Child and Family Development

Child and Family Development enjoys collaboration with United Sleep Medicine Center. Our pediatric therapy team often refers to this organization and others in the Charlotte community. 

According to the experts there, disrupted sleep in children can result in:

• behavior or discipline problems
• delayed growth and cognitive development
• ADHD-like behaviors (hyperactivity, aggression, irritability or mood swings)
• poor school performance
• difficulty getting along with peers
• inability to control emotions
• poor sleep habits
• Circadian Rhythm Disorder

The Infant and Child Division offers evaluation and management services.  Visit their website for more information, www.unitedsleepmedicine.com.

In-hand skills typically emerge after 2 years of age, with the greatest number emerging between 2 and 2 ½ years of age. Simple in- hand skills are mastered by age 3.

• Translation
  • Finger to palm
  • Palm to finger
  • Manipulating a coin
• Shift
  • Occurs at finger tips, usually for fine adjustments
  • Moving pencil in fingers
• Rotation
  • Simple – turning a knob <180
  • Complex – turning an object >180 to 360

Sensory Processing is the method the nervous system uses to receive, organize, and understand sensory input.  It enables a person to respond to environmental demands based on the sensory information that is available. 

• Tactile, proprioceptive, kinesthetic
• Visual – receptive
• Visual cognitive
  • Form constancy
  • Visual discrimination
  • Position in space
• Vestibular

Neuromuscular capabilities must also be used.

• Muscle tone
• Strength
• Postural control
• Crossing midline
• Bilateral integration
• Laterality
• Praxis

Information adapted from Case-Smith (2004) textbook & Beery 1992

Look who's talking about Occupational Therapy!

"Courtney was wonderful and helped my child feel comfortable and also challenged her to reach her goals. My child is motivated here at home to improve so that when we return to Child and Family Development, Courtney will see imporvement."

The Center for Disease Control (CDC) released the results of a new study on March 29 showing the prevalence estimates for Autism Spectrum Disorders (ASD) are now at 1 in 88.  Additional statistics:

• ASD is 5 times more common in boys than girls.
• 1 in 54 boys are diagnosed with ASD.
• The rate of identification varies among states ranging from 1 in 210 in Alabama to 1 in 47 in Utah.
• The largest increases were among Hispanic and African American children.
• Children being diagnosed by the age of 3 increased to 18% for those born in 2000.
• 40% of children are not being diagnosed until after the age of 4.

Autism is now considered to be of epidemic proportions!  There are few people who have not been touched by the impact of ASD.  The report suggests that the increase can be attributed in part to the way children are identified and diagnosed, as well as greater awareness.  However, this dramatic increase is not fully explained by better identification and media exposure.  There is an urgent need for further research and collective advocacy and commitment.  To learn how to help, go to the Autism Speaks website. 

Occupational therapists look at how deficits in handwriting affect a child’s daily performance at home and school. The OT looks at 3 things:

1. the actual tasks of handwriting                                
2. school context                                             
3. the student’s abilities                                         

Handwriting development can be affected by many things including in-hand manipulation skills, sensory processing, neuromuscular control and cognition/understanding of handwriting concepts. There are 5 important prerequisite skills needed for handwriting and they include:

1. small muscle control
2. eye hand coordination
3. the ability to hold writing tools
4. the ability to form basic strokes (vertical, horizontal, diagonal lines and basic shapes)
5. letter perception (recognizing forms, different letters and being able to copy geometric forms

Pre-writing and handwriting

• Scribbles                                                                                                                          10-12mths
• Imitates hori./vert/cir. scribbles                                                                                      2 yrs  
• Copies hori./vert./ and circle                                                                                             3 yrs
• Copies cross, slanted lines, square, some letters & #s, own name (maybe)     4-5yrs
• Copies triangle, prints own name, most upper and lowercase letters                  5-6yrs      

Information adapted from Case-Smith (2004) textbook & Beery 1992

Clients are talking about Child and Family Development's Administrative Team!

"I was most impressed of how informative and kind the lady was when I called for the first time. She explained everything, took her time and reassured me. Being the first person representing Dr. Granetz, she is an asset."

Check out what a parent had to say about Leslie Holmes, Pediatric Physical Therapist in Charlotte, NC.

"Leslie is wonderful and I can see the results of her wonderful work with my son."

In my occupational therapy work, a current interest is working with children who have both difficulties with handwriting and visual perceptual skills. I am always looking for new ways to work on skills, while having fun.  One area of visual perception that can be developed through toys and games is figure ground skills. Figure ground skills are the ability to find hidden pictures or objects in a background of other objects. A good practical example of this is trying to find an object in a cluttered drawer or freezer. 

Child and Family Development is accepting new referrals for speech therapy services.  Typically, the first appointment occurs within 1 week of the initial call to our office. 

With diverse expertise, interests and experiences, we are ready to provide a wide range of evaluation and treatment services. Our SLP team includes:

We accept insurance plans including Aetna, Blue Cross Blue Shield (BCBS), Cigna, Medcost, Primary Physician Care (PPC), United Healthcare (UHC), as well as NC Medicaid. 

Visit our website to learn more about our services and therapists and call our office to schedule the initial appointment. 

Greetings!

I am so excited to be a part of the Child and Family Development pediatric therapy team!  I want to take this opportunity to introduce myself. 

I moved to Charlotte from Ohio in 2006, after completing my undergraduate and graduate work at Ohio University in Athens, OH.  Since moving here, I have worked with children ages birth to 15 years in a variety of settings including public schools, private schools, home, daycare, and preschool settings.  I have experience working with children with hearing loss, language disorders/delays, learning disabilitites, Autism, developmental delays, articulation/phonological disorders, apraxia, augmentative communication, and other difficulties. 

Since starting at C&FD, I have been extremely impressed with the quality of services and level of knowledge the therapists display, as well as the love, support and motivation of the families and children that come here.  I am so glad to be a part of this TEAM.

To learn more about me, read my biography on the C&FD website.

Megan Keller, a member of our Occupational Therapy team, continued her professional training this week by attending a course titled ADHD and Processing Disorders: Immediate Evidence-Based Strategies that Work!

The course objectives were to identify core problems in Sensory Processing Disorder and Central Auditory Processing Disorder, provide strategies for inattention and disorganization and demonstrate tools that can be used with adults and children.

Since Megan specializes in treatment of children and adolescents with autism and sensory processing difficulties, this course was well suited to her work at Child and Family Development.   

When I, as an occupational therapist, evaluate handwriting, I often further evaluate visual perceptual skills. These are the skills that allow you or your child to understand what it is that they are seeing and interpret that information so that it can be used. Visual perception is not as simple as it may sound, and is broken down into a number of categories. These areas are both necessary for handwriting, as well other functions of our everyday lives and include:

This week, a representative of A Special Needs Plan shared an exciting endeavor with the Child and Family Development team. 

They have published a guidebook to special needs planning called The Family Advocate™ that is designed to educate families on what they need to do to secure their loved one’s future.

Their team wants to give this book to at least one million people, so we are spreading the word too.

Here’s how to learn more about this:

• Call: 800-SN9-8610
• Email: info@specialneedsplan.com
• Visit: www.aspecialneedsplan.com or www.specialneedsknowledge.org

Recently, Relay NC shared some exciting news with every licensed speech therapist in our state. 

They have a contract with the Division of Services for the Deaf and Hard of Hearing to provide a variety of relay services to citizens with speech disabilities. 

One free service is called Speech-to-Speech (STS).  It can be accessed without special eqiupment. An individual can dial 7-1-1 and connect with a relay operator, who serves as the individual's voice and gives  information to the outbound line. 

Visit the website, www.relaync.com, to learn more about STS and other services offered by Relay NC.

As an Educational Specialist, I am 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.  My answer is a resounding yes.  Because reading disabilities are the most prevalent learning disabilities, I will focus on dyslexia.

Students with dyslexia often have solidly average or advanced vocabulary skills.  Parents typically report that their child met language milestones in a timely manner.  Many of these students carry on engaging conversations about a variety of topics.  In their reading, this extensive word knowledge helps them to derive meaning from the text.  While they may not be able to read every word, they have the ability to use context clues to make predictions about the missing pieces.  Additionally, these children often have a strong capability to memorize some words that they encounter regularly.  In doing so, they may present as readers who are on grade level in school.

However, it is essential to consider reading at the level of the individual word.  While bright children may be able to “fill in the gaps” and compensate for a period of time, their progress will plateau and begin to decline.  Over time, students reach a point at which they can no longer memorize words or rely on previous knowledge.  They must then rely on their application of phonetic skills to decode all of the new words that they encounter as they move forward.  It is at this point that dyslexic students exhibit their greatest struggles.  Their weakness is rooted in the inability to accurately and efficiently process the individual sounds of language.

Early identification and intervention is the key to helping students with specific learning disabilities.  I enjoy consulting with parents who have questions about their child’s learning and concerns about possible learning disabilities, such as dyslexia. 

Arthrogryposis

Cerebral Palsy

Developmental Delay

Down syndrome

Gross Motor Coordination

Torticollis

Child and Family Development is accepting new referrals for physical therapy services.  Typically, the first appointment occurs within 1 week of the initial call to our office.  Our experienced PT team includes:

We accept insurance plans including Aetna, Blue Cross Blue Shield (BCBS), Cigna, Medcost, Primary Physician Care (PPC), United Healthcare (UHC), as well as NC Medicaid and SC Medicaid. 

Visit our website to learn more about our services and therapists and call our office to schedule the initial appointment. 

Augmentive and Alternative Communication or AAC is a resource available for individuals who are unable to effectively use spoken language.  Children that may benefit from using AAC include those that may have diagnoses such as cerebral palsy, autism, genetic disorders, motor speech disorders and brain injury.  Types of AAC range from low tech to high tech.  Low tech AAC does not require the use of batteries or electronics.  Examples include a simple board of letters, words, phrases and/or pictures of symbols that a person can point to for communication.  High tech devices allow the individual to communicate using speech output.  There are many different companies that specialize in making these types of devices.  Many high tech device have the ability for the user to communicate an unlimited variety of messages.

There are great benefits from using AAC.  It allows the child to communicate with other people in the community and not just family or those familiar with the child.  Using AAC helps with development of language and literacy skills.  For children that are able to use some verbal communication, AAC does not interfere with the development of spoken language and in fact actually aids in language acquisition.

If you feel your child may be able to benefit from AAC, please discuss this with your speech therapist.  A speech therapist can complete an Augmentative Communication evaluation to determine if your child would benefit from using AAC as well as what type of AAC would be beneficial for your child.  In Charlotte, the speech therapy team at Child & Family Development offer evaluations for AAC devices.

When an occupational therapist evaluates handwriting, we not only look at handwriting samples and copying tasks, we also look at underlying factors. There are a number of underlying factors that support the development and success of handwriting. Some of these areas include postural and core support, hand and pinch strength, visual attention and concentration. More directly handwriting requires fine motor coordination, visual perceptual skills, and visual-motor integration. Motor coordination is necessary for holding and manipulating the pencil successfully. Visual perception is the ability to look at a picture and interpret it in your mind. Visual-motor integration is when you are able to combine visual perception (understanding what you see) and motor coordination (controlling the pencil) to create or reproduce images or letters. If any one, or more, of these areas are affected handwriting, per-writing, and drawing can suffer.

If handwriting is very difficult or even impossible for your child, an occupational therapy evaluation may be able to identify obstacles and help to remediate them.

The Child and Family Development Occupational Therapy team in Charlotte is ready to help!