6 Ways to Support your Child through a Dining-Out Experience

I worked in the restaurant industry for many years as a hostess as well as a waitress. I recently observed a family out at dinner on a Saturday night. After seeing some of the behaviors of their son and hearing some feedback from their waiter, it became obvious to me that this family had a child with special needs.  Shortly after ordering food, the family had to request that their food be boxed up to take home instead of eating at the restaurant. I found this to be very unfortunate, as there were many actions the restaurant could have taken to accommodate this family’s needs.

Mother and daughter restaurant

Eating out at a restaurant is like participating in a dance. Everyone needs to know the right steps to make the dance smooth and make sure no one’s toes are stepped on. What diners don’t understand is that they are very much a part of this dance. Typically, waiters are able to read their tables and determine their needs. As a server, I am able to determine the timing and tempo desired by diners and make sure their food is delivered appropriately. Knowing what accommodations you can ask for is important.

The following tips will better prepare you to make the requests you need. A restaurant staff should be able to accommodate these needs no matter what time of day:

Know the menu

Before going out to a restaurant, look at possible food items you would like to order. You do not need to pre-order your food as cravings change when you get to the restaurant, but becoming familiar with the available foods will help make an order quicker. This can also assist in talking to your children about the restaurant. They could choose what they want to eat and become excited about going! It will also make an unfamiliar environment feel more familiar.

Request a quiet table

Request a table in a quiet area that has some space for movement. Try to avoid tables in the middle of dining areas or ones that are far from the exit or bathroom.

Call ahead and ask about existing reservations

Parties of 15 or more tend to be very loud and take up a lot of the dining space. Avoid going to restaurants during the time of the party. Once my restaurant had a reservation for 70 people! It took up the entire dining space. Also, the time it takes for the kitchen to prepare the food was extended for other diners in the restaurant at that time.  From the time the waiters placed the food order, it took the kitchen one full hour to make it!

Order everything all at once

Order your drinks and food all at the same time. Waiters control the pace of your meal and how soon your food arrives.  Let your waiter know what your dining experience looks like.  Do you want your food all at once?  Do you want your child’s food first?  If you need your meal fast, just inform them and they can make it happen. Restaurants are able to deliver food within 10-12 minutes of ordering, maybe sooner.

Tell your waiter about your child’s needs

Be an advocate for your child. Create a “menu” of your child’s needs before going to the restaurant. For example, you can say, “my name is _____. I like to have my food delivered quickly. When this does not happen, I can become upset. When I am upset, it may look like this­­­_______.”  By doing this, your waiter will understand your child’s needs and can work to have them met. This also helps further prepare your child for going out to eat.

Be prepared

Bring tabletop activities for your child to enjoy while waiting for the food to be delivered. Perhaps ask for a table with extra space so that there is plenty of room on the table for cups, plates, and activities.  Also, talk with your child ahead of time about the restaurant experience. Create a visual schedule to follow and label the dining expectations.  First, we sit down, then the server takes our order,  then we receive our drinks, then we color/read/watch a show for a certain amount of time ( you can ask your server how long the food will take),  then we receive our food,  and finally we eat.

Knowing what accommodations you can ask for is important.  By knowing these tips, you will be better prepared to make the requests you need to make your “dance” smooth.

Love What You Read?  Click Here To Subscribe To Our Blogs Via Email!

How To Introduce 2 Words Into a Sentence Using Baby Sign Language | Pediatric Therapy Tv

In today’s webisode, a pediatric speech language pathologist explains effective ways of introducing a second sign into a sentence when teaching your baby sign language.

If you haven’t already seen the previous Webisode, you can view it here 

In this video you will learn:

  • How to use sign language to teach variety of other signs and gestures
  • How to incorporate 2 signs in one sentence
  • What is the best resource out there for sign language

Executive Functioning Activities At Home

Many kids have difficulty mastering skills such as problem-solving, organization, sequencing, initiation, memory, attention, and breaking downgirl with homework books tasks.  These skills (and many more) fall under the category of executive functioning.  As children get older and begin middle school, these skills are expected to advance quickly.  It is usually in about 5th grade where teachers and parents start to notice their child may be having more difficulty than her peers in executive functioning skills. Academic specialists, occupational therapists, and neuropsychologists are just a few of the professionals who address challenges in these areas, but there are also a variety of activities that can be done at home that are both fun and target the development of certain executive functioning skills.

Here is a list of activities that build certain aspects of executive functioning and are fairly easy to orchestrate in the home:

  • Using Playdoh, blocks, or Tinkertoys, build a figurine and have your child build an exact replica in size and color.  This works on multiple skills, including initiation, breaking down tasks, sequencing, organization, and attention.  If you are unable to build an example, or if you have an older child who enjoys playing independently, there are often pictures of structures to build that come along with block sets or images online that can be printed.
  • Have your child go through a magazine and make a list of all the toys/items wanted. Then, have her organize the list in some sort of order (most wanted at the top, alphabetical, price, etc.).  For older kids, you could also have them write a description of the item, cut the pictures out, and type up a list with descriptions and pasted pictures, or even plan a presentation.
  • There are many board games that target executive functioning skill development.  A few of the games used in the therapeutic setting that would be easy and fun options for home use include: Rush Hour (a problem-solving and sequencing game involving getting a specific car out of a traffic jam when the other vehicles can only move in straight lines), Mastermind (trying to determine what the secret code is by process of elimination), and Connect 4 Stackers (a game of attention, organization, and planning to be the first to get four in a row, like the original, but this game involves different dimensions).
  • There are many resources that can be printed from the internet. Logic puzzles come in many different levels of difficulty and involve taking given clues, making inferences from those clues, and eventually solving some sort of problem through the use of the clues. There are often charts that accompany these puzzles and require attention, organization, sequencing and problem-solving.
  • Have your child choose a recipe from a magazine. After verifying that it is a realistic recipe that can be made in your home, have her write a grocery list containing everything needed to prepare that dish, create a list of the necessary cooking supplies, and for older children, have them look up the price of each item at the store and create an estimated budget. If possible, let them be part of the entire process, and take them with you to the grocery store. Again, with older children, you could even put them in charge of pushing the cart and finding the items in the store. For older kids, they may also act as the “head chef” and be responsible for completing most of the cooking. For younger kids, if there are safety concerns, assign specific tasks as their job in the cooking process.

One of the most important aspects of doing therapeutic activities at home is that your child is having fun. These are just a few of the many activities that can be done at home to develop executive functioning skills and are also engaging and enjoyable for school age kids.




Love What You Read?  Click Here To Subscribe To Our Blogs Via Email!

Sample Activities to Increase Oral Awareness!

Development of oral facial muscles is important for a child to accurately produce speech sounds. Poor coordination and strength of articulators can adversely affect skill development for speech sound production. When looking at oral development it is important to ensure the child is provided a variety of movement opportunities to build a variety of oral skills. Movements should include movements of the jaw, tongue, and cheeks to build strength and coordination.

Father practicing oral awareness with child

Below are sample activities to do at home to increase oral awareness and movement

  1. Gather two sets of 5 items varying in size, texture, shape, and temperature. For example; ice, a tongue depressor, straw, teething toy, and straw. Encourage your child to use each of the objects in oral-exploratory play. Imitate your child’s movements and comment on what your child is doing and how it makes the mouth feel.
  2. Mirror play! Have your child sit with you in front of a mirror. Explain that you will be playing a “clown” game. Feel free to dress up in silly hats or clothes to play the game! Instruct your child that you will be taking turns making silly faces in the mirror and copying each other. With your models, make sure you do a variety of tongue movements. Stick your tongue out, move it side to side, lift up the tip up to touch your nose. Have your child practice the movement 2-3 times before it is his or her turn to put the clown hat on.
  3. Play musical “chairs”. Choose objects around the house that include a target sound. For example if the target sound is “b” you could find a book, bear, bottle, bread, and bowl. Place pieces of paper on the floor, with the item on the paper, in a circle. Have the child walk from sheet to sheet until the music stops. Once the music stops, have your child say the target word they land on. You can also write the word on the pieces of paper to increase print sound awareness.
  4. Cut an egg carton in half lengthwise, turn it upside down, and color or paint each of the 6 protruding sections a different color. Next, find a puppet or an animal with a large mouth. Find small “food” items to feed the puppet. These could be marbles or pretend food. Tell your child that you are going to sing silly songs to help feed the very hungry animal! Model a sequence of three sounds varying in intonation tapping the egg cartons to pace each sound as they are sung. Different intonation patterns can include rising/falling pitch or increase/decreased loudness on individual sounds. For example, “ ba BA ba”. Think of the NBC studio signature tone. Once the silly song is imitated you can feed the hungry animal! Using rhythm and a singsong voice has been proven to help facilitate speech output.

These activities will encourage oral motor development in a fun and exciting way. Your child will be learning and exploring and improve his oral awareness in the process!




5 Reasons to Cook for the Family!

Most parents would agree that good nutrition for their kids is a priority, but it is difficult to put that priority into action on a daily basis. Parents today family cookingare busier than ever. The Bureau of Labor Statistics reported that as of 2011, both parents are working in 58.5% of married-couple families (1). This is compared to 51% in 1998 and 33% in 1976 (2). Also, the labor force participation rate (the percent of the population working or looking for work) for all mothers with children under age 18 was 70.6% in 2011 (1). More time at work for parents means less time at home to make meals for the family. And of course it takes additional time to plan meals, find recipes, and grocery shop for the food.

As a dietitian, it is my job to educate families on the importance of nutrition and how to achieve good nutrition status, especially for growing children and those who have special healthcare needs. But I am also able to personally help those busy parents and families by offering in-home cooking sessions, meal planning, and grocery store visits. In this way, better nutrition status as well as nutrition education can be accomplished.

Here are 5 reasons why cooking from home is so important:

  1. It is almost always healthier. Cooking from home, especially when using whole food ingredients, most often means fewer calories, fat, sodium, preservatives, and other additives than eating out or eating packaged convenience foods. Alternatively, excessive calories, fat, and sodium are implicated in cardiovascular disease, hypertension, overweight and obesity, cancer, and many other chronic medical conditions.
  2. It is often cheaper. When you crunch the numbers, it can be much more affordable to buy ingredients to make meals from home (which may also provide leftovers for future meals) than it is to buy those same meals out at a restaurant. In other words, you could feed your whole family spaghetti with meat sauce, salad, and breadsticks for less than what that meal would cost to serve one family member at a restaurant.
  3. Home-cooked food instills good eating habits. When you are planning family meals, you are making an effort to include a variety of healthy foods. When you take time to make the meal and share the meal with the family, you have the opportunity to be a role model for healthy eating. You can also have positive discussions about eating well and what is nutritious about the meal.
  4. Cooking at home provides a platform for establishing and sharing family traditions. Food and cooking are a big part of cultural traditions. That is, if your family continues to cook and share meals that your relatives and ancestors did. If we stop making and sharing these recipes, then we lose that aspect of our family’s culture that makes us who we are. Instead we may end up aligned with the “culture” of major food corporations and their marketing efforts.
  5. Research shows that eating as a family has numerous positive effects on children. In fact, studies have demonstrated that teenagers who regularly eat dinner with their families are healthier, happier, do better in school and engage in fewer risky behaviors than teenagers who don’t regularly eat family dinners (3, 4). Again, the family dinner is a great platform for communicating with your kids. It is a chance to really hear about what is going with them and show them that you are engaged in their lives.

To make an appointment with a registered dietitian at North Shore Pediatric Therapy who can help YOUR family, call 877-486-4140 to schedule an appointment. Our registered dietitians offer grocery store shopping and/or education sessions, meal planning services to meet your families’ nutrition needs, and in-home cooking services. We are happy to help make your life easier and your family healthier.


Schedule A Nutrition       Assessment


1. http://www.bls.gov/news.release/famee.nr0.htm
2. Tamar Lewin, “Now a Majority: Families With 2 Parents Who Work,” New York Times, October 24, 2000.
3. Eisenberg, M.E., Olson, R.E., Neumark-Sztainer, D., Story, M., & Bearinger, L.H. (2004). Correlations between family meals and psychosocial well-being among adolescents. Archives of Pediatrics and Adolescent Medicine, 158, 792-796.
4. Lyttle, J., & Baugh, E. (2008). The importance of family dinners. Gainesville, FL: Cooperative Extension Service, Institute of Food and Agricultural Sciences, University of Florida. FY 1054, http://edis.ifas.ufl.edu/fy1054.

LOVE WHAT YOU READ?  CLICK HERE TO SUBSCRIBE TO OUR BLOGS VIA EMAIL!

Are Premature Babies Delayed?

The term premature refers to any infant that was born earlier than 37 weeks of gestation. Premature births occur in 10% of all live births. Premature babies (“preemies”) are at risk for multiple health problems, including breathing difficulties, cerebral palsy, learning disabilities, and delays in their gross and fine motor skills.

Premature baby

Why are babies born pre-term?

The cause of premature labor is not fully understood. However, there are certain risk factors that can increase the likelihood of premature labor: a woman that has experienced premature labor with a previous birth, a woman that is pregnant with multiples (twins, triplets, etc), and a woman with cervical or uterine defects. Certain health problems can also increase the risk of premature labor, including diabetes, high blood pressure and preeclampsia, obesity, in-vitro fertilization, and a short time period between pregnancies.

What are the effects of being born pre-term?

In addition to multiple medical complications, a baby that is born before 37 weeks of gestation is at risk for developmental problems in gross motor skills, fine motor skills, sensory integration, speech and language skills, and learning. The baby may take longer to reach specific developmental milestones or need help to reach those milestones. The earlier babies are born, the more at risk they are for having delays. Each child is different as well, and no two preemies will be delayed in exactly the same manner.

If you or your pediatrician suspects that your baby is developmentally delayed, there are a variety of professionals that can assist your child in achieving his or her full potential. A physical therapist can help facilitate development of gross motor milestones such as sitting, crawling, walking, running, or jumping. An occupational therapist can help develop fine motor skills such as object manipulation, hand-eye coordination, and reaching, as well as sensory integration. Speech therapists can help improve language skills and articulation.  Consult with your pediatrician or talk with one of our Family Child Advocates to receive more information on setting up an evaluation with a skilled therapist at NSPT.

Love What You Read?  Click Here To Subscribe To Our Blogs Via Email!

Toe Walkers Part 1: What are Reasons Children Toe Walk | Pediatric Therapy Tv

In today’s Webisode, a pediatric physical therapist explains why children may walk on their toes.

Learn more from this blog called “Is Toe Walking Normal?”

In this video you will learn:

  • How sensory input is related to toe walking
  • What is muscular dystrophy
  • What is idiopathic toe walking

Video Transcription:

Announcer: From Chicago’s leading experts in pediatrics to a worldwide audience, this is Pediatric Therapy TV, where we provide experience and innovation to maximize your child’s potential. Now, your host, here’s Robyn.

Robyn: Hello, and welcome to Pediatric Therapy TV. I’m your host, Robyn Ackerman, and I’m standing here today with Colleen Kearns, a Pediatric Physical Therapist. Colleen, can you give our viewers an explanation of why some children toe walk?

Colleen: Of course, Robyn. There are three main reasons why children may toe walk. The first one is related to sensory issues. Some children may actually be hypersensitive to certain textures on the floors that they are walking on, and the surfaces that they are walking on. So if that occurs, they may be more prone to walk on their toes to avoid those uncomfortable textures.

On the other hand, they may also be seeking extrasensory input. Maybe, some kids need a little bit more of the sensory input, and by walking on their toes they are locking their ankles and knees, and by doing that, they are actually getting more input from their joints. So that’s also why children with autism will walk on their toes, to get that extrasensory input.

The second main reason that children toe walk is due to an underlying diagnosis. Muscular dystrophy is a big one. That’s a genetic disorder where the muscle tissue is destroyed and it’s actually replaced by fat, and the calf muscles are often the first ones to be involved with that. So children with muscular dystrophy will toe walk in an effort to stabilize, due to the decreased strength. Any condition that results in an abnormal increase in muscle tone will also result in toe walking. A common one with that would be cerebral palsy.

The third reason why kids may toe walk is actually unknown. Some children, who don’t have an underlying diagnosis and don’t have sensory issues, just prefer to walk on their toes, and that’s what we call idiopathic toe walking, which means we just don’t know. Unfortunately, they can get into a very strong habit of doing it, and when they do that it results in a shortening of the muscles in their calf, and that actually makes it harder for the child to be able to get their foot flat on the ground. And when that happens, it’s kind of like a vicious cycle. They are more likely to be walking on their toes because they have a strong habit, then their muscles get shorter, then it’s harder for them to walk on their flat feet, so then they are even more prone to walking on their toes.

Robyn: All right. Well, thank you so much, and thank you to our viewers. And remember, keep on blossoming.

Announcer: This has been Pediatric Therapy TV, where we bring peace of mind to your family with the best in educational programming. To subscribe to our broadcast, read our blogs, or learn more, visit our website at learnmore.me. That’s Learnmore.me.

Up Up and Move Away with Kids!

Moving is already a stressful process without adding children into the equation.family moving day

Here is a list of life-saving tips that may help to ease both you and your children throughout the transition!

  • Before the move, start preparing the children by showing them books about moving to a new home. Show them pictures of the new city, the schools, the playground, the pool, etc. You should also discuss any feelings that the children may have regarding the move.
  • The day before the move, make sure the children have enough sleep.  Tired children will make the moving experience much more difficult for the entire family.
  • During the day of the move, have a backpack ready for each child that includes music, books, activities and additional batteries to keep them busy throughout the day.  Remember to pack snacks as well as the day will become quite busy. Hungry kids =cranky kids
  • Take a log of pictures of the entire experience, from packing and moving days to the first few weeks og living in the new house.  Make the experience very exciting!
  • Once you arrive at your new home, remember the needs of your children. You are bound to encounter issues that will most likely exhaust you. Consider hiring a babysitter for the first few days of the transition. An extra adult to have around will be able to give your children the attention they need while you are packing and unpacking.
  • Plan to take a day off from everything once you are finished with the move. This will allow the family to reconnect and recharge.

If your child is in therapy, ask your therapists for home program information so that you may continue the therapy on a daily basis.

Enjoy your new home!

LOVE WHAT YOU READ?  CLICK HERE TO SUBSCRIBE TO OUR BLOGS VIA EMAIL!

Keeping Up Behavior Goals at Home and at School

You have already taken the first positive step to developing a set of behavior goals for your child; however, as it is true with many of life’s most boy yellingimportant projects, follow-up is equally important as the initial step.

This blog offers suggestions relating to meeting those behavior goals you have set for your child by using three basic techniques:

  • Making Tracking Behavior Fun
  • Using Public Posting as a Motivator
  • Involving your child in the process of tracking behavior.

Making Tracking Behavior

The task of tracking behavior is much more effective (and pleasant) when you and your child cooperate as a team.  For instance, allowing your child to participate in making or decorating their behavior goal chart may make the process more fun.  Sit down with your child with a poster board and crafts materials to come up with the chart as a team!

Using Public Posting as a Motivator

It is important to understand that public posting should be used to motivate, rather than punish your child.  For that reason, using a reward-based system, such as giving gold star stickers, is a great way to get results. It also allows your child to see their progress he has made.

Involving Your Child in the Process of Tracking Behavior

Children respond best to behavior goal programs when they are involved in the data tracking.  Whichever system you are using, be sure to involve your child in the data tracking element.  For example, if you are using a chart in which behaviors are tracked with a tally system, allow your child to make the tally marks and be sure that they understand what the marks signify.  By doing this, they will be more involved in the process of tracking behavior and they will better understand the goals they are trying to achieve!

Get Teachers involved in Tracking Behavior

Consistency is crucial when it comes to reaching behavioral goals.  This implies that the behaviors need to be tracked and addressed at school as well as at home.  Teachers are a great resource that can help your child reach behavioral goals. Open a dialogue with them and do not be afraid to discuss any behavioral issues that you are trying to address.  Goal-based programs are much more successful when all of the child’s caretakers are on the same page!

LOVE WHAT YOU READ?  CLICK HERE TO SUBSCRIBE TO OUR BLOGS VIA EMAIL!

Diagnosing ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurological conditions that affects between 3 to 6 percent of school-aged boy jumping on couch children.  Children with this condition exhibit significant issues with their ability to pay attention to tasks, inhibit their impulses and/or regulate their behavior.   In order for the diagnosis to be made, one has to witness significant impairment in regards to attentional regulation and/or activity level within multiple settings.  This means that the child must exhibit the concerns within the home, school, after-school program, sports team, etc.  In reality, the diagnosis can be made by a pediatrician or health care provider that is able to ascertain levels of functioning in the various domains by observing behavior or collecting parent and teacher report forms.

In the Neuropsychology Department at North Shore Pediatric Therapy, we focus on a comprehensive evaluation of a child’s functioning, including cognitive functioning, academic achievement, attentional regulation, executive functioning and social/emotional functioning.  Now, if the diagnosis can be made by a parent and teacher report, one must ask why a comprehensive evaluation should be mandated.  The answer to this is that over 45% of children that have been diagnosed with ADHD meet clinical criteria for multiple neurodevelopmental conditions.  Children with ADHD often present learning disabilities, emotional concerns and deficits with social regulation.  Sole treatment of the inattention may improve attentional regulation; however, there are other unaddressed concerns that may still linger.

Research has continuously demonstrated that the most common treatment of ADHD is a combination of pharmacological intervention, behavioral therapy, parent training, and teacher education.  Pharmacological intervention consists of stimulant medications that help to improve the child’s ability to attend to tasks.  A recent research article, which was even reported in an October edition of the Chicago Tribune, indicated that the majority of children who have been diagnosed with ADHD and are prescribed medication report significant improvement within their daily lives.  In the past, the main identification of improvement within children with ADHD was based upon teacher report.  Parents can now feel comfortable when asking their child if medication is helping. Behavior therapy focuses on the modification of the child’s environment to improve the frequency and duration of positive, on-task behaviors while extinguishing negative behaviors.  Parent and teacher education has a primary intent on discussing expectations within the home and school settings as well as possible modifications to ensure success.


Schedule Your        ADHDConsultation No

LOVE WHAT YOU READ?  CLICK HERE TO SUBSCRIBE TO OUR BLOGS VIA EMAIL!