Author: Janis Bautz

Back-to-School: Helping Children and Families Navigate the Challenges of a New School Year

Back-to-School: Helping Children and Families Navigate the Challenges of a New School Year

As summer comes to an end, families begin preparing for another school year filled with new opportunities, routines, friendships, and experiences. While back-to-school season can be exciting, it can also bring feelings of stress, anxiety, uncertainty, and overwhelm for children, teens, and parents alike.

Returning to school often means adjusting to earlier mornings, managing homework, navigating social situations, meeting new teachers, and balancing academic and extracurricular responsibilities. For some children, these changes may feel manageable, while others may experience difficulty adjusting to the demands of a new school year.

At BDI Children’s Therapy, we understand that the transition back to school can bring a variety of emotional and behavioral challenges. With preparation, patience, and the right support, families can develop healthy strategies to make this transition feel more manageable.

Understanding Common Back-to-School Challenges

Every child experiences the school year differently. Recognizing potential challenges can help parents and caregivers provide support before stress becomes overwhelming.

Some common back-to-school challenges include:

  • School-related anxiety: Worries about academic performance, tests, new teachers, unfamiliar classrooms, or being away from caregivers.
  • Difficulty adjusting to routines: Transitioning from a relaxed summer schedule to early mornings, structured days, and regular homework can be challenging.
  • Social pressures: Making new friends, navigating peer relationships, managing conflict, or worrying about fitting in can create emotional stress.
  • Academic expectations: Increased workloads, challenging subjects, and pressure to succeed may contribute to feelings of frustration or self-doubt.
  • Emotional overwhelm: Children and teens may struggle to communicate their feelings, regulate their emotions, or manage multiple responsibilities.
  • Changes in family routines: Busy schedules, transportation arrangements, extracurricular activities, and work commitments can create additional stress for the entire household.

It is important to remember that children do not always express stress by saying they feel anxious. Sometimes, emotional distress may appear as irritability, withdrawal, difficulty sleeping, frequent stomachaches, or reluctance to attend school.

Responding with curiosity, compassion, and understanding can help children feel safe sharing what they are experiencing.

7 Ways to Help Your Child Navigate the School Year

1. Establish Healthy and Predictable Routines

Predictable routines can help children feel more secure and prepared for the school day. A consistent bedtime, morning routine, and designated homework time can reduce uncertainty and make daily transitions easier.

Consider gradually adjusting sleep schedules before school begins, preparing backpacks and clothing the night before, and creating a family calendar to keep track of important activities.

Remember that routines should provide structure without becoming another source of pressure. Flexibility is important, especially during the adjustment period.

2. Encourage Open and Honest Communication

Create opportunities for your child to talk about their thoughts, feelings, and concerns.

Instead of immediately offering solutions, begin by listening. Ask open-ended questions such as:

  • “What are you looking forward to this school year?”
  • “Is there anything about going back to school that feels difficult?”
  • “What would help you feel more comfortable?”
  • “How can I support you when things feel overwhelming?”

Validate their emotions by letting them know that it is okay to feel nervous, frustrated, excited, or uncertain.

Statements such as “It makes sense that you feel nervous about something new” can help children feel understood rather than dismissed.

3. Teach Healthy Coping Skills

Children and teens benefit from learning practical ways to manage stress and regulate their emotions.

Some coping strategies to practice at home include:

  • Deep breathing: Encourage slow, gentle breaths when feelings of anxiety or frustration arise.
  • Grounding exercises: Help your child focus on what they can see, hear, and feel in the present moment.
  • Positive self-talk: Practice replacing thoughts such as “I can’t do this” with “I can take this one step at a time.”
  • Movement and physical activity: Walking, stretching, playing outside, or participating in sports can provide a healthy outlet for stress.
  • Taking breaks: Encourage children to step away from challenging tasks when they feel overwhelmed and return when they are ready.

The goal is not to eliminate every uncomfortable emotion. Instead, children can learn that difficult feelings are manageable and that they have tools to help themselves through challenging moments.

4. Build Confidence Through Small, Achievable Goals

A new school year can feel overwhelming when children focus on everything they need to accomplish at once.

Help your child break larger responsibilities into smaller, realistic steps. For example, instead of focusing on an entire week’s worth of homework, begin with one assignment or a short period of focused work.

Celebrate effort, progress, and persistence rather than focusing exclusively on grades or outcomes.

Remind your child that making mistakes is a normal part of learning. Developing confidence often comes from experiencing challenges, receiving support, and discovering that setbacks do not define their abilities.

5. Support Healthy Social Connections

Friendships and peer relationships can have a significant impact on a child’s school experience.

Encourage your child to explore opportunities to connect with others through clubs, sports, extracurricular activities, or shared interests.

If your child is nervous about making friends, help them practice simple conversation starters or role-play situations they may encounter at school.

For children experiencing friendship difficulties, exclusion, or bullying, listen carefully and take their concerns seriously. Work collaboratively with school staff when additional support is needed.

6. Prioritize Emotional Wellness and Self-Care

Academic success is only one part of a child’s overall well-being. Emotional health, physical health, relationships, and opportunities for rest are equally important.

Help your child maintain a healthy balance by encouraging:

  • Consistent and adequate sleep.
  • Regular meals and hydration.
  • Time for play, hobbies, and enjoyable activities.
  • Breaks from screens and social media.
  • Opportunities to relax and spend meaningful time with family.
  • A healthy balance between school responsibilities and personal interests.

Parents and caregivers also need time to recharge. Taking care of your own emotional wellness can help you respond to your child’s needs with greater patience and understanding.

7. Maintain a Partnership With Your Child’s School

Parents, caregivers, teachers, school counselors, and mental health professionals can work together to support a child’s success.

If you notice ongoing academic, behavioral, emotional, or social difficulties, consider reaching out to your child’s teacher or school support team.

Sharing concerns early can help identify appropriate resources, accommodations, or strategies before challenges become more difficult to manage.

You do not have to navigate every concern on your own. Asking for support is a proactive step toward helping your child thrive.

When Back-to-School Stress May Require Additional Support

Some nervousness and adjustment difficulties are common during transitions. However, when emotional distress becomes persistent, intensifies, or begins interfering with daily functioning, additional support may be beneficial.

Consider reaching out to a mental health professional if your child experiences:

  • Persistent anxiety or excessive worry about attending school.
  • Frequent emotional outbursts, irritability, or difficulty managing feelings.
  • Ongoing sleep difficulties or physical complaints associated with school stress.
  • Withdrawal from friends, family, or activities they previously enjoyed.
  • Significant changes in mood, behavior, or motivation.
  • Difficulty completing everyday responsibilities because of emotional distress.
  • School avoidance or repeated difficulty attending school.

These experiences do not automatically indicate a mental health disorder, but they may be signs that your child needs additional care and support.

Early intervention can help children and teens develop skills to navigate challenges, strengthen emotional resilience, and improve their overall well-being.

How Counseling Can Help

Counseling provides a supportive environment where children, teens, and families can explore challenges, develop coping strategies, and build confidence.

Depending on the individual’s needs, counseling may help with:

Managing anxiety and stress: Learning practical techniques to identify triggers, regulate emotions, and respond to stressful situations.

Developing emotional regulation skills: Understanding feelings and practicing healthy ways to communicate and manage them.

Strengthening self-esteem and confidence: Challenging unhelpful thought patterns, recognizing personal strengths, and developing a more balanced sense of self.

Improving social skills and relationships: Building communication skills, practicing problem-solving, and navigating friendships and peer interactions.

Supporting parents and caregivers: Learning strategies to respond to emotional and behavioral challenges, establish healthy boundaries, and create a supportive home environment.

Building resilience: Developing the ability to adapt to change, recover from setbacks, and approach challenges with greater confidence.

Counseling is not just for moments of crisis. It can also be a valuable resource for children and families who want to strengthen their skills, improve communication, and prepare for upcoming transitions.

A Reminder for Parents and Caregivers

As your child navigates the school year, remember that adjustment takes time. Some days will go smoothly, while others may bring unexpected challenges.

Try to approach difficult moments with patience and compassion. Focus on progress rather than perfection, and remind your child that they do not have to figure everything out on their own.

Your willingness to listen, offer encouragement, and seek support when needed can make a meaningful difference in how your child experiences the school year.

And remember: You do not have to be a perfect parent to be a supportive one.

We’re Here to Help

The back-to-school transition can bring many emotions and challenges, but families do not have to navigate them alone.

At BDI Children’s Therapy, we are committed to supporting children, teens, and families as they work through life’s challenges and develop the tools they need to thrive.

Whether your child is experiencing school-related anxiety, struggling with emotional regulation, navigating friendship difficulties, or simply needs additional support adjusting to change, counseling can provide a safe and supportive space to work through those concerns.

Let’s work together to make this school year a season of growth, confidence, connection, and emotional wellness.

Contact us today to learn more about our counseling services and how we can support your family this school year. Your child’s emotional well-being matters, and we’re here to help.

Therapy for Parents: When “Do It Again!” Comes 100 Times

If you’ve ever told your child to do something… and then told them again… and again… and again… you are definitely not alone.

Sometimes parenting can feel like you’re stuck in a loop, like a video that won’t stop replaying:

  • “Brush your teeth!”
  • “Do it now!”
  • “Okay, one more time…”
  • “Wait, did you hear me?”
  • “Brush your teeth: 100% this time!”

And when you’re exhausted, it’s easy to think, “Why won’t they just listen?”

But here’s something important: kids aren’t trying to be difficult to annoy you.

Most of the time, they’re still learning skills like listening, remembering, switching gears, and doing tasks when their brain feels like saying, “Nope!”

That’s where therapy can help not only children, but parents too.

Why Telling a Kid Something 100 Times Happens (Even in Great Families)

Kids have growing brains. Their brains are busy building skills like:

  • Attention (staying focused)
  • Memory (remembering what you said)
  • Self-control (doing something even when they don’t feel like it)
  • Understanding (knowing what “now” means)
  • Transitions (stopping one thing and starting another)

So when you say, “Time for pajamas,” your child might hear it like:

  • “Pajamas… later… maybe…”
  • “Wait, I want to keep playing.”
  • “I forgot.”
  • “I don’t want to stop!”
  • “This is too big.”

That doesn’t mean they don’t love you. It means they’re learning.

What Therapy Does for Parents (Yes, Parents!)

Parenting support in therapy isn’t about making you feel guilty. It’s about helping you feel like you have a toolbox, not just a worn-out voice.

Therapy can help parents:

  1. Feel calmer when reminders pile up

When you’re calm, your child’s brain has an easier time cooperating too. Therapy teaches parent strategies like:

  • breathing tools
  • calming scripts
  • how to pause before repeating

2. Use “one-and-done” ideas instead of “repeat and repeat”

Therapy can help you try approaches like:

  • clear, simple directions
  • fewer words
  • matching your tone to what you want
  • giving a choice when possible (without giving control away)

3. Turn battles into predictable routines

Routines are like friendly maps for your child’s brain.

Therapy can help you build patterns such as:

  • a “first/then” schedule
  • visual steps (especially helpful for younger kids)
  • a consistent “transition plan”

4) Spot the reasons behind the “no”

Sometimes the “100 times” isn’t because your child is ignoring you.

It might be because they’re:

  • overwhelmed
  • bored
  • struggling with instructions
  • having trouble switching tasks
  • distracted
  • worried about something

Therapy helps parents understand what’s underneath the behavior so responses match the need.

A Fun Parent Myth to Drop: “They’re Not Listening”

Let’s rename the problem.

Instead of: “They’re not listening.”

Try: “They’re struggling with the skill.”

That’s a huge mindset shift and therapy helps you practice it.

Because when you see the struggle, you can choose support that works, like:

  • breaking tasks into smaller steps
  • using visuals
  • helping with transitions
  • praising effort (not just “doing it right”)

The “Parent Power Plan” (A Tiny Toolbox for Big Days)

Step 1: Say it clearly (once)

Keep it short. Think: simple instructions, not speeches.

Step 2: Follow through calmly

Not angry. Not lecturing. Just consistent.

Step 3: Help your child succeed

If they struggle, it might help to:

  • remind with a visual
  • show the first step
  • offer a quick break
  • use “first/then”

Step 4: Catch them doing it right

This is powerful. When your child starts cooperating, therapy encourages parents to notice it. Because attention can be like sunshine: kids grow toward what gets noticed.

A Closing Thought

If you’ve had to remind your child 100 times, you haven’t failed. You’ve been doing your best in a situation where your child is still learning. And therapy can help you build a plan that makes those reminders less frequent and more effective so you can both feel proud instead of frustrated.

baby helmet

Helmet Heads!

Helmet Heads!  Shaping Baby Inside and Out

Putting your baby in a helmet is a difficult decision for parents to make, but more often parents are choosing to put one on their baby. Are helmets necessary and why are so many babies wearing them? An explanation of why, when and how little melons are getting shaped by helmets. 

A Helmet is Not Just For Vanity!

The Cranial Orthosis (CRO) or helmet does help your baby look their best by giving them a more symmetrical head, eyes, ears and even jaw. But, the CRO does so much more than making pretty babies! The skull holds and protects our baby’s most important organ, the brain. When the skull is misaligned, so is the brain. The helmet allows the skull to serve and protect allowing for the best position and shape for optimal neurological development. Sensory input from the outside world is organized in the brain. For example, if the eyes are misaligned this fires misinformation to the brain which is also misaligned and that is less than ideal for our baby’s development. 

Why is Head Shape Important? 

 A baby’s face, ears, eyes, mouth and head should look symmetrical on both sides. Asymmetry caused by a head tilt (torticollis) or any other asymmetry noted on a baby’s noggin should be evaluated by a pediatric physical therapist. These small asymmetries now can cause big delays later. Gross and fine motor milestones and other coordination skills can be affected down the line, like playing sports, playing instruments or keeping up with their peers. 

 

What is Plagiocephaly and What Causes It?

Plagiocephaly is a term to describe a misaligned head shape. Other names used are brachycephaly and scaphocephaly. Each of these terms describes a particular head shape deficit which is a flattening on one or more sides of the head. Sometimes a bulge is present as bones pushed on one side will cause a protrusion to another. 

There are many known and unknown factors that can cause a misalignment of cranial bone plates. Here are some known reasons: 

  1. Lack of Tummy Time: Back to sleep and tummy to play! Tummy time will reduce the risk of flat spots.
  2. Torticollis: A preference to turn to one side can cause a flat spot. Increased tummy time is recommended for torticollis.  
  3. Sleep Preference: “Back to sleep” campaign to reduce Sudden Infant Death Syndrome (SIDS) has been successful at saving lives but has caused an increase in flat heads. 
  4. Containers: Too much time in car seats, bouncy seats, or other soft bottom containers restrict babies ability to turn and move naturally.
  5. Medical Conditions: Premature or medically fragile infants required to spend more time in certain positions early on for their safety.  
  6. Multiples or Intrauterine Constraint: Inability to move in the mother’s womb can cause muscle imbalances during development.  

When Is the Best Time to Get a Helmet?

Baby’s head doubles in size within the first year! Ideally, it is recommended that a baby has a helmet between 3-6 months of age. Sometimes it is recommended earlier than 3 months depending on the child. Typically, the earlier the helmet goes on the less time they have to wear it due to the speed of head growth in the first few months. A helmet may not be recommended after 12 months because the head growth slows down which in turn slows down the changes the helmet can make. Physical Therapy is recommended before, during and after helmet treatment for exercises, positional changes and stretches can improve asymmetries and progress motor skills. 

Parents Don’t Regret Getting a Helmet but Do Regret Not Getting One

This is a common phrase physical therapists hear from parents. Parents often forget their baby had a helmet until they look at old pictures because it is on and off so fast. Baby helmets have a small window of opportunity to make big changes that will last a lifetime!

Be sure to ask your PT who they recommend to evaluate and be fitted for a custom cranial orthosis. Schedule a free screening with a physical therapist at BDI Playhouse if you have any questions about the shape of your baby’s head!  

Written By: Dana Bukala, PTA

 

Serial Casting

Serial Casting- Casting That’s Not for Broken Bones

Dynamic serial casting is a conservative treatment method in which skilled physical therapists apply and remove a series of lightweight casts to a patient’s leg(s) in order to improve foot alignment and increase range of motion. The goal of serial casting is to improve range of motion in order to prevent chronic skeletal issues, reduce falls, improve function and efficiency, improve the child’s walking pattern, decrease current pain or prevent future pain, and improve alignment for future orthotic use. Serial casting can help to delay or prevent the need for surgical intervention. 

The casting process is performed by skilled physical or occupational therapists. A soft, semi-flexible casting material is applied over stockinette that is padded to protect bony prominences (natural bony points such as the ankle bones) and wrapped in a layer of cotton wrap. The joint is carefully positioned in a neutral position to maximize alignment and gently stretch the soft tissue, with the position maintained throughout the casting process. The child wears and walks (and squats, walks up and down stairs, and stands) on the cast for several days (typically 4 days on and 3 days off), with increased movement and weight bearing allowing for increased gains throughout the casting process. This process is repeated every week for 6-12 weeks until the desired range of motion gains have been made. Notable and measurable gains can be noted in just a few casts, too! 

Conditions that can be addressed with serial casting:

*This is not an exclusive list, as serial casting can benefit a wide variety of patients. Patients who are younger typically make quicker gains throughout the serial casting process; however, patients of any age can participate (and have participated) in serial casting. 

  • Cerebral Palsy
  • Idiopathic Toe Walking
  • Club Foot
  • Charcot-Marie-Tooth
  • Traumatic Brain Injury
  • Duchenne Muscular Dystrophy
  • Spasticity (abnormal muscle tone)
  • Contractures

This noninvasive process is designed to make gains while having limited impact on the child’s typical daily activities. Children can play, stand, and walk within their home, school, and community and participate in after school activities and sports (with the exception of swimming and water play). It is typically not a stand alone treatment method. Casting typically coincides with or is followed by ongoing physical or occupational therapy, and a referral for a pediatric orthotic evaluation to continue to maximize the gains made throughout the serial casting process.  

Check out BDI’s Serial Casting page or ask your child’s BDI physical therapist for more information.

Cassidy Bannon, PT, DPT

 

feet forward

Put Your Best Foot Forward!

When to see a pediatric physical therapist for your child’s feet?

How do you know if your child’s little feet are functioning at their very best? Here are 10 clear signs that you should have a pediatric physical therapist screen your child’s feet so they can put their best foot forward!

Pain 

If walking causes pain in your child’s feet this is a concern that should be addressed immediately. There are a number of reasons for pain in the feet and a pediatric PT can assess and address painful walking.  

Asymmetry

Any difference in one foot compared to the other foot should be seen by a pediatric PT. Feet should look and move the same at the other foot. Seek advice if you notice a difference in foot size, a heel lifted on one side, turning in or out of one foot or any other noticeable differences. 

Toe Walking

Toe walking is an abnormal gait or walk at any age at any time! We often see children raise up on their toes when they are very excited, nervous or cold but only for a few steps and then come down to their heels to walk or run. The earlier a child is seen for toe walking, the faster the treatment and the better the outcome. Don’t Wait!

In or Out Toeing (Pigeon or Duck footed)

Toe inning or outing is a common foot alignment deficit. When the feet are not aligned, the knees are not aligned which can lead to pain and inflammation. Often it can be a sign of leg, hip or trunk weakness or all three! It could also be a misalignment of bones within the joints. Seeing a pediatric PTl will determine the root cause and help get those duck feet in a row!

Flat Feet / Pronation

Flat feet is when almost the whole foot makes contact with the floor while standing. Pronation is when the ankle collapses inward when standing. Both flat feet and pronation can cause similar problems. Postural deficits are usually present as well as over use and under used muscle groups. This imbalance causes poor body mechanics which can lead to premature breakdown of joints. Flat feet and pronation cause the body to move inefficiently. It will take more energy to walk, run and jump!  

Tripping

Children are still developing their sensory systems and body awareness which can look a bit messy. It’s common to miss a crack in the sidewalk or move too fast for their feet causing them to trip and fall. Tripping becomes a problem when they are doing it so much they are hurting themselves. Tripping on the same thing over and over, on stairs or ramps, carpets or even nothing at all can be concerning.  A pediatric PT will be able to assess why they are tripping so often and help keep them on their feet!

Fatigues Quickly with Walking

Carry me! Is a phrase often used by a child who fatigues quickly when walking. A child who has good endurance, body mechanics, postural control and strength will want to walk vs being pushed in a stroller or carried. A child who struggles with one or more of these deficits will fatigue quickly when walking and ask to be carried more often. Ask a professional if your child seems to fatigue quickly when walking vs other children their age. 

Aversion to changing shoes

New shoes or any new clothing item can be stressful to a developing sensory system. Our children who are more sensitive to change will often break down their favorite pair of shoes to a thin sole, or wear shoes that lack proper support such as slip-on type shoes. A professional can help get children into good quality shoes that support the foot properly, helping them to move with better posture and efficiency. Let’s make shopping for new shoes fun! 

Sprained or twisted ankles

This painful injury literally stops you in your tracks. It’s common once in a while but abnormal if it happens over and over again, especially when doing everyday activities. Ankle weakness, misalignment or even vision could be the cause of ankle sprains. A PT can assess and address the reason for this very painful problem. 

Abnormal gait / walk

Any abnormality of a child’s gait should be addressed as soon as possible. Sometimes it’s hard to put your finger on it because the smallest thing could be affecting their gait or it comes and goes. Listen for your child’s steps on a hard surface. It should be an even beat most of the time. Rubbing the top of their foot while walking can be a sensory movement that is affecting their gait. Running instead of walking. Gait abnormalities can easily be addressed in PT. 

High Arches

High arches do not always need to be addressed but if your child has any other deficits such as any problems above, then high arches may need extra support. A PT can assess their gait and determine if treatment is necessary. 

Pediatric Physical Therapists assess the cause of these symptoms and use conservative interventions to improve their everyday function on their feet! They will also refer you to the appropriate healthcare professionals when extra attention is required for the best care of those little feet! 

Set up a free screening with a pediatric PT to ensure your child is putting their best foot forward!

Written By: Dana Bukala, PTA

 

Tummy Time

COVID Babies – Impacts of Quarantine on Development

The Global Pandemic of 2020 has left its mark on our lives in a variety of ways. It has changed the way we shop, the way we work, and even the way we learn. The lives of our kiddos have also been changed, especially for our “COVID Babies.” Babies born just before, during, or shortly after the global pandemic do not know anything different than the lives we live now. 

So how has this new “normal” affected the way they learn and grow? Has it even affected them at all? Here’s what the latest research shows: “COVID Babies” were less likely to “wave” to greet others, point/use gestures, and say their first words prior to their first birthdays. 

So, how can we support these “COVID Babies” and make sure they are on the right track? Meaningful play and reading together can be great ways to work on development. Exposing your child to as many different experiences as possible can create new environments for them to learn. It doesn’t have to be big and expensive. Something as simple as packing a snack and heading to the park can create new and unique learning opportunities for your little one. Click HERE  for a list of more ideas. 

If you have concerns about your kiddos development, click HERE for a link to our milestones page resources or schedule a free screening with one of our skilled therapists at BDI Playhouse. It’s never too early to make sure your little one has the skills needed to grow!

REFERENCES

Byrne, S., Sledge, H., Franklin, R., Boland, F., Murray, D. M., & Hourihane, J. (2022). Social communication skill attainment in babies born during the COVID-19 pandemic: A birth cohort study. Archives of Disease in Childhood. https://doi.org/10.1136/archdischild-2021-323441 

Emily Francis, M.S. CCC-SLP

 

Understanding Visit Limits in Pediatric Therapy

 

  • What does understanding visit limit mean in Pediatric Therapy mean?
  • What is the difference between hard and soft visit limit?
  • If my visit limit says 60 visits, why does my insurance not let me use all those visits?
  • What does “Medically Necessity” mean? If I have 60 visits why is insurance saying it’s not medically necessary?

Visit Limit

is a set number of visits your plan will consider for services for the year. For Pediatric Therapy, this may be a combined visit limit for any/all services. It could also be a separate limit for Physical, Occupational, and Speech Therapies. 

Hard Limit

is when your insurance company determines a set number of visits per year, such as 30. They will not pay for any therapy services once you have reached that number. As a result, if you choose to continue to treat after your hard max, those services would be your full responsibility, and will not be applied to your insurance deductible, co-insurance, or out-of-pocket expense. 

Soft Limit

is when your insurance company says they are allotting a set number of visits, such as 30, BUT they will consider additional visits beyond that number based on their determination of medical necessity. They would review medical records, and determine if therapy services are warranted, and could choose to allow or deny additional visits based on their review. And note, extra visits are not a guarantee.

My plan says I have 60 visits, and I was cut-off at 40. Why? 

Some insurance plans will say your plan has a set number of visits, but that does not necessarily mean you can “use” all of them. Many times, insurance companies request medical records from your Pediatric Therapy provider, and perform their own independent medical review. They can determine at any time, services are no longer needed. If that occurs, you would be financially responsible for those services.

What does Medical Necessity mean?

Many insurance companies have outside review companies they partner with to review records. They determine if they “feel” services are warranted, or a patient can be discharged from care. In short, f the reviewer determines that visits are not medically necessary based on their criteria, they will no longer cover services. 

Written by Ann Marie Johnson

Click here to schedule a phone call with a Next Steps Coordinator if you have questions or call us directly at 708-478-1820.

Visual Schedules

Importance of Schedules and Routines

Just like adults, children feel more confident and secure when their daily activities are predictable and familiar. Consistent daily schedules and step-by-step routines give children a predictable, safe day. Schedules and routines help children:

  • Feel in control of their environment
  • Feel safe, secure, and comfortable
  • Know what is happening now and what comes next
  • Know how to do an activity or task

However, what happens when you have a change in schedule or routine?  Does your toddler or child melt down or show big behaviors?  An unexpected schedule change or a change in their routine can be upsetting and stressful. If your child is struggling when transitioning between tasks or with changes in schedule or routine, BDI Playhouse recommends you use simple visual schedules to make those transitions and changes smoother.

What is a visual schedule?

A visual schedule is an image-based tool that helps support children of all ages. It presents a sequence of events for what is going to happen during a specific task, during an activity, or throughout the day.  Visual schedules help individuals complete a sequence of tasks or activities, attend to tasks, transition from one task to another, or maintain emotional regulation in various settings.

A visual schedule may use a sequence of photographs, videos, illustrations, or other visual elements that help your child understand what they are expected to do.  The visual schedule can be virtual on your phone or printed on paper.

Benefits of Using Visuals

  • Provides clarity and predictability in routine which allows a feeling of control (reducing anxiety or confusion)
  • Provides concrete visual information for (can make something abstract feel concrete, such as the length of time before an activity will be over).
  • Reduces behaviors caused by frustration, confusion, anxiety.
  • Provides a critical avenue for visual learners to understand and retain information.
  • Serves as a virtual “contract” for completing expectations and delivering rewards.
  • Assists in building independent routines with better success (such as packing a backpack, washing hands, or cleaning up after snack).
  • Helps children know what to expect and/or what the expectation is so that they don’t have to fear what will happen or become impatient and frustrated.

How to create your own visual schedule

  1. Identify your Target/Routine for the schedule
  2. Choose the type of visual that will be most meaningful to the child: 
    • Photographs of the child/child’s environment
    • Real life images
    • Line drawings 
    • Clipart
    • Text writing only
  3. Keep language simple and direct
  4. Involve the child in preparation
  5. Involve other caregivers

Easy Resources for Visual Schedules

If you find that your child is still having difficulty when you have a change in schedule or routine or need help learning how to use a visual schedule, contact BDI Playhouse to set up a free screening with one of our pediatric occupational therapists or speech language pathologists.  We can help you help your child!

AAC Winter Activities

Do you know what AAC is? It’s all the way someone communicates besides talking. AAC stands for Augmentative and Alternative Communication. Augmentative means to add to someone’s speech. Alternative means to be used instead of verbal speech. AAC is used when individuals have trouble with speech and language skills. AAC can look like an iPad/tablet with an app and a voice or a picture board. Here at BDI, we have many AAC users! 

It’s so important to model on your child’s AAC device. This is the best way for them to learn about their device. Modeling requires a communication partner with SLP’s typically begin by modeling core words. Core words refers to words that are in an individual’s vocabulary that make up most of an individual’s daily communication. Core words help AAC users to express their basic wants and needs. Examples include: help, stop, more, want, in, on, up, open

The best way to model is to use the device while you’re talking. For example, you can model “help me” by pressing “HELP” on device (or pointing to HELP on a low tech device) at the same time you say “help me”. 

With winter here, here are a few activities that you can do with your child with some tips on how to incorporate AAC! 

Snowman craft 

Snowman AAC

Supplies: Paper plate, construction paper (black, orange, brown, red, child’s favorite color), scissors, glue, pen/pencil

CORE WORD

Phrases to Incorporate

MORE“More glue”, “more paper”
WANT“Want glue”, “want paper”, “want black”, “want scissors”
HELP“Help me”, “help open”, “help cut”, “help glue”
ON“Put on”, “on top”, “on head”
OPEN“Open glue”

Sensory bin 

Sensory AAC

Supplies: Bucket, snow (real or fake!), shovel or scooper, bowls, cookie cutters, mini objects (i.e., snowflakes, christmas tree stickers, penguins, candycanes)

CORE WORDS

Phrases to Incorporate

MORE“More snow”, “More snowflakes”, “More scoop”
HELP“Help scoop”
ON“On top”, “Snow on”
IN“Put in”, “Go in”
GO“Ready, set, go”, “You go”, “I go”, “Go snow”
UP“Pick up”, “go up”

We hope you enjoyed these activities with your child!  We’d love to hear how it went.

 

Written by: Shannon Okland, M.S. CCC-SLP

Winter Swimming

Winter Swimming

Shake Off Winter Blues in the Pool!

Consider your local pool or aquatic park this winter for all it’s amazing benefits! 

Welcome winter and all it’s fun activities like ice skating, sledding and SWIMMING! The joy of swimming doesn’t have to end when winter begins. Indoor pools are the ultimate good mood booster along with so many other benefits! Open swim, swim lessons, aqua therapy and aquatic parks are amazing ways to get some exercise and a splash of the summer feels during the cold winter months.  

Winter swimming has even more benefits than summer! Here are some cool pool perks!

  • Playing in the water makes us happy! Water is a natural anti-depressent. Prevent “SAD” (seasonal affective disorder), a common syndrome in the winter months. Water submersion stimulates our sensory system, exercise releases endorphins and decreases anxiety. 
  • Master those swim skills! Practicing safety and swimming skills in the winter months will improve skills over the summer.  Motor planning for treading water, breath control, floating and swimming takes practice. Those skills are lost during the winter months and need to be reintroduced for water safety and proficiency. 
  • Create joyful memories! The family that plays together stays together! Exercising with family is not only fun but promotes a healthy lifestyle for your children to follow as they grow older. Promote year long family fitness and a lifelong healthy lifestyle.
  • Water is magic! Water play improves mobility, flexibility, balance, coordination, strength, posture, spatial awareness, endurance, circulation, attention, sensory motor integration and confidence. It decreases pain, muscle spasms, abnormal tone, rigidity, joint compression and stress. 

Concerns of increased illness from winter swimming are common. Check out these pool facts that address common miconceptions of winter swimming. 

  • Only a virus can cause a cold or flu. Viruses are more common in winter months from school and being indoors. Any indoor activity during the winter months increases the chances of catching a virus.   
  • Risk of illness is greatly reduced from a properly maintained pool.
  • Illinois Department of Health enforces rules and regulations for water quality in public pools.
  • Several studies have shown that wet hair along with cold exposure has not been linked to increase illness.  
  • Indoor pool water temperatures must be kept at 77-84 degrees and warm water pools are between 86-92 degrees for safety all year long. 
  • Prevent chills or risk of hypothermia by drying off properly, wearing a hat, and dressing appropriately for the cold weather after a fun winter day at the pool! 

Aqua Therapy is a great way to get started with a life long love of the water in a safe and accepting environment. Ask your pediatric therapist how aqua therapy can benefit your child! https://bdiplayhouse.com/aquatic-therapy/ 

Written By: Dana Bukala, PTA