Monday, July 4, 2016

Drowning Risk and Prevention

This week's blog is not a parent question. Rather, it was a request my own mother made last year - to run a water-safety blog at the beginning of summer each year. So, in discussing the special needs child: drowning risks and prevention, I begin with current statistics on drowning.
According to the CDC (downloaded June 2016):
  • From 2005-2014, there were an average of 3,536 fatal unintentional drownings annually in the United States —about ten deaths per day.  
  • Approximately one in five people who die from drowning are children 14 and younger. 
  • Drowning is the leading cause of injury-related death among children between 1-4 years of age.  
  • For every child who dies from drowning, another five receive emergency department care for nonfatal submersion injuries.
*  More than 50% of drowning victims treated in emergency departments (EDs) require hospitalization or transfer for further care (compared with a hospitalization rate of about 6% for all other unintentional injuries). These nonfatal drowning injuries can cause severe brain damage that may result in long-term disabilities such as memory problems, learning disabilities, and permanent loss of basic functioning (i.e., permanent vegetative state).
Drowning is of particular concern for children with Autism.  
According to the National Autism Association (June 2016), the risk of death by drowning is twice as high for children with ASD than in the general population. In 2009, 2010, and 2011, accidental drowning accounted for 91% of injury-related deaths in the U.S among children with ASD ages 14 years and younger. Many factors contribute to this high mortality rate, including wandering, seizures, and a general lack of safety awareness.  
What should we do?
Here are some things you can do to help protect your children:  
  • Teach your kids to swim! For families with children with special needs, the comparatively high risk of drowning makes learning to swim even more imperative. As a life skill, learning to swim can be a goal targeted with a child's occupational therapist and/or physical therapist. Children's Therapy TEAM's Aquatic Center is a great point of reference for families who seek an option specifically designed and individualized for their child with special needs. There are also options such as the Boys & Girls Club, American Red Cross, private pools/clubs (you don’t always have to be a member to participate), local colleges/universities, word of mouth private teachers, etc.
  • Know your child’s personality/abilities. Does your child have Autism, ADHD, or is he impulsive? Know your child’s temperament and if he tends to be a risk-taker or not. If he is the risky type, be even MORE vigilant than you would otherwise. However, don’t just assume that your very timid child who won’t even put his face in the water is automatically safe because he is timid. For example, my extremely timid 6 year old son was drying off one day after a swim lesson at a public pool. I turned my back for just a minute, and found him clinging to the side of the pool. In the water. At the deep end! (Insert heart attack here!)
  • Underestimate your child’s swimming ability. Yes, your child may have passed the check list as a beginner swimmer, and yes, he may be able to swim across the deep end of the pool. But don’t just assume that he can swim well enough to keep himself safe. When it comes to water safety, maintain extra vigilance with less than ideal swimming conditions such as the lake, swim parties, canoeing, the ocean, etc. It is also important to share your child’s swimming abilities (or lack thereof) with any camp counselors, babysitters, or family friends who might be taking your child swimming. It is always a good idea to insist that your child wear a life jacket, just in case. Yes, many children will balk at the idea of continued use of the life jacket, but the rules are there for a very important reason.
  • Watch for both a LACK of supervision as well as a LAPSE in supervision. Another personal true story:  When my daughter was 3 years old, we went swimming with extended family while on a vacation. I was actually IN the water, sitting on the pool steps, my daughter within arm's reach. I turned my head to watch my niece doing a flip in the pool. I turn my head back, and my daughter is completely silent, under water, no splashing. She had simply taken that one step too far toward the deep end, and could no longer keep her head above water in the “shallow end.” Scary. According to Autism/Aspergers Digest, 90% of drowning deaths occur while the child is being supervised. Unlike what you see in the movies, drowning is generally silent. No splashing. No screaming. Silent. Again, scary.
  • Make your home pool Fort Knox. The CDC recommends 4-sided fencing at least 4 feet tall. This fence should include a self-closing and self-latching gate, with the latches being out of reach of children. Additionally, move pool furniture away from this fence so that it can’t be used as a step stool. Make sure pool toys are not left in the pool. Install a pool alarm to alert you if the pool water is disturbed. Lock back doors/gates to create additional barriers to the pool area. The more layers of protection you have surrounding the pool, the less likely a child will wander off and decide to go for a dip, alone.  
Yes, swimming is excellent exercise and a great way to cool off in the summer. Just make sure your child is safe and supervised. And by the way, don’t forget the sun block!
Resources:
Swimming Pool Safety, HealthyChildren.org (downloaded June 2016).
Home Pool Safety, American Red Cross (downloaded June 2016).
Water Safety: The Ultimate Life SkillAutism/Asperger’s Digest, July/August 2010. 
Water Safety at Home, Safe Kids Worldwide, (downloaded June 2016).
Unintentional Drowning: Get the facts, Centers for Disease Control, (downloaded June 2016).

Monday, June 27, 2016

An Interview with TEAM's Faith-Based Program Coordinator



As the recently named Faith-Based Program Coordinator at Children's Therapy TEAM, what do you hope to achieve?
I have a lot of goals for these programs, but ultimately I want to see all families in Northwest Arkansas whose lives have been touched by disability actively thriving, knowing that they are loved and supported, being earnestly embraced by the community, and also having avenues to actively participate and contribute back to their communities as well. I would love to see Northwest Arkansas become a landmark area of the world in regards to disability awareness and ministry.

How has your past missionary experience overseas served you in your current work?
I think a big way that my time overseas is playing into the present is that I don’t fear taking risks – even if sometimes I fail. I’m not afraid to run really hard after things, even if I don’t have all the details worked out yet, or even if I know I’m not the most gifted at it. If there is a need, I want to do anything in my power to try and meet that need (while at the same time actively recruiting someone who might be a better fit than me). I was thinking about this one morning while leading “The More” open worship set at the Fayetteville Prayer Room. I’m not the best guitar player, I’m certainly not the best worship leader, but I wanted there to be a designated time and space for families, therapists (OT/PT/DT/SLP), and individuals to come and lay down their burdens to the Lord and to hopefully be filled with His presence, hope, and peace. So I started this worship set. One morning I couldn’t get the sound equipment to work. So there I was, singing raggedly into a microphone that I couldn’t get to turn on, and I thought, “I’m kind of failing at this whole worship thing today... and that’s ok because the Lord is still present.” Failure is just an opportunity to learn, and it doesn’t define who I am. Taking risks, whether they work out or not, is such a reminder of how shame, and placing our identities in what people think of us, is not from the Father. Because we are gathered into His fold, because He loves us, because He only has good plans for us, and because nothing is impossible for Him, we can - with full confidence and abandon - be obedient to Him and take risks when He asks us to.  Because of our love for Him and by our faith and trust in Him, we are to risk for His Kingdom. Shame doesn’t allow for risk. Saving face or fear doesn’t allow for risk. But without risk, rarely does greatness happen.
While overseas I also really experienced the joy of being so completely dependent on Jesus - and how having that close of a relationship with Him is better than anything else. It leads us to wholeness and healing. This is a foundational driving force in all that I do. There is probably nothing I love more than seeing people grow in healing - having past hurts, disappointments, injustices, etc. mitigated by the love of Christ and the identity He has for them. I’m not sure people really believe that He can do this, that He can make all things new again, but I’ve seen it both in my life and in the lives of others. It can take time and effort, and sometimes it is very much darkest right before the dawn, but it’s so worth it. Fighting for your heart, fighting for your wholeness, knowing that God is good and because of that we can dream big and take risks - it’s so worth it. And once you’ve glimpsed even just a piece of this, once you’ve seen Him come through in impossible situations or break through what feels like an indestructible barrier in your heart, you’ll never want to go back to anything less than complete dependence on Him.

As an Occupational Therapist, you are obviously well grounded in medical science. What is your understanding of the role that faith and spirituality has in medicine?
A big theme in OT is holisticness. I believe that spirituality is a piece of being holistic. For me personally, it is my faith in Jesus that brings me peace, comfort, joy, perseverance, compassion, and so much more. For me as a practitioner, it is what pushes me to pray for the kids that I see, to constantly try to see their inner value - the gold inside of them - and bring that gold to the forefront. It is the identity that I have in Christ and the confidence that this brings that causes my heart to break for any child who says, “I’m not good enough,” or “I don’t have friends.” My job is not just a job to me - it is the platform that gives me access into loving children, their parents, and their siblings to the best of my ability. My faith is what keeps me grounded in knowing that I alone can’t fix everything, but I believe in a big God who can.

What tips do you have for families and faith communities?
I think there are several faith-based communities within Northwest Arkansas that are striving to provide better support and awareness through various types of disability ministry. If I were to give one tip to both families and to these communities, it is to create an atmosphere for open dialogue. To the families I would say - for those of us attempting to love you and support you, we are going to make mistakes. You might walk into a church and have someone stare at you. You might have someone approach you and ask a really ignorant question. But choose to be unoffendable. Instead, help us. Communicate with us on what your needs are, how we can better meet those needs, and what is helpful or hurtful. To the churches and other faith based communities I would say - stay humble. It is really difficult to be criticized when you are just trying to do the best you know how, but this is going to happen. So keep asking questions, don’t make assumptions, ask for forgiveness when you inadvertently offend, and pray without ceasing.

What are some local outreach programs that you are particularly excited about?
I literally get excited about whatever program I’m working on in the moment. I honestly think each one of them, in different ways, has the potential to truly change lives. I get excited about the Tuesday morning worship because I believe in the power of prayer. There are various summer fun events coming up that I am hoping will help to connect families who are wanting/needing community. We had a pool party at the Boys and Girls Club on June 25th, which was fun and so encouraging. Cross Church graciously supported a sensory-friendly tent at their Fireworks at the Crosses event this weekend. I am networking with various local churches to begin community groups and parent encouragement groups. Children’s Therapy T.E.A.M. has partnered with Potter’s House and New Heights Church’s All Abilities Ministry to form a mentoring program for the summer, and it is my hope to eventually develop a year round program. There are various projects in the works that are providing older children with special needs work training and volunteer opportunities. And Children’s Therapy T.E.A.M. is working on a partnership with the Joshua Center, a local counseling center, to provide counseling for families, children, and therapists. These are all steps towards community, healing, and wholeheartedness. Sometimes it seems a little overwhelming how much God has done just in the past couple of months, but I think it is truly evidence of His heart for these families. He desires for them to know that they are seen and that they are loved.

How can families learn about opportunities in our community?
Children’s Therapy T.E.A.M. has a Community Calendar. As events develop, I’ll post them there - along with more detailed descriptions of the various programs as they launch. This is definitely still a work in progress, so keep checking for updates.

Amanda Wherry is a local and international advocate for individuals and families with disabilities. She spent nearly 7 years in a remote area in inland Asia developing a hospital pediatric therapy program with teaching in physical, occupational and speech therapy as well as NICU therapy. read more

About the cover art: Whose hands are pictured? The picture shows Amanda Wherry (right) giving Dimitri Clark (left) a high five. Dimitri is a TEAM kid with Cerebral Palsy who serves as the spokesperson for Heroes for Kids. The picture was taken at the 2016 Heroes for Kids Run. The non-profit awards adaptive recreation equipment to kids with special needs so they can enjoy the natural beauty of the outdoors in Northwest Arkansas.

Monday, June 20, 2016

When is Physical Therapy needed?


Dear Melissa, 
I have a student in my preschool classroom who I think would benefit from physical therapy. How do I know when a child needs a PT referral?  

As a mama who still has a youngster in preschool, I frequently get pulled aside by preschool teachers or fellow parents to be asked if what a child is doing is “normal." 
First of all, any concerns about child development should always be discussed with the child’s pediatrician. In addition, I highly value the opinion of preschool teachers, Sunday School teachers, and any other adult who is both actively involved in the child’s life AND has frequent experience with typically developing children as well.  

This blog is actually the conclusion of a 3 part series on “How do I know if my child would benefit from therapy?” If you have questions for speech, refer back to the speech blog.  If you have questions for occupational therapy, look back at the OT blog. Over the years, I have found that oftentimes, therapists just know when a child would benefit from therapy, and often these “red flags” don’t necessarily match up with what is on common developmental milestone lists. 

When is Physical Therapy needed? For the question of gross motor development, I compiled a list of gross motor developmental milestones from reputable sources located in the resource section listed below. However, the resource lists are long, and some valid concerns seem to not make their way into those developmental milestones lists. Therefore, I interviewed TEAM physical therapists Holly Hill and Wade Cunningham to learn what red flags make them question whether a child might benefit from further, formal gross motor evaluation. Once again, I broke these concerns up into rough stages to help with your scanning needs.

Birth to 2 years:
  • An infant who greatly prefers looking to one side or the other, or consistently tilts his/her head to one side (as in the ear of one side generally stays closer to the shoulder of that side)  
  • Flat head - where the skull does not have a round shape
  • Not crawling by 10 months – as an OT, I echo the importance of crawling!
  • Preferring to stay in one place once he/she has the skills to be mobile
  • Not walking by 15-16 months
3 to 5 years:
  • Consistent toe walking
  • Consistent “pigeon toe-ing” where the toes point toward each other 
  • Chronic “W” sitting where the knees face forward and the ankles/feet face backward
  • Not jumping with both feet off of the ground at the same time (by 2 years)
  • Unable to walk up stairs without holding onto the hand rail at 3 years
  • Unalble to walk down the stairs without holding onto the hand rail by 4 years
  • Overly fearful of catching a playground ball by 3 years
  • Frequent tripping and falling, especially when the child does not “catch himself” with his hands when falling, and frequently bumps his face/head
  • Appearing to fatigue more easily than peers 
  • Appearing weaker than peers
  • Collapsed foot arches “flat feet”
  • Not able to stand on one foot
  • Incoordinated running pattern
  • Not able to keep up with peers on playground  
Resources:
Move Forward – A Physical Therapist’s Guide to Developmental Delay, American Physical Therapy Association, Accessed March 2016
Developmental Milestones, CDC, Accessed March 2016 
Ages & Stages, American Academy of Pediatrics, Accessed March 2016 

About the Author:
Melissa 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, June 13, 2016

Mom's Insight on Food Allergies

Food Allergies

The Asthma and Allergy Foundation of America (AAFA) has declared May as “National Asthma and Allergy Awareness month,” and May 8 – 14, 2016 was Food Allergy Awareness week, deemed so by Food Allergy Research and Education (FARE). We’re a little late with this post, but better late than never, right?    
Food allergies are a significant issue in the lives of many of our children. According to the American College of Allergy, Asthma and Immunology, food allergies occur when the body’s natural defenses overreact to exposure to a particular substance, treating it as an invader and sending out chemicals to defend against it. 
How Common are Food Allergies? According to the American College of Allergy, Asthma and Immunology:
  • Food allergies are estimated to affect 4-6% of children and 4% of adults.  
  • The most common food allergens are milk, soy, eggs, wheat, peanuts, tree nuts, fish and shellfish.  
  • Peanut is the most common allergen, milk is second, shellfish is third. 
The most severe allergic reaction is anaphylaxis – a life threatening whole-body allergic reaction that can impair breathing, cause a dramatic drop in blood pressure, and affect heart rate. Anaphylaxis can come on within minutes of exposure to the trigger food. It can be fatal and must be treated promptly with an injection of epinephrine (such as an EpiPen).
In this post I wanted to offer a Mom’s insight on food allergies. As I, myself, do not have a child with food allergies, I decided to locate a parent who is actually “in the trenches” when it comes to problem-solving the very real concerns related to severe food allergies. Therefore, I interviewed Martha Tompkins, a local mother, whose 7 year old son, Luca has severe food allergies.  
Melissa:  When did you first know that your child had food allergies? 
Martha:  During his 6 mo check-up, Dr. Harvey, Luca’s pediatrician, saw Luca scratching the side of his belly and said that it looks like he has allergies. He recommended we see Dr. Campbell. We set an appointment and got him tested and sure enough, Luca was diagnosed with food and environmental allergies. We started reading and researching about food allergies. I don’t think we have stopped reading about it to this day. There is a lot of new information about food allergies. We try to stay updated and follow three or four blogs and Facebook pages to keep informed. 
Melissa:  What are your son’s specific allergies?  
Martha:  His food allergies are peanut, tree nut, soy, egg and sesame. His peanut/tree nut allergy is high enough that we were prescribed an EpiPen. We don’t leave home without it. 
Melissa:  What tricks do you have for avoiding allergens at school, birthday parties, etc., when your child is not able to be under your watchful eye?
Martha:  Luca takes his lunch to school every day. He sits at the “peanut-free table” while he eats lunch at school. For birthday parties, we bring cookies with us in case he cannot eat the cake. But his friends know about his allergies, and they try to accommodate. I have had moms text me to see if it’s safe for Luca to have whatever they are thinking about having at the party. Luca is now old enough to tell people about his allergies. He is very good about asking if something has peanuts or soy, because he’s allergic to it. If his dad and I are not around, we tell the other parents about Luca’s allergies and give them his EpiPen. So far, everyone has been very accommodating.
Melissa:  Who do you teach to use the EpiPen, and how difficult is it for them to use?
Martha:  Anytime Luca is going to spend time with another adult, we share with them his Epi and walk them through how to use it. We have never had to use his EpiPen so far. 
Melissa:  What are your best tips for avoiding “close calls”?
Martha:  We are always on high alert for allergies. We read the ingredients of everything Luca eats. Also, we always tell the waiter about it, regardless of what restaurant we go to. We have never encountered a restaurant that wasn’t willing to answer our questions or show us their allergy menu. 
Melissa:  It seems as though you have so much figured out! How do you stay informed on the latest food allergy information?
Martha:  The internet is a fantastic resource. I follow many blog pages to swap stories with other parents who are in the same boat. My favorite one is Kids with Food Allergies Foundation (KFA). I also follow FARE (Food Allergy Research and Education). We’ve participated in the FARE walk three times. We love the community participation, and it helps Luca to see that other kids have food allergies too. Allergy Moms and AllergyEats are good too. 
Resources:
Asthma and Allergy Foundation of America:  Allergy Facts and Figures (accessed May 2016)
Food Allergies, American College of Allergy, Asthma & Immunology (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.

Monday, June 6, 2016

Thriving on Long Trips with Kids: Car Trip Games and Activities

Car Trips with Kids
Featured in the Peekaboo Magazine, TEAM OT Melissa Foster shares her tips for thriving on trips with kids. The car trip games and activities she suggests can help make long trips more enjoyable for everyone!

Monday, May 23, 2016

Tech Time vs. Talk Time

With new data showing that a majority of speech-language pathologists say children’s preoccupation with today’s personal technology is qualitatively different from past generations’ distractions of choice, such as television—with greater potential for harm—The American Speech and Language Hearing Association urges parents to implement some basic tech rules in their households to make time for verbal communication. This advice is especially timely given that May is Better Hearing & Speech Month.
Among the top concerns for surveyed speech-language pathologists is that excessive technology use by children is replacing conversation and human interaction, “Talk Time”. The most basic of activities, such conversation and interaction is essential to children’s speech and language development as well as future academic and social success. Unfortunately, the availability and convenience of tablets and other kid-friendly devices may be supplanting time for talking, reading, and interactive play. This is where the concerns to communication development come into play.
A trip to the supermarket, downtime in a doctor’s waiting room, or a ride in the car are ideal times to point out new objects, ask your child questions, and generally converse—all of which contribute to children’s speech and language development. It’s important that parents stay mindful of these learning opportunities, and not allow tech time to encroach on such daily opportunities—tempting as it may be to keep a child occupied. Even if a child is playing an ‘educational’ game on a device, nothing replaces what is learned through person-to-person communication.
Maintaining a realistic approach, a vast majority of speech-language pathologists (73%) say the solution to children’s tech overuse is to encourage parents to set reasonable parameters and model safe technology usage at home. A very small number (2%) advocate for tightly restricting children’s technology usage. We know that technology is here to stay, but consider when you can carve out some dedicated tech-free time each day.
In addition to implementing basic tech measures, we ask parents, especially those of young children, to use May as a time to assess their children’s communication development and familiarize themselves with the signs of speech/language disorders. These are among the most common conditions young children experience, and they are highly treatable. However, it is important that parents not delay should they have concerns.
Some parents may not take action about a speech delay until a child is 3 or older, even though they may have had concerns for a year or longer at that point. Any parent with a concern should seek an assessment from a speech-language pathologist right away for the best possible outcome.
For more information about communication milestones, visit http://identifythesigns.org. To set up an interview with Children’s Therapy TEAM to learn more, please contact us.

Monday, May 16, 2016

An Interview with Ms. Wheelchair Arkansas!

Ms. Wheelchair Arkansas
Did you know that we have a celebrity right here at Children’s Therapy Team? Our own Ms. Tabitha Mayberry is not only a fantastic speech therapist, but was recently named Ms. Wheelchair Arkansas! On April 20, 2016, Tabitha went to the Arkansas Governor’s Mansion and was crowned by First Lady Susan Hutchinson. To get the scoop, I interviewed Tabitha to find out what being Ms. Wheelchair Arkansas is all about.  
Melissa: So how did you find out about the Ms. Wheelchair Arkansas competition?  
Tabitha: I randomly came across Ms. Wheelchair through Facebook. When I saw the post, I thought to myself, "What a great way to raise awareness for those with disabilities, a group I am so deeply a part of!" Becoming Ms.Wheelchair would allow me so many opportunities to have a voice, a voice for myself and a voice for those without one. 
Melissa: What was the application process like?
Tabitha: The application was approximately 3-4 pages long with many questions, including questions about high school, college, work experience, volunteer work and a platform. 
Melissa: Can you tell me a little about your platform? 
Tabitha: I would like the opportunity to educate more people on disabilities. The need for communities to be educated about people living with disabilities is ever-growing. Often, discrimination and negative attitudes toward people with disabilities come from a general lack of information and misunderstanding. Visual impairment, hearing impairment, physical disabilities, hidden disabilities, and cognitive disabilities are all included in the thought process when considering those with disabilities. Through awareness, knowledge and skill building we can create a more inclusive environment for the disabled community members and strengthen our own communities as a whole. In order to strengthen our communities, we must first strengthen ourselves through available resources. Connecting with people and resources is an integral part of our lives. It is vital that we offer and make those resources known to all, including those with disabilities, in order to help us all live an active and engaged life.
Melissa: That is such a fantastic cause! What other responsibilities do you have as Ms. Wheelchair Arkansas?  
Tabitha: The responsibilities for Ms. Wheelchair Arkansas include promoting awareness to eliminate a variety of barriers, while informing the able-bodied public of the achievements and accomplishments of people with disabilities in my own community and our surrounding communities. This, in turn, will have a positive effect on my state as a whole. These responsibilities will include visiting advocacy groups, making public appearances and conducting interviews. 
Melissa:  We at Team are so proud of you! What is your next step in the Ms. Wheelchair process? 
Tabitha: The next step is to attend Ms. Wheelchair America in Grand Rapids, MI, during the month of August. It is a week long event with an agenda larger than I could have ever expected. There will be 4 interviews, a speech, a masquerade ball, a 50's night, a crowning gala, a farewell breakfast, etc. I am most excited about meeting all of these inspirational women who have so much passion and knowledge to share. 
A final word
We here at Children’s Therapy Team are SO PROUD of Tabitha and all of her accomplishments, both immediate and to come, as Ms. Wheelchair Arkansas. We already know that she is an extraordinary speech therapist and is able to empower her clients to use their voices. Now, we are learning how she is using her own voice to speak up for disabled members of our entire community as well. 
Are you interested in helping Tabitha Mayberry in her pursuit of Ms. Wheelchair America? Please consider donating to her GoFundMe account in order to help raise awareness for those with disabilities across the state and hopefully across the nation.