Where To Go If Your Child Has Been Misdiagnosed

Parents come to professionals in order to ascertain what is going on with their child.  As a neuropsychologist, the two most common questions I hearmother upset with child are:What is wrong with my child? And How do I fix it?  

A diagnosis will help clarify the symptom characteristics that the child exhibits which in turn will lead to developing the most effective interventions and accommodations for that child within the home, school, and private clinic settings.

Many times parents question the appropriateness of a diagnosis that was given to their child.  It is important to understand that there are several factors that can lead a clinician towards an inappropriate diagnosis or a diagnosis that is not the best fitting based upon the child’s symptom characteristics.

How Assessments Are Conducted:

An evaluation constitutes several hours out of one day of your child’s life.  Many factors impact the child’s performance during the testing, including;

  • Lack of appropriate sleep the night before
  • Being hungry during the evaluation
  • Anxiety over the testing situation

How many of those factors contributed to the diagnosis that was handed to the child?  Second, did the diagnostician receive or ascertain all appropriate information.  Did that individual receive information from the school, past medical records, detailed information regarding the child’s early development?  You are your child’s best advocate.  As much as any diagnostician may know about the responses on the testing, the response to the testing as well as explanations for the testing has to gel with you.  If you are uncomfortable with a diagnosis, ask questions.  Explain to the diagnostician that the behaviors that were observed are not consistent with what is observed on a daily basis.  Work as a team to figure out what lead to the discrepancy between actual behavior and observed behavior/test scores.

If you do not feel that your questions were answered with a diagnosis or are hesitant to follow through with the interventions that were offered, it is then recommended to seek a second opinion.  Oftentimes a second set of eyes, even in the form of reviewing the report/test performance can help solidify the diagnosis that was given or help establish what additional testing/information would be needed.




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Encouraging Crawling in Babies

There is nothing as heart warming as watching your child crawl across the room to try to pull your grandparents wedding china onto the floor.

baby crawling

Crawling is an important form of movement for infants.  It helps to build a stronger core and begins to introduce weight through the bones of the upper leg to increase bone density.  Crawling is singular in its ability to promote strength and stability of the shoulder and the surrounding muscles (which become important postural muscles once the child is standing) using the child’s own weight.  From a visual standpoint, they begin to hone their ability to maintain a smooth visual field while the head is in motion as well as work on their objects per minutes. Reciprocal crawling also develops the ability to coordinate their right and left sides (bilateral integration).

It is typical for babies to progress from scooting backwards on their belly, “swimming ” (where arms and legs are both moving up off the floor), belly crawling (“army/military crawling”), and then reciprocally crawling on hands and knees.  This sequence cannot begin if they are never on their tummies to play, so the foundation is tons and tons and tons of tummy time.

Attempting to change the movement habits that you little one has, or challenging them to build new habits is not easy.  Yeah, very not easy.  I would encourage you to understand their frustration, empathize with them, but stay the course.  Remind yourself of your own tears every time you try to give up coffee.  Remember how tough it was to begin something you wanted to challenge yourself with, but how rewarding it was when you accomplished your goal.  So there may be some tears (some from the baby), but there should also be plenty of cheers and hugs and kisses.

Try these activities at home to encourage crawling:

1. Strong foundations – Tummy time, tummy time, tummy time. I know I said this above, but it is worth  repeating.
2. Get down and get busy – Lay, roll, and crawl around with your child.  You can make a lot of eye contact, and if you are on the floor your face can still be seen if they need to put their head down to rest, so they may enjoy being on their tummy longer.
3. Get low – If laying next to them is not enough, lay on your back, and place your child on your chest.  This is great for bonding and
4. Born free– Take them out of the exerscaucer or bouncy seat – When children do not have to move to get a toy or look at something new they won’t, which leads me to……
5. Move a toy just out of their reach – Yes, I said that you needed to be mean, and this may lead to screaming. They may just surprise you and themselves by moving towards it.
6. Try a different toy- perhaps with lights and/or music.
7. Try using your phone to motivate them -I have seen this work, just don’t let them put it in their mouth.  Ew!
8. Try changing what they are wearing- Layers of clothing can impede sensory input and get in the way of movement.
9. You are the local expert – If these things do not work, you know what motivates your child, mix it up, and then let me know, I’m running out of ideas.
10. Tummy time -which means getting them out of the bouncy chair/bumbo seat.  Learn more about the importance of Tummy Time from this 2 minute video

How to Use a BOSU for Exercise with Children

BOSU BallA Bosu, also known as a “blue moon” during Occupational Therapy and Physical Therapy, is a great piece of exercise equipment for adults and children alike. A Bosu helps to work on balance, trunk control, strength, endurance, motor planning and body awareness. A Bosu is flat on the bottom and round on the top; and it can be used either with the flat side down on the floor or with the round side on the floor. Even a more simple body position, such as lying in prone (on stomach) over the Bosu, with your hands flat on the floor, and arms and shoulders supporting your body in an extended position, really helps to work on your upper back and neck strength, endurance, and weight bearing through your upper body. Listed below are several activities to try out at home or at the gym; let the workout begin!

Standing Exercises with a Bosu:

The activities below can be used in a standing position on top of the Bosu, either with both feet on the Bosu, or balancing on one leg to really challenge your balance

  • Balloon volleyball: see how long you can keep the balloon in the air before it hits the ground and before you lose your balance
  • Catch: use a variety of size/weighted balls to throw and catch with a partner; by mixing it up, you will more greatly challenge your center of gravity
  • Crossing midline: have game pieces to the right side and left side of the Bosu, have child use opposite arm/hand to pick-up game pieces reaching across their body
  • Inverted bowling: stand with head between legs, using one hand lightly to support self if needed, and using the other hand to toss/roll the ball towards the pins (you could also create your own bowling pins using plastic cups, toilet paper tubes, empty plastic bottles, etc.)

Yoga Poses with a Bosu:

The activities below incorporate traditional yoga poses on top of the Bosu. To start off, try out the yoga pose on the floor next to the Bosu first, and then build-up to maintaining the yoga poses on top of the Bosu once you are ready to challenge yourself. See pictures below for examples of these positions.

  • Boat: Seated on Bosu, lean backwards slightly and lift legs into 90 degree angle, with arms lifted straight in front
  • Plank: Place both hands or both elbows onto the top of the Bosu, tuck toes under and lift back and bottom towards theceiling,keeping your entire body in a straight line like a table
  • 4 point (contralateral limb extension): Place your right knee onto the center of the bosu, and place your left handonto the Bosu for support; then extend your right arm and left leg, keeping your head and neck neutral with your spine **Then make sure to switch sides, placing your left knee onto the center of the Bosu, and using your right hand for support

  • Airplane: Step onto the center of the Bosu with one foot, resting the opposite foot lightly on the floor until you are ready to lift it off the ground behind you; lean slightly forward, bringing arms out to the side like airplane wings, and then slowly lift the leg (resting on the floor) up behind you

Note: Make sure to have adult supervision when trying these activities, as it is easy to lose your balance. Also, it is always a good idea to have mats or pillows nearby, in case you fall. Lastly, ask your occupational therapist or physical therapist if you have any further questions on how to correctly position your body for the exercises above.

 

Good Handwriting | When Should Your Child Develop Writing Skills? | Pediatric Therapy TV

Pediatric Occupational Therapist Gives Our Viewers Age Guides For When Children Should Have Legible Handwriting

In This Video You Will Learn:

  • What age children should have legible handwriting
  • What age they should have their capital letter by
  • What age they should be writing words and sentences

Video Transcript:

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 am your host, Robyn Ackerman. Today I am standing with pediatric occupational therapist Deborah Michael. Deborah, at what age would you say children should have legible handwriting?

Deborah: Children are developing at different speeds and they have different exposure to fine motor play and to handwriting. Definitely, by kindergarten they need to have their capital letters. By the beginning of first grade, they should have their lower case letters. By the end of first grade they should be writing words, and by second grade we want sentences. Now, having legible handwriting does not mean that the actual spelling will be correct. Children use inventive spelling and you need to give them time to get their correct spelling.

Robyn: Great. Thank you, Deborah, 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 LearnMore.me.

The Importance Of Tummy Time For Your Baby | Pediatric Therapy TV

Today we interviewed a Pediatric Physical Therapist on why Tummy Time is so important for the growth and development of babies.

Click Here to read more about Tummy Time

In This Video You Will Learn:

  • The importance of Tummy Time early on
  • The risks of not doing Tummy Time
  • Milestones Tummy Time helps babies reach

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 am Robyn Ackerman, your host. Today I am standing with Bridget Zarling, a pediatric physical therapist. Bridget, can you tell us why tummy time is so important?

Bridgett: Absolutely, Robyn. Starting very early on in a baby’s life, they need to be on their tummy during playtime. What this does is establish strength within the baby’s neck, chest muscles, and arm muscles. If they are not on their tummy time they can have risk for plagiocephaly, which is flattening of the back of their head. Tummy time is also important for developing gross motor milestones in a baby’s life. They learn to crawl, roll, and even sit, the longer that they are on their tummy during playtime.

Robyn: Great. Thank you, Bridget, 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 LearnMore.me. That’s LearnMore.me.

6 Ways Aquatic Therapy Can Help Your Child

Aquatic therapy is a wonderful activity for children and adults of all ages. If your child likes the bath and is motivated by water, aquatic therapy is aqua therapygreat way to build their skills and confidence.

Below are 6 ways that aquatic therapy can help your child reach their full potential:

1. Gains in range of motion:

After an injury, such as a broken leg or an ankle sprain, joint movement is often limited by swelling or decreased strength to muscles. Aquatic therapy pools are generally set to a comfortable 80-90 degrees, which is warmer then a normal pool. Using the warm temperature of the water, joints will be able to be more flexible and stretch to new limits.

2. Increased strength:

Once proper range of motion is achieved at a joint, proper strengthening is needed in order for the muscle to perform well at its new length. Using the principle of resistance, muscles are able to gain strength by performing simple actions in the water, such as lifting a leg to the side of the body.

3. Achievement of gross motor milestones:

Children have an easier time completing gross motor milestones, such as rolling, walking and jumping in the water secondary to buoyancy principles. For example, a child with cerebral palsy may learn to roll in the water with the assist of a therapist and the buoyancy of the water. Once the nervous and musculoskeletal system in the child’s body learn how to roll in the water, it will be easier to learn on a mat table in the clinic and then transfer to rolling in bed at home.

4. Increased tactile input:

For kids with sensory processing disorders, the water can provide the deep pressure input that they crave. This deep pressure and overall increased tactile input will help a child who has difficulty processing sensory input transfer into a more organized, calm child.

5. Helps with breath support:

For kids with speech issues, aquatic therapy can be very helpful. By using techniques such as holding their breath under water, deep breathing and by raising their arms up and bringing them down with the resistance of water can all help with proper breath support for speaking.

6. Better social interaction:

Completing gross motor activities can often help to decrease social anxiety. Often times, jumping into the water or swimming across the length of the pool can encourage speaking in children who have anxiety. Kids can also learn a swimming stroke from watching each other, share toys and participate in fun games together in the pool setting.

Aquatic therapy can be a great way to help your child reach their full potential. Not only can it help with gross motor skills, but can also help with speech and social interaction. So, if your child is motivated by the water, encourage them to jump on in!

Have aquatic games you would like to share? Leave us a comment and let us know!

OT Skill Olympics | Fine and Gross Motor Skill Building Games

Children love games and competition, and parents love when their children are active and engaged with their siblings and friends. What better way to combine social skills, turn-taking, and fine and gross motor skills than with new creative activities? Below are a few new ideas to try incorporating with your family before the summer is over. Who will win the “gold” wheelbarrow racemedal at your OT Skill Olympics?

These activities help to address several occupational therapy skills, such as: motor planning, body awareness, hand-eye coordination, trunk control, grasping, and balance.

1. Dizzy bat baseball: The batter-up places his forehead onto the baseball bat and spins around in circles with the baseball bat on the ground and hands wrapped around the neck of the bat (approximately 10 spins). After the batter is done spinning, the pitcher pitches the ball like in a typical baseball game, and the batter runs his bases.

The challenge: to maintain balance and eye-hand coordination after making yourself dizzy!

2. Ping-pong ball races: Each player has a spoon and a ping-pong ball. They players can create many variations. For instance, players could walk across a balance beam while holding the spoon/ping-pong ball; set-up several cones or markers, and weave between the cones; or skip/gallop/bunny hop from one end of the room to the other while holding the spoon/ping-pong ball. The players could race one another or time one another using a stop watch.

The challenge: to keep the ping-pong ball on top of the spoon the entire time, holding the spoon with only one hand if possible.

3. Hula-hoop “ring of fire”: This activity should be done inside where lots of pillows and blankets can be used to jump onto. One or two players hold the hula hoop a few inches over the pillows/blankets, and another player must “dive” through the “ring of fire” onto the pile of pillows/blankets. The players can continue to raise the hula hoop a little bit higher each time; however, players should make sure to have their arms out like superman, so that the arms can help to protect the head and neck.

The challenge: to “dive” through the hula hoop without touching it with your body.

4. Relay races: Set-up two cones or markers to illustrate the starting line and the finish line. Have players choose a variety of different styles to get to the finish line: crab walks, bear walks, inch worms, wheelbarrow walking, or prone (on stomach) pulling self on scooter board or skate board.

5.Inch worms: start in the downward-facing dog yoga pose, with hands and feet on the ground, and hips and bottom raised in the air; next walk hands forward as far as they will go without falling, and then keep the hands where they are, and walk feet forwards to meet up with the hands.

The challenge: to maintain the proper body position the entire length of the course, from start to finish (e.g. crab walks: hips and bottom should be lifted off of the ground).

 Try a couple of these out and then leave a comment below with what worked best!

10 Ways To Use An Exercise Ball To Help Your Child Grow

I am sure many of you have either seen or used an exercise ball before, whether at your child’s therapy appointment or at your own session at the gym! Exercise balls are a simple and easy piece of “equipment” for you and your child to use at home in a variety of ways. Exercise balls help to strengthen the muscles; and increase endurance, motor planning, body awareness, and postural control. Exercise balls come in multiple colors and sizes, and really help to challenge balance and multi-tasking of the whole body.

1. Seated at the kitchen tableGirl With Exercise Ball

Have your child sit on an exercise ball during mealtime or homework time; make sure that your child’s feet are flat on the floor, with knees bent to 90 degrees, approximately hip-width apart; and remind your child to keep a tall posture with the shoulders relaxed and down, rather than rounded forward.

2. Seated on ball during television shows or video games

Have your child sit on an exercise ball while attending to a favorite television show/movie or while playing a video game, rather than lounging on the couch. Make sure your child is a reasonable distance from the television and furniture, and has a clear area around the ball in case balance is lost.

3. Standing back to back with a partner:

Have your child work on trunk rotation, visual skills, and timing by standing with a partner with their backs facing towards one another, a few feet apart; work on passing a ball from left to right, and then right to left. The larger the exercise ball, the harder this activity will be, as more upper body and trunk strength will be required.

4. Standing overhead ball reaches

Have your child stand hip-width apart while holding the exercise ball in his/her hands, tapping the exercise ball to the ground directly in front of feet, and then lifting the ball overhead towards the sky. Make sure to engage the abdominals by keeping them tight (e.g. as if someone was going to punch you in the stomach), which will also help to protect the back.

5. Inverted (upside down)

Have your child select a favorite board game, or use beanbags or other items to pick-up, while seated on the exercise ball. Place the game pieces or beanbags behind your child to retrieve. Slowly roll your child forward by holding onto his legs and have him get into an upside down position with head tipped over the exercise ball. Then have your child reach overhead with both arms for the game pieces or beanbags and return to a seated position in a slow and controlled manner, using the abdominals rather than momentum.

6. Prone (on stomach) for nose touches

Have you child lay his stomach over the exercise ball with feet on the floor spread more than shoulder width apart behind the ball and hands placed behind the head; lean forward touching your nose to the exercise ball (or as close as you can get) and then bring yourself back up, focusing on keeping your back straight, making a line with your entire body.

7. Prone (on stomach) for contralateral (opposing) limb extensions

Have your child lay on his stomach over the exercise ball with hands and feet touching the floor; next extend the right arm and left leg while keeping the other two limbs lightly resting on the ground for support; hold for 5-10+ seconds and then switch to left arm and right leg.

8. Supine (on back) for ball passes

Have your child lay down on his back on the floor or on top of a blanket or mat; place the exercise ball between feet, making sure to squeeze the exercise ball tightly with feet and legs and lower legs to floor; next raise legs off floor, above the torso, and grab the ball with hands; lastly lower legs together slowly and reach exercise ball overhead with arms. Do as many reps as possible in a slow and controlled pattern.

9. Supine (on back) for hip bridges

Have your child lay down on his back on the floor or on top of a blanket or mat; place heels on top of the exercise ball, with arms on the floor next to torso; next, raise hips and torso off of the floor and either hold as a static position for approximately 5-10+ seconds, or do repetitions by lowering the hips about an inch or two above the floor and then back to the sky again.

10. 4 point position (hands/knees) for child’s pose stretch

Have your child get into a hands and knees (puppy dog) position on the floor with the exercise ball directly in front of body; next lower hips/bottom towards heels and place arms on top of exercise ball to stretch forward overhead on the floor while lowering the head towards the floor as well.

 

Francis Parker, Latin, University of Chicago Lab, Chicago City Day, Anshe Emmet, Sacred Heart or Somewhere Else? Which school is best for my child?

How do I pick the best school for my child and what if my child has special needs?

IBack To School Chalkboardf you have a baby and you live in a big city like Chicago, then soon enough you will be thinking, “Oh boy, what activities do I sign him up for? Where do I register for preschool? When? Is today too late?”. For some parents, you will have now discovered your child also has some learning or attention need. Now, which school is best?

Consider the following when deciding where to send your children to school:

  •  There are always the suburbs, but keep in mind, you will still need to do a lot of research on which is best because each suburb has something different to offer.
  • Make a list of what is important to you in a school. One may be very competitive, one may be less so, one may be in a better neighborhood, one may go all the way up to high school, and one may stop at eighth grade. If you decide which characteristics are most important, you can narrow down your list.
  • If you child needs services, will the school have them? What do they look like? Remember, you will still need to supplement school services but you do need the support.
  •  How competitive do you want the school to be and in which areas? One may be more arts based while another may place high importance on math and science.
  • What kind of friends do you want your child to have? Each school has a different sort of parent body, different values taught to children, etc.
  • If you need financial aid, will they have it? How does the application process work to get in and to get assistance?

Enjoy the process and start very early. Talk to and seek advice from many people but in the end base your decision on who you and your family really are and who you hope your children will turn out to be.

Please feel free to leave a comment below with your own experience in choosing a school!

Got Chopsticks? A Great Tool For Improving Hand Skills

Colorful Assortment Of Chopsticks

Chopsticks are a great utensil to use during mealtime and for a variety of creative games and activities. Chopsticks can help children to work on hand-dominance, pre-handwriting/handwriting skills, and improving their grasp in a fun and exciting manner.

Games with chopsticks

Relay race:

Place a bucket at one end of the room and the objects to be picked-up on the other side of the room (e.g. marbles, beads, cotton balls, dry cereal). Read more