Posts

What is a Tongue Thrust?

A tongue thrust is the most commonly known type of Orofacial Myofunctional Disorder. According to the American Speech-Language Hearing Association, this is when “the tongue moves forwardblog-tongue-thrust-main-landscape in an exaggerated way during speech and/or swallowing. The tongue may lie too far forward during rest or may protrude between the upper and lower teeth during speech and swallowing and at rest.”

A tongue thrust or an Orofacial Myofunctional Disorder may impact speech, chewing and swallowing as well as create changes in the dental pattern. An improper tongue resting pattern may develop as a result of enlarged tonsils or adenoids, allergies, extended thumb, finger, or pacifier sucking. It may also be related to restrictions in tongue movement, lip movement or the shape and size of the mouth.

Who Can Help With A Tongue Thrust?

This issue may be identified by a pediatric dentist or orthodontist due to the bite pattern seen in the child. An open bite (where the front teeth do not meet creating an open space) may indicate that there is a tongue thrust or an abnormal tongue resting position. A Speech-Language Pathologist trained in the area of orofacial myology or a Certified Orofacial Myologist (who may be a speech-language pathologist or a dental professional) are among the professionals who can diagnose an OMD.

To screen for the possibility of an OMD, it is beneficial to look at all the underlying factors including:

Habits – Thumb sucking, finger sucking, tongue sucking, extended bottle use and overuse of a “sippy cup.”

Airway – Open mouth breathing, enlarged adenoids and/or tonsils, allergies.

Lips – Do the lips rest apart or together habitually? Are there structural restrictions that don’t allow comfortable lip closure?

Tongue – Any difficulty moving the tongue to the roof of the mouth? Does the tongue appear to move forward during speech? Any structural restrictions impacting the movement? Sometimes the “lingual frenum” which is the attachment under the tongue is too short or tight and creates issues with tongue movement.

Teeth – What does the bite pattern look like? Is there an “anterior open bite” (the upper and lower incisors don’t meet when the teeth are together)? The “anterior open bite” is a very common pattern seen with tongue thrusts and other OMDs.

Speech – Speech may sound distorted especially the sounds “s,” “z,” “sh” and “j.”

Chewing and Swallowing – May show up as eating too quickly, too slowly, messy eater, as the swallow pattern is altered. This is sometimes referred to as a “reverse swallow.”

How is tongue thrust treated?

The approach to treatment involves first the proper diagnosis and designing a tailored approach to the particular OMD and how it is presenting in the individual patient. The therapist works closely with the rest of the OMD team, which may include the physician, ENT, gastroenterologist, oral surgeon, dentist and orthodontist. Any habits, structural issues, allergies or airway restrictions are addressed by the appropriate professionals.

Using tailored exercises, the treating therapist addresses forming correct placement of the lips, tongue and jaw at rest and the habituation of this over time. Addressing correct swallow patterns and the carryover into the ability to do this on an everyday basis with all foods is also addressed. Also addressed by the speech-language pathologist are any speech articulation issues with increased emphasis of the correct placement of the tongue and the appropriate tongue pattern.

Successful treatment involves ongoing treatment in weekly therapy, daily exercises done in the home and a collaborative approach with the family and the other professionals on the team.

Resources:

The American Speech-Language Hearing Association’s website information page: http://www.asha.org/public/speech/disorders/OMD/

International Association of Orofacial Myology information page: http://www.iaom.com/OMDisorders.html

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

Meet-With-A-Speech-Pathologist

Age Appropriate Toys for Motor Development

It’s the holiday season! As we approach the end of December, plenty of parents have been inquiring about appropriate and educational toys and games that encourage speech and language growth, blog-motor development-main-landscapefine and gross motor development, and problem solving skills. Below are some of our favorite toys that we believe would make great additions to the family toy closet:

Baby toys (birth-24 months):

  • Fisher-Price Brilliant Basics Rock-a-Stack
    • Why we love it for infants: brightly lit colors encourage basic skills such as eye tracking which helps facilitate gross motor skills like rolling and reaching across the body’s midline. These multi-sized rings are also the perfect size to encourage the baby to start using a gross grasp and release pattern, which is integral for fine motor development. The baby can learn basic discrimination skills related to sizing and colors which is necessary to develop basic problem solving skills. These rings allow the baby opportunity for oral exploration without hazard of choking, and the product boasts that the material is safe for teething.
  • Melissa & Doug Stack and Sort Board – Wooden Educational Toy With 15 Solid Wood Pieces
    • Why we love it: Facilitates tactile discrimination, encourages basic language skills by introducing names of basic shapes as well as different colors, facilitates fine motor development (particularly pincer , tripod, and lateral tripod grasp usage), and requires basic eye hand coordination to stack and unstack items on and off the centerpiece.
  • More suggestions: Caterpillar Play Gym, Fisher-Price Little People Lil’ Movers Airplane, Busy Poppin’ Pals, Fisher-Price Laugh & Learn Count and Color Gumball

Toddler Toys (3-5 years):

  • Pop Up Pirate
    • Why we love it: This is a fan favorite for kids and therapists. We use it in OT, PT, and Speech, and the kids love it because of the uncertainty of who is going to make the pirate pop out of the barrel. Therapists enjoy using this toy to encourage direction following, visual motor integration skills, and fine motor coordination. When played in a small group, it provides a great opportunity to learn some basic impulse control and encourages turn taking. This is a great game for kids who may still have difficulty playing games with 2 or 3 step directions, as there are no rules other than waiting your turn to place the sword when directed.
  • Sneaky Snacky Squirrel 
    • Why we love it: Great game to address basic social skills and direction following. This game can be played with 2-4 individuals, and can help to encourage turn taking and fine motor control to manipulate a set of squirrel-shaped tweezers. This game also helps to build frustration tolerance, as children must learn how to react when losing their turn, or having a peer take away one of their acorns. It’s also easy to understand, and there is no reading required.
  • More suggestions: Wooden Shape Sorting Clock, Pop the Pig, Spot It, Zingo, Elefun, Hungry Hungry Hippos

Grade school toys and games (6-9 years):

  • Games for balance, coordination, and core strength: Zoomball, Twister, Labyrinth Balance Board
  • Games for fine motor development: Operation, Barrel of Monkeys, KerPlunk, Angry Birds, Jenga, Operation
  • Games for visual perceptual and problem solving skills: Rush Hour, Rush Hour Junior, S’Match, Marble Runs, Cartoon It
  • Games for Social skill and cooperative play: Race to the Treasure, Stone Soup, Don’t Let the Pigeon Drive the Bus

Adolescent games (10-15):

  • Games for Executive Functioning : Logic Links, Qwirkle, Mastermind, Labyrinth
  • Games for Visual perceptual and problem solving skills: Knot so Fast, Blokus, Rush Hour
  • Games for Social development: Life, Scattergories, Scrabble, Apples to Apples

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to  help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

Meet-With-An-Occupational-Therapist

Creating SMART Goals for Kids with Autism

When it comes to creating goals for kids with autism, it can be overwhelming where to start. What goal do you pick? When should they meet their goal? How can everyone work on it together? blog-smart-goals-main-landscapeRest assured, creating effective goals is as simple as making sure it is a SMART goal: specific, measurable, attainable, relevant, and time-bound. Following these simple guidelines will help your child achieve the goals you set in place.

Specific

It is easy to have a general goal in mind for kids with autism, such as increasing their language or self-help skills. However, general goals are hard to work on since they do not have specific behaviors that you are looking to increase. Being as specific as possible with your goal is the most effective way to ensure your child will meet their goal.

Measurable

When we create a goal, we have to make sure we can measure a child’s success. If our goal isn’t measurable, we cannot accurately determine if the goal was met. The two most common ways to make goals measurable are frequency (e.g. 3 times per day, etc.) and accuracy (e.g. with 80% success, in 4 out of 5 opportunities, etc.).

Attainable

Before we start working on a goal, we have to make sure it is something the child can attain (i.e. a goal they can achieve). We need to look at prerequisite skills (i.e. skills the child needs in order to achieve the current goal). We also need to look at how realistic our goal is. We cannot expect a child to get dressed by themselves each morning if their underwear drawer is too high for them to reach.

Relevant

Relevant goals are goals that will make a difference in the child’s life. If the goal isn’t relevant to the child, the child will not be motivated to achieve it. If a goal is determined to not be relevant to the child or the one helping teach the goal, it will need to be adjusted to become relevant.

Time-bound

If all goals had an eternity to be achieved, there would not be a desire to teach and attain the goal in the near future. Making goals time-bound ensure that the goal is mastered in a realistic time-frame. Determining the time-frame of your goal should be dependent on the goal. The more challenging the goal, the longer the time-frame should be.

Example of a SMART Goal

Your goal is to work on your child asking you for help when you are in another room. At this time, your child does not ask you for help when you are in the same room consistently. Let’s go through each criterion to make our SMART goal.

Specific: Child will say “help me” while handing the object they need help with to the adult

Measurable: 4 out of 5 opportunities

Attainable: We will first work on when an adult is in the same room

Relevant: Your child frequently needs help when playing with new toys or opening and sealing food

Time-bound: 2 weeks

Now that you know how to write SMART goals, start making some and see your child blossom!

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

Meet-With-An-Applied-Behavior-Analyst

Teaching Children Mindfulness

By now, there’s a good chance that you have heard of mindfulness. It seems to be everywhere these days, but what exactly is it? Mindfulness is a meditation practice that begins with paying blog-mindfulness-main-landscapeattention to breathing to focus on the here and now. It means being aware of your present moment (thoughts, feelings, and physical sensations) without judgments and without trying to change it.

Why Teach Mindfulness?

In today’s world with TV, video games, computers and busy schedules it can be hard to focus on the here and now, however, the benefits of being able to be mindful are vast. Recent scientific research has shown the positive effects it can have on positive well- being and mental health. It has been shown to improve attention, reduce stress, and increase the ability to regulate emotions and feel compassion and empathy.

3 Benefits of Being Mindful for Children:

  1. Being mindful can give you more choices and more control over behaviors. Being fully aware is important if a child is overly emotional or impulsive. It allows them the opportunity to slow down and catch themselves before they do something they might regret later.
  2. Being mindful can increase compassion and empathy for oneself and others. When kids learn to be aware while being nonjudgmental, they can turn the criticisms into observable facts.
  3. Being mindful can help with focus and make kids more productive. When kids stay focused, they can stay engaged better in activities and school work.

How to Teach Mindfulness at Home:

An excellent way to teach mindfulness at home is to model and participate in mindfulness as a parent. Setting routines to take a few moments, close your eyes, notice your breath, thoughts, emotions, physical sensations without judgment can make a great impact on the whole family. Parents can encourage their kids to take a few moments during homework time, stressful times or just any transition time to practice being mindful. Being mindful can be fun too!

Try the following exercises with your child:

  1. The seeing game can be asking your child to take a minute to notice things around the room they haven’t noticed before. Did they notice anything new or different?
  2. Going on a nature walk can be turned into a mindfulness exercise encouraging your child to use their five senses (sight, sound, smell, taste and touch) to be mindful of the world around them.
  3. The “tense and relax” exercise; in this exercise kids tense different muscles in their bodies for a few seconds and then release. This is a great way for kids to relax and be present.
  4. Breathing friends- Use a stuffed animal to help your child practice mindful breathing. Teach your child to take deep breaths and notice how their body feels as their chest and belly goes up and down. Then have the child teach the deep breathing to the stuffed animal to empower them.

References:

http://www.ncbi.nlm.nih.gov/pubmed/18365029

http://www.ncbi.nlm.nih.gov/pubmed/17940025

Rathus, J. H., & Miller, A. L. (n.d.). DBT skills manual for adolescents.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee! If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

Social Work

Sensory at Summer Camp | Facebook Live Video

Kids are having fun at summer camp and it’s time to do everything we can to make sure they’re getting as much out of it as possible! Join one of our expert occupational therapists for Sensory at Summer Camp!

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

Meet-With-An-Occupational-Therapist

Fidget Tools Overview

There are many strategies children use to attempt to regulate themselves. Whether this is more obvious Fidget Tooland large scale such as jumping on a trampoline or spinning around in circles continuously, or smaller, more discrete ways such as grinding their teeth, picking their skin, or squeezing their fists, each of these strategies are satisfying a need within their sensory systems.

These can be mindless or intentional, but the bottom line is that it is fulfilling their bodies and brains in a way that only they can truly understand. While we want to allow children to gain as much sensory input as they need to maintain a regulated state, it is important to explore options that are appropriate and safe. One such option is called “fidgets,” and they are a great tool, especially within the classroom environment, so as not to draw attention away from class learning.

It is important to understand the root of your child’s sensory seeking behaviors in order to provide him or her with the most appropriate fidget tool. There are two main sensory systems that fidget toys typically stimulate; these are the tactile and the proprioceptive system. The body reads touch based on light and deep touch, light being more stimulating (tactile) and deep being more calming (proprioceptive). Think, the feeling of a feather brushing across the underside of your arm versus the feeling of a deep tissue back massage.

  • If your child seeks regulation through obtaining deep pressure input i.e. jumping, crashing, and squeezing, a fidget that targets the proprioceptive system may be the best option. To put this in perspective, think about a child friendly and inviting “stress ball.” These may be in various forms, i.e. foam resistance balls, stretchy theraband, theraputty, and squeeze toys.
  • If your child tends to seek regulation through touch i.e. seemingly mindlessly touching other people, fabrics, or objects, a fidget that targets the tactile system may be the best option. For example, swatches of various fabrics, bracelets with a preferred fabric, and balls or other toys with bumps or (soft) spikes.
  • If your child seeks regulation through movement, and you are looking for something to provide him or her with that while maintaining appropriateness based on the environment (…as it may be frowned upon to start doing jumping jacks in the middle of circle time), there are options for this, as well. When it comes to movement, though it is important to consider if the fidget is facilitating the child to cope and pay better attention, or if it is actually contributing to increased distractibility. Typically, if a child needs their eyes to utilize the fidget, it may not be serving its ideal purpose and other options should be considered. Fidgets that provide movement include snaps, marble tubes, and plastic tangle tubes.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

Meet-With-An-Occupational-Therapist

4 Practices Parents Can Do at Home That Will Help Children with ADHD at School

This guest blog was written by retired teacher, Joyce Wilson.Blog-ADHD-Main-Landscape

It’s common for parents of children with ADHD to be concerned for their children’s behavior at school.
But there’s no need to feel powerless. Implementing a few best practices at home will create a ripple effect and help improve your child’s behavior in the classroom, too.

  1. Encourage Physical Activity

Regular exercise has many benefits for children with ADHD, most having to do with increased brain function. Play games and sports with your child or simply go for a walk outside. The fresh air and bodily movement will help calm his restlessness and sharpen his focus.

It’s wise to let your child’s teacher know that taking away his recess time as a punishment is the exact opposite of what she should do if she wants to see an improvement in his behavior. Let her know how important this active time is for his mental focus.

  1. Encourage Organization

Teach organization and tidiness at home so your child can take these habits to school with her.

Teach her the importance of having a tidy room and work space and help her organize her school supplies. Use dividers, Post-it notes, folders, and color coordination to break her schoolwork down into a manageable, organized chunks.

  1. Create Structure

Your child will benefit from routine in the form of a daily schedule that runs morning to night. Keep schedules and to-do lists posted where your child can see them and include checkboxes next to each task on a list.

Sticking to a schedule helps children with ADHD persist with tasks that they might not necessarily feel like doing at the moment. Insisting they stick to a routine will help performing these tasks become habits for them. For instance, although it’s often difficult for children with ADHD to fall asleep, they still need to stick to a regular sleep schedule the best they can.

  1. Make Your Expectations Clear

When your child is organized, sticking to his schedule, and participating in physical activity like you’ve asked him to, make sure you’re rewarding him for his efforts and thanking him for his cooperation.

Positive reinforcement through small rewards is just one aspect of managing your child’s behavior. Set rules and make it clear to your child that you expect him to follow them at home and at school. Be specific when disciplining your child and let him know exactly how you’d like him to improve his behavior.

Be specific with your praise as well so he can continue to make you proud by doing exactly what you’ve asked him to. Giving him the praise he deserves will encourage him to continue to succeed in life at home and life in the classroom.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

Find-Out-More-About-ADHD
Joyce Wilson is a retired teacher with decades of experience. Today, she is a proud grandmom and mentor to teachers in her local public school system. She and a fellow retired teacher created TeacherSpark.org to share creative ideas and practical resources for the classroom.

Administering Effective Healthcare in ASHA

I attended a graduate school program that took great pride in a multi-disciplinary approach. They ASHAheavily emphasized the importance of working together to obtain the most accurate diagnosis within a medical model that was centered on patient wellness and experience. “It’s the wave of the future!” they said, “Funding in healthcare will be directly related to a patient outcome!”

When I started working at North Shore Pediatric Therapy, I couldn’t believe that the ‘wave of the future’ concept (simply translated to: increased and improved communication between patients and health care providers) was something that had been fundamental to this practice for so many years! They were so ahead of their time because they thought about how they wanted their family, friends, and children to be treated within a healthcare setting. It’s something that I find value in everyday and would like to share more information about in the upcoming paragraphs. *Of note, this blog post is in response to information derived from an article found in The ASHA (the American Speech-Language-Hearing Association) Leader (a monthly publication sent to licensed speech-language pathologists) titled What Does the Patient Want? by Sarah W. Blackstone.

This blog post seeks to explain the ways in which the model of care NSPT has implemented for so many years is compliant with the recent changes in health care laws, policies, and regulations for patient-centered, communication-supportive care.

  • Why has the government recently realized this as a need in healthcare? Because, “Successful patient-provider communication correlates positively with patient safety, patient satisfaction, positive health outcomes, adherence to recommended treatment, self-management of disease and lower costs.”At NSPT, we have been working this way since day 1! We’re familiar with the positives of this model and know how to set up the challenges for success. We use these skills to impact our patients and improve our practice every day!
    • NSPT EXAMPLE: A colleague of mine had a client with a speech impediment and an upcoming school play. She reached out to the girl’s teacher (with the permission of her mother of course!) and they worked together to obtain a passage that had fewer of the sounds that were difficult for her. After the performance, all 3 parties rated the experience to review how the collaboration worked for everyone!
  • Participation in interprofessional rounds to generate relevant concerns and questions for our patients!
    • NSPT Example: I am a speech-language pathologist that works with physical therapists, occupational therapists, behavior therapists, social workers, and family child advocates. Some of our more involved kiddos see more than one therapist to address multiple areas of concern. This is where “rounding” is particularly helpful. It is the process of checking in and making sure that everyone is on the same page regarding the plan of care. Rounds are also a place to problem solve new challenges and talk about a client’s recent progress!

These are only a few of the ways that NSPT has already incorporated novel health care concepts into the foundation of what we do to convey our appreciation for the wonderful families we work with!

Resources:

Blackstone, S. W. (2016, March). What Does the Patient Want?. The ASHA Leader, 38-44.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

Meet-With-A-Speech-Pathologist

Handling the Death of a Family Pet

Pets, be it a furry dog, fluffy cat, or bright orange fish, become honorary family members quite quickly. Dealing with the Death of a PetHave you glanced at the latest family drawing your child created at school? My guess is the family pet is in the mix. Handling the death of the family pet can be an overwhelming and emotional experience not only for parents, but for children in the family as well. Below are some ways to help your child through this difficult time:

Planning the Goodbye

Although some pet deaths are unexpected, when they are not it is important that your child be able to take part in the goodbye process in an age-appropriate way. This could include writing a goodbye letter to their furry friend or drawing their pet a picture. These activities can help with the grieving process as they allow your child to review positive memories and experiences, as well as express their feelings in a healthy way. For younger children, it may also be helpful to read children’s books addressing this topic as a jumping off point for parent-child conversations related to your pet.

Informing your Child’s Support System

Letting your child’s teachers and caregivers know about the recent passing of a pet can create a safe environment for your child to express their feelings. Children, just like adults, may seem off, irritable, or sad during these times. When adults caring for children are made aware of recent events, they can be on the lookout for these emotional changes and be more accommodating as needed.

Moving Forward After Death

Each family is different regarding their interest in continuing to care for a pet. As the grieving process unfolds it may be helpful to speak with your child about the possibility of adopting a new family pet. Although your previous pet is irreplaceable, the process of adopting a new pet can allow for your family to work together and create a caring home for a pet in need.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

New Call-to-Action

How To Teach Your Child Pre-Writing Skills | Pediatric Therapy Tv

In today’s Webisode, a pediatric occupational therapist explains strategies she uses to teach pre-writing skills.

Click here to check out our previous Webisode, suggesting games for fine motor practice to develop handwriting skills.

In this video you will learn:

  • How an occupational therapist uses shapes to teach a child beginning to advanced handwriting
  • At what age a child should master all shapes for writing

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. I’m standing here with Lindsay Miller, a Pediatric Occupational Therapist. Lindsay, can you explain to us, what are some exercises you can do with a child to help with pre-writing skills?

Lindsay: Sure. With some children who are too young to begin writing their letters, we work on practicing making particular shapes. These shapes include horizontal lines, vertical lines, circles, diagonal lines, crosses, Xs, squares, and triangles. So with younger kids, we would probably start off working with the simpler shapes, such as the horizontal and vertical lines, and also the circles.

Once they’ve mastered those, then we would move on to the more complex shapes, like the diagonal lines, the crosses, the Xs, the squares, and the triangles. We work on these shapes in particular, because these are the shapes that you generally use when you’re writing. So if children learn how to write their horizontal and vertical lines and their circles, then it helps them once they’ve begin to start writing their letters, because these are the shapes that we use for upper and lowercase letters. So generally, by age five a child should be able to make all of these shapes.

Robyn: Wow. That’s really great tips. Thank you so much, and thank you to our viewers. 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.