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Author: J Keenan

Middle School Picky Eater

Middle School Picky Eater

Are you a middle school parent on the fence about whether or not to try feeding therapy for your picky eater?  At BDI Playhouse, we work with middle schoolers both in the clinic or from the comfort of your own home.  We help kiddos with a variety of feeding needs such as increasing their caloric or nutritive intake without the need to supplement all the way to eating chicken at your neighborhood BBQ or pizza with their friends after a sports activity and anything in between.    

The best part about doing feeding therapy with older kiddos, in our opinion, is that they can tell us what they are feeling and thinkin

g when it comes to food and they can be active participants in setting (and achieving) their own goals.  

Here are a few thoughts from a middle schooler in feeding therapy:

What’s the best part of doing feeding therapy?

I get to try foods that I haven’t tried before and that I am interested in trying.  I like doing it at food therapy because more than one person gets to see my reaction and I get to talk and chat!  

What’s the best part of doing food therapy online?

You can do food therapy and not worry about the virus.  Whenever I am at home, I don’t have to wait until my parents drive me home, I get to do whatever I want as soon as the session is done.

What would you tell a kiddo your age if they were on the fence about trying feeding therapy?  

The more therapy that you do the more excited you will get to try new foods.  

What’s your favorite thing you’ve done in feeding therapy?

I got to try a food from a show (dalgona cookies from Squid Games).  We also get to do “challenges” where we pick a food and try different flavors of it!  We had a candy night and tried all different candies.  We’ve done a poptart night and tried 8 different flavors of pop tarts.  We make food together.

Still on the fence of whether it would be a good fit for your kiddo?  Schedule a free screening with one of our feeding therapists to learn more about how we can help your middle school kiddo learn to love trying new foods!

reading

Reading Difficulties in Children

The Orton-Gillingham Approach

The path to reading for some children is not often an easy one. It is assumed that children will begin to read and spell naturally.  However, some children may persistently struggle with learning the process of how to read fluently.

Children who demonstrate challenges early on with word recognition, poor spelling, weakened decoding skills, and difficulty with their handwriting may continue to present with deficits within the areas of listening, reading, writing, and speaking, if intervention is not received.

There are numerous reading programs geared toward helping emergent readers as well as older children who are struggling using a more traditional approach to reading.  The Orton-Gillingham Approach was established to help provide a more systematic approach to reading, specifically for children with dyslexia. Research has shown that children without specific learning disabilities could also benefit from this approach in order to help them overcome their specific challenges. 

What is the Orton-Gillingham Approach?

The Orton-Gillingham Approach focuses on the five critical areas of reading:

  1. Phonemic Awareness
  2. Phonics
  3. Fluency
  4. Vocabulary
  5. Comprehension

The approach implements a multi-sensory approach by integrating the visual, auditory, and kinesthetic pathways to more efficiently teach children the rules and sequence of reading.

The Orton-Gillingham approach to reading follows a specific format to help teach these language skills and patterns in a systematic way. Orton-Gillingham begins with teaching the individual sounds.  Then it focuses on building words. By doing so, the child visually sees the letters, hears the sounds, then writes the letters.  Thereby, using a multisensory technique that includes these three sensory pathways.  This is referred to as the “language triangle”.

The specific lessons are flexible based upon the child’s level of functioning. They continue to build from simple to complex, as the children are taught the specific rules of language, such as spelling and decoding certain patterns in text. This ultimately helps to build upon their mastery. It leads to automaticity when reading, since there is a continual review of previously learned material during the sessions. The children cannot progress to the next level until they master certain lessons and drills. 

Early Indicators of Reading Difficulties

Teachers and parents will often recognize challenges with pre-reading skills in kindergarten, though some children may not demonstrate weaknesses with reading until after the second grade. Some early indicators of reading difficulties may include:

  • Family history of dyslexia or reading difficulty 
  • Weakened phonemic awareness skills
  • Decreased skill blending sounds and reduced comprehension of rhymes
  • Difficulty with letter and sound recognition 
  • Letter reversals (b-d) and inversions (w-m)
  • Lack of interest or avoidance of reading 
  • Dysfluent speech
  • Articulation errors: substitutions, omissions, cluster reduction  
  • Word retrieval difficulties
  • Frequent spelling errors 
  • Omitting words when reading 
  • Decreased processing speed when verbally responding 
  • Inconsistent memory and recall  
  • Poor executive functioning skills 
  • Weak handwriting skills 
  • Reduced auditory and/or reading comprehension 

Later Indicators of Reading Difficulties

Older children may present with language processing difficulties, as well as persistent challenges regarding their reading fluency, comprehension, handwriting, grammar, and spelling. Additionally, these children may have progressed with reading but continue to demonstrate deficits with clearly expressing their thoughts and ideas, therefore writing, vocabulary, and conversational skills may continue to be weak even years after they have acquired adequate reading skills.

Therefore, a more customized approach is warranted for these children to help them better succeed using strategies that will compliment the specific way they learn. By implementing the specific strategies using the Orton-Gillingham approach, children will continue to build upon their confidence and interest in reading by providing them with the skills they need in order to become more successful and proficient readers.  Does your child struggle?  Schedule a free screening with our Orton-Gillingham trained SLP.

Written by Meghan Grant, M.S. CCC-SLP

Sleeping in crib

Sleeping Safe Baby

It’s getting chilly out there! Are you wondering how to keep your baby warm and safe while sleeping? Here is a quick guide on how to keep your baby safe while sleeping in warm and cold weather!

4 simple steps

1. Place your baby on their BACK during naps and at night.

2. Use a firm mattress in a safety approved crib.
3. No bedding, pillows, bumpers, toys, and stuffed animals in the crib.

4. Baby can share your room but NOT your bed.

sleep arrangement

These simple steps are recommended for any season and time of the year by the CDC and National Institute of Child Health and Human Development.

Always remember! BACK to sleep & TUMMY to play! Click here for more information about the importance of Tummy Time!

Can my baby sleep in a swing or car seat?

Consumer Reports states, “car seats are safe for travel, not prolonged sleep. Parents and caregivers should feel confident that using an infant car seat is essential in a car, but a baby shouldn’t be left unattended in a car seat, it shouldn’t be your baby’s primary sleep space.”
If your baby falls asleep in their car seat, swing, bouncer or any other place that is not a flat firm surface, it is recommended to gently remove your baby from the “container” and place them in a safe sleep space. This allows your baby to move naturally which is essential to typical development. “Container” sleeping is not only unsafe for prolonged sleeping but linked to primitive reflex integration deficits, torticollis, visual deficits, plagiocephaly, toe walking, and delayed milestones.
 

Is my baby warm enough?

To determine if your baby is too warm or cold, feel their chest or back of their neck. They should be warm, not hot, clammy or sweaty. Babies have poor circulation so hands, feet, cheeks, and ears can be cool to the touch during sleep and does not necessarily mean they need more layers. The ideal temperature for a baby’s room to sleep in is between 68-72F (20-22C).

Can my baby wear a hat, socks or mittens?

No, it is not recommended for baby to have any clothing that can come loose to avoid suffocation. Hats are not necessary if baby is dressed appropriately for temperature. Mittens should be avoided as babies use their touch to learn and self soothe. You can clip or file nails often to avoid scratches. Footy PJ’s are a great alternative to keeping baby toes warm.

Can my baby have a blanket?

No. To reduce risk of suffocation avoid using blankets or ANY soft items in the crib. Instead use a sleepsack which is a blanket that baby wears. Be sure to look at the TOG rating of the garment to assess which sleepsack should be used depending on the room temperature. Remember to dress baby for the room temperature and not the temperature outside. It is suggested that you get a room thermometer because baby monitor temperatures can be inconsistent. What is a TOG rating? Thermal Overall Grade (TOG) is a standardized unit of measurement that calculates the thermal insulation of warmth of a textile. Keep in mind every baby is different and always check your baby for warmth with touch as described above. This chart is a general reference of how to dress baby with a sleepsack depending on the temperature.

According to the CDC, In 2019, there were approximately 1,250 deaths due to SIDS, approximately 1,180 deaths due to unknown causes, and approximately 960 deaths due to accidental suffocation and strangulation in bed.  Take these simple steps are the best known ways to reduce the risk of SIDS and allow baby to sleep safely and comfortably.  If you are concerned about your baby’s sleep, tummy time, feeding or any other infant development reach out to your pediatrician and your local pediatric therapists. Have questions?  Schedule an appointment with a pediatric therapist for a free infant screening at BDI playhouse!
Written by: Dana Bukala, PTA
Healthier Garden

Small Steps for a Healthier Life

Worried about your child’s health related to weight?  “The most common causes of childhood weight issues are are genetic factors or family history of obesity; decreased participation in physical activities; unhealthy eating patterns or behaviors; and, in rare cases, medical conditions.” – AOTA.  Do you have concerns about your child? Getting healthier doesn’t have to be overwhelming. Making small changes in activity level and making healthier food choices are a great way to start feeling good and reducing weight related illness.

What can I do to start making healthy changes?

Healthier Park

  • Make conscious decisions about your activities. Start with making small changes like:
  • Adding a little movement to morning routine to get body ready for the day like animal walks or a walk around the block
  • Encourage activities your child and family enjoy. Do you like to dance or play sports?
  • Adapt evening routine to decrease screen time and prepare body for sleep like doing some fun yoga stretches 

 

 

 

 

Healthier Raspberries

How can you make mealtime fun and healthy?

  • Make mealtime a valued time for socializing and sharing
  • Eat dinner together as often as possible
  • Make small swaps for healthier meals like quinoa for white rice
  • Let the kids select a healthy menu and help make it 
  • Add some fun with trying a new fruit or vegetable

 

How to get some quality Zzzz’s? 

Healthier Sleep

  • Provide time for lots of movement throughout the day
  • Keep a consistent wake-up time every morning, and nap time for little ones
  • Have a consistent bedtime routine every night 
  • Decrease screen time in the evening at least 1-2 hours before bed
  • Mealtime should be at least 1-2 hours before bedtime and include complex carbohydrates (fruits, veggies and whole grains)
  • Reduce simple carbohydrates like candy, cakes, cookies, juice, soda
  • Check temperature of room not too hot and more on the cooler side
  • Dim the lights, if child needs a nightlight use a pink light bulb
  • Make sure pj’s are comfortable, not itchy
  • Use white noise to drown other environmental sounds
  • Use lavender or vanilla essential oils for calming scents

Getting healthier doesn’t have to be overwhelming. Making small changes in activity level and making healthier food choices are a great way to start feeling good and reducing weight related illness. If you need support for a healthier lifestyle don’t hesitate to give us a call. BDI Playhouse Children’s Therapy offers free screenings and consultations through telehealth or at one of our child friendly therapy gyms in Aurora and Orland Park, IL.  Our occupational therapists can help you curate culturally appropriate healthy food preparation and meal ideas as well as identify enjoyable physical and social activities for you and your child.

Written by Jessica Frederick, COTA/L

Healthier Climb
Healthier Carrots
Bedtime routine

Bedtime Routines

Bedtime routines are essential for getting the appropriate amount of sleep each night. Lack of sleep within children can disrupt the important cycles their bodies go through to help with development, attention and so much more. Creating a bedtime routine doesn’t have to be difficult, just utilize these tips and your child will be snoozing in no time.  

Consistency

Whichever tip you decide to implement, the most important is consistency. Providing a predictable bedtime routine that is consistent allows your child to understand the sequence of events that lead up to the point of going to sleep. Utilizing verbal reminders, prompts or a visual schedule of the tasks that need to be completed before bed, help with active engagement as well as relieving anxiety. 

 

Calm Down Time

Relaxation is an important step in falling asleep. Provide a time before bed where your child is away from alerting stimuli like a TV, iPad, or phone screen. Reading books, picking up toys, or listening to calming music is much more appropriate for a bedtime routine. 

 

Meditation

Meditation is a great way to clear the mind to decrease anxiety before going to sleep. Here are some examples to implement within your bedtime routine:

  • Deep breathing
  • Progressive muscle relaxation
  • Guided imagery

 

Environmental Changes

Changes to your child’s sleep environment is an easy and great way to make your child comfortable enough to fall asleep and stay asleep.

  • Weighted blanket/compression sheets: Utilizing a weighted blanket or compression sheets can provide the proprioceptive input children crave as they sleep. This simple change can decrease anxiety and provide a calming effect to better facilitate a good night’s sleep. 
  • Light level: Utilize curtains to block out light. A dark room helps the body recognize that it is time to sleep.
  • White noise: Static noise can block out other sounds within the environment that may be disruptive.
  • Soothing Scents: Scents like lavender or other calming smells can help relax your child before bedtime. 

 

If your child has difficulty following a bedtime routine or has continued trouble falling asleep, please do not hesitate to contact the office at BDI Playhouse Children’s Therapy to receive a free occupational therapy screening

Written by Kiersten Robertson, MOT, OTR/L

Holidays

Thriving, Not Just Surviving, The Holidays

During this time of the year, a lot is going on so it is natural for kids to be overwhelmed and act out! If you plan on having a family gathering that involves new smells, loud voices, or too many sights; try some of these tips to help your kiddo out.

 

Social Stories

Reading a social story about what will happen during your next holiday event is a great way to prepare your child. 

  • You can make the social story together! Have your child color in pictures or have them make their own to go along with the story. 

 

Give Them a Job

Having a specific job during the holiday season can help make your child feel needed or important. Some ideas include: 

  • Setting the table
  • Helping with the cooking process for a dish or two
  • Cleaning up (bring dishes to the sink, dry dishes or even help wash)
  • Bring used napkins and dish cloths to the laundry room
  • Put away the dishes
  • Write down what family members want for dessert 

 

Calming Space

Provide a quiet space for your child to go when upset or overwhelmed. Go over calming strategies to use when in your calming space. 

  • Build a blanket fort together or use a tent as a place to go.
  • Put calming items inside like a stuffed animal, calming music, putty, a fidget, some coloring supplies, or any other favorite calming tools
  • Explain to your child that this is a place to go if you need to calm your body, but after you are calm you can come back out. 

 

Practice Beforehand

Practice, practice, practice! Talk about the different strategies provided or come up with your own before the event and leading up to it! Have your child practice smelling or trying the new foods that will be made for the gathering, make this fun-they can sniff it, lick it, eat it or even play with it! Try coming up with topics to talk about at the table, this can help with attention and social interaction skills.  

Holiday gatherings can be overwhelming but thankfully there are tools to help guide you through to make this experience enjoyable for all! If you still have challenges after trying some of these strategies, contact the office at BDI Playhouse Children’s Therapy to receive a free screen, or check the website at https://bdiplayhouse.com/free-screenings/

 

Written By Kiersten Robertson, MOT, OTR/L

 

Elbow

Hypermobility in Children

What is Hypermobility?

Hypermobility is a term used to describe joints that move more than normal and can place the joints in increased stress.  

How can Hypermobility affect my child?

Risk of Injury

Increased joint movement can cause joints, ligaments, and tendons to be at higher risk of injury.  Joints are less stable and can strain all the structures attempting to make the joint more stable.  In addition to joints moving more than normal the signals to the brain about where the body is in space can be impaired due to the ligaments requiring increased stretch before the message is sent to the brain making it harder for children to know where they are in space and making it harder for them to correct the joint position prior to exposure to extremes of  range of motion.  

 

What are the common signs of hypermobility in children?

Knee HyperextensionElbow HyperextensionHands to the Floor with

Straight Knees

Flat Feet
ELBOWHands to floorflat feet

NOTE: These are all postures that can occur in typically developing children with no cause for concern.  However, when multiple joints are impacted and your child twists their ankles or knees frequently, or reports leg pain this may be a sign to follow-up with your physician. 

Who can help my child?

BDI Pediatric Physical Therapists create a strengthening and proprioception program that can improve your child’s participation in recreational activities as well as lower their risk of injuries. Exercises consist of 

  • strengthening the muscles around the joints
  • working on postural control
  • sport specific training 

 

Next Steps

Do you think your child is at risk for injury due to hypermobility?  Schedule a free screening with one of our pediatric physical therapists.  When hypermobility is identified and treated with a proper development regimen, your child will report less pain, improve balance, strength, and functional performance.  In addition, your child can prevent future pain. 

Written by: Lisa M. Wood, PT, DPT

Girl refusing tomato

Feeding Fiasco

For some families, meal time can be the most challenging part of the day. Parenting a child who is having difficulty with eating can be tough for the entire family! Some kids are picky for a short time, or avoid only a few specific foods, and some kids may outgrow a food challenge. Some children maintain a difficult relationship with food for an extended period of time, seem to be regressing in skill, or make meal time a complete disaster with no end in sight. 

The Battle Field

When the preparation of food, the presentation of food, and/or the act of coming to the table is just the beginning of the mealtime battle, getting your child to eat nutritious and delicious food can be tough. If you are having to frequently pull out your sword and shield in preparation for a mealtime battle, it’s time to seek help from feeding therapists!

Too Tiny

If your child’s eating is impacting their growth, or your child is requiring supplements for weight or growth, our therapists can assist in food expansion strategies to enhance your child’s food intake and overall well being. 

  • Flee the Scene

Some children are overwhelmed by specific foods or the mealtime experience and will run away. Others require parents to strap them in, bribe them, pull out the tablet, or chase them down just to get to the table. If your child is having trouble coming to or staying at the table, feeding therapists can help make food more approachable, assist in attention enhancement, and provide strategies to remain at the table for the entire meal!

  • Tantrum Time 

When your dinner is thrown on the floor, smeared on the table, or screamed about in protest, your little one is struggling with food. Anxiety and frustration look different on each child, and tantrums can be one of the many responses to complex feelings food may be causing. Your therapist can help determine what abilities your child is struggling with that make the meal so difficult, and assist in developing skills to engage in meals and manage big emotions throughout the eating process.

  • The Picky Eater

A child is defined as being a “picky eater” when their food intake/variety is limited, but they are able to eat 30 or more food items. This number includes being able to eat the same food item prepared in a variety of ways! A picky eater may avoid an entire food group, or limit foods to a specific consistency or flavor. A feeding therapist can help picky eaters develop a meaningful relationship with their food and help the number and types of food accepted increase.

  • The Problem Feeder

A “problem feeder” is a child that eats 20 foods or less. This child may be brand specific in the foods they tolerate, they may have eliminated entire food groups, or they may avoid all foods that are a specific color, texture or consistency. Problem feeders may have underlying difficulty with oral motor or sensory processing skills resulting in gagging/vomiting, choking, coughing, or drooling. Our therapists are trained to assist in assessing the areas of challenge and increase the types of foods a child is eating to improve their nutritional intake and overall health/wellness.

  • Social Skills Suffer

Eating is a social activity. Families and friends sit down to share a meal, go out to eat meals together, bond over coffee dates, celebrate milestones with food, and more! If a child is having difficulty remaining at the table or tolerating being around others eating food, a feeding therapist can step in before social skills and meaningful events are impacted!

If your child falls into any of the above categories, bring your worries to BDI Playhouse feeding therapists! Set up a free consultation to get more information, and put your worries to rest!

Written by: Maggie Lord, MS, OTR/L

Potty Accidents

Potty Accidents

Why is my child having potty accidents?

Potty accidents aren’t fun for anyone. It can impact a child’s relationships with their family and friends.  Here are 5 common reasons children have accidents

Constipation 

Chronic constipation is the main cause of pee and poop accidents in children that have been potty trained. This is a great handout to see if your child has any of the main signs of constipation. Did you know that pooping every day doesn’t mean they aren’t constipated? “The Poo in You” is a video with a great explanation of what happens inside the body. 

Lack of Awareness 

Many kids may not have any idea that they have to go. They may not realize that they have to use the bathroom until it’s too late, or until they’ve already gone. Knowing what is happening inside the body can be a hard concept for kids with difficulty with sensory awareness. 

Poor Potty Posture 

Poor potty posture makes it hard to clear out the bladder and bowels. The Squatty Potty  or other step stool helps support the feet which lets the pelvic floor muscles relax. Therapists can also help with postural awareness and strength to help with the proper potty posture for successful toileting.

Scary Bathrooms

The bathroom can be a scary place for kids! Sitting with dangling feet, the noise, and the smell can all make kids avoid the potty. Many children avoid public bathrooms because of these fears. 

Medical Reasons

There could be a medical reason your child is having accidents. If you have concerns about your child’s accidents talk to your pediatrician. They can help decide if a referral to gastroenterology or urology is needed.

 

Who can help my child?

If you think your child might have constipation or is struggling with accidents, please reach out for a free screening! Sometimes, you may need the help of a physical, speech, or occupational therapist to help identify the reasons for your child’s accidents and/or constipation. 

Pediatric Therapists

Therapists trained in pediatric incontinence can provide treatment with:

    • Core strengthening
    • Biofeedback
    • Bladder re-training
    • Behavior and diet strategies
    • Body awareness to help realize the urge to go 
    • Posture training
    • Increasing fiber rich food intake 
    • Increasing variety of foods
Halloween

Halloween Activity

Happy Halloween month! At BDI, the therapists have been incorporating Halloween vocabulary throughout their sessions!  This simple activity of stickers and real image vocabulary card can be used to target all different areas of communication, fine motor skills, and visual processing.  Targeting holiday specific vocabulary can help your child communicate in their community.  Why?  Because our kiddos are seeing Halloween items everywhere (i.e pumpkins on walks in their neighborhood to spooky spider displays at the grocery store)!   The following are examples of ways to achieve different developmental goals by using the same activity.

Halloween Bingo

Matching

Starting out, simply matching the animated sticker to the real image is a perfect way to help teach reality vs. fantasy and to make sure the child isn’t just memorizing one specific image!

Imitation

The child imitates the vocabulary word and receives the sticker to mark as “complete”.

Independent labeling

The child labels the Halloween card or sticker independently

Receptive identification

If your child is a great talker but needs to work on his/her listening skills, you can ask your child questions!  For example, you can ask your child “where is the cat?” or “which one is round and orange?”.  Columns or rows can be covered to reduce the amount of items he or she is scanning.

Image description

After basic labeling is mastered, you can have your child be more descriptive with their request.  The child can request the “black cat” sticker, “scary spider”, “two bats”, “silly pumpkin” etc.

Simple requesting

“I want + vocabulary word” or “Can I have + vocabulary word”

Complex requesting

“I want the purple hat”; “I want the scary ghost”

Articulation

Try finding all the final /t/ sounds in these fun Halloween words!

Are you looking for more ideas on how to make every day activities a little more festive?  Join our Talk and Groove class to learn about more ways to help your child develop their language and fine motor skills at home!