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.

Monday, May 9, 2016

OT's Discuss Developmental Red Flags

RED flags for OT
Dear Melissa,
I have a 4 year old “typical” grandson who seems a bit behind in several areas. I am worried that he won’t be ready for kindergarten next year. How do I know if he would benefit from some type of therapy to help him be better prepared?

I, too, have a daughter in preschool. It seems as if any time I go to a birthday party or am talking to other parents/grandparents/teachers, I always get asked the question, “Is this normal?” or “How do I know if my child would benefit from therapy?” Yes, I can refer concerned caregivers to various developmental milestone lists, and I have included some of these developmental lists in the Resources section of this blog. However, through years of experience and observation with children we OT's, PT's and ST's just know in our gut that certain things are not quite right. Other times, there are certain things that may not be “typical” but are really just fine.

Over the next several weeks, I will be interviewing fellow occupational therapists, physical therapists, and speech therapists to determine what they feel are “red flags" for a child possibly needing therapeutic intervention. The focus of this series will not necessarily be children who have a specific diagnosis. Rather, it will focus on “typically-developing children” (generally pre-school-aged) who are not identified as having any type of specific delay, and when these children might benefit from therapy intervention to help improve success.

First of all, some of the best resources if you have concerns about your child’s development, are his/her pediatrician and any teachers your child may have. Teachers tend to have a good handle on what they typically see in their classroom, as well as which behaviors fall well outside the norm. In addition, your child’s teacher has also had the opportunity to observe your child for many hours at a time over several weeks, months, or even years. This helps the teacher to have a good idea as to what is an isolated oddity, and what is a pattern of troubling behavior. Pediatricians have a very solid base in child development, and a pediatrician will ultimately need to write a prescription for evaluation for any type of therapy interventions.

For the purpose of early concerns in OT, I enlisted the assistance of two of our fabulous TEAM occupational therapists, Allison Schmitz and Katie Gehrki. The following is a list of red flags they look for in determining whether a child would benefit from occupational therapy services:
Birth to 2 years of age:
  • Not looking at caregiver's face or making eye contact
  • Not crawling and going directly from sitting to pulling up/walking
  • Crawling in an abnormal pattern (deviating from traditional crawling or “army crawling” patterns)
  • Strong hand preference with the exclusion of the other hand
  • Not reaching across midline (not reaching across the center of the body)
  • Not feeding self (either not finger feeding or not attempting to use spoon/fork)
  • Not isolating index finger by 1 year (to either point or grab objects)
  • Not displaying “showing/sharing” behaviors, which include the act of looking at a caregiver with an, “Isn’t that neat?” look on the child’s face, even if no words are used
  • Poor self-soothing skills
3 to 5 years of age:
  • Not engaging in pretend play
  • Still using gross grasp (whole-hand grasp for crayon or pencil)
  • Either always stationary or never stationary
  • Consistently screaming rather than attempting to use words
  • Not engaging in play with peers
  • Consistently screaming with transitions
  • Throwing tantrums significantly more often than peers
  • Appearing overly sensitive to grooming tasks
6 to 8 years of age:
  • Falling behind peers academically
  • Difficulty following the teacher's directions
  • Unable to tie shoes
  • Unable to cut food with a knife/fork
  • Hyperactivity
  • Being labeled a “bad kid” (There are NO BAD KIDS, OT can help determine why the child may be displaying bad behaviors)
  • Having difficulty engaging with peers on the playground and/or in extracurricular activities.
  • Not having friends
  • Immature handwriting skills
  • Poor organizational skills – forgets to turn in homework assignments, desk is messy, papers are messy, etc.
Please keep in mind that these are not lists of developmental milestones. You can follow the links below to find complete lists of OT milestones. However, the items above are simply items that cause concern for an OT. Again, if you have questions or concerns, please discuss them with your child’s pediatrician and teacher, or you can call our Family Support Referral Coordinator, Ashley Stewart, 479-521-8326.

Resources:
Developmental Milestones, CDC (accessed March 2016)
Ages & Stages, American Academy of Pediatrics (accessed March 2016)
Fine Motor and Visual Perceptual Checklist, Children’s Hospital of Orange County, (accessed March 2016)

Monday, May 2, 2016

Effective Communication: Ask for what you need

Ask for what you need
There is something powerful that comes from being able to ask (in the right way, in a healthy way) for what you need.

We all have needs, and we all have wants.  But if you’re like me, from a very young age, as long as I can remember, I was scared to ask people for what I needed – and I definitely didn’t feel comfortable asking people for what I wanted.
A Family's Communication Culture
All families have a “culture” that surrounds them and impacts actions, words, and thought patterns. One of the cultures in my family was, “Don’t inconvenience people.”  My parents are highly respectful people – they place great value on other people’s time and effort. They hate to “bother” others. But the way this was interpreted in my childhood mind was, “Never ask. Ever. For anything. Asking someone for anything is always a hassle to them.” 

So well into my adulthood (and even sometimes lingering now), I had the underlying belief that asking for what you need or want was a horrific thing. It may cause others to be inconvenienced and in turn cause them to be annoyed with you. This also meant they wouldn’t like you or accept you.  And let me tell you, if you think that asking will cause that person to dislike you forever, you are most certainly never going to ask.

Instead, I became an expert “sideways talker,” and in my heart I “willed” for people to know what I was saying. For example, when I was a kid, if I saw a friend using a toy I wanted to try, I might say, “Wow, that’s a neat jump rope. It’s so pretty. It looks like it goes really fast. I wonder how well I could jump with it.” Interpretation: “I want to try your new jump rope.”
What I later learned is that asking is really not annoying...but sideways talking is! And it’s unfair. It’s unfair because it puts the other person in the position of being expected to mind read what you are really saying. It means they are supposed to be an expert guesser. And really, who is an expert guesser?

My years in Central Asia
Within my first year of living in Central Asia, I joined a Sunday house fellowship. It was an amazing blend of foreigners from all over the world – England, Canada, Korea, The United States, Hong Kong, Mongolia, Australia, etc. I loved how diverse it was. The blend of cultures brought so much vibrancy and fun learning experiences.  But, there was one area where it was not diverse – almost everyone was a part of the same organization, and I wasn’t.

There were times when this didn’t matter much – for example, on Sunday mornings when we were all worshiping together.  But there were many, many times where it made for a very “outsider” feeling. For example, when the discussion after fellowship on a Sunday morning turned to planning details for a picnic, an excursion out of the city, or other fun activities – activities that I wasn’t invited to because I wasn’t a part of that team.

The activities weren’t specific to that organization, and there weren’t rules that I couldn’t join in. But because I wasn’t a part of that team, I was often times overlooked. I just wasn’t on the radar. Not in a malicious way – just in a, “Oh, you didn’t cross my mind/sorry I forgot to invite you” sort of way. Living overseas without a family, without a team, and without an organization can be incredibly lonely. I wanted deep and meaningful fellowship desperately, and so I kept trying in every way I knew how to get myself on the radar.

I was already contributing to Sunday fellowship by leading worship and teaching Sunday school. And I knew that my friends in the fellowship appreciated the time and effort it took to do these things…but it still didn’t bring me to the forefront of their mind when it came to including me on girls’ nights or birthday dinners. Those seemed to be reserved for “team only” members.

So I began “sideways talking.” When hanging out with a group member, I would comment that I’d heard that a recent outing was really fun. Or, I’d mention how I always felt nature-deprived by not having a vehicle or a way to get out of the city on my own. So, their hiking trip looked really fun. Or I’d bring up how I sometimes wished I had a team or an organization. But either they didn’t recognize that I was asking them to reach out to me, to include me, to extend themselves beyond their team and organization – or I was talking with people that didn’t feel like they had the authority or position to do so.

Effective communication would have meant sitting down with the leadership of that group and directly telling them how I was feeling. Effective communication would have been to directly ask for what I needed in order to thrive and feel included.

But I was scared
I felt like if I opened my heart up in such a vulnerable way and things stayed the same, then the hurt and rejection from my closest group of foreign friends would be too much of a crushing blow. I was scared that the deeper places of my heart would be dismissed as insignificant, needy, whiney, or too much of a bother. At the root of things, I was scared that the leaders would feel inconvenienced by a person who was not a part of their organization and therefore not directly under their care – and by inconveniencing them, by bothering them, they would emotionally, mentally, or physically kick me to the curb.

I was walking in fear instead of trusting in the hearts of people that I knew cared about me. And so, in that fear and with the build-up of hurt feelings, I began believing the lie that the individuals in the Sunday fellowship just kept me around because I could sing, play guitar, and was willing to take care of their children.  I began to believe that they were cliquish and selfish. In my mind, these so-called selfless missionaries weren’t willing to reach out to someone right in front of them simply because I wasn’t on their team, and I wasn’t a part of the local Asian community that was their “purpose” for being there.

This is what not asking directly for what you need leads to – it leads to significant misperceptions. It leads to incorrect assumptions about your friends’ or co-workers’ intentions and motivations. And these can lead to anger, frustration, disunity, and a complete breakdown of the relationship. It also can lead to a whole lot of sideways talking – which is never productive.

Just Ask
After a couple of years of feeling this way (yes, years I’m ashamed to say) and a whole lot of prayer, God graciously intervened in my situation. One of the group leaders and I ended up attending the same conference outside of our city. For four glorious days we lived in the same hostel room, ate together, walked miles of that city together, and talked non-stop.
Late one evening we sat on the filthy carpet outside our hostel door. (It is common in the areas I lived in to not use vacuums. To attempt to clean them, carpets are mopped…but these are the same mops used to mop the bathrooms.) We talked for hours on that carpet, and I shared my heart. I told this kind and amazing woman that, although I was thankful that they had allowed me into their fellowship, I still felt like an outsider. After years of spending every Sunday with them that at the end of the day, if a pipe burst in my apartment and flooded the place, I’d still end up mopping my floors alone. I told her that I needed to be seen as more than just someone who was capable to contribute on a Sunday morning, but that I needed to be included into the lives of the members.

Things began to change. It wasn’t instantaneous – but this woman graciously and lovingly heard my need and began promoting small changes. Instead of that organization going on a picnic and leaving me out, they turned it into a Sunday Group picnic and invited me along. Instead of spending Sunday morning time discussing team business that left me out of the conversation, they saved those discussions for their team meetings.

Now, granted, things could have gone very differently. I could have stated what I needed, been vulnerable and transparent, and been horrifically rejected. But that too would have brought about a kind of closure. I would have seen that perhaps it was time to find a different Sunday fellowship. I’m thankful that’s not how the story went, but regardless the lesson I learned through it all was to honestly and candidly ask for what I need.

Ask for what you need titles
I think about this in regards to the parents I work with and the children I treat. Do parents feel supported? Do mothers feel loved on and fathers feel respected? Do they feel listened to? Have I created space for parents to ask for what they need?  Have I created space for my co-workers to ask for what they need?

That’s my encouragement to parents. Ask. Don’t demand. Don’t sideways talk. Just ask. And if you ask one place and you get a no, don’t let it rattle you. I cannot tell you how many times I have asked and been brushed off. Give that person the benefit of the doubt – maybe they’re having a bad day, maybe they are going through something really hard, maybe there’s really no way they can make it work. So move on and ask someone else.
  • Do you need to spend 15 minutes of a treatment session talking with your child’s therapist to brainstorm some suggestions? Then ask.
  • Do you wish your child could go to this or that camp/summer activity but you assume there’s no accommodation for that? Call them up and ask.
  • Need prayers? Ask.
  • Need a hug? Ask.
  • Need someone to listen? Ask.
And in the same breath, let’s work together to teach your children healthy ways to ask for what they need. Let’s work together to teach them that it’s safe and strong to ask. If they’ve had a hard day at school, let’s teach them that it’s courageous to say, “I felt dumb today. Can you remind me that I’m not?” Let’s teach them that it’s mature and wise to say, “I need to talk to you. I want to tell you something from my heart. I want to tell you how I’m feeling.”
Asking can be scary and vulnerable.  But the result of asking can be amazing. And the result of not asking can be destructive. So let’s work together and learn to ask.

About the Author
AmandaWherryThumbAmanda 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