The More the Merrier- Why Having a Fieldwork Student is Beneficial for Your Child

NSPT strongly believes in taking on new fieldwork students in order to create a great learning environment for both the therapists and the families.  As a parent, you may be asking, “what’s in this process for me”?  Here is a list of 5 examples why having a fieldwork student working beside your child’s therapist serves as such a wonderful growth opportunity for everyone involved. Pediatric therapist smiling

  1. New knowledge:  Oftentimes, new editions of textbooks come out each year, which include new case studies and updated information.  When a student comes in, she is able to share this current knowledge, and apply it to the therapist’s caseload as appropriate.  Similarly, a student usually subscribes to research-based articles through her school, which can be a great resource for families (e.g. OT Practice Magazine; ASHA).
  2. Flexibility:  Having a fieldwork student helps your child work on his flexibility skills as he has to build a relationship with a new person, follow a new set of directions, and possibly follow a new layout for the treatment session.  Flexibility is an important life-long skill, as things won’t always go as your child  hopes or plans, and it is crucial to be able to work through these situations and say “no big deal”.
  3. Extra set of hands and eyes:  When an extra body is present, this allows for an extra set of hands and eyes to watch how the child moves around and interacts with the environment.   Having a student typically helps the child’s therapist try new equipment and/or more complicated treatment activities that she might not otherwise be able to use (e.g. the rainbow swing- one person needs to open up the swing, and one person needs to lift the child onto the swing).
  4. Fresh perspective on treatment ideas:  As a fieldwork supervisor, the therapist tries to challenge the fieldwork student to bring in new creative treatment ideas to the child’s therapy sessions each week.  This helps the child work through novel tasks and demands, and it also puts a new spin on how to help the child work towards his current goals.
  5. Extra practice for social skills:  Having a fieldwork student means that your child will have a new person to meet and greet.  This will help your child continue to work on eye contact, manners (e.g. shaking hands), and turn-taking (e.g. during games or when creating a plan/schedule for the session).

There are many benefits that come from allowing a student to complete her fieldwork rotation at NSPT, both for the clinicians and the clients.  A student can bring a new perspective to the table, and can offer new creative strategies  to help the child best reach his goals.

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If you have any questions or concerns regarding the process of taking on a fieldwork student, please feel free to reach out to your child’s current therapist, or contact anyone on our NSPT team.

Farmer’s Markets in the North Shore

It’s farmer’s market season! If you have ever tried farm-fresh fruits and vegetables, you know that you can taste the difference between them and those that are frozen, canned, or even sitting on produce stands in the grocery store. Going to a farmer’s market is a fun family activity that provides kids with a different way to experience fresh food. Often, farmer’s markets will have live music, arts and crafts, and of course, lots of tasty food to sample.

Mother at a Farmers Market location

I am often surprised at how affordable produce is at farmer’s markets. Taking just $20 out of the weekly food budget will buy a sack full of fruits and vegetables. My toddler loves coming to the farmer’s market with me. She can’t believe all the colorful fruits and vegetables within her reach.  I always let her choose one piece of fruit to munch on as we stroll along. I think there is something fascinating to kids about seeing all of that food outside on display under the sun, with so many people and kids and pets everywhere at the same time. It is really a great opportunity to get kids interested in fresh fruits and vegetables. The other perks are supporting local farmers, enjoying the community, and spending time having a healthy family outing.

Kids can learn so much about food and where it really comes from at a farmer’s market. I will never forget speaking to elementary schools with a basket of vegetables and quizzing kids on each one. Believe it or not, the kids often could not correctly identify a tomato, cauliflower, eggplant, and most surprisingly, a whole carrot with its leafy top. I realized that in today’s world, kids identify carrots as the little 2-inch long oblong orange things in a baggie. And they see tomatoes as ketchup or pizza sauce. And some never see cauliflower or eggplant at all.

Kids will grow up eating the kinds of foods they are exposed to and offered regularly. It is your choice as a parent what foods your kids are exposed to while they are in your care. Make trips to the farmer’s market a part of your summer routine. Maybe by fall, your kid will be asking for you to pack those fruits and veggies in their school lunch!

Some Farmer’s Markets in the North Shore Area:

Deerfield Farmer’s Market. Saturdays 7AM-12:30PM at Deerfield Road and Robert York Avenue.
Evanston Farmer’s Market. Saturdays 7:30AM-1PM at University Place and Oak Avenue.
Glenview Farmer’s Market. Saturdays 8AM-12PM at Wagner Farm, 1510 Wagner Road (Opens June 23rd).
Northfield Farmer’s Market. Saturdays 7:30AM-12PM on Happ Road across from New Trier’s freshman campus.
Ravinia Farmer’s Market. Wednesdays 7AM-1PM on Dean Avenue between Roger Williams and St. James Avenue.
Wilmette French Market. Saturdays 8AM-1PM at the Village Center.

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All About Voice

With summer around the corner, I thought it would be a great time to remind parents about what it means to have a healthy voice! So many of the activities we choose to do in the warm weather can impact our vocal quality. Let’s start off by reviewing what is involved in having a voice.

How do we produce voice?: A person’s voice is a combination of respiration (i.e. breathing in and out) and phonation (i.e. making sound).

Two birds singingLet’s break it down even more! 
Respiration: Respiration involves taking the air in and out of your lungs. As the air travels from the lungs to the mouth, it passes the vocal cords (composed of both tissues and muscles). The vocal cords vibrate and this is called PHONATION!
Phonation: The sound that you hear when a person talks or sings.

Ways to maintain a healthy voice:

  1. Avoid talking in a funny voice – i.e. robot or monster voice
  2. Drink lots of water every day
  3. Avoid caffeine (e.g. pop, tea and coffee)
  4. Avoid clearing your throat or coughing
  5. Avoid yelling and screaming
  6. Avoid smoking and/or smoking environments
  7. Get plenty of rest!

Poor voice development can result from:

  1. Too much screaming, yelling, crying or laughing
  2. Excessive coughing and/or throat clearing
  3. Excessive loud talking and muscle tension
  4. Poor hydration

Warning signs of an unhealthy voice:

  1. Harsh or raspy voice
  2. Breathy voice
  3. Neck pain
  4. Body and voice fatigue

If you are concerned with your child’s voice, it’s important to talk to an Ear, Nose and Throat Specialist (ENT). They can use a special instrument to look at your child’s vocal cords. He/she may then recommend contacting a speech-language pathologist, who can complete a thorough voice evaluation and begin speech-language therapy.

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Healthy Supermarket Shopping for Your Family

The first step to having a healthy diet for your family happens when you make a trip to the grocery store. Choosing what foods you put in the cart actually determines your child’s health, in a lot of ways.

Here are some tips to make grocery trips a healthy success

Make a habit and priority of going to the grocery store at least once a week.
This sounds basic, but what happens when you are low on food in the house? Often this means picking up fast food, random snacks, or making a meal out of chips. Also, cooking food at home is key to a healthy lifestyle. Research supports this, and also shows that families who eat together eat more fruits and vegetables. It’s also wonderful family bonding time and a place for kids to learn healthy eating habits from their parents

Here is a basic list of foods to get weekly for the family

  • Meats, beans, tofu, or seafood for main dishes
  • A variety of fresh fruit for side dishes and snacks, frozen fruit for smoothies, and/or dried fruit for snack.Mother shops for food with child at the supermarket
  • Vegetables to eat raw, like salad greens, carrots, tomatoes, celery. Vegetables to eat cooked like potatoes, onions, garlic, brussell sprouts, zucchini, squash, peas, green beans, broccoli, cauliflower.
  • Eggs (if your family eats them), for breakfast or to cook with.
  • Milk or milk alternative.
  • Cereal and/or oatmeal.
  • A jar of nut butter.
  • “Flavoring and cooking” items like sauces, dressings, olives, seasonings, cheese, olive oil, etc.
  • Whole grain bread.
  • Whole grain side dishes like pasta, quinoa, or brown rice.
  • The rest of your list can be the specialty items needed for new recipes or specific meals.
Make a list based on healthy recipes.

Keep a pen and paper handy for an ongoing list for the next grocery trip. That way if you come across a good recipe in a magazine or online, you can write down the ingredients needed. Some people find it helpful to create a “menu” plan for the week for dinners, and use new recipes throughout the week. A list keeps you focused and organized while you are in the store.

Be sure to gather plenty from the perimeter of the grocery store.

Picture a typical grocery store in your mind and how it is set up. The middle aisles draw you in, but what do you find there? What do you find when you walk the perimeter of the store? It is not random that most grocery stores are set up this way. The middle aisles draw you in, but mostly are filled with processed foods. The outer part of the store is where many whole foods are:  fruits, vegetables, meat and seafood. Don’t skip the produce section.

Organic or on sale? Reduced fat or regular? Local or best buy? 

There are many side by side options of every food product out there, making a grocery trip feel like a “Where’s Waldo” experience. My choice is to buy organic and local as much as possible. Reduced fat or regular depends on what you and your family needs as part of a healthy diet. I choose regular, as many reduced fat foods are loaded with sugar or other chemicals in place of the reduced fat.

Let the kids pick!

If you’re brave enough to bring the kids along to the grocery store (or maybe you don’t have a choice), let them pick from healthy options you have preselected. For example, give them a few breakfast cereal options and let them pick which one they want. Or bring them to the produce section and let them pick one fruit and vegetable each. This gets kids engaged in healthy eating, and if they picked it, they are more likely to be excited about eating it.

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Homework Station Planning | Pediatric Therapy Tv

In today’s Webisode, a pediatric occupational therapist explains techniques on how to setup the ideal homework environment for your child.  She will cover various techniques that will help kids to enhance their homework corner at home.

In this video you will learn:

  • What setup will help the child to concentrate better when doing homework
  • What materials to use to setup the homework station
  • Long term setup for the child when doing homework

Video Transcription:

Announcer: From Chicago’s leading experts in pediatrics to a worldwide
audience, this is Pediatric Therapy TV, where we provide experience and
innovation to maximize your child’s potential. Now your host, here’s Robyn.

Robyn: Hello and welcome to Pediatric Therapy TV. I’m your host, Robyn

Today I’m standing with Lindsey Miller, a pediatric occupational
therapist. Lindsey is going to show us exactly what a homework
station should look like. Lindsey?

Lindsey: Today I’m going to show you what a homework station should look
like that will maximize your child’s ability to complete their

The first thing to keep in mind with a homework station is that
ideally you want it to be in a separate location from their
bedroom and from other things going on in the house so that they
know that when they go to this place, that’s where I do my

Another thing to keep in mind is the location of the desk. It
would be best if it was up against a blank wall so that there
are no visual distractions, no pictures or clutter so it can
allow them to really focus on what they’re doing.

Another consideration is the actual layout of the desk. You want
them to have just their homework and a pencil on the desk and
nothing else. We want to decrease the clutter so that they can
focus on what they’re doing. It’s also a good idea for them to
have their backpack nearby so if they need anything from their
backpack they can just grab it and use it right away rather than
getting up from their chair and going to a different room to
find other items they may need. Also, if your desk has drawers
it’s a good idea to put all of the materials that they may need
in the drawers, such as a calculator, a ruler, extra paper,
markers and things like that so everything is in one location.

They can also use a move-and-sit disc. This is just a circular
disc that they can sit in on their chair. It allows them to
wiggle around in their chair so if the child likes to move
around a lot they won’t have to get up and move around. They can
just sit in their chair and wiggle around. Also, when they’re
sitting it’s a good idea for them to sit with their hips, knees,
and elbows at a 90 degree angle because this will help them
write better, more efficiently, and a little bit easier.

Another thing to keep in mind is good lighting. You want them to
be in a room with good lighting so they can see what they’re
doing. If your child gets very distracted by noises, sometimes
it’s a good idea to use headphones that cover their ears and
play some calming music that will help them focus on their

Robyn: Thank you, Lindsey, and thank you to our viewers for watching.
And remember, keep on blossoming.

Announcer: This has been Pediatric Therapy TV, where we bring peace of
mind to your family with the best in educational programming. To
subscribe to our broadcast, read our blogs, or learn more, visit
our website at That’s

Oppositional Defiant Disorder

Behavior problems in children are nothing new. Many children present with concerns regarding oppositional and defiant behavior. In fact, studies have indicated that the highest rates of referral for mental health services for children involve aggression, acting-out, and disruptive behavior patterns (Achenbach & Howell, 1993). Oppositional Defiant DisorderAggressive child (ODD) is a diagnostic condition that focuses on a pattern of negative, hostile, and defiant behaviors lasting at least six months. The Diagnostic Statistical Manual, Fourth Edition, Text Revised (American Psychiatric Association, 2000) indicates that four or more of the following behaviors must be present in the child to make the diagnosis: often loses temper, often argues with adults, often actively defies or refuses to comply with adult’s requests, often deliberately annoys others, often blames others for his or her own mistakes or misbehaviors, is often touchy or easily annoyed by others, is often angry or resentful, and/or is often spiteful or vindictive.

ODD is believed to be a fairly common disorder in children.  The condition is thought to occur in 5-16% of children under 18 years old (Burke, 2002). The majority of children who exhibit ODD show signs of behavioral dyscontrol prior to their ninth birthday. The condition is more common in boys than girls before puberty; however, it is thought that the rates are equivalent for children after puberty. Boys are more likely to engage in ‘direct aggression,’ in which the child actively engages in verbal or physical aggression towards another child. Girls, by contrast, are more likely to engage in ‘indirect aggression,’ in which third parties are used to get even (e.g. spreading rumors) (Hinshaw & Anderson, 1996). ODD is thought to highly co-exist with other mental health conditions including ADHD, Mood Disorders, and Learning Disorders. Thus, a comprehensive evaluation is often warranted for children who exhibit behavioral problems in order to ensure that the most appropriate intervention is applied.

The treatment of ODD focuses on behavior management. Behavioral therapy focuses on working not only with the child who exhibits the behavioral concerns, but also with parents and teachers, to help create appropriate behavioral reinforcement schedules across all environments. In addition, pharmacological intervention might be implemented for children who demonstrate co-existing ADHD, or academic tutoring might be in place for those with significant learning disorders.

In summary, ODD is a fairly common disorder of behavioral dysregulation in childhood. It is a condition that often presents simultaneously with other conditions, and as a result a comprehensive evaluation is often recommended to determine whether or not the child also has these conditions. Additionally, the treatment of choice is behavioral therapy, in which a therapist works with the child, parents, and teachers to discuss methods of increasing the frequency of positive behaviors while extinguishing the negative oppositional and defiant behaviors.

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Low Muscle Tone Signs To Look Out For in Your Child | Pediatric Therapy Tv

In today’s Webisode, a Pediatric Occupational Therapist explains different ways to determine how your child may have a low muscle tone and what you can do once you figure out the symptoms.

In this video you will learn:

  • The meaning of muscle tone
  • How you can determine if your child  has low muscle tone
  • What to do when discovering the symptoms of low muscle tone

Video Transcription:

Announcer: From Chicago’s leading experts in pediatrics to a worldwide
audience, this is Pediatric Therapy TV, where we provide experience and
innovation to maximize your child’s potential. Now your host, here’s Robyn.

Robyn: Hello and welcome to Pediatric Therapy TV. I’m your host, Robyn
Ackerman. Today I’m standing here with Pediatric Occupational
Therapist Dana Pais.

Dana, can you tell us what are some signs to identify a child
who may have low muscle tone?

Dana: Muscle tone refers to the muscle’s ability to sustain a contraction.
It’s different than strength, which refers to the muscle’s
power. To identify a child who has low muscle tone, you may see
them do things such as slouching when they’re sitting in a
chair, or having difficulty holding their head upright when
seated at a desk. You may see them prop their head on their
hands or lay their head down on the desk.

You may also see a child have difficulty sitting for extended
periods of time, particularly without back support, and you may
also see them sitting in the ‘W’ position when they’re on the
floor, which is when their legs are splayed out to the side in
the shape of a ‘W’.

You can’t actually change muscle tone, but what you can do is
strengthen the muscles around the joints so that it can help
compensate, and then the child can complete their daily tasks.

Robyn: All right. Thank you so much, Dana, and thank you to our
viewers. And remember, keep on blossoming.

Announcer: This has been Pediatric Therapy TV, where we bring peace of
mind to your family with the best in educational programming. To
subscribe to our broadcast, read our blogs, or learn more, visit
our website at That’s

Home Activities for Articulation Therapy

The more you practice a movement, the stronger your muscle memory gets, until the movement becomes habitual. This concept applies to both gross and fine motor movements as well as to the movement of the articulators: the jaw, tongue, and lips. If a child focuses on practicing speech sounds once a week, they will progress. However, if the target sound is practiced every day, the child will demonstrate even faster progress.Father communicating with child

Think of doing a jumping jack. We all learned that jumping jacks are done by jumping up and spreading your legs apart horizontally while clapping your hands above your head. Now try doing a jumping jack by jumping up and spreading your legs front/back while clapping your hands above your head. (Caution: you may feel very uncoordinated!) It may be difficult at first, but after doing it a few times, the movement becomes easier. Because you were taught the traditional way of doing a jumping jack, trying to do it another way is difficult. Keep this demonstration in mind as your child similarly tries to re-learn how to pronounce their target sound.

Tips for carry-over activities at home

  1. Repetition: make it a point to set up times throughout the day to practice target sounds (For example, driving home from school or before you brush your teeth).
  2. Encouragement: I see children that try their very best and still just can’t quite get the sound right. Offer positive encouragement and only prompt the child to pronounce the target word/sound three times before moving on to the next item.
  3. Acknowledgement:  Mention that you know the child is doing their best and recognize how challenging this is for them.


Oftentimes, playgrounds are overlooked as just places where children can run around and  burn some energy. While this is true, playgrounds are also a great environment to practice your child’s gross motor skills, such as balance, trunk control, motor planning, bilateral skills, hand-eye coordination, and strength. Below are several ways to use various pieces of equipment at your local playground to improve your child’s motor skills. Feel free to let your imagination run wild!

Here are 8 tips for motor skill activities at the park:

  • Monkey bars: challenge your child to hang from the monkey bars for as long as he can. This will help develop his hand strength, upper body strength, and endurance. Similarly, have your child practice chin-ups or pull-ups on the monkey bars. Your child can also practice crossing the monkey bars by placing both hands onto the same bar or alternating hands (one on each bar).Child is rolling down a slide
  • Prone down slide: have your child ride down a slide on his stomach like Superman (head first, with arms and legs extended). Once your child reaches the bottom of the slide, help your child wheelbarrow walk across the playground, as he will already be in the correct position (support your child at his ankles, knees, or hips, depending on his skill level).
  • Zip line: when crossing the zip line, instruct your child to lift his knees towards his chest the entire way. This will help develop his core muscles, along with his motor planning and upper body strength.
  • Rock climbing wall: choose which color of rock your child is or is not allowed to use to help him get up the wall (e.g. do not use the blue rocks). Rock climbing addresses upper body strength, bilateral skills, trunk control, motor planning, and problem solving.
  • Fireman pole: challenge your child to climb up the fireman’s pole as high as he can, with the goal of reaching all the way up to the platform. This will help increase his upper body strength, bilateral skills, and motor planning.
  • Pull-up bar: have your child hang upside down on the pull-up bar (with legs hanging over the bar, and head inverted). This will address his vestibular system, as his head will be tipped out of its normal alignment, changing the position of his ear canals (e.g. going on a roller coaster). The vestibular system is important for balance and body awareness.
  • Lily pads: work on your child’s opposition by challenging him to step onto the lily pad with one foot and the opposite arm (e.g. step with right foot, grab with left arm), then switch. Opposition is needed for ball skills used in sports such as baseball and soccer. This activity will also help address his balance and motor planning.
  • Tunnels: have your child army crawl through the tunnel (on his belly, propped up on elbows/forearms, and using upper body to propel self forward). This will address motor planning, upper body strength, and trunk control. Similarly, if the tunnel is large enough, challenge your child to complete different animal walks through the tunnel (e.g. crab walk, seal walk).

Note: Make sure to monitor your child during the above activities to keep him safe, along with  others at the park. Stay tuned for my next blog on ways to work on social skills at the park.

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