The Benefits of Increasing Therapy Over the Summer

Summer is the time of the year when children engage in more free play and physical activity. Therefore, summer is the perfect time of the year to improve upon skills that children need in order to be active, successful, and independent children!Little girl jumping a rope

Here are some of the best reasons to consider starting therapy or increasing the number of therapy sessions for your child over the summer:

Maintain and improve skills for school – Since school is out for the summer, it is important that children do not lose the fine motor, problem-solving, planning, and organizational skills (and more) that are necessary to be productive students at school. Although summertime is a great time to provide opportunity for free play, it may create academic issues for your child once school starts back up if he or she does not engage in challenging tasks  during their 3 month break from school.

Practice physical activities, such as bike riding, climbing, and jumping rope – During the summer, children are often playing outside for hours on end. It may become noticeable that your child is not keeping up with their peers. Activities with which you may notice some difficulty are often when children have to coordinate their arms and legs, such as jumping jacks, climbing the jungle gym, and learning to ride a 2-wheeler. By participating in therapy over the summer, therapists can address these specific concerns in order to help your child stay up to speed with their friends while performing these activities.

More availability over the summer – Since your children are out of school for the summer, they may have a lot more time and availability during the day to participate in more therapy. Summer camp and extra-curricular activities often only take up part of the day, so there may be more times you are available to schedule therapy appointments. Furthermore, although camp and extra-curricular activities are great options for staying active, they do not necessarily offer the same therapeutic benefits as therapy.

Provides structure to their day– Oftentimes, summer can be a season of unstructured play time in which children can do anything they would like. Sometimes the choices are so overwhelming that this can often lead to hours of playing video games, watching TV, and other sedentary activities. Therapy can provide structure to your child’s day to make them feel like they are being productive by spending their time doing valuable tasks.

Opportunity for peer interaction outside of school – Once school is over for the summer, some children may only spend their time with the same friends every day. Therapy sessions can provide the opportunity to make more friends in the clinic and learn how to engage in social situations with other people.

These are just a few of the many benefits that therapy can provide to your child over the summer! By making your child more actively engaged in goal-directed activities, you are setting your child up to be productive students the following school year and active children during the summer!

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5 Roles to Assign a Sibling When There is a New Baby

It’s Friday night and you are at the dinner table with your 3 week old baby boy and 5 year old daughter. After taking a sip of water, your daughter looks at you and says, “Mommy, I need a diaper.” Because your daughter has been potty trained for 2 years now, these are words that you never thought you would hear again from her. Before you scream, take a deep breath and RELAX. She is simply adjusting to the new little one – this is normal. Since the new baby is taking up a lot of your time, your 5 year-old is going to act out (or act younger) to get your attention, especially if you are feeding or spending time with the new baby. The best thing to do is give your 5 year-old special “big sister” or “big brother” roles. The following are five roles you can assign to a sibling when you have a new baby:

5 Roles To Assign a Sibling When There is a New Baby:

  1. Baby Watch – Put your older child on “baby watch”. sister and new babyWhile you are still in the room, ask him or her to make observations about what the baby is doing and let you know. Ask your older child what he/she and the baby have that is the same and what is different.
  2. Night time reader– Let your older child tell the baby a story. Engage him/her in making a picture book with you that includes all the fun things that you have done together, so the new baby can learn about activities you do in your family. After you have finished creating this book, tell your older child that he/she is on “night time reader” duty. Explain the importance of reading this story to the baby and how important it is that the baby gets to learn who everyone is. Stress how great he/she is with learning who everyone is and how you want him/her to teach the baby… BECAUSE HE/SHE IS THE BEST TEACHER!!!
  3. Special jobs helper– When you are giving your baby a bath, ask your older child to help. He/she can get the soap and help wash the baby’s legs. If your baby needs a new diaper, you can ask your older child to go get it. You can ask him/her to help rub your baby’s back to calm her down when she is crying. Remember to praise your older child when he/she is able to soothe the baby!
  4. Advice helper– When you are dressing the baby, ask your older child what he/she thinks the baby wants to wear. If the baby is crying, ask your older child if he/she thinks the baby is tired, hungry, etc. You may already know the answer to this question; however, asking your older child for his/her advice makes him/her feel very important.
  5. Creative helper– Ask your older child to think of a creative nickname for the baby to help establish a special bond between them. Helping create that bond and relationship is one of the toughest tasks. Creating a close bond at an early stage will ensure that the bond will last a lifetime.

Trisomy, What Does It Mean?


The term Trisomy 18 has gotten significant media coverage in the last month as Rick Santorum’s daughter, who was born with the chromosomal disorder, was recently hospitalized. Santorum cites his family’s struggles with his daughter’s medical condition as a partial player in his decision to remove himself from the current political campaign. trisomyBut what, exactly is Trisomy 18 and how does this disorder and others like it effect children? The following is a brief review of three trisomy disorders, from a Speech-Language Pathologist’s perspective.

The Three Trisomy Disorders:

Trisomy 18

Trisomy 18, also known as Edwards syndrome, is a chromosomal disorder (1 in 3000 births) that results from the formation of three copies of a the 18th chromosome, instead of two. Children born with this chromosomal disorder experience significant and life-threatening medical issues which cause high mortality rates; less than 50% of children born with this disorder live past their 1st birthday. Children who do live longer require intensive medical attention to treat kidney and heart defects, digestive issues, as well as complications related to craniofacial anomalies (small jaw, small head, irregular shaped head, or low-set ears). Each child born with this disorder experience individual challenges and treatment should be provided to meet that child’s specific needs.

Trisomy 21

Trisomy 18 is just one of several disorders which result from the creation of a third copy of a specific chromosome at conception. The most common of these disorders is Trisomy 21, or Down syndrome (1 in 800 births). Children born with Down Syndrome also meet many challenges, however these children live into adulthood and are likely to require various levels of medical, therapeutic, and academic support to reach their potential and highest level of independent functioning. Children with Down syndrome experience gross developmental delays as well as a varying degree of intellectual disability. Children with Down syndrome exhibit distinct craniofacial features, including a small oral cavity which impacts speech production and feeding. Hearing concerns are also prevalent in this population of children. These children benefit from speech and language intervention to encourage both increased speech intelligibility as well as to develop higher level language skills.

Trisomy 13

Trisomy 13, or Patau syndrome (1 in 10,000 births) is typically diagnosed before or immediately after a child is born due to the high instance of craniofacial anomalies, including cleft lip and/or palate, small head size, small eyes, and irregular ear shape. Cleft lip and/or palate will cause immediate feeding difficulties for which specialists, including a Speech-Language Pathologist or Occupational Therapist, will be involved in assisting families to ensure safe feeding, often through use of alternative bottle nipples . Many children with Trisomy 13 will have congenital heart defects, defects in the formation of their brains, as well as kidney defects. These children experience a high infant-mortality rate, and those who live through their childhood will experience significant developmental delays, for which a team of professionals including Occupational Therapists, Physical Therapists, Speech-Language Pathologists, Audiologists, Nutritionists, and others should be involved in providing a comprehensive and individualized plan of care.

It is important to note that children born with any of the Trisomy disorders do not experience this chromosomal abnormality due to any actions taken by their parents. It is a chromosomal irregularity that occurs at conception and is not the fault of either parent. Please visit for more information, and to support the children and families affected by these disorders.

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What To Expect When You Are Expecting… Special Needs

With the new movie “What To Expect When You’re Expecting” coming out based on the pregnancy bible, it is important for expectant mother’s and father’s to also familiarize themselves with the possibility that they may have a child with a special need.  Of course, the last thing we want to think about when we are What To Expect When You're Expectingpregnant is a special needs child. However, a pregnant couple can just keep in mind what to look for or ask when they are expecting:

5 Steps to take when you are expecting a baby:

  1. If the ultrasound is anything but normal, or if they see anything that raises concern, find out what can be done immediately upon birth.  You may also want to set up meetings with a therapy clinic to talk with experts and specialists.
  2. Read up on parenting, behavior management, and normal child development so that you know what to look for when the infant arrives. You do have a pediatrician, but you are the expert on your own child and even pediatricians will depend on you, the parent for providing any concern or red flags. The American Pediatric Association is a great resource as is the state association, such as the Illinois Pediatric Association.
  3. Tell your best friends and your family to let you know if they ever think something is off or up with your baby once it comes. Ask them beforehand, you may be too emotional afterwards.
  4. Eat well, exercise per doctors orders, keep yourself happy and calm, and avoid alcohol and non-advised medicine, see your OBGYN for regular pre-natal visits and stay out of trouble!
  5. If you are an expectant mom, expecting an adoptive baby, use expert websites such as the Children’s Research Triangle  in Chicago, or Northwestern Family Institute, to know what to be looking for in your child. You may not have been there for the first months and need to be a super-detective when it comes to you child.  Read the blogs here, to learn everything you can about child development!

While you need to enjoy your pregnancy, reality and knowledge is always a good thing to have just in case.  No parent is ever fully prepared for a special needs child.  However, have any knowledge prior to a diagnosis, will only help you make the right decisions for your child and family.

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Tummy Time Frequently Asked Questions

What exactly is tummy time?

Tummy time is either:

  • Supervised time when your child is laying on a firm flat surface on her tummy.
  • When your child is being in a position where she is face down and has to lift her head up against gravity.

Why does my child need tummy time? Why is it so important?tummy time

  • Studies have shown a link between slowed achievement of developmental milestones and diminished tummy time in babies.
  • Tummy time builds the muscles in your child that are necessary for advanced movements like crawling, walking and (gulp) running.

My child always cries during tummy time, what should I do?

  • Lay on the floor with your child. Babies are often frustrated because they have less ability to interact with the world when they are lying on their tummies, and if they can see your face (and your smile), they may calm down. You may also utilize mirrors or toys to distract them when they get frustrated.
  • Try a “tummy time alternative.” This can be carrying your child face down in a “superman” position or sit with them supporting her trunk and tilt her forward so her shoulders are in front of her hips.
  • As your child gets stronger (and more able to lift her head and play with toys in this position) she will enjoy tummy time more and more.

What can happen if I don’t give my child tummy time?

  • If the child is always on their back, it increases the risk of flattening portions of their head, and if they do not move their heads around in all directions, it increases their risk of developing torticollis.
  • There may be slowed attainment of developmental milestones such as independent sitting, crawling, and walking.

How much tummy time should my child be getting?

  • The goal is that by 6 months of age, your child should be on their tummy 50% of her play time (not including feeding time, bath time, or sleeping time). Remember that this is a goal to work towards and not to be expected the first day you introduce tummy time.

 How old should my child be before I begin tummy time?

  • You may introduce tummy time on day 1, as long as there are no medical complications whereby your pediatrician would recommend avoiding tummy time.

***Most importantly, babies should always be placed to sleep on their back, and supervised when on their tummy***

Click here to watch a 2 minute webisode on the Importance of Tummy TIme

Click here for a printable copy of this blog

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Positioning for Infants 101

Recent statistics show that 1 in 10 babies have plagiocephaly, or flatness to one side of their head. Since 1992 when the American Academy of baby on tummyPediatrics launched the “back to sleep” campaign, cases of SIDS have dramatically decreased. However, cases of plagiocephaly, or flat head, have increased. With babies spending so much of their day on their backs, in swings, car seats and bouncy chairs, babies aren’t given the proper tummy time to let their head naturally round out.

Positioning your infant to switch the direction that they are laying is recommended to prevent flatness to one side of their head. Simple positioning things that parents of little ones can do at home are:

Ways To position Your Infant:

  • Providing ample tummy time daily: start with just a few minutes and work your way up from there. By 5-6 months, aim for ½ of play time to be on the tummy.
  • Alternate the hip or arm where you carry your baby. This way, they have equal opportunity to look both ways and keep their neck muscles flexible.
  • Alternate the end of the crib each night where you place your baby to sleep. This way, if they are always looking at one part of the room, ie a nightlight, window or door, they will have a different part of their head that they are sleeping on each night.
  • Alternate the end of the changing table where you change your baby.
  • Limit use of carseats, swings, bouncy seats or any device where a child is “contained.” Excessive time in these “containers” can cause a flat head on one side and limit gross motor development.
  • When your child is in a car seat, a cushioned head support will help keep some pressure off the back of their head.

It is normal for your babies’ head shape to not be completely round following a vaginal delivery; however, head shapes usually round out from the pressures of delivery within the first 6 weeks of life. It is important to use the positioning techniques above to ensure that your baby has a nice round head shape as they continue to develop.

If you are concerned about your babies’ head shape, talk to a physical therapist or your pediatrician. Physical therapy can help round out your child’s skull and help with gross motor development.

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What is Oral Motor | Pediatric Therapy Tv

Pediatric Speech and Language Pathologist explains what Oral Motor is and how it develops in babies through childhood. For more on Oral Motor and feeding problems read this blog:

In this video you will learn:

  • What is Oral Motor
  • How babies can build oral muscles
  • How oral motor realtes to speech

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 TV. I’m your host, Robyn
Ackerman. Today I’m standing here with Allison Raino, a
pediatric speech and language pathologist.

Allison, a question we get a lot from our viewers is what
exactly is oral motor and how does it relate to speech?

Allison: Oral motor is essentially the strength and coordination of the
oral muscles in the mouth. There are thousands of receptors and
muscles in the face that all need to work in conjunction with
each other in order to say speech sounds accurately, as well as
being important for feeding and swallowing.

Many of our responses are reflexive, such as coughing and
swallowing. Those muscles need to be strong enough. We do those
while we are sleeping so we don’t even think about those while
we are doing them. Building up their strength is important, and
is especially important for babies and toddlers. We want to
provide an environment where they are exploring the environment
orally so we are providing multiple ways to develop that oral
muscle strength and coordination.

As you know, babies stick everything that they find in their
mouth. That’s their first way of learning about their
environment – it goes right in their mouth. We want to encourage
that, because with that they are learning a variety of different
tongue movements as well as increasing their jaw strength.

How that relates to speech is we see their development grow from
the cooing stage, where it’s the very basic sounds of the vowel
sounds. As their muscles mature and they become stronger and
more coordinated, we see the babbling stage, and then eventually
the move up to true words and then to phrases. We want to
encourage them to develop those patterns and provide a variety
of opportunities for them to strengthen their muscles as well as
coordinate them.

Robyn: Great. Thank you so much. 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

How Hearing Affects Your Child’s Speech And Language Development

If you are concerned about your child’s articulation (the way he produces his speech sounds) and are considering a speech and boy hearinglanguage evaluation, a hearing evaluation may be helpful as well!

“But I am concerned with my child’s speech, not his ability to hear” – you say? Consider this: if you weren’t able to hear people speaking, how precisely would you be able to imitate their speech? Not very easily! Continue reading to discover just how important and informative a hearing evaluation can be.

Q: What does an initial hearing evaluation consist of?

A: Typically, an audiologist will conduct the following screening measures:

Pure Tone Audiometry Test: This consists of your child wearing headphones and responding (usually by raising his hand) to tones in each ear at different frequencies (pitch) and intensities (loudness). This test identifies the various pitches and loudness levels your child can hear.

Speech Reception Threshold: The audiologist will read two-syllable words pronounced with equal stress on each part, like “hotdog” and ask your child to repeat them. This test checks your child’s ability to understand speech sounds in each ear.

Speech Discrimination Testing: The audiologist will read single-syllable words, like “ball” and ask your child to repeat them. The purpose of this assessment is to determine the percentage of words your child can hear.

Q: Why is a hearing evaluation so important?

A: A hearing evaluation can help to determine if a hearing loss is present.

A: If a hearing loss is present, the evaluation can be the first step to correcting the hearing loss (hearing aids, cochlear implant, amplifier systems for your child’s classroom, etc).

A: A hearing evaluation may help explain why your child’s speech production skills are lower than what is expected for a child his age. For instance, certain speech sounds are heard at different pitch levels or at different volumes. This means, if your child has a hearing loss in a specific area, he wouldn’t be expected to accurately produce the corresponding sounds!

  • Even with a mild hearing loss, many speech sounds (z, v, p, h, g, ch, sh, k) may be affected!

A: A hearing evaluation can even help identify disorders of the ear. For instance, the evaluation can help identify external otitis (more commonly known as “swimmer’s ear”)!

A: A hearing disorder can affect your child in the classroom. Results from an evaluation may help to adjust your child’s school day to optimize his performance (e.g. changing his desk position in the classroom, using an FM system, giving the teacher a small microphone, etc).

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TOT collar: What is it and When it is Appropriate to Use?

A TOT collar is a device used to correct torticollis, often in addition to physical therapy. Next, you may be asking “what is torticollis?” Torticollis, often referred to “wryneck” is a tightening or shortening of the sternocleidomastoid muscle in the neck. Infants with torticollis will likely present with a head tilt to one side, and chin rotated to the other side. Congenital muscular torticollis is usually recognized in the first 6 to 8 weeks of life. With physical therapy, it is correctible in over 90% of cases. tot collarHowever, if left untreated, can lead to scoliosis, plagiocephaly (head flattening) and asymmetry with gross motor milestones.

If the child has a head tilt of 5 degrees or more and can lift his or her head away from the side of the head tilt, a TOT collar can be used, in addition to physical therapy, to help correct torticollis. The TOT collar is made of soft tubing and nylon tubes. The tubing is then fastened with a connecting strap.

The basis of the TOT collar is to have a stimulus to the side of the head tilt so that the child will be able to move his or her head away from the stimulus toward a midline head position.

Early intervention is key when treating torticollis. If you or your pediatrician see flattening on one side of your infants skull and notice that they are looking to one side, make sure to see a physical therapist for treatment.

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When Should You Take A Pacifier Away | Pediatric Therapy TV

Pediatric Speech and Language Pathologist explains when a parent should take a pacifier away from a baby or toddler.

In this Video You Will Learn:

  • If there is a specific age to take the pacifier away
  • How sucking on a pacifier can cause feeding and speech difficulties
  • What kind of pacifier a child should be using

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 with speech and language pathologist, Allison Raino. Allison, can you tell us at what age a child should stop using a pacifier?

Allison: Sure. Unfortunately, there’s no definitive age but what I can talk about are the limitations that pacifiers have on oral development. The first reason why pacifiers can become problematic is the amount of time the baby has a pacifier in their mouth, and the second being the size and the shape of the pacifier.

As the baby transition into chewing, jaw strength and stability is very important developmental growth, and sucking on a pacifier drastically limits the amount of jaw movements, reducing the strength and stability which could cause future feeding and speech difficulties.

The second being the size and the shape of the pacifier. The pacifiers that are rounded on the top and flat on the bottom, they’re too big for the baby’s mouth. The pacifiers that are rounded on all sides, those are preferred because it puts the tongue in a more natural position.

So, my two suggestions would be to limit the amount of time the pacifier is used as well as using the pacifier that is rounded on all sides.

Robyn: All right. Thank you for those suggestions and thank you to all of 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