Epilepsy brain

Diagnosing and Treating Epilepsy

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Epilepsy is diagnosed when the child experiences two or more seizures with no known cause (e.g. no significant illness, no known fever, or no known physical hit to the head).  Epilepsy is fairly common and it is estimated that 1 in 26 individuals will develop epilepsy over their lifetime (Epilepsy Foundation of America, 2014).

Seizure activity is typically identified by characteristics of an electroencephalogram (EEG).  An EEG is when the individual has several electrodes placed on their head which measures electrical activity.  Seizures are identified by having sudden changes in electrical activity in either the entire brain or specific regions.

There are two main types of seizures with several subtypes underneath them.  Generalized seizures are when there are abnormal
findings on an EEG in all parts of the brain at the same time.  Children who exhibit generalized seizures will lose consciousness.  Partial seizures are when there is limited EEG findings to only one single area in the brain.  Children with partial seizures typically do not lose consciousness.

Epilepsy brainThe usual front line treatment of epilepsy is pharmacological intervention.  Some children do not respond to the anti-epileptic medications and may require surgery to help address seizure activity.

There are numerous cognitive and academic concerns associated with epilepsy.  There is some indication that IQ can be effected by seizure activity.  It is hard to classify specifically what effect there might be with IQ as research has indicated that seizure location as well as age of onset of seizure activity have a major impact on changes in IQ.  Studies have indicated that memory, attention, and executive functioning are often impacted by seizures.  Research has also indicated that children with epilepsy have a much higher rate of special education services for learning issues in the school setting.

It is important that if a child has epilepsy, a comprehensive evaluation be conducted in order to monitor IQ, academic achievement, attention, executive functioning, and memory in order to ensure that he or she is receiving the most efficacious interventions in the classroom setting.
Yeates, Ris, Taylor, & Pennington (2010), Pediatric Neuropsychology: research, theory, and practice

Hunter & Donders (2007), Pediatric Neuropsychology Intervention

What is Co-Treating?

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You may have heard your therapist say, “I think a co-treat would be a great option for your child!” But what does that really entail? Will your child still be getting a full treatment session? Will his current and most important goals be worked on? Will he benefit as much as a one-on-one session? When a co-treatment session is appropriate, the answer to all of those questions is…YES!

What is a co-treatment session?

Co-treatment sessions are when two therapists from different disciplines (Speech Therapy (SLP), Occupational Therapy (OT), Physical Therapy (PT), etc.) work together with your child to maximize therapeutic goals and progress.

When is a co-treatment session appropriate?

When the two disciplines share complimentary or similar goals.

EXAMPLE: Maintaining attention to task, executive functioning, pragmatics, etc. Playing a game where the child needs to interact with and attend to multiple people while sitting on a stability ball for balance. [all disciplines]
*When children have difficulty sustaining attention and arousal needed to participate in back-to-back therapy sessions.
EXAMPLE: Working on endurance/strength/coordination while simultaneously addressing language skills. Obstacle courses through the gym while working on verbal sequencing and following directions. [SLP + PT or OT]
*When activities within the co-treatment session can address goals of both disciplines.
EXAMPLE: Art projects can address fine motor functioning as well as language tasks like sequencing, verbal reasoning, and categorizing.
*When a child needs motivations or distractions. [OT + SLP]
EXAMPLE: Research has shown that physical activity increases expressive output. Playing catch while naming items in category or earning “tickets” for the swing by practicing speech sounds.  [PT or OT + SLP]
EXAMPLE: PT’s need distraction for some of their little clients who are working on standing or walking and working on language through play during these activities works well. [PT + SLP]

Why co-treat?

  • Allows therapists to create cohesive treatment plans that work towards both discipline’s goal in a shorter amount of time.
  • Allows for therapists to use similar strategies to encourage participation and good behavior in their one-on-one sessions with the child.
  • Allows for therapists to collaborate and discuss the child’s goals, treatment, and progress throughout the therapy process. Together, they can consistently update and generate plans and goals as the child succeeds.
  • Aids in generalization of skills to different environments, contexts, and communication partners.
  • Allows for problem-solving to take place in the moment. For example, an extra set of hands to teach or demonstrate a skill or utilizing a strategy to address a negative behavior.

Co-treatments sessions can be extremely beneficial for a child. There are endless ways therapists can work together to promote progress and success towards a child’s therapeutic goals.. However, co-treatments may not always be appropriate and are only done when the decision to do so is made collaboratively with the therapists and the parents.

Contact us for more information on the benefits of co-treating in therapy sessions.

Learning Disabilities Demystified

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Learning concerns are one of the most common neurological issues with which children and adolescents present.  It has been estimated that approximately six percent of the general population meet the clinical criteria for a diagnosis of a learning disability.  The Diagnostic and Statistical Manual, Fifth Edition (American Psychiatric Association, 2013), which is the guide book for psychologists and psychiatrists that provides information regarding diagnostic information, indicates that there are several essential features of specific learning disabilities in children.

5 Features of Learning Disabilities in Children:

  1. Persistent difficulties learning basic foundational academic skills with onset during the early elementary years.  The manual indicates that these foundation academic skills include: reading of single words accurately and fluently, reading comprehension, written expression and spelling, arithmetic computation, and mathematical reasoning.
  2. A child’s performance is well below average for his or her age.
  3. Learning difficulties are readily apparent in the early school years in most individuals.  That being said, there are some instances in which the concerns are not fully evident until later in the individual’s academic life.
  4. The learning disorder is specific in that it is not attributed to other factors such as intellectual disability, socio-economic status, medical conditions, or environmental factors.
  5. The deficit may be restricted only one academic skill or domain.

Prior studies have indicated that learning disorders are more common in males than females.  There are several long-term consequences associated with learning disorders in which the individual never receives any intervention, including:  lower academic achievement, higher rates of high school dropout, higher levels of psychological distress, higher rates of unemployment, and lower incomes.
Data has indicated that children with learning disabilities are often at risk for a variety of co-existing conditions including ADHD and social-emotional concerns.  Click here for more information on learning disabilities.


How Does Occupational Therapy Help with ADHD?

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It has been well documented that children with ADHD often struggle with maintaining focus in various areas of their day to day lives and consequently achieving their full potential. As Dr. Greg Stasi explains in his June blog, ADHD and Learning: Attention Deficit Hyperactivity Disorder’s Impact on Learning, children with ADHD often exhibit impulsivity or hyperactivity, difficulty with following directions, and poor executive functioning skills. The impact of these difficulties can be extensive on a child’s success in school, relationships, and overall self esteem.

How does occupational therapy help a child with ADHD?

Occupational therapists often work with children to help them develop self-regulation and executive functioning skills. By teaching children strategies to address these challenging areas, we empower them to become more independent and self assured by targeting two important areas: Read more

What to Do When a Teacher Notices Concerns About Your Child

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With the new school year well underway, teachers are beginning to gain information regarding their student’s areas of strength and weakness.  Many times teachers are hesitant to bring up concerns to parents.  Also, many parents will want to take a ‘wait and see’ approach in order to help determine whether or not these areas of concern will go away on their own.  Our advice to both parents and teachers is this: Do not wait and act now. 

Advice for teachers regarding bringing up student concerns to parents:

  • Collect anecdotal data to reveal the concern to the parents.
  • Provide the parents with the strategies that have already been tried in the classroom.
  • Provide the parents with specifics as to how the behaviors of interest are impacting the child’s learning or social needs.

Advice for parents regarding handling concerns brought up by teachers:

  •  Do not take the concern as an insult about your parenting or your child.
  • Ask the teacher questions about the frequency and duration of the behaviors.  When are they occurring? Read more

5 Tips to Help Your Child with Motor Planning

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Does your child have difficulty learning or doing a new or unfamiliar task? Does he appear clumsy or avoid participating in sports or other physical activities? Does he have trouble coming up with new play ideas or knowing how to play with toys? If this sounds familiar, your child might have difficulty with motor planning.  Motor planning is the ability of the brain to conceive of, organize, and carry out a sequence of unfamiliar actions.  If your child needs help with motor planning, read on for 5 helpful tips.

5 Ways to Help Your Child with Motor Planning:

  1. Do activities that are composed of a series of steps (i.e. making a craft, making a sandwich, or creating an obstacle course).  As you do this, help your child identify, plan, and execute the steps to promote the ability to sequence and map actions. Break down the steps to make them more manageable and attainable, which can build self-esteem.
  2.  Determine what aspects of motor planning are a strength for your child (e.g. imitation, following verbal directions, timing, sequencing, coming up with ideas).  Play to these strengths when doing activities with your child to compensate for the areas of difficulty.
  3. Engage your child in activities that involve climbing over, under and around large objects.  For example, playing on playground equipment or coming up with obstacle courses will help your child gain basic knowledge of how to move his body through space.
  4. Encourage your child to come up with an idea for a new activity, or a new way to play with a toy or equipment, to promote motor planning. Read more

Strategies to Help Your Teen Make Good Decisions

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The teenage years are marked with new experiences.  Teenagers want to be independent and are drawn to exciting, new opportunities.  During this time period, chemical changes in the brain also motivate teens to seek out risky behavior.  What can parents do, then, to help their teens learn to exercise good judgment despite the internal and external motivators they have to make poor choices?

Strategies parents can use to help teenagers make good decisions:

  1. Help your teen to take positive risks.  For example, encourage your teen to try out for a new sport, visit a new place, or make new friends.  This will help instill confidence and self control in your teen.  It will also satisfy your teen’s quest for new or exciting things. Read more

Create a ‘Fidget’ to Help Your Child Focus This School Year

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Markers. Crayons. Pencils. Book-bag. Pens. Glue. Ruler. Scissors. Calculator. Folders. Tennis Shoes. 3-Ring Binder. Notebooks. Etc. The “Back-to-School Checklist” seems to grow longer and longer each year. However, there is one useful item that often does not appear on this list which can help your child to stay focused throughout the ups and downs of the school day.   This item is known as a fidget.

As your child picks, pushes and squeezes his fidget, it will be provide his fingers, hands, and wrists with proprioceptive input. This input is extremely regulating for a lot of children, which can help them to stay focused during class.  Read on for simple instructions to make your own fidget at home.

Simple instructions to make your very own fidget:

  1. Encourage your child to choose his favorite colored balloon.
  2. Use a funnel to fill the balloon with rice or sand so that it is about the size of a baseball.
  3. Tie the balloon’s end into a knot.
  4. With markers, encourage your child to decorate his new fidget as desired. Read more

Helping Your Client to Optimally Attend: Advice for Pediatric Therapists

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“Show me you’re ready!” As a Pediatric Occupational Therapist, I can’t even begin to guess how many times this utterance is repeatedchild attending throughout my day in the therapy gym. While I’m sure that my clients think I sound like a broken record, the bottom line is that if they’re not ready to pay attention, they’re not going to learn what I’m teaching.  What does it look like when a client is ready to attend?  Here are three important ways for young clients to show you, their therapist, they are ready to work and learn.

Three Tips to Gain Maximum Attention from Pediatric Therapy Clients:

  1. Ready Body: The body is still and facing the person who is speaking. It is not jumping, running, or facing other areas of the room. Read more

Q and A: Gender Differences in ADHD

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Recently we highlighted a study that suggested that diagnosis rates of ADHD differed in children of different races.  Today’s blog points out the differences in symptoms and diagnosis rates between genders. ADHD

Now, more than ever, researchers are uncovering tangible evidence to explain the differences in Attention Deficit Hyperactivity Disorder (ADHD) symptoms among boys and girls.  With accumulating data, we are better equipped to understand the neurobiology of these developing boys and girls, refine assessment, and focus on treatment.

Q & A | Gender Differences in ADHD:

Q: Are boys, in fact, more likely to have ADHD? 

A: The ratio of ADHD in boys to girls is relatively equal, with reliable reports ranging between 2:1 (CDC, 2011) and 1:1 (Froehlich, 2007).  To no surprise, however, boys continue to be disproportionately diagnosed at higher rates than girls (Bruchmuller, Margraf, & Schneider, 2011), likely due to their tendency to display more disruptive behaviors. Read more