises, babbling less, few words, distorted speech sounds, etc.)
  • Not turning head toward interesting or startling sounds
  • Delayed language (difficulty understanding simple words, following directions, etc.)
  • Delayed or absent emergence of first words as by two years old children should start combining words into 2-word phrases)
  • If child is older, they may frequently asks others to repeat themselves for clarification
  • Child is speaking louder than others
  • Lack of attention to others, conversations, environmental surroundings
  • Struggles with academics

 

What causes hearing loss in young children? 

  • Frequent ear infections (otitis media; most common)
  • Measles or meningitis
  • Head injuries
  • Exposure to loud noises 
  • Genetic disorders

Interesting Fact… 5/6 children experience ear infections (otitis media) by the time they are 3 years old!

 

What should I do if I suspect my child has hearing loss? 

If you suspect your child has hearing loss, speak with your healthcare provider and discuss your child’s current hearing abilities and address your concerns if you suspect signs of hearing difficulties at home. Early hearing detection and a formal evaluation completed by an audiologist, ENT and/or other qualified medical professional can help determine specific needs and appropriate treatment goals to further support your child’s success. It is important to regularly check on your child’s hearing health to monitor potential changes in hearing!

 

How can Speech therapy help?

Speech-Language Pathologists can play a role in your child’s hearing health by completing hearing screenings as a part of a formal speech and language assessment. If your child does not pass a hearing screening completed by the Speech-Language Pathologist, then a referral will be made for further evaluation with audiological/medical professionals to provide the best of care to your little one. Language acquisition is an essential component of your child’s overall development. Significant hearing loss, if undetected early, can lead to a speech and language delay, further putting your child at risk of falling behind same-aged peers. Given that our hearing plays a significant role in living our daily lives, it is crucial to have your child’s hearing formally evaluated at key milestones, beginning at birth to help lead them to better speech, language, and educational outcomes in the future!

Schedule a screening at Carolina Therapy Connection today!

 

Blog By: Lindsey Bryant, SLP

What is AAC?

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AAC stands for Augmentative and Alternative Communication. It encompasses all of the ways in which an individual may communicate outside of speaking verbally. Augmentative communication means to add to someone’s existing speech skills, and alternative means to be used in place of verbal speech. There are many different kinds of AAC including, but not limited to: gestures, facial expressions, writing, pictures symbols (e.g., picture exchange communication system/ PECS), drawing, sign language, high-tech speech generating devices, communication boards, etc. Some people may use one of these modalities, and some may use multiple modalities depending on the way in which they can most quickly and clearly communicate the topic.

Who Needs AAC?

Many different people use AAC throughout their lifetime. It can be used across the lifespan by any age, at any time, and for a variety of different reasons. Some people use AAC for their entire life, and some use it for only a short period of time. AAC can help any person who has difficulty fully or partially meeting their daily communication needs such as expressing wants and needs, socializing, asking questions, and a variety of other functions.

 

 

How can AAC help your child?

AAC may be able to help your child if they have difficulty being understood by others, have a limited vocabulary, demonstrate limited spontaneous speech, are non-speaking, and a variety of other different reasons. There are no prerequisite skills to your child beginning to use AAC. One common misconception is that AAC will hinder language development or cause your child to become dependent on it for communication. While some children may have minimal to no verbal speech throughout their lifetime, there is research to show that AAC can actually help children to develop language. Using AAC can also help to reduce frustration surrounding communication attempts, and help your child to communicate their needs more clearly, quickly, and effectively.

 

 

Parent’s Role in AAC

When introducing AAC to your child, it is important for family members/ caregivers to make the commitment to help the child succeed with the chosen AAC device. Your input is crucial in helping to choose and develop an appropriate AAC system, and using the device at home and in the community is a vital step to help both you and the child continue to learn the system. According to Jane Korsten, SLP, the average 18-month-old has been exposed to 4,380 hours of oral language at a rate of 8 hours/ day from birth. A child who has a communication system (AAC) and receives speech/language therapy 2 times/week for 20-30 minutes will reach the same amount of language exposure (in their AAC language) in 84 years. It is our role as professionals and caregivers to help minimize the communication gap between oral language users and AAC users. 

Modeling:  Modeling is an awesome way to both learn your child’s AAC system, and teach them an example of how they can use it. The best way to model is to speak and use the system at the same time, although you do not always have to select an icon for every word you say. For example, you may verbally say “time to go to school” while modeling “go” and “school” on the AAC system. A general rule of thumb is to model the number of icons your child is currently using, plus one. If your child uses 1 icon at a time, you may choose to model 1-2 icons at this time. It is important to model without expectation, meaning that you use the AAC system without expecting or requiring the child to respond, withholding items or activities, or “testing” their skills. The goal is to provide an example to the AAC learner, which they will then learn by watching and listening to what you do/say.

 

How can CTC help you and your child?

Whether your child is already receiving speech/language therapy services at our clinic or not, CTC is ready to help support both parents and children through their own individual journey with Augmentative and Alternative Communication. If you believe that your child may benefit from the use of AAC, talk to one of our many incredible speech-language pathologists to begin the process of figuring out what type of system (no tech, low-tech, mid-tech, high-tech) will work best. This process can take time, but with your support and the support of your SLP, it is possible to find the right system for your child! 

Down Syndrome Awareness Month!

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

 

What is Down Syndrome?

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

 

You are welcomed here!

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

Hannah: Age 8

 

How can therapy help?

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

 

A Total Communication Approach 

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

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

 

How can Carolina Therapy Connection help?

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

By Ashley Holloway, MS, CCC-SLP, CAS

Is My Child Ready For Potty Training?

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Is My Child Ready For Potty Training?

Many parents ask the question, “Is my child ready for potty training?” Making the transition out of diapers is an important developmental milestone but it can also be a topic that causes frustration and anxiety for both children and their caregivers. Questions about when to start and how to promote a child’s success with potty training can feel overwhelming. If you are a caregiver that can relate to any of those feelings, this blog post is for you!

When Should I Start Potty Training?

This is a question that many caregivers ask themselves. A variety of factors must be considered before initiating the toilet training process. A child must be physically, emotionally, cognitively, and physiologically ready prior to  starting the process. Here are some tips to identify whether your child may be ready:

Emotional readiness – Can your child tolerate sitting on the toilet or potty training seat? Are they excited about wearing “big kid” underwear?

Cognitive readiness: Can your child follow 1-2 step directions? Can they communicate their need to use the restroom?

Physiological readiness: Are they able to stay dry up to two hours at a time or wake up from a nap with a clean pull-up?

Physical readiness: Is your child able to sit on a toilet or potty training seat without assistance? Can they get on and off the toilet with little to no assistance? Can they assist with managing their clothing during toileting tasks?

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If you have said yes to the majority of the above questions, then your child may be ready to begin potty training! 

At what age can I expect my child to start potty training?

 The following list includes general guidelines to help establish a baseline of where a child might be on their journey towards potty training. However, each child has a different timeline in which they are emotionally, physically, cognitively, and physiologically ready for potty training. It is vital that you never push a child towards progressing through the developmental sequence. If you see meltdowns or signs of regression, it may be best to take a break and try again at a later time.

 

Developmental Sequence for Toileting:

1 year – Children indicate that they are wet/soiled through non-verbal signs of distress

2 years – Child begins to tolerate sitting on the toilet

30 months – Child communicates that they need to use the bathroom and will likely require assistance with managing their clothing and wiping

3 years – Children will initiate using the toilet independently. They may attempt to wipe but continue to require assistance for thoroughness. 

4-4.5 years – Children may have a few accidents. They are able to manage their clothing independently. 

5 years – Child is able to complete a full toilet routine independently, including washing and drying their hands. 

5-7 years – Children are consistently able to stay dry throughout the night. 

 

Tips to Help Progress Through the Potty Training Process

  • Make potty training FUN!

Whether it is the sound of the toilet flushing or the new environment, some children may have a fear of sitting on the toilet. If a child is anxious, they may be hesitant to sit on the toilet or may not even tolerate sitting on it. One method to help ease this transition is to allow the child to play with their favorite toys while sitting fully clothed on the toilet. Another method to make potty training fun is to invite the child into the process. You can do this by allowing the child to pick out their underwear and ask them to choose their potty seat. This helps address their newfound need for autonomy and allows them to take pride in the potty training process. 

  • Consistency is key. 

Establishing a consistent routine will help minimize a child’s accidents and increase their likelihood of using the toilet successfully. A general guideline is to prompt the child to sit on the toilet as soon as they wake up, after naps, and in two hour intervals throughout the day. Encourage your child to sit on the toilet for a few minutes at a time. It can be helpful to read a story to them while on the toilet or provide them with a preferred toy to make this time fun and engaging.

  • Know the signs. 

If a child is squatting, holding their genital area, or fidgeting, they may need to use the bathroom. Prompt the child to sit on the toilet when these signs occur. This can help the child become familiar with these signals to increase their ability to identify these signs as well. 

  • Celebrate the small victories. 

It is important that parents and caregivers build up a child’s confidence and self-efficacy during the potty training process. Caregivers can do this by providing their child with positive praise and celebrating the small victories! Some examples of this include praising their child for sitting on the toilet, communicating that they need to use the bathroom, successfully using the toilet, and completing all other steps in the toileting sequence (ex. Pulling up their pants, flushing the toilet, washing their hands). Sticker charts can also help motivate children to use the bathroom by providing them with a tangible reward to work towards!

  • Know there will be accidents. 

In combination with Point 4 above, it is important to know that accidents will happen and how to respond when they do. Never punish a child for soiling their clothing. Instead, always be prepared with an extra set of underwear or clothing, especially when going out in the community. 

You can find more tips on the potty training process here!

 

How can Carolina Therapy Connection Help?

If your kiddo struggles with self-regulation, completing their daily activities, or meeting developmental milestones, call our clinic at (252) 341-9944! Your child may benefit from an occupational therapy screening or formal evaluation!

Blog By: Emily Britt, OT