Autism Therapy Charlotte

Due to the pervasiveness of autism spectrum disorders, awareness is rising rapidly with media playing a significant role in this awareness. In recent years, there have been many wonderful films portraying the life of those affected by autism. Although every child with autism is unique and has a different story to tell, it is because of such films that many people’s eyes are opened to autism for the very first time. Films like Adam, Temple Grandin and Wretches and Jabberers have captured hearts across America. There is now much anticipation for the upcoming documentary titled The United States of Autism, which is sure to resonate with families across the country affected by the disorder.

This project all began with the vision of one father on a mission to create a voice for the autism community across America. Richard Everts is the father of a child with autism and the founder of The Tommy Foundation, an award winning non-profit organization that works with families affected by autism in the Northeast. With support from The Tommy Foundation team and a grant awarded by the Pepsi Refresh Project, filming was a success! On April 2, 2011, in honor of Autism Awareness month, a glimpse of this success was shared with the world through the movie trailer.

(This post is the 2nd in a series of 2 posts by this therapist addressing sign language)

Teaching signs to a child who has a developmental delay or a language impairment such as autism or childhood apraxia of speech can be helpful for increasing communication and decreasing frustration. After all, using signs to communicate is much more effective than having no way of communicating at all! After the initial speech-language evaluation, a speech therapist may begin teaching a child with limited verbal skills to sign by choosing 1 sign to start with, and adding more signs as the child learns the cause-and-effect of communicating with signs. 

From here, the course of therapy truly depends on the individual child. For many children, the use of signed words helps verbal skills come along. In addition to or in lieu of signs, the therapist may implement an augmentative/alternative communication approach. 

Is signing right for your child? For the short term?  For the long term?  There are many factors that a speech therapist takes into account when deciding whether or not to teach signs to a child. Feel free to contact a speech therapist at either of our Charlotte offices – we’ll be glad to hear your concerns and answer your questions.

She will be based at the South Charlotte office on a full-time basis.  

Jessica is a 2010 graduate of SUNY-Buffalo with special interests in autism and sensory integration. 

Welcome Jessica!

In treating children with Autism practicing Pediatric physical therapy or Relationship Development Intervention (RDI) here at Child and Family Development in Charlotte, NC, I see core difficulties in children with Autism as they try to manage the challenges of daily life.  People with autism have difficulty negotiating an emotional world where so many things are decided by how you feel about a situation.

This week I had a mother come to my therapy room and tell me her son (my client) was down at the car with his sister and wouldn’t come up. She said she thought he was overly tired and hungry. Could I please come help? Sure, I thought. No big deal. The moment he saw me, I knew he would come right up. He loves me and requests me all week long. I got down to the car, and sure enough there he was clinging to the outside of the car crying and saying he wanted to go to McDonalds and get chicken McNuggets. When he saw me, nothing changed. I was flabbergasted. I’ve seen him for almost 10 years and he had never done anything like this. I tried to catch him, pull him, drag him, bribe him with food, and nothing worked. He was crying and wanted to go to McDonald’s and get chicken McNuggets. I wondered since he had never done this before, should we let him go to McDonald’s and just skip PT? What would be the ramifications of this if we did? His mom asked me what we should do. I said more to myself than to his mom, “As soon as I figure out what is the best thing to do, I’ll do it.”

Isn’t life a lot like this? How many times in my life, have I thought, “If I just knew the right thing to do, I’d do it.” I’ve felt this way about friendships, relationships, sibling differences, work outs, medical issues and more. Don’t you just wish life came with a little book that you could look up in the index what the answer is? More times than not, the answer comes down to emotional decisions informed of course by experience, speculation, and your gut feeling about a situation. How do you know when it is time to choose a new friend, a new décor for the living room, a new school or a new behavior management technique for your child? When is it time to let an old friend go? It comes down to advice from all your friends (or maybe despite all the advice from your friends) and your final feelings on the matter. These kinds of choices and conflicts are natural challenges for people on the spectrum.

What happened with the child in the parking lot? The mom commented that her son had been doing this recently at school, lying in the floor crying and getting out of work. That’s all I had to hear, and in my gut, I knew the answer. I “helped” him in the building, and we got to work. 

Emotional choices and challenges task all of us, but are particularly challenging for people with Autism. Relationship Development Intervention targets the core deficits of autism to work on the building blocks of these skills. Call me if I can help you, (704) 332-4834 ext 114.  

In treating children with Autism practicing Pediatric physical therapy or Relationship Development Intervention (RDI) here at Child and Family Development in Charlotte, NC, I see core difficulties in children with Autism as they try to manage the challenges of daily life.  People with autism have difficulty negotiating a world where so many things happen in such imperfect ways.

Dr. Steve Gutstein, founder of RDI, says, “The world is imperfect. Rarely in our modern world do we complete something without interruption or finish it with 100% perfection. Most times decisions and follow through are based on “good enough” criteria. …As in all relationships, there are significant periods of getting it wrong. In fact, the importance of dealing with manageable failure is critical to the development of personal competence.” 

In my clinical experience, the idea of perfect is often related to what a person thinks is perfect. I have kids who think in a perfect world my door is closed… or who feel all the toys in my room must always be put up. If one particular child comes in my room and a toy is left out…he’ll put it up for me. I have another kid who decided that how he saw my room for the first time was the perfect example. So unfortunately a ball had casually been thrown “behind a mat”. From that point on, “behind the mat” is where that ball belonged. If he came in the room and the ball was up on the ball rack, he wasn’t happy until it was “behind the mat”. I know growing up, I didn’t want food to touch on my plate and the sauces shouldn’t run together either. But for some kids, Harris Teeter waffles are totally unacceptable but Eggo Waffles are perfect. For another child, he becomes frustrated when he doesn’t do an activity according to his standard that he hasn’t exactly specified and then refuses to try anymore. Some kids get bent out of shape if I don’t do the exact sequence of activities that I last week. 

I personally think that perfect for neurotypical people is something that would be nice, at least in the short run, or maybe less stressful. But with children with Autism, I believe that the need for “perfect” is coping related. I believe they have trouble efficiently developing/storing/retrieving/organizing a mental file of successfully coping with past situations that are less than perfect. They feel that things won’t go well/the day will be ruined unless the door is closed, the toys are put up, the ball is behind the rack, the mash potatoes and peas are not touching, and the Eggo waffles are really Eggo and they are all done in the correct order and in the correct way …so it will all be perfect. I don’t know about you but all that makes me really tired. 

Imperfect challenges task all of us, but are particularly challenging for people with Autism. Relationship Development Intervention targets the core deficits of autism to work on the building blocks of these skills. Call me if I can help you, (704) 332-4834 ext 114.  

*Quotations are from the RDI Messier brochure.

In treating children with Autism practicing Pediatric physical therapy or Relationship Development Intervention (RDI) here at Child and Family Development in Charlotte, NC, I see core difficulties in children with Autism as they try to manage the challenges of daily life.  People with autism have difficulty negotiating a world where so many things happen in such surprising ways. 

To come up with ideas for this post, I spoke to a mother of a child who is high functioning with only aspects of his personality in common with people who are autistic. I thought he might be able to verbalize his concerns.  I spoke to him and his mother and asked them to tell me what was hard about surprises.  His mother explained that she tries not to tell her son about potential surprises that are upcoming in his schedule...unless they are definite. Then a warning could help...otherwise the potential drives him nuts. 

She said that vacations were really stressful for him.  "Stressful?  Vacations?" I asked.  Yes, she said that on vacations the family tended to make last second decisions and decide to go fun places without notice.  This unnerves him.

Another great example was the problem with the monthly fire drills at school. His mother explained that if it got toward the end of the month and the fire drill hadn't happened that he became convinced that it was going to happen at any moment.  She said, "Don't even think about concentrating on the teacher or getting any work done.  He would just sit and worry."  They finally coordinated with the school to let him know before a fire drill so he wouldn't have to worry about the potential surprise.  

His mother explained that she thinks her son feels that with surprises...that if anything changes...that anything could change....and then nothing could be trusted.  Then the world just becomes unbearable chaos...

At this point in the discussion, the son looks up and says, "Is this your way of telling me something is about to change?"  His mother reassured him, "No honey, we are just talking about surprises."  ..."Just answer the question?"  "No, no surprises honey", she answered. "Why don't you just tell me?..."  and on and on for several minutes...

Surprising challenges task all of us, but are particularly challenging for people with Autism. Relationship Development Intervention targets the core deficits of autism to work on the building blocks of these skills. Call me if I can help you, (704) 332-4834 ext 114. 

 

The Child and Family Development team, The Wild Things, looks forward a big event next month, Autism Speaks Walk Now for Autism in Charlotte.  Several members of our pediatric therapy team will participate in support of the children that visit our clinics.

It takes place on Saturday, October 9, starting at 10 A.M. at Lowe's Motor Speedway. A Resource Fair begins at 8:30 and continues throughout the day.  Stop by our table for fun, games and information.  

The walk is designed to promote awareness and raise money. 

For more information, visit these websites:

• www.autismspeaks.org
• www.walknowforautismspeaks.org

In treating children with Autism practicing Pediatric physical therapy or Relationship Development Intervention (RDI) here at Child and Family Development in Charlotte, NC, I see core difficulties in children with Autism as they try to manage the challenges of daily life.  People with autism have difficulty negotiating a world where so many things happen simultaneously. 

To come up with examples of this, I problem solved with Gail Fennimore, a physical therapist. We decided that play between children has lots of simultaneous challenges. Playing sports are classic examples. Think of all the important things that happen simultaneously in a game of kickball, soccer, freeze tag or duck duck goose. Simply playing safely on a crowded playground requires know what you are doing and the children next to you are doing or hope to do. Even by yourself, processing lots of information simultaneously allows you to walk safely up and down stairs, jump rope, or ride a bike for example.

In Speech Therapy, Sadia Syed explained to me that in a conversation we take in information not only from the words that people say but also from the tone of their voice, their inflection, their gestures, and facial expressions. The rate or loudness of their words can dramatically change the meaning of what is said. She explained that people with Autism may have poor processing skills, poor eye contact, short attention span, and decreased memory skills that make processing simultaneous information yet more difficult. As Sadia flipped her braided hair, she said, “Some children become  distracted by something as simple as me flipping my hair or by my cool shiny ring, then nothing else is processed”. 

In Occupational Therapy, Lindsey Pritchard said that when we write we have to simultaneously think of the formation of the letter we are writing, its spacing, alignment, and size, all while keeping in mind the word, sentence and paragraph and the overall theme/idea of the assignment. 

In Psychology, Steve Elliott talked about how you have the simultaneous influence of multiple subsystems. A child has simultaneous relationships with his siblings, his parents, his pets, his peers, and his school, to name a few. The quality of the relationship between his parents, between a parent and his older brother, and between his siblings (or pets) has an effect on us. I think we all struggle to keep difficulties between us and our sister for example from affecting how we talk and interact with our parents or our teacher at school. 

In Education Therapy, Martha Knight spoke to me of how difficult it could be while teaching to keep the attention of her class. Students have to listen and take notes (2 different types of processing) while tuning out the cool bulletin board beside them, the kid beside them picking their nose, the blinking of the fluorescent light or the police car with its siren blaring as it goes down the road. 

Simultaneous challenges task all of us, but are particularly challenging for people with Autism. Relationship Development Intervention targets the core deficits of autism to work on the building blocks of these skills. Call me if I can help you, (704) 332-4834 ext 114. 

As an Educational Specialist at Child and Family Development in Charlotte, I consult with parents about their child’s difficulties in the classroom setting.  However, academic struggles do not always occur in isolation.  In fact, as I review children’s background information, I frequently find that the parents have concerns in other developmental areas.  Some have even pursued answers in the form of previous evaluations, but they still have lingering questions…

At Child and Family Development, we seek to understand the whole child.  As a part of our initial meeting with parents, we gather detailed information about the child’s birth, developmental milestones, medical history, behavioral and emotional functioning, educational background, and previous evaluations/therapies.  This input helps clinicians to determine the next step to take.

When a comprehensive evaluation is recommended, the clinicians spend time reviewing any data from prior evaluations so that we know what measures have been used and what findings were made at the time.  However, our comprehensive evaluations seek to take those results to the next level.  Oftentimes, a struggle in one area may be the cause or effect of a weakness in another area of performance.  While other tests may have examined a specific issue in isolation, we work to fill in the missing pieces so that parents can see the complete picture. 

Based on parent concerns, we establish our initial assessment measures.  These may include IQ tests, academic achievement tests, language processing tests, visual-motor tests, receptive and expressive language tests, ADHD measures, autism spectrum measures, or social-emotional scales.  However, as the clinicians move through the evaluation process, they use their observations and preliminary findings to guide the need for any further assessments.

The interpretive parent conference is an important component of the comprehensive evaluation process.  Our clinicians focus not only on the numbers that make up the results but, even more importantly, the patterns of performance and the ways in which the child's strength and weaknesses play out in daily living.  We also refer to any previous evaluation measures to examine changes over time.  At Child and Family Development, clinicians make recommendations for further services based on our findings.  We can make the determination about whether it is appropriate to pursue therapies, such as occupational therapy, physical therapy, speech therapy, psychological services, or educational therapy.  We also enjoy helping parents to take our information and put it into practice by remaining available for assistance as parents work through the next steps.        

Child and Family Development is blooming this summer!

An occupational therapist, Beth White, OTR/L, joined the team on June 8.  She has 8 years of experience working in pediatrics, primarily in the outpatient hospital setting, but also inpatient hospital, with additional training in early intervention and school settings. Her primary focus of experience is in the areas of Sensory Integration, behavioral management, autism, social skills, aquatics, Attention Deficit Disorder, developmental delay, dyspraxia, handwriting difficulties, visual motor and perceptual concerns, Oppositional Defiant Disorder, brain injury, and executive functioning. She has had extensive training in Sensory Integration and she is currently completing the certification to administer the SIPT (Sensory Integration and Praxis Test), as well as further extensive continuing education in the above listed focus areas. Beth believes strongly in family involvement to assist the child in being the best they can be! She is based at our South Charlotte office.

A speech-language pathologist, Sadia Syed, M.S., CCC-SLP, joined the team on July 5.  She has worked in private school, clinic and natural environment settings. Her clinical experience includes working with children with Developmental Apraxia of Speech (DAS), articulation, Pervasive Developmental Disorder (PDD), autism, behavioral feeding, language, literacy, processing disorder (CAPD), oral motor, phonology, and voice.  In addition, Sadia has training in Applied Behavioral Analysis (ABA) and Picture Exchange Communication System (PECS).  She believes in a collaborative and multi-disciplinary approach to therapy.  Sadia likes to create a fun and naturalistic environment for the children to interact and learn.  She also incorporates the family to help facilitate and achieve the communication goals.

An occupational therapist, Danielle Perugini, MOT, OTR/L, joined the team on July 12.  She has worked in outpatient pediatric rehabilitation, early intervention, home care, public/private school, and residential school settings. Danielle has had the opportunity to work with children and adolescents with varying needs including strength deficits, fine motor/visual-motor delays, dyspraxia, visual impairments, sensory processing disorder, developmental delays, orthopedic impairments, handwriting legibility issues, and learning disabilities. She has also served as the primary treating and consulting therapist in two different programs for children with autism. Danielle believes strongly in the occupational therapy principle that meaningful, motivating activities provide the best opportunities for learning and skill development and greatly enjoys the challenge of making therapy fun and engaging in order to maximize therapeutic gains. 

August brings more people to our pediatric therapy team.  Look for my upcoming blog about another occupational therapist and a child psychologist.

Welcome Ladies!

Child and Family Development is already excited about the Autism Super Conference scheduled for October 21-22 in Charlotte, North Carolina.

Experts in the autism spectrum disorders field will be leading the event, including:

At least one person from each of our 5 disciplines is planning to attend, including Occupational Therapy, Physical Therapy, Speech Language Therapy, Psychology and Education.

It's the last day of the April, so another Autism Awareness Month is coming to a close.

In recognition and as part of our regular work, Child and Family Development has been involved in a number of community activities including regional Autism Society family meetings, professional gatherings pertaining to Charlotte residents access to related services and the Autism Aware Fare.

Throughout the year, we provide pediatric therapy services to children with this diagnosis, including:

• ASD Diagnostic clinic led by psychologist, Carol Capehart
• Feeding group, led by occupational therapist, Ellen Bruce
• Interactive Metronome, led by a number of occupational therapy and physical therapy team members
• Relationship Development Intervention (RDI) led by certified RDI provider and physical therapist, Amy Sturkey
• Sensory Processing Disorder (SPD) services