Monday, September 5, 2016

Leks Clark: My Service Dog Megan


Leks Clarks Dog

Everyone loves a good story about a boy who loves his dog, right? So, today I share an interview with a 15 year old young man, named Leks, who has a service dog named Megan. Megan is truly a working dog. She not only works with Leks, but she also works here at Children’s Therapy TEAM during the day with the clients at the clinic. Last week, I interviewed Lek’s mom, Amanda Clark, as part of our three part series on service animals and now it’s Lek’s turn to share.
So, on to the sweet story…
Melissa:  How long have you had Megan?
Leks:  I have had her around 3 or 4 years. 
Melissa:  Tell me how you got Megan.
Leks:  We rode on a plane to California to attend 2 weeks worth of training [at the Canine Companions for Independence Training Center]. Before we even got there, the puppy raiser, Chris, had already taught Megan many commands. The first thing I did with Megan [when matched with her on day 3 or 4 of the training] was work on bonding. I laid on the bed the first night and cuddled with her. I loved knowing that this was my dog to take home. I was ready for this change. I was so happy. I told her that I was ready to take her home. Then we worked with Sarah and Seamus (the dog trainers). They taught me and Mom and Dad how to work with Megan. There were several other families there at the same time, learning to work with their new dogs, too.
Melissa:  What jobs does Megan do for you?
Leks:  She can pick up stuff that is dropped, opens doors by grabbing the door handles with her mouth, and open the pantry door. She has a command to close doors too.  
Melissa:  Does Megan go into public places with you?
Leks:  Yes. She likes to go to my grandma’s house, the clinic, and she goes to doctor’s appointments with me in Kansas.
Melissa:  Who helps you take care of Megan?
Leks:  I can’t have Megan by myself until I am 18 years old. So she has to stay with my Mom and Dad and me for now.  
Melissa:  Does she have to work all of the time, or does she have play time, too?
Leks:  She has both work and play time.
Melissa:  What do you like  to do with Megan during her play time?
Leks:  We take her to the dog park and play with her. I like to sit on the couch or lay on the bed with her. I like to love on her.
Leks and Megan are truly a great pair! I have many families ask me for more information on service dogs, comfort companions, and how to obtain service animals for their own children. If you are interested in obtaining a service animal or comfort companion (the two ARE different) for your family, please find more information in my resource list.
As a reminder:
  • Service animal – provides a particular action/service for an individual with a disability and is protected by the Americans with Disabilities Act (ADA)
  • Comfort companion – provides comfort and support (rather than a particular action) and is NOT covered by the ADA
Resource List (accessed in July 2016)
Canine Companions for Independence, the agency Lek’s family went through to pair Leks with Megan
Amanda Clark: My Family’s Journey with a Service Dog, Service Animal Blog Series Part 2, Children’s Therapy TEAM Blog, August 2016
Animal Assistance and Therapy, Children’s Therapy TEAM Resource Library
United States Department of Justice Civil Rights Division, Americans with Disabilities Act
Service Animals and The Americans with Disabilities Act, Service Animal Blog Series Part 1, Children’s Therapy TEAM Blog, August 2016
Service Animals and Emotional Support Animals, ADA National Network
Frequently Asked Questions about Service Animals and the ADA, U.S. Department of Justice, Civil Rights Division, Disability Rights Section
About the Author:
MelissaFosterThumbMelissa Foster is the leading contributor to Children’s Therapy TEAM’s Weekly Blog. She is a Pediatric Occupational Therapist with over a decade of experience in the field. An active public advocate in the NWA community, Melissa addresses topics related to Autism, Sensory Processing Disorder and general health and child development.

Monday, August 29, 2016

Amanda Clark: My Family's Journey with a Service Dog


Service Dogs 2Last week we explored the question of what constitutes a “service animal” and discussed the differences between a service animal and a comfort companion. To recap:

  • Service animal – provides a particular action/task for an individual with a disability and is protected by the Americans with Disabilities Act (ADA).
  • Comfort companion – provides comfort & support (rather than a particular action) and is NOT covered by the ADA.
Did you know that we have not one but two highly trained service dogs that come to work every day at Children’s Therapy TEAM? I interviewed Amanda Clark, TEAM’s Billing Supervisor and Health Information Systems Manager, about the process of joining Megan, who is a service dog for her son, Leks. (Sneak peek – I will interview Leks on his experiences with Megan for my next blog post!)
Melissa:  Why did you decide to explore getting a service animal?
Amanda:  We wanted a companion to help Leks and a way for him to interact with the public more. We looked into a lot of service dog programs and found that Canine Companions for Independence (CCI) best fit the type of dog we were looking for. I work at Children’s Therapy TEAM and also wanted the dog to be a facility dog during the day, and she has that training as well. 
Melissa: What type of training does Megan have?
Amanda:  Megan was specifically bred by CCI to be a service dog. They choose breeder dogs based on medical history and temperament and have a very rigorous training and selection process. Only a few dogs ever make it through the program to become service dogs. She started training at 8 weeks with one of the CCI volunteer trainers. At around 14 months the dogs who pass the medical and testing requirements go through a 4 month intensive training at a CCI facility. Once they make it to this stage, only about 12 dogs out of 40 make it through advanced training and on to being a service dog. 
Megan is trained in 40 commands. She is able to pick items up from the floor, open and close doors and the refrigerator, hit the automatic door opener, turn lights on and off and many more actions. Service dog training also includes training the dog to not do many things as well. So part of Megan’s training focused on things she doesn’t do or only does on command. For instance, Megan is trained to only bark on command. She also uses the restroom and eats on command. This is important so she isn’t in a public situation and breaking focus to try to go after food on the floor or to use the restroom. Because she has public access under ADA, her behavior in public is very important. When we are at restaurants or on airplanes, other people around us usually don’t even know there is a dog in the location until we leave. 
As Megan’s handlers, we have also been through a 35 hour a week, 2 week training course and had to pass a test to be certified in public. We also have to retest every 2 years. Even with all this training on both our part and Megan’s part, she doesn’t have public access when she is only with me or my husband. Her public access is only allowed when she is assisting my son because he has a disability, and that in combination with her training to assist him, is what gives her public access. 
Melissa:  What services in particular does Megan provide for Leks? (Reminder to readers… In order to be considered a service animaland be protected under the ADA, the dog must provide a specific action/task for the individual with a disability.)
Amanda:  Megan assists Leks mostly by helping him to engage with peers and adults in public. He loves to introduce her along with himself, and it breaks down the barrier to approaching him. Sometimes people are not sure how to approach a person in a wheelchair, and Megan provides an easy way to start a conversation.  
Melissa:  I find more and more people having both highly trained service animals, as well as “comfort companions.” How does this affect you as the owner of a highly trained service animal? 
Amanda:  Because the comfort or emotional support dogs are not usually trained like service dogs, they sometimes act up in public and cause people and business owners to have negative associations about service dogs. Untrained dogs can also interfere with a service dog who is trying to do their duty. Since these dogs are not covered by the ADA and do not have public access, they also put businesses in a bad position of needing to ask questions, which has to be done carefully under ADA law. I’ve heard several stories about dogs who were being passed off as service dogs using the bathroom in public places and barking or whining and causing a distraction in workplaces.  
Melissa:  What are the “rules” for bystanders interacting with Megan when you are out in public?  
Amanda:  Whenever talking to a person with a service dog, you should always ask if you can approach or pet the dog before interacting with the dog, and be prepared for the answer to be no. Depending on what the dog’s function is, it may be very important that the dog stay on task and not be distracted. For instance, if you were to distract a dog whose purpose is to alert its owner of seizures, they might not alert them in time for them to get into a safe position.  
As an aside from service animals, another thing to remember when talking to someone with a disability is that you should always look them in the eye and direct your question to them. Even if you think they are nonverbal and not able to respond, still direct your question to them instead of the people with them. If the child is nonverbal, then there is usually someone there to help you communicate, but you should still address your question or greeting to the person with the disability first. 
Thank you so much,  Amanda Clark, for telling us about Megan and what a fantastic service dog she is! If you would like more information on the rules and regulations surrounding service animals, please follow the links below.  
Resources accessed in July 2016.
Animal Assistance and Therapy, Children’s Therapy TEAM Resource Library
United States Department of Justice Civil Rights Division, Americans with Disabilities Act
Service Animals and The Americans with Disabilities Act, Children’s Therapy TEAM Blog, August 2016
Service Animals and Emotional Support Animals, ADA National Network
Frequently Asked Questions about Service Animals and the ADA, U.S. Department of Justice, Civil Rights Division, Disability Rights Section
About the Author:
MelissaFosterThumbMelissa Foster is the leading contributor to Children’s Therapy TEAM’s Weekly Blog. She is a Pediatric Occupational Therapist with over a decade of experience in the field. An active public advocate in the NWA community, Melissa addresses topics related to Autism, Sensory Processing Disorder and general health and child development.


Amanda Clark has three children with cerebral palsy whom she and her husband Jimmie adopted from Ukraine. She refers to Children’s Therapy TEAM as, “a huge blessing to our family and our children’s future.” As a founding member of the TEAMworks Non-profit Organization, Amanda proudly states, “our therapists not only make a big difference in the lives of the children they work with here, but have impacted hundreds of children and families internationally as well.” Amanda holds a Bachelors Degree in Computer Information Systems from Missouri Southern State University.

The Clark Family

Monday, August 22, 2016

Service Animals & the Americans with Disabilities Act

Service DogsDear Melissa,
My son will be getting a Poodle puppy in a few weeks. How do I go about getting it certified as a service dog? I would like my son to be able to take it to Wal-Mart with him so that he is calmer while I am shopping.
I have been asked this question many times. Just as I was finishing this blog, a co-worker asked the same question for one of her clients. Service animals, comfort companion animals, emotional support dogs… They seem to be extremely popular right now, and there seems to be a wide range of animal training as well as the services that they provide. Let's start with a few definitions.
What is a “service animal”? 
According to the Americans with Disabilities Act National Network, "A service animal means any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability." Tasks performed can include, among other things, pulling a wheelchair, retrieving dropped items, alerting a person to a sound, reminding a person to take medication, or pressing an elevator button.
What is the difference between a “service animal” and an “emotional support animal” or “comfort companions”? 
While emotional support animals or comfort animals are often used as part of a medical treatment plan as therapy animals, they are not considered service animals under the ADA. These support animals provide companionship, relieve loneliness, and sometimes help with depression, anxiety and certain phobias, but do not have special training to perform tasks that assist people with disabilities. Even though some states have laws defining therapy animals, these animals are not limited to working with people with disabilities and therefore are not covered by federal laws protecting the use of service animals. These therapy animals provide people with therapeutic contact, usually in a clinical setting, to improve their physical, social, emotional and/or cognitive functioning.
Summary of ADA coverage:
Service animal:  Performs specific action/task. Protected under the ADA.
Comfort/emotional support companion:  Provides comfort and support but NOT a specific action, and NOT covered by ADA.
What if someone’s dog calms them when they are having an anxiety attack? Is this a “service animal” or a “comfort companion"? 
According to the ADA, this depends on the specific animal’s training. If this dog has been trained to sense that an anxiety attack is about to happen, and the animal has taken a specific action to help avoid the attack or lesson its severity, then this would qualify as a service animal. However, if the dog’s mere presence provides comfort, then this does not qualify as a service animal under the federal ADA law.
In public, how do I know if a dog is a “service animal” or simply a “comfort companion”?
In cases where it is not obvious that the dog is a service animal, staff in businesses or schools are legally allowed to ask only two specific questions:
  1. Is this dog able to provide a service that is required due to a disability?
  2. What work or task has this dog been trained to perform?
Staff are NOT allowed to request any documentation for the dog, request that the dog demonstrate the task, or inquire about the nature of the person’s disability. Furthermore, the ADA does NOT require that service animals wear a vest, ID tag, or specific harness. However, many service animals do, in fact, wear some form of vest or harness as a sign to the animal that it is time to work vs. time to play.
What special training or certification is required to qualify a dog as a “service animal”? 
Some individuals choose to use a specific dog training agency/school to help train their animal to perform specific tasks. However, people with disabilities have the right to train the dog themselves. In addition, no special certification or screening process is required of the dog or the owner. Many individuals or organizations sell service animal certifications or registration documents online. (Trust me, there are a TON of these websites out there). However, these documents do not convey any rights under the ADA. Again, it is the dog’s ability to provide a specific service or action that protects its presence in a public space under the ADA law. Service animals are also subject to all local dog licensing and registration requirements that apply to general dogs as pets. In addition to federal laws under the Americans with Disabilities Act, each state also has its own laws and laws can change if you are traveling from state to state.
Are there any businesses/institutions that are exempt from the ADA laws regarding service animals?
YES, there are actually many exempt organizations that CAN ask you to keep your service animal outside. These include:
  • Swimming pools
  • Churches/places of worship
  • Commercial airlines – services animal rules on airlines are NOT regulated by the ADA, but rather by the Air Carrier Access Act which is part of the U.S. Department of Transportation, Aviation, and Consumer Protection Division
Still interested in service dogs? We actually have TWO highly trained service dogs here at Children’s Therapy Team! Stay tuned for next week’s blog where we will discuss how one of these dogs was trained and it’s benefit to children with disabilities.
Resources accessed in July 2016.
Service Animals and Emotional Support Animals, ADA National Network
Frequently Asked Questions about Service Animals and the ADA, U.S. Department of Justice, Civil Rights Division, Disability Rights Section
Animal Assistance and Therapy, Children's Therapy TEAM Resource Library

Monday, August 15, 2016

Guest Blogger Amanda Wherry: Doing Battle for HOPE

Doing Battle for HOPE
We all have things we hope for. Some of these hopes are Jesus inspired… some of them aren’t.
I am a tall, white woman... with a fro.
My hair is a bit of a mystery. Although my mother and her two sisters both have curls, when I wake up in the morning I more closely resemble Don King than any of my relatives. The curly hair genetic factor seemed to get exponentially magnified when it was passed down to me. But that’s not really the mysterious element to my hair. The real mystery is the fact that it doesn’t grow past an arbitrarily short length. I’ve never had a hair cut in my whole life. And this means three things:
(1) I always win when I play the game “Two Truths and a Lie” with strangers;
(2) I’ve been told again and again that I’ve saved a lot of money over the years by not requiring haircuts; and
(3) I have always stood out. I guess a 4th interesting point is that my head often gets petted by strangers who are curious about the phenomenon that is my hair.
I was teased for my fascinatingly different locks.
In elementary and middle school, I was regularly teased for my fascinatingly different locks. But, to be honest, my classmates’ pokes and prods rarely bothered me. I didn’t mind it when someone shaped my hair into spikes so that I looked like the Statue of Liberty – I simply extended one hand to the sky as though holding a torch and wrapped the other hand around as though embracing a tablet, and pronounced freedom and welcome to everyone around me. I didn’t mind it when I went swimming, and my friends (and sometimes strangers) asked me to flip my hair forward so that it piled on top of my head and came to a thick curl in the front with an uncanny likeness to Elvis Presley. Rather than get upset, I joined in the fun by belting out a round of “You Ain’t Nothin’ But A Hound Dog” while performing my best hip swivel. I was perplexed, but not dismayed, when I took a mission trip to Nigeria, and dozens of Africans followed me down the street to tell me in their beautifully lilting English, “Sister, come home. Come home to Africa.” They thought I was albino African and treated me as though I was a mystical unicorn or the Pied Piper. And I didn’t get annoyed when I spent my summers throughout college working at a Christian camp for children with special needs, and some of the counselors took to calling me “Fro-Wheezy” – a rather spastic blend of my last name (or at least the first three letters of my last name) and my hair's appearance. Even though I thought this nickname sounded like an asthmatic character from a 1970’s sitcom, I figured at least these new friends would probably remember me long after the summer ended.
So the fro didn’t hold me back.
If anything, throughout my life it has created an instantaneous connection and conversation piece. To this day, it is not unusual to be standing in line at the grocery store and have someone I’ve never met before ask me what my heritage is and then follow that question with, “Can I touch your hair?” While living in Asia, I was asked on a nearly daily basis if my hair had a perm. And when I explained that it was completely natural, I was rarely, if ever, believed. Asians love curly hair (since theirs all grow stick straight), so knowing where to get a good perm is valuable information. So the Asian women (and sometimes men) who asked me about my hair would then beg to know where I had it done – as though I was holding out on telling them a magnificent secret.
What I didn’t like about my hair was the lack of changeability. With hair that grows long, there seems to be (from my “outside looking in” opinion) endless options and possibilities. Long-hair-ers can choose to cut their hair at any moment into a vast variety of styles, shapes, and creative concoctions. They can curl their hair, straighten their hair, perm their hair, and color their hair. And since their hair grows, if some dastardly mistake is made, then no harm, no foul (or at least “low” harm, “less” foul) – because wait a few months, and that horrific haircut or bangs-chopping poor judgment call can just grow right on out.
But not for me. I’ve always feared dying my hair or using any sort of harsh chemical product – because if I destroyed my fro then I’d have to painstakingly wait for each strand to slowly replace itself with a new one. And so growing up, I struggled with the boredom of having hair that in essence is unchangeable.
As a child, I prayed for a change.
Therefore, as a young child, I would occasionally (actually, consistently) pray for a miraculous change in my follicle future. I prayed that one day I would wake up and look just like Rapunzel – be able to throw down a bushel-full of hair. I prayed that all of my missed-out-on hair growth would miraculously happen in one fell swoop so that I, too, would suddenly have the options of a bob, a pixie, or a pony. I would sometimes dream of getting struck by lightning. As a 4 or 5 year old, I rationalized that if getting struck by lightning always fried people’s hair (as portrayed in cartoons), then since my hair already looked like it had been electrocuted, perhaps getting hit with a bolt of pure energy would cause my hair to grow straight and flowing. But, much to my young heart’s disappointment, no amount of prayer or hair product ever changed my hair’s status quo. And since I find wigs hot and horrifically uncomfortable (the few times I’ve worn them to costume parties), I’ve had to just settle in and accept my hair as is.

“Hope deferred makes the heart sick, but a desire fulfilled is a tree of life.” (Proverbs 13:12)

HOPE
We’ve all had hopes that have, until now, remained unfulfilled. For me, my childhood hope for long hair ended in disappointment, but as an adult, I don’t mind my hair so much. In fact, the unusualness that sits on top of my head gives me a strange ability to blend into multiple cultures. No one knows where I’m from (except that I’m obviously not Pygmy - this girl be TALL). Am I white? Am I African American? African? Mixed? Other? This “blending” has been nothing but beneficial in my work overseas because it has helped me to ebb and flow and be embraced and accepted by people of various colors and ethnicities. So, even when I didn’t understand it, God had a plan – for me and for my hair.
However, as an adult, I’ve had very real and deep hopes and desires that have not yet come to fruition. These are hopes that I have prayed for constantly – for years. For decades even. And I’m still… waiting.
While living overseas, whenever things were difficult, a friend of mine would regularly tell me to “do battle for my heart.” What she meant was don’t shut down. Don’t walk away from the processes of life OR the processes that your heart and emotions go through while in the throes of life. Don’t shut out the emotions – whether they be joy or disappointment, happiness or pain, but rather fight – to remain engaged with those around you AND with the Lord. I think the wisdom behind “doing battle for your heart” is that hopelessness is incredibly destructive. Hopelessness makes people either desperate and act in ways otherwise unfathomable, or it makes people despondent and not act when action is most needed.
Sometimes not getting what you hoped for is the best thing.
I love how Proverbs 13 does NOT say that “not getting what you hoped for makes the heart grow sick” – because that’s not the case. Sometimes not getting what you hoped for is the best thing, the absolute biggest blessing that the Lord could grant you, me, or us. When I look back over my life, there are some stand-out things that I prayed and fasted for years over, that, when I reflect, I cannot thank God enough for not giving them to me. It is when we lose hope that things start to slide into the abyss.
Losing hope in something is just another word for distrust, I think. If I lose hope in an object, I start to distrust it – I distrust that it works or that it’s safe. If I lose hope in a person, I start to distrust in that person’s ability, in their care for me, in their consistency or dependability. So, if I lose hope in God, lose hope in His desire and ability to answer my prayers, to bless me in great and glorious ways, to listen to and care about even the tiniest places of my heart, and to do what’s best for me, then I start to distrust in my Creator. That means I start to try and take over and take control. I walk away from God, while at the same time try to become God. And I will always fail when I try to be the Almighty. All the while, my heart gradually will become more and more disgruntled with Jesus, increasingly bitter, exhausted, disillusioned, angry, disparaging, anxious, frustrated, aloof, distant, cut off, and… sick. There is this miraculous connection between hope and joy – the joy that comes from knowing and truly believing that there are better days ahead (even if those days won’t happen until Eternity), that Someone has your back, and that you are not forgotten. It’s like my friend said, "The heart is worth fighting for." Having hope so that your heart does not grow sick is worth doing battle over.
We all have that “one thing.”
We all have that "one thing." That one thing that we are still waiting on. Maybe that one thing is a totally God-given desire. Maybe it’s not. My desiring long hair as a child was based on vanity, insecurity, and comparison (and boredom I suppose). Having long hair probably wouldn’t have drawn me closer to my King, and might have even distracted me away from Him. So, I use that example to encourage you to take your hopes back to Jesus. Ask Him what your hopes should be. Ask Him if your hopes are glorifying to Him, if they are what are best for you, and if they will help you to fall more in love with Him. Because there is absolutely nothing more satisfying, more encouraging to our hearts, or more energizing to our lives than being more and more in love with Him. And if your heart has grown a little “sick,” then do battle over it. Fight for hope.
Remember that if there is any area of your life where you are feeling hopeless, then that is an area of your life where the enemy has spoken a lie to you, and you are currently believing that lie. Because our God is nothing but hope. He is all about hope. He commands hope and is hope itself, and is the giver of hope. Don’t agree with the lies our enemy has placed in your mind, heart, and soul. Fight for your heart. Do battle for HOPE!
Amanda+Wherry+2015Amanda Wherry serves as Children's Therapy TEAM's Faith-Based Program Coordinator. She is a local and international advocate for individuals with disabilities and their families. She spent nearly 7 years in a remote area in central Asia developing a hospital pediatric therapy program with teaching in physical, occupational and speech therapy as well as NICU therapy. read more

Monday, August 8, 2016

Back-to-School Tips

Back to School
Dear Melissa, 
As summer is starting to wind down, and the school supply lists are popping up at my local Wal-Mart, my first grade son is becoming more and more anxious about returning to school, even though it is the same school he attended last year for kindergarten. Do you have any tips to help relieve this anxiety?  
Returning to a familiar school has a separate set of fears than a child might have when entering kindergarten or entering a new school. For tips on entering a new school/kindergarten, see my Kindergarten Transition blog from last year.
When a child has anxieties about re-entering a familiar school, it is important to determine why those anxieties exist. While it is perfectly normal to have back-to-school jitters, more significant anxieties may need to be addressed more carefully. Either way, here are a few back-to-school tips to get you started:
  • Talk to your child about his/her fears.  Talking to your child is always a good place to start. However, make sure you choose your words carefully. If you say, “Are you anxious about school starting next month?” then that tells your child that he should be anxious, whether he already was or not. Rather, ask open ended questions such as “How do you feel about school starting?” or “What can I do to help you get ready for school?” It's even less threatening if you can grab a couple scoops of ice cream, sit on the back patio, and have a simple chit-chat.
  • Fear the work will be too hard?  Try getting a few grade-level workbooks and “get back into the swing of things” in the few weeks before school starts.
  • Fear of not having friends?  Try to schedule a few playdates with others from the school.
  • Fear of bullies?  Again, try to align your child with friends. Role play how to deal with a bully and how to ask a grown-up for help.
  • Fear of not liking the teacher?  Make sure you attend the teacher meet-and-greet. In addition, your child can work on a back-to-school card to give the teacher in order to help foster positive feelings about the teacher. Make sure to have the child include a few fun facts about him/herself to help establish a rapport with the teacher.
  • Summarize last school year.  This can also be included in your “ice cream on the back patio” chit-chat. What went well? What did not go so well? What was silly? Who was friendly (students and adults)? What subjects were the easiest? What subjects were tricky? Try to focus on the positive, but keep your ears open for recurring themes/fears.  
  • Practice the back-to-school routine.  It’s hard for all of us to get back into the swing of things once schoolstarts. Summer is for staying up late, catching fireflies, sleeping in, and NO HOMEWORK! In the days/weeks leading up to that first day of school, slowly work on getting to bed earlier, waking up and getting out the door (even if it is to a fun engagement like a playdate or a day at the pool). Another fun way to practice the back to schoolroutine is to pack a picnic lunch and practice your normal “getting to school” route whether it be driving, pretendingto get on the bus, or walking/biking. My own kids love packing a snack or lunch and heading to their school so they can have free play on the playground, as well as a fun picnic. And again, it may be a good idea to get back into the practice of reading/writing/math (even just a tiny bit!).
  • Let your child help with back-to-school shopping.  Whether it is clothes, shoes, lunch box, backpack, schoolsupplies, etc., it is exciting to have something new to try out on the first day of school. Many children will find helping to shop for everything a bit overwhelming, so pick at least one or two items that might excite your child and hit the store!
  • Restart that rusty brain.  If you haven’t noticed, this is the third time I have mentioned schoolwork in this blog. A story published August 2015, by CNN, reported that 53% of public school parents cited homework and schoolwork as “the driver of the most stress for their kids." I am definitely part of this 53%! Now, I certainly am not going to ruin my son’s summer by making him do homework every day, but, we are making sure to read frequently and throw in some writing and math here and there as well. 
When to seek additional help:
Yes, most children have back-to-school butterflies, but when do you need to be concerned that there might be a deeper problem? According to the Anxiety and Depression Association of America (ADAA), approximately 2 to 5 percent ofschool-age children experience anxiety-based school refusal. It commonly takes place between the ages of 5-6 years, 10-11 years, and at times of transition, such as entering middle and high school. This anxiety can be displayed as physical symptoms shortly before it is time to leave for school or repeatedly asking to visit the school nurse. If the child is allowedto stay home, the symptoms quickly disappear, only to reappear the next morning. According to the AADA, missing schoolactually reinforces the anxiety rather than alleviating it. If you have concerns that your child is experiencing more school-based anxiety than other children, you should discuss this with your child’s pediatrician, occupational or speech therapist, or seek out the advice of a mental health professional. 
Looking for more advice on making that back-to-school transition? Check out the resources below:  
Back to school: What kids are most anxious about is… CNN, August 24, 2015
7 Ways to help ease your kid’s back to school anxiety, Babble, accessed June 2016
School Refusal, Anxiety and Depression Association of America, June 2016

Monday, August 1, 2016

Guest Blogger Danielle Cunningham: Shedding a light on Torticollils

Shedding a Light on Torticollispicture of the Cunningham Twins compliments of Sarah Pope Photography
What is torticollis? 
Congenital Muscular Torticollis (CMT) becomes evident shortly after birth. A key muscle in the baby’s neck is tighter on one side of the neck than the other side. This causes restriction of movement of the baby’s head. CMT can be caused by many different factors including the baby’s position in utero, injury during delivery and/or underlying musculoskeletal pathology. The exact cause is often unknown.
What might cause a parent to suspect torticollis in their infant? 
Parents can carefully observe their baby’s preferred head position. Does the baby’s head seem to regularly tilt to one side, with an ear being closer to one shoulder as compared to the opposite shoulder? Parents can also observe their child’s movement. Does the baby tend to prefer to rotate their head and look to one side consistently rather than looking to both sides equally? Finally, parents can also observe their baby’s head shape. Does the back of the baby’s head appear to be flat? Do the baby’s facial features appear to be asymmetrical?
Can torticollis resolve on its own without treatment? 
If left untreated, torticollis is likely to worsen and may lead to further complications. The child may develop a strong preference to use and move to one side of the body more than the other. This can result in scoliosis, difficulty with balance, and possibly a negative effect on the visual field. Significant flattening on one side of the head or face (plagiocephaly) could result in the need to use a cranial shaping helmet for correction. When a baby is unable to freely turn her head to see, hear and interact with her surroundings, then her cognitive development may also be delayed.
What is the best time to offer treatment? 
The earlier the better! Referral to the pediatrician and physical therapist when the very first concern arises is crucial. The Pediatric Section of the American Physical Therapy Association has shared some remarkable numbers related to the effectiveness of early intervention. For example, they have noted that if treatment is started before 1 month of age, 98% of babies achieve near normal range within 1.5 months, but waiting until after 1 month of age prolongs intervention to about 6 months. Waiting until after 6 months can require 9 to 10 months of intervention, with progressively fewer infants achieving a near normal range of motion.
How can therapy help? 
Physical therapists provide parents and caregivers with training and education regarding immediate implementation of correct positioning at home and improper use of baby equipment that may actually be worsening the symptoms. Therapists develop daily exercise and stretching programs specifically for the child's level of impairment.
Danielle Cunningham
Danielle Cunningham's interview "Shedding a Light on Torticollis" is featured in the August 2016 edition of Peekaboo Magazine and the NWA Kid's DirectoryDanielle completed her bachelor's of science at Texas Woman’s University. She went on to receive her Doctorate in Physical Therapy from UCA in 2008. She pursued post-graduate work in rehab with neurologically impaired patients before joining the Children’s Therapy TEAM family in 2009. Danielle serves as Coordinator of Clinical Education in Physical Therapy at Children’s Therapy TEAM. In 2011, Danielle served internationally with TEAMworks Therapists in Ukraine. She continues to be an active supporter of TEAMworks outreach. Danielle and her husband live in Rogers, Arkansas and have three young children. Danielle gave birth to twins in 2015, so she and her husband fondly call their home-life busy.

Monday, July 11, 2016

It Happens Fast: Hot Car Danger for Children

Hot Car Danger
Just as with the Drowning Risks and Prevention blog, this week's blog will be a bit more of a public service announcement as opposed to answering an actual parent question. As the mercury keeps rising on these summer days, I notice how hot my car is every afternoon when I get off work. Every time I get in my hot car, I remember that chilling YouTube video entitled One Decision that went viral in 2013. The video depicting how loving parents can easily get distracted, and how it can create disastrous results.  
Statistics on Vehicular Heat Stroke
According to the non-profit safety group KidsAndCars.org, on average, 37 children die each year from heat-related deaths after being trapped inside a car. In addition, from 1990-2015, there were 755 children who died as a result of vehicular heat stroke. This can happen when a child is forgotten and left unattended in a hot car, a parent intentionally left the child in the car while he/she ran a “quick” errand, or because a child climbed into an unlocked car and became trapped in it. Within minutes, the danger can be real.  
Why is it so dangerous to leave a child in a car?  
Two words:  “Greenhouse Effect." According to KidsAndCars.org, the inside of a vehicle heats up extremely quickly.
  • The inside temperature can reach 125 degrees in just minutes, with 80% of the increase in temperature happening within the first 10 minutes. Therefore, purposefully leaving a child in the car while you “run in real quick” is NEVER a safe choice.
  • Cracking the window does very little to slow down the heating process or to decrease the overall maximum temperature. 
  • Children have died from vehicular heat stroke when outside temperatures have been as low as 60 degrees.  
Why are infants and toddlers more susceptible to heat-related deaths?  
  • A young child’s body overheats 3-5 times faster than an adult body.  
  • Even loving, caring parents are often distracted by changes in routine, lack of sleep, hormone changes, juggling multiple responsibilities, etc., which makes them even more likely to accidentally leave a child in the car.  
  • Rear-facing seats look the same whether there is a baby in them or not. When babies fall asleep in this rear-facing position, it is easy to forget that they are back there.  
  • The vast majority of children who have died from vehicular heat stroke (87%) have been age 3 years or younger, and 55% of vehicular heat stroke deaths involve children under the age of 24 months.  
  • In the majority of child vehicular heatstroke cases (55%), it was a loving, responsible parent who unknowingly left the child in the car resulting in a total of 413 fatalities from 1990-2015. (www.KidsAndCars.org)
Tips to avoid child vehicular heat stroke (from WebMD)
  • Never leave a child in a car. It doesn't matter how brief the time period is. As stated earlier, the largest increase in temperature occurs in the first 10 minutes, so just making a “quick trip inside” is never safe.  
  • Place a valuable item in the back seat. In researching many websites for this blog, several suggestions for this “valuable in the back seat” have included: 
    • Your left shoe
    • Purse/wallet
    • Cell phone - which provides the added safety bonus of no texting while driving!
    • Keys for push button start cars – my car gives me an alarm if I am about to lock the keys in the car
  • Get involved if you are a bystander. The National Highway Traffic Safety Administration advises bystanders tocall 911 immediately if they spy a child alone in a hot vehicle.  
  • Prevent kids from wandering into the car. Lock you car when you leave. Educate children to never play in the car, and keep your keys out of reach. Many children want to “drive like mommy or daddy," so they will want to get inside the car to pretend play. Unfortunately, they can also become accidentally locked in the car with disastrous consequences.
  • If a child does become missing, always check the car first. Once again, the car is an attractive but dangerous play area, where the stakes can become very high very quickly. If you notice your little is missing, always check nearby vehicles first.  
Want more information on how to keep your children safe around cars? Follow the links below:  
Heat Stroke, KidsandCars.org, (accessed June 2016)
Dangers of Heatstroke, KidsandCars.org, (accessed June 2016)
Danger: Kids Left in Hot Cars. WebMD, (accessed June 2016)  
About the Author:
MelissaFosterThumbMelissa Foster is the leading contributor to Children’s Therapy TEAM’s Weekly Blog. She is a Pediatric Occupational Therapist with over a decade of experience in the field. An active public advocate in the NWA community, Melissa addresses topics related to Autism, Sensory Processing Disorder and general health and child development.