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Happy Footnote from a PT Graduate |
Every year near graduation time I receive letters or e-mails from families whose children were part of the practice at some time. This year I received a letter from Carol W. a mother whose son Gary was seen by me 21 years ago. I was so touched by this correspondence that I asked her if I may share it with all of you. Of course, she agreed. Some background information on Gary and his family: Gary has cerebral palsy, spastic quadriplegia. He came to my practice when he was six months old. He went through the typical physical therapy, crying each session, while both parents sat with tears in their eyes. I knew even then that he was smart, I was able to see it in his eyes, even at this young age. Gary began talking in sentences at age two. He was uncooperative, a fighter, a hitter, a biter, a screamer, and I knew he was very smart! - I could see it in his eyes. Gary had multiple orthopedic surgeries, braces, walkers, crutches, and canes. His parents got divorced. His mom eventually re-married and they moved out of the area. When he left the practice he was walking independently, not pretty, but walking without any assistive devices. Here is Carol's letter:
Hi Suzan,
I don't know if you will remember me or Gary, it has been years since you treated him. I found you by your website. Sounds like you are doing great. Wow your practice has grown. I thought you would like to know about Gary. He is twenty two years old and has just graduated from college! (hey, never thought he would, but he did). He graduated cum laude with a degree in graphic design! (hey, never thought he could but he did). He has a girlfriend (never thought he would but he does) and he is driving (never thought he would be able to but he is) to Boston with his girlfriend to look for a job. I am including some graduation pictures. I know I am his mom but I think he has turned out great and is very handsome. He still walks with his "CP" gait but does not use crutches. He is still as feisty as ever and you cannot tell him anything (which is why he is driving cross country to Boston with a girl and without a job). Oh well, who would have thought he would have made it this far. You always said he was smart and if we could channel his behavior positively there would be no stopping him. Thanks for everything. I will keep you posted on his travels.
Sincerely,
Carol
I know not everyone will reach this level of success, but I hope that each of you will find the best in your children, and marvel at their accomplishments, no matter how small they may be. And who knows…maybe one day you, like Carol, will be saying "hey, never thought he would, but he did". Suzan
Summer is a great time to deviate from the normal routine and therapy schedule by including those outdoor activities such as swimming, playgrounds, biking...etc.
Your goal for these activities should indeed be recreational and fun, however, it certainly would not hurt to have some therapeutic goals as well. Ask your therapist to help you implement some activities that would be advantageous to your child's specific needs. Water is an excellent medium to improve flexibility, strength and balance for children with neurological conditions. If is warm enough, it may also help with tone reduction. Moving a body part under water also provides excellent resistance which translates into improved strength. For children with sensory integration deficits, water is a wonderful tactile and vestibular experience. Use equipment such as inner tubes, kick boards, "noodles", Frisbees, balls, and sinkable toys to aide in therapy. For children with oral motor weakness, one can use blowing ping pong balls in the water, blowing bubbles in the water and other activities that enhance the muscles in the face.
Continue to be on the lookout for playgrounds that provide variety. Encourage vestibular stimulation by introducing movement through swings, slides, merry go rounds, teeter-totters, see-saws and rocking horses. If your child has a physical disability there are several adaptive playgrounds in the area that accommodate wheelchairs and/or crawling. Otherwise, get on the equipment with your child and enjoy!
Summer is also the perfect time to introduce roller skating and biking. Remember helmets! Many companies have a variety of adaptive bikes for those who are in need and I think this is a wonderful investment for your family. Biking, whether self propelled, or assisted by a parent, allows for strengthening of the lower extremities, reciprocal movement of the legs, and excellent socialization in the neighborhood. If you need help deciding on the right bike, please ask your therapist.
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July |
Collaborative Medical Education Project
Third year medical students who are on their pediatric clinical rotation are getting a new perspective on family care thanks to a project that sends them directly into homes of parents who have children with special needs or disabilities. This program is in collaboration with the Bethesda based Institute for Family Centered Care. The institute recruits, trains and supports parents to serve as faculty and advisers for the project. The goal of this program is to have the medical students understand the demands facing families with special needs children. The medical students do home visits for several hours in order to understand the demands facing families who have children with diagnoses of Down Syndrome, Cerebral Palsy and/or severe/profound multiple disabilities. To schedule an orientation meeting, or to learn more about this program please contact Penny Veerhoff at 301-295-2805.
Here is a way for kids to deal with their issues and learn about emotions in a safe, fun and creative environment. It is a game one can order: "Oceans of Emotions".
Taylor Made Games are actual board games that are specifically designed, and customized, to meet the needs of a child with special needs. Based on your individual responses to a detailed questionnaire that the company provides, the game will be customized for you and your child. The game can be used over and over again with newly designed sets of cards that address your family's special concerns. The games focus specifically on behavioral and emotional issues. They can also address such things as peer pressure, social issues, and communication challenges. The developer of the game is a behavior specialist with an expertise in working with special needs children. For more information log on to www.oceansofemotions.com. One of our families has ordered this game and found it extremely valuable. Hope you do too! We have posted two brochures on our bulletin board for your perusal.
Information on The Brain Injury Foundation
Since 1984, The Virginia Central Registry for Brain Injury has been providing information and assistance to anyone who qualifies by definition of a traumatic brain injury. This central registry is housed at the Virginia Department of Rehabilitative Services and is an excellent outreach program. If your child has suffered a traumatic brain injury, you should call 804-355-5748 in order to get identified in this program.
DanceAbilities is now advertising their fall schedule. Classes in perceptual awareness and creative expression and movement will be held at a variety of locations. Call 703-218-0751.
As always many of our "graduates" and their parents continue to call with information on their children. Here are a few more great stories:
- Melanie R. has spastic diplegia. She was a patient of mine when she was a baby. She is now about 24 years old and has just received her Master Degree in Social Work. She is moving to London with a group of friends to look for work! Melanie had the typical medical course of physical therapy, numerous orthopedic surgeries, and very delayed gross motor skills. She still walks with bilateral canes and wears bilateral orthotics. Just a great success story to share.
- Catherine F. has cerebral palsy. She will be starting college at The New England Conservatory of Music in Boston where she will major in music and flute. Catherine also has been a patient of ours for many years due to the diagnosis of cerebral palsy.
- James Mc. has a brachial plexus injury. He is currently in college and has tried out for the Olympic Track Team (for special needs) His time was just short of making the Olympic Team and running in Greece. He also was recently at an Air Show where he was tested by the Marines using their specific criteria for their Marine Fitness Test. He was able to perform eleven one arm pull ups! Very impressive!
Dr. Stanley Greenspan and The International Council on Developmental and Learning Disorders are looking for videotapes of children who have been diagnosed with autistic spectrum disorder showing their early months and years of life. If you are able to assist with this study by providing videotapes and background information, please call or write for more information: ICDL Early Detection Study, 4938 Hampden Lane, Suite 800, Bethesda, Md. 20814. Phone: 301-656-2667.
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September |
Back to School
Many of our families will have children heading off to school this September. If your child is a high school, middle school, elementary student, or a new pre-schooler, The Children's Therapy Center, PC is here to help make their initial school experience a good one.  During the summer, many of our therapists have begun preparing several of our ambulatory patients with cerebral palsy for the transition to middle school or high school. The physical therapists have been diligently working on balance techniques and protective extension techniques that will indeed come in handy when they are faced with that dreaded hallway experience called "changing classes". There are many strategies that we can implement to make this challenge easier. Ask your physical therapist for assistance.
As always, I must begin each September with my back pack lecture. Remember that if your child has trunk weakness, asymmetries such as hemiplegia cerebral palsy, scoliosis, or lordosis, it is very important that he or she is equipped with an appropriate school bag. One recommendation is to make sure that the back pack is not too heavy. Talk to the school about possibly having two sets of books, one for class and one for home, to eliminate the extra load and stress on the musculature. If your child must carry a heavy load of books, make sure that the pack is evenly placed over both shoulders. The fad these days is to carry that backpack very low on the back. If your child has trunk hypotonia or is lordotic (sway back due to weak abdominals) this will exacerbate the malalignment of the spine . If your child has asymmetries due to hemiplegia one sided weaknesses, or scoliosis, make sure that the back pack is not carried over one should (especially the weaker side). This will accentuate the C shaped curve of the back. If possible, rolling back packs are an excellent choice. Ask your physical therapist to help you with specific concerns.
Fine Motor Activities at School
The Children's Therapy Center's occupational therapists have a variety of pencil grips available for your perusal. If your child has difficulty with handwritng tasks, your OT may have a recommendation.
Also if you are shoe shopping, remember to be aware of your child's capabilities in regard to shoe tying. Velcro straps may be more appropriate than laced shoes. If your child absolutely must have tie shoes, there are laces that allow tightening of the shoe without actually tying them (spyrolaces). Ask your OT for further assistance in this matter.
If fine motor activities such as zipping, buttoning, snapping, cutting are a problem, talk to your OT about such devices like zipper pulls, zipper grips, velcro style button aids, button hooks, adaptive scissors, and other assistive devices.
FEEDING AND ORAL MOTOR ACTIVITIES AT SCHOOL
For those children requiring additional help with feeding and oral motor, there are many varieties of straws, cups, sandwich holders, and adaptive spoons that will allow an easier time in the cafeteria during lunchtime. Your occupational therapist and speech therapist can certainly help you problem-solve specific needs. Also, we can also help you decide which foods may be easy to chew, swallow, etc. during the hurried lunch period. We are here to help.
CHILDREN WHO RECEIVE SCHOOL SERVICES
Many times parents ask us to help them with the IEP process. This may mean reviewing school goals, attending school meetings, or writing specific reports, or observing your child in the classroom. Although we want to be part of your child's team, it is The Children's Therapy Center's policy to not infringe on the school's policy or their provision of therapy services. Please remember that we have the luxury of operating as a private entity, which allows us to work on refining skills that are functionally based, or academically based. We are able to include your goals into our treatment and operate as a MEDICAL MODEL, with frequency and duration of treatment decided by you, and your therapist, (and, unfortunately, your insurance company). The school, on the other hand, must follow their guidelines and work under the auspices of an EDUCATIONAL MODEL. This may mean that direct services may be denied if your child is not exhibiting a 25% delay. The school may also recommend group therapy or consultative services. We will gladly support your family by inviting a therapist to our treatment session, consulting by telephone in order to coordinate services, collaborate on specific equipment, and align with them on behavior strategies. However, we want to remain respectful of their mission and policies and not overstep professional boundaries.
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February |
Community Information
Kindermusic is a curriculum designed to teach music to children from birth to 5 years of age. Through music, children become better learners. It is a program designed to provide movement, listening and expression for young children. Classes are held in Alexandria at St. Mark's Church. Please call 703.966-7329 for further details.
A parent of one of our patients has a case of high caloric frozen shakes (Nervados health shakes) which she is willing to give to any family who is in need of such an item. Please call Rebecca at 703.764-2006.
Parents have been recommending a new book entitled The Happiest Baby on the Block. This is a book of strategies for parents who may be dealing with crying babies or babies who are not sleeping through the night.
Children in wheelchairs are very prone to decubitus ulcers, especially if they are immobile and spend a majority of their day in the chair. Make sure that their weight is shifted often during the day. This could be as simple as having them lean from side to side periodically or having the caregiver or teacher do this for them. If the child has function in his/her upper extremities, a wheelchair push-up would serve the purpose if performed periodically throughout the day. Also, remember that there are many wheelchair cushions/inserts that can be purchased to eliminate this problem. Ask your therapist if you need specific advice.
Resurrection Children's Center is a parent cooperative preschool. It is a well known program that integrates preschoolers with disabilities into the mainstream. They are accepting applications for fall enrollment for ages 2-1/2 through 5 years. Tuition assistance is available. Call 703.578-1314 for more details.
Carol Kranowitz, author of the book The Out of Sync Child, will be offering a course on Sensory Processing Disorders. It is open to parents as well as professionals.
Parktakes, a quarterly guide to recreation in Fairfax County, has their spring catalog available. We have several copies in the office. There are many inexpensive classes for children with disabilities. Please look into their aquatics program, spring and summer camps, adapted soccer and dance.
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March |
Community Information
Kids on the Block is a traveling puppet show that is very appropriate for ages 5-12 years. The show has puppets that portray children with physical and emotional disabilities, and it is geared for elementary children. It is an excellent show to explain a variety of disabilities, how children feel and how we should interact with those who have disabilities. If you are involved in a church group, school, camp or any other organization that incorporates mainstreaming, this would be an excellent avenue to pursue. Contact the ARC of Northern Virginia for further details.
Support groups are available for adolescents with Aspergers (ages 12-16) that focus on peer relationships and on their family relationships and social skills. Call Dr. Judith Sewickley, Psy. D., at 703.550-4130 for further information.
The Northern Virginia Chapter of Autism Society of America (ASANV) meets monthly in Fairfax County and also in surrounding counties. Call 703.594-8444 or visit the web site
www.asanv.org for further information.
Two seminars are being held at the Lab School in Washington, DC. Visit www.LabSchool.org: a parent seminar on Obsessive Compulsive Behavior and a parent seminar entitled Current Perspectives on Childhood Anxiety Disorders.
Simple Changes is a new center offering equine-assisted activities at Meadowood Stables in Lorton, Virginia. This facility offers therapeutic horseback riding to children and adults who are mentally, physically or socially challenged. Participants will ride once a week with an NARHA certified instructor. There is access to an indoor arena, several outdoor arenas, and miles of trails. Limited Hippo therapy slots are also available. Lessons are held throughout the year. Call 703.402.3613.
The Arthritis Walk is the Arthritis Foundation's annual nationwide event that raises awareness and funds to fight arthritis, the nation's leading cause of disability. Our local walk will be on Saturday, May 21st. It will begin at Robinson High School. Registration is at 9 a.m. We will have the brochure on our bulletin board, and you may also get more information at the web site: www.arthritis.org.
Herndon Optimist Youth Baseball League is sponsoring Herndon Buddy Ball. This is for boys and girls ages 6-13 who have any physical, developmental, mental or other disability and provides them with the experience of baseball and team play. Players are paired with an older buddy who helps and encourages as the children field, bat and round the bases. Please register at www.herndonbaseball.com. Uniform shirts and hats are free.
The Keep It Green Electronics Recycling Program is a project that specializes in protecting our environment by recycling computer equipment while ensuring meaningful, paid work for Northern Virginia citizens with disabilities. Keep It Green collects all types of computers and either refurbishes or dismantles them. Call 703.461-6000 or go to www.keepitgreen.org.
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April |
Recreational Activities
With spring and summer approaching it is time to think about recreational activities that are done in the great outdoors. Children with disabilities should be able to enjoy the same type of activities as their peers. There are several companies that have developed equipment to do just that.
Freedom concepts not only makes adaptive bikes that adjust to accommodate children requiring maximum trunk support or assistance in pedaling, but they also make a wonderful tandem bike that allows the parent to do the pedaling while the child rides in front well supported. What a great way for an entire family to enjoy bike riding. Sure it is a little more work for the person pedaling but the rewards seem worth it.
When it is time for the beach, children in wheelchairs can enjoy the ocean as well. Think about renting or purchasing an all terrain wheelchair. These chairs have large inflated rubber wheels that roll easily over sand and uneven terrain. There are even some that can be rolled into the water/sand . Two companies to check out are: Deming Designs Inc. www.beachwheelchair.com and Natural Access at www.landeez.com.
All children enjoy playground equipment. The Equipment Shop has many adaptive swings that can be placed on regular playsets in your backyard. Contact www.equipmentshop.com for more information. We also have these catalogs at the office, so ask your therapist for one if you are interested.
Fairfax County Community and Recreation Services is offering their annual Therapeutic Recreation Services for children of all ages. There are excellent programs offered throughout the year and in the summer. The fees are quite minimal. Here are just a few of the programs that would meet the needs of our families:
- The S.M.I.L.E. Program is an integrated play program for children who have disabilities and their typically developing peers. Fee is $15 per session. Sessions are each Saturday morning during the fall, winter, and spring.
- Saturday Leisure Program: designed to provide individuals with developmental disabilities, ages 5-12, an opportunity to engage in a variety of activities such as sports, fitness, arts, and crafts, games and special events. Program operates fall, winter, and spring. Space is limited.
- After School Motor Skills Program: for ages 5-12 is held every Tuesday and Thursday from 3:15-5PM.
...And for summer:
Ages 5-12:
- Summer Adventure Program (for children with ADD/ADHD)
- Summer Explore Program (for children with physical disabilities)
- Beepball Program (for children with visual impairments)
Ages 13-18:
- Summer Leisure Program
- Leisure Exploration Program (for children with Asperger's)
Please call Therapeutic Recreation Department at 703-324-5532 for more information.
The Sure-Step is a new orthotic developed for low tone feet. Recently we had the developer of this product in the office for an in-service. The Sure Step uses unique principles of compressing the foot into neutral alignment which then corrects low tone pronation. This appliance is not for every child, but it does have some appropriate uses. Ask your therapist for more details.
Therapeutic Electrical Stimulation (TES) is a wonderful modality that is applied in the comfort of your own home. It is electrical stimulation that is applied on a sensory level, which means children do not feel the electrical impulse, nor do they experience an active muscle contraction. It is applied during the night and it promotes better blood supply to bones and muscles, adds to muscle bulk, and reduces the chance of atrophy to unused muscles. Very often it is combined with neuromuscular electrical stimulation (NMES) which is the modality that does allow a muscle to visibly and involuntarily contract. The Children's Therapy Center has staff who are certified in evaluating your child for TES. Excellent results have been achieved with this device. Ask your therapist if this mode of intervention is appropriate for your child.
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May |
An organization called DAN (Defeat Autism Now) provides information on physicians who treat children with autism. Here's their website: www.autism.com.
REHAB EQUIPMENT EXCHANGE NETWORK
Do you have used rehab equipment you would like to sell or donate?
Do you need rehab equipment on a short term basis or want to purchase good used equipment? Log on to www.RehabEquipmentExchange.com for further information.
DanceAbilities summer workshop will be held from August 8th thru 12th for ages 6 and older. Cost is $500. Deadline is June 8th. Call Lynne Bauer at 703-218-0751 for further details.
If you are in need of equipment due to a disability and are a resident of Virginia, you may be eligible for low-interest loans for a wide variety of special equipment. This may include such things as wheelchairs, scooters, hearing aids, communication systems and environmental devices including vehicle modifications. Contact ATLFA at 866-835-5976 or e-mail them at ATLFA@ATLFA.org
Our OT's have found the book entitled My Many Colors by Dr. Seuss very helpful with children who are having difficulties understanding their emotions and moods. Check it out.
KEEP LINES OF COMMUNICATION OPEN
Our very dedicated and wonderful staff of speech, occupational and physical therapists are here to help your child maximize on their treatment sessions. Their direct role is to be an interventionist to your child, a teacher of home programs, and a team member in your family. Please use their skills by keeping them in the loop with your child's progress, or needs. Also keep them informed of other professionals who may be assisting you in the care of your child. If we work as a team, we are that much closer to success.
In addition, if for some reason you are dissatisfied with any treatment, please talk to your therapist openly about this. If you feel your concern is not addressed, the next step would be to contact Suzan Syron directly. The Children's Therapy Center has built the practice on quality services; please help us provide you with the best possible intervention.
DID YOU KNOW....
- That the frontal lobes of the brain are the last to develop? Recent research has found that the frontal lobes continue to develop through the teenage years and into the early 20's. The frontal lobes are responsible for sleep patterns, executive functioning, planning, reasoning, working memory, organization, selective attention, goal directed behavior, impulse control and mood modulation.
- That fantasy, which involves both interacting with imaginary friends and impersonation, plays a role in child development, both cognitively and emotionally? This kind of activity allows children to manage social situations in a safe context, such as practicing how to handle conflict with something that may or may not talk back to them. Recent studies show that two-thirds of all children have had an imaginary companion by age 7.
- That the earlier you allow a child with a physical disability to gain mobility, the more effective you may be in his/her overall development? Research is showing that between the ages of 10-18 months of age, when a child is crawling or walking, they are efficiently exploring their environment. Children with physical disabilities have delayed self-initiated mobility skills. Therefore, the sooner we allow a child access to either power chairs, or some form of independent mobility, the more we can enhance perceptual and cognitive skills.
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