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insights is a helpful blog brought to you by Child & Family Development

Child & Family Development is a multi-disciplinary pediatric clinic serving the needs of Charlotte area children and their families.

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  • MIDTOWN OFFICE
  • 4012 Park Road, Suite 200
  • Charlotte, NC
  • 704.332.4834
  • PINEVILLE OFFICE
  • 10516 Park Road
  • Charlotte, NC
  • 704.541.9080

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The information contained in this website is intended to provide general educational information and client education on certain topics only and is not intended to offer healthcare/medical advice. This information should not be considered complete and should not be used in place of a visit, consultation, or advice from a licensed healthcare professional. Child and Family Development is not liable or responsible for any advice, course of treatment, diagnosis or any other information or services you obtain through this website. If you have, or suspect you have, a health problem you should never disregard medical advice or delay seeking medical attention because of something you have read on this website. Never rely on information on this website in place of seeking professional medical advice. If you have questions about a medical condition or seek advice, see your healthcare professional immediately.

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Links from our website to other websites are provided as a service to help users find appropriate information. Absolutely no responsibility is taken by Child and Family Development or its employees for the accuracy of the information you may receive from any of the referred links. If you have questions about a medical condition or seek medical advice, contact your healthcare professional.

Occupational Therapist follows AOTA potty training tips

Sunday, Dec 21, 2014 by Child & Family Development

Abbey Wash, occupational therapist at the Midtown office of Child and Family Development, follows news from the American Occupational Therapy Association.  

Recently, she discovered an updated tip sheet on potty training that she uses in occupational therapy and shares with parents.  

Abbey notes that potty training can be a great source of stress for families.  Our communities and schools put a lot of pressure on success!  Keep in mind that most children don’t consistently master bladder control until 4.5-5 years.  Bowel control comes a little earlier at 3.5-4  years.  Before attempting to toilet train, you’ll need to first make sure that your child is showing signs of readiness and then prepare for a training routine.  A half-hearted failed attempt can actually hinder success!  

The tip sheet includes:

Identify signs when the child is ready to begin participating in a toileting routine.  Children will often demonstrate signs when they are ready to be toilet trained. These signs include:

  • Interest in the bathroom or in the toileting process, which includes wanting to visit the bathroom, playing pretend toileting, touching toilet paper, or being curious about how the toilet flushes
  • Wanting to observe others using the bathroom
  • Reporting to a caregiver when they have gone in a diaper and/or asking to wear underwear
  • Starting to “hold” their urine or bowel movement and/or getting upset when a diaper is soiled

It is important that families begin toilet training when it works for them and the child, typically between 18 months and 3 years of age. Toilet training is a family commitment, so all members should collaborate for success.

Set up a successful routine for potty time.  An important aspect of toileting is for children to learn their body and the cues it is giving them to know when to go to the bathroom. But families should also encourage toileting routines, including the following times during the day for bathroom visits:

  • When waking up
  • Before and after naptime
  • Before and after a new play activity
  • Before a meal
  • Before bedtime
  • Before leaving the house for an event

Consistently taking a child to the bathroom at established times helps identify a routine for the family and child. If a child is showing signs of needing to go to the bathroom by wiggling or grabbing his or her clothes, families can ask if it’s time to visit the bathroom. But it is also important to teach children to recognize their body signals and go on their own.

Increase independence in toileting skills. Part of successful toileting is to ensure children wear clothes that can be easily removed. This often means clothing with elastic waistbands. If a child has a difficult time grasping the waistband, families may attach a loop the child can pull on.  
Provide a comfortable and inviting environment.  The bathroom can be a scary place with lots of noises, sensations, and smells. Some strategies for setting up a good toileting routine include making the space accessible and inviting, including:
  • Placing items needed for toileting, such as toilet paper, within easy reach, and having a sturdy stool nearby to help the child get onto the toilet.
  • Allowing the child to do an activity while on the toilet, like reading a favorite book.
  • Talking to the child about the bathroom and how the toilet works to avoid fear.
  • Placing brightly colored towels and fun-smelling soaps at the sink to make hand washing fun.
  • Addressing smells with air fresheners as appropriate.
  • Adapting the toilet seat so the child feels secure. For example, consider using a potty chair, potty ring, or foot rest.

Offer steps to help your family learn a positive routine.  Learning to toilet may take time, and it is important not to rush a child. Children may need to sit for a bit to be successful. They may benefit from:

  • Running the sink water to initiate pottying
  • Singing a song or two to relax
  • Looking at a book while on the toilet

If a child cannot remember all the steps in the process of toileting, a series of pictures of each step posted by the toilet may help. Remember, children need to practice, and toileting has a lot of steps! Bathrooms are also different, so a child may need additional time when in a new bathroom.

Help your child learn proper hygiene.  Some children may need assistance getting clean after toileting. They may need coaching on how much toilet paper to use, and visual checks to ensure that they are clean. Hand washing is important, and children should be able to access the sink with a sturdy stool. Soap and towels should be easy to reach. In order to protect children from water burns, families can label the faucets with colors to indicate which is cold and which is hot.   

Encourage positive behavior.  Toileting accidents are a part of the learning process and to be expected. Children may be so interested in something else that they forget about getting to the bathroom until it’s too late. A child should never be punished for an accident. Instead, praise a child when successful and clean up accidents calmly. If necessary, carry extra clothes so children won’t be embarrassed if they have an accident. Consider plastic sheets on the bed as a temporary measure and reduce fluids before bedtime. Children can also help clean up the mess, which may help them learn to avoid future accidents.  Reward children for their responsibility and participation as they learn toileting skills by complimenting their “big boy” or “big girl” underpants, and by praising their successes in keeping their bed and clothes dry. 

Click here for the AOTA article.  

Abbey and the othere pediatric occupational therapists are available.

Learn more about developmental milestones on our website. 

 

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Topics: Abbey Wash

"Don't Take Our Word For It "note for Amy Gossett, Speech Therapist

Saturday, Dec 20, 2014 by Child & Family Development

Amy Gossett, speech therapist at the Midtown office of Child and Family Development, offers a number of social skills groups for Charlotte children. 

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Topics: Amy Gossett

Holiday tips for kids with sensory processing difficulties

Friday, Dec 19, 2014 by Child & Family Development

Kati Berlin and Abbey Wash, occupational therapists at both offices of Child and Family Development recommend these tips from the STAR Center.  

Holiday celebrations bring joy, and sometimes challenges.  Excited children become noisier, decorations provide greater visual input and the lack of routine make some children more anxious and reactive. For children with sensory processing issues, the daily challenges of communication and social skills can be magnified.  

Here are some suggestions to support communication and emotion regulation for successful social interactions:

  • When changes in the school routine occur, it is important to compensate by providing greater predictability and structure at home.
  • Make a holiday calendar. Create a list or insert pictures of planned activities that are outside the regular routine.
  • Help your child learn basic phrases to use when meeting relatives that he or she hasn't seen for a while.
  • Provide a break for your child by watching a DVD or quiet time when days are full and busy.
  • Help your child stay regulated by watching for signs of sensory overload or emotion dis-regulation and help your child regain control before it is too late.

Read another blog post for more ideas to help kids at this time of year. 

Happy Holidays! 

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Topics: Abbey Wash, Kati Berlin

Looking for pediatric therapy services near Fort Mill, South Carolina?

Friday, Dec 19, 2014 by Child & Family Development

 

 Our Pineville office is less than 5 miles from the border and easily accessible from I-77 and the 485 loop.

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Dyslexia and Your Bright Child

Thursday, Dec 18, 2014 by Child & Family Development

 

Our Educators are often asked questions about whether it is possible to have learning disabilities in children who show dramatic strengths in other academic subjects and life skills.  The answer is a resounding YES. 

Because reading disabilities are the most prevalent learning disabilities, let's focus on dyslexia.

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Topics: Mary Froneberger, Marie Pacini, Jessica DeLing

Why is writing is hard for my child?

Wednesday, Dec 17, 2014 by Child & Family Development

Writing difficulties are often seen in children in the upper elementary grades, as well as in middle school and high school.  Many of these children present with or have a history of language delays, language processing difficulties, or even diagnosed learning disabilities. 

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Topics: Aleksandra Liss, Gretchen Hunter, Stephanie Gerlich, Colleen Nolan, Allison Parker, Joy Granetz, Mary Froneberger, Marie Pacini, Michelle Pentz, Amy Gossett, Jessica DeLing, Melinda Bumgardner, Brandyn Street

Developmental Reflexes in 1st Year of Life: Birth to 3-4 months

Tuesday, Dec 16, 2014 by Child & Family Development

Our physical therapy team provides this summary of reflexes that begin to develop at birth and take a couple of months to fully integrate.

It describes what to do to elicit the reflex and what you should see your child do in response.

Reflex

Timeline

Description

Response

Spontaneous Stepping

Birth to 1-2 months

While supporting the infant in the standing position with your hands under their arms and around the chest and their feet touching the surface, incline the child forward and gently move them forward to accompany any stepping.

Child will make alternating, rhythmical and coordinated stepping movements.

Rooting Reflex

Birth to 3-4 months

While child is lying on back with head in the middle and hands on the chest, use finger to stroke from the corner of the mouth out towards the check, upper lip and lower lip.

Stimulation of corners of mouth will result in a directed head turning toward the stimulated side. Stimulation of upper lip causes mouth to open and head to tilt backward. Stimulation of lower lip cause mouth to open and head to tilt forward. Infant tries to suck the finger.

Sucking Reflex

Birth to 3-4 months

While child is lying on back with head in the middle and hands on chest, place a finger or nipple in infant’s mouth.

Will result in rhythmical sucking movements.

Palmar Grasp

Birth to 3-4 months

While infant is lying on back with head in middle and hands free, place your index finger into the hands of the infant from the pinky finger side and gently press the palm surface.

Infant’s fingers flex (grasp) around your index finger.

 

 

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Topics: Amy Sturkey, Jessica Sapel, Lisa Gigliotti, Leslie Cordero, Erin Harkins, Gail Fennimore

How Does Your Engine Run?- Just Right Speed

Monday, Dec 15, 2014 by Child & Family Development


 

The Williams and Shellenberger Engine Program describes 3 different engine speeds: High, Just Right and Low.

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Topics: Abbey Wash

Looking for pediatric therapy services near Waxhaw?

Sunday, Dec 14, 2014 by Child & Family Development

 

 Our Pineville office is less than 5 miles from the border and easily accessible from I-77 and the 485 loop.

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Child & Family Development celebrates with Erin Harkins

Thursday, Dec 11, 2014 by Child & Family Development

Erin Harkins marks 7 years at Child and Family Development this month! She is a physical therapist and the Clinical Supervisor of Occupational Therapy, Physical Therapy and Speech Therapy. 

Erin likes to think she can make anyone smile :) and believes laughing is good for the soul.

 Happy C&FD Anniversary!

 

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Topics: Erin Harkins

How to Make a Fidget

Thursday, Dec 11, 2014 by Child & Family Development

Kati Berlin, Occupational Therapist, shares ideas on how to make a fidget. 

Fidget toys are small objects that can be used during school, in the classroom, or at home to focus a need to move, help kids pay attention, or help to decrease anxiety. Children with attention deficit disorder (ADHD), hyperactivity, sensory processing disorder, or anxiety may be able to benefit from a fidget toy. Fidgets should help your child focus, should not make distracting noises, and should not distract other children in your child's class. When fidgets start to interfere with focus and functioning in the classroom, they should be taken away & a new approach should be attempted. Make sure to ask your child's teacher before sending a fidget with your child to school.

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Topics: Kati Berlin

Sensory Processing Disorder: Keeping calm during the holidays with an occupational therapist

Wednesday, Dec 10, 2014 by Child & Family Development

The 2014 holiday season is upon us and many adults are already feeling overwhelmed.  The holidays can also be an exciting time for children; but for those children who have Sensory Processing Dysfunction (SPD), the holidays can be very over stimulating.  Here are a few ideas from Marion Wilm, Occupational Therapist, to keep your child calm and organized.

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Topics: Marion Wilm

Looking for pediatric therapy services near Rock Hill, South Carolina?

Tuesday, Dec 9, 2014 by Child & Family Development

 

 Our Pineville office is less than 5 miles from the border and easily accessible from I-77 and the 485 loop.

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Neuro-Developmental Treatment (NDT) at Child and Family Development

Monday, Dec 8, 2014 by Child & Family Development

According to the Neuro-Developmental Treatment (NDT) Association, the NDT Approach is used for management and treatment of individuals with central nervous system (CNS) pathphysiology. The individual's strengths and impairments are identified and addressed in relation to functional abilities and limitations. The NDT Approach continues to evolve with the emergence of new theories, models, research, and information in the movement sciences. NDT is a hands-on, problem solving approach. Intervention involves direct handling and guidance to optimize function. The approach is guided by the client's reactions throughout every treatment session.

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Topics: Amy Sturkey, Marion Wilm, Gail Fennimore, Ann Guild

Does my child have a learning disability? Educators advise "trust your instincts".

Sunday, Dec 7, 2014 by Child & Family Development

 

child_8

As an Educational Specialist at Child and Family Development in Charlotte, I consult with parents who express concern that their child may have a learning disability. Parents frequently comment that "something is not quite right”. That gut reaction is often on point.  Trust your instincts and take the time to consider the following:

  • Make a list of all the “red flags” that you have noticed at home. Additionally, plan a teacher conference to discuss any school struggles that might need to be added to the list. 
  • Think about other important factors related to your child’s learning. Reflect on family, developmental, and medical histories. No observations are insignificant; all of the small pieces will help to form the big picture.
  • Consider your child’s pattern of strengths and weaknesses. Does your child excel in some areas while struggling in others.
  • Examine your child’s behavior and emotional reactions. Most children are truly eager to please, and negative behaviors can be a reaction to difficult situations. Learning disabilities can produce sadness, anger, or feelings of insecurity in a previously happy youngster.
  • Consider an evaluation or consultation.

 

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Topics: Mary Froneberger, Marie Pacini, Jessica DeLing

Add Learning to Your Holiday Celebration

Friday, Dec 5, 2014 by Child & Family Development

 

The holidays bring a break from the daily routine of school, but learning can still be a part of your fun and festivities. Our Educators have some great ideas. 

gift-1

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Topics: Mary Froneberger, Marie Pacini, Jessica DeLing

Physical Therapy helps infants with torticollis

Thursday, Dec 4, 2014 by Child & Family Development

Our physical therapy team gets great satisfaction from helping infants diagnosed with torticollis or plagiocephaly. 

Infants experience such rapid gross motor development in the first seven months of life and with just a few tips to new parents, there can be huge improvements in their overall development.

A diagnosis of torticollis means that there is a neck musculature imbalance, and the sternocleidomastoid muscle (SCM) is the muscle involved. Plagiocephaly is usually a secondary diagnosis to torticollis. It is caused by the infant resting heavily on one part of the head which leads to a flattening of the head in that area.

A helmet is usually prescribed to improve head shape, but many of the cases I have treated by conservative measures have improved head shape and a helmet is not necessary.

The SCM is the large neck muscle that runs from the mastoid process (close to the ear), all the way down to the sternum. Its function is to rotate and tilt the head. When the SCM is tight on one side it causes the head to tilt in that direction and rotate to the opposite direction. For example, if the right SCM is tight, the child's head will tilt to the right and rotate to the left. Now, there are exceptions to every rule and sometimes a child's head will tilt and rotate to the same side, but for the most part, torticollis follows the previously mentioned pattern.

The cause of the musculature imbalance could be related to how the child was positioned in the womb, positioning following birth during sleep or resting, and/or if the child is not getting the necessary amount of "tummy time." 

Most of the time, a parent or a pediatrician notice the child's head is flat on one side or on the back or notice a slight tilt of the neck/head in photographs.

The treatment for torticollis is effective. Weekly physical therapy usually takes 6-12 weeks, depending on the severity. There's also a home exercise program of daily stretching. 

Want more info or to schedule an appointment?

Contact Leslie Cordero, DPT or another physical therapist at Child and Family Development in Charlotte.

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Topics: Amy Sturkey, Jessica Sapel, Lisa Gigliotti, Leslie Cordero, Erin Harkins, Gail Fennimore

College students with ADHD and Learning Disabilities

Wednesday, Dec 3, 2014 by Child & Family Development

 

Applying to college is stressful enough without trying to also find a college that suits your needs as a student with a disability. 

Our Educators recommend Applying to College for Students with ADD and LD: A Guide to Keep You (and your parents) Sane, Satisfied, and Organized Through the Admission Process by Dr. Grossberg.  It may be a good resource to help you navigate the maze of college search and application.

For more information regarding Dr. Grossberg's article or book you can visit the website: www.myadhd.com.

 

 

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Topics: Mary Froneberger, Marie Pacini, Jessica DeLing

Prematurity and its impact on the nursery years

Monday, Dec 1, 2014 by Child & Family Development

There are a number of ways that prematurity can affect children in the early stages of growth, while in the nursery setting, at a daycare or in the preschool.  These children may have poor trunk stability, strength and coordination, resulting in delayed rolling, sitting, crawling, walking, talking and hand use.  Feeding and communication may also be compromised in preterm infants.  Inefficient breast or bottle feeding may result in poor weight gain and a slowed transition to textured food with a limited diet or picky eating.  There children may also display a decreased amount and variety of babbling and delayed use of single words.

Child and Family Development is a multi-disciplinary pediatric therapy clinic in Charlotte, North Carolina. 

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Gifts and toys for a 1-year-old

Sunday, Nov 30, 2014 by Child & Family Development

It's the holiday season!  Are you trying to come up with some good gift ideas for kids? Here are some motor milestones to consider and Physical Therapist approved toy recommendations for a 1 year old child.

 

 

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Topics: Amy Sturkey, Jessica Sapel, Lisa Gigliotti, Erin Harkins, Gail Fennimore