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. |
Who are the Educational Specialists at Child and Family Development?
Established in 1980, Child and Family Development has been serving the needs of children and their families in Charlotte. Our pediatric therapy team has over 400 years of combined clinical experience, with expertise and additional certifications in many diagnostic areas.
Our Educational Specialists are trained to evaluate and treat the underlying causes of learning difficulties. Learning concerns may involve specific disorders of reading, writing, and mathematics or problems with attention, organization and study skills.
All of the Educational Specialists at C&FD have advanced graduate degrees in the field of Special Education. They help students understand their learning style, strengthen underlying processing weaknesses and develop strategies for school success.
Educational Specialists offer the following services to maximize growth and development:
- Developmental Screenings and School Readiness Assessments for children 3-5 years of age to help parents plan for the most appropriate learning environment for their child.
- Comprehensive Educational Evaluations to identify a child’s learning strengths and weaknesses
- School Consultations to present a child’s learning strengths and weaknesses to the school to provide the ground work for developing a team approach to meeting the child’s school needs and establishing informed parent advocacy.
- Treatment of Learning Disorders in Reading, Mathematics, Written Expression, Literacy Readiness, Handwriting, Dyslexia, Dysgraphia, and Phonological Processing Delays through an Individual Educational Treatment Plan
- Support for children and adolescents with learning concerns including Study Skills, Homework Strategies, Time Management, Test Taking Strategies through individual treatment as well as intensive small group session available if needed
When looking at behavior, there are close similarities displayed with both children who have attention difficulties (ADD/ ADHD) and sensory processing disorder (SPD). Co-morbid diagnoses may include Autism, Developmental Delays, and Learning Disabilities. Common characteristics for children with both sensory seeking SPD and ADHD (hyperactive/impulsive type) are as follows: impulsivity, excessive activity, disorganization, impatience and poor self-control.
However, more specifically, children who have SPD tend to be more in control of stopping impulsive behaviors. They may crave activity relating to a specific sensory system, may become more organized after receiving proper sensory input and may be more patient while waiting if give proper sensory input. They commonly poke/pull/touch others without proper sensory input.
Those who have ADHD (hyperactive/impulsive type), tend to continue impulsive behaviors, be disorganized and have difficulty waiting-even with sensory input. They tend to crave activity not related to a specific sensory system. They often talk a lot, impulsively interrupt, and have difficulty waiting a turn during a conversation.
At Child and Family Development, we offer School Readiness Assessments for children ages 4 to 6 years. Assessments provide valuable information to teachers and parents on school readiness, learning styles, appropriate learning environments, and developmental strengths and weaknesses. We recommend this service for children prior to beginning a formal kindergarten experience.
School readiness testing examines pre-academic/readiness skills in reading math, written language. Development tests of fine motor coordination, auditory memory, receptive language and expressive language help determine developmental readiness. An educational specialist can provide parents with useful information to aid in their school readiness decisions
The testing is typically completed in two visits to our clinic. During the first appointment, the educator will administer standardized tests as well as complete an informal assessment of ABC knowledge, rhyming, sound blending, and counting. The second appointment is a feedback session for the parent(s). A brief written report will be mailed to the parents following the assessment.
If you are interested in learning more, contact us to schedule an appointment with one of our Educational Specialists, Mary Froneberger and Martha Knight.
At Child and Family Development, our psychologists can accommodate most requests for testing, including Early Admissions and IQ testing for Charlotte students. • Wechsler Preschool and Primary Scale of Intelligence (WPPSI) which assesses children’s learning ability and how they process information. It is an aptitude test. • Test of Early Reading Ability (TERA) which assesses basic reading skills. It is an achievement test. Young Children's Achievement Test (YCAT) which assesses early academic and pre-academic skills in general knowledge, reading, math, written expression, and spoken language. • Woodcock-Johnson which assesses academic and pre-academic skills in reading, math, and written expression. It is an achievement test. Wechsler Individual Achievement Test (WIAT) is an achievement test which also assesses skills in reading, math, and written expression. The testing is typically completed in one visit to our clinic in a 2 1/2 hour appointment. During that time, the psychologist will spend some time getting to know the child and making sure he is comfortable with the setting and tasks. The psychologist will administer a cognitive test or intelligence test (IQ) and a brief assessment of academic achievement. Once testing is finished with the child, the psychologist will provide a brief verbal interpretation of results to the parents. A brief written report will be mailed to the parents within 10 business days of the appointment. The fee for this service is $450.00 and it is due at the time of service. |
The holidays are a time for family gatherings, traveling, no school, and no routine. For some that sounds fun, but for children with sensory processing difficulties, Autism, and other developmental delays, it can be a very scary time.
Children who have auditory and tactile sensitivities will likely struggle most during family gatherings.
Children who are sensitive to movement or need a lot of movement will have the most difficulty being couped up in a car or airplane while traveling.
Children who already feel like they have no control over their own body rely on routine to give them a sense of control and organization. When their environment is unpreditable, these children will likely either shut down or act out.
Remember your child's needs when you are making plans this holiday season. If you go to a family gathering, make sure that your child has a quiet space to go when they need a break from all of the commotion. If you are traveling, make sure you are able to take frequent movement breaks to allow your child to more succesfully ride in the car. Most importantly, remember to keep sleep, meal, and daily routines as close to typical as you are able.
Hope you and your family have a wonderful holiday!
Most often it is the more severely involved or neurologically injured child who is referred to physical therapy, occupational therapy or speech therapy at an early age. However, an increasing number of infants and toddlers have mild to moderate developmental issues that will greatly benefit from the therapeutic expertise of a skilled pediatric therapist.
Some infants may have a known diagnosis or medical condition. However, some toddlers may simply be experiencing delays in walking, talking or overall socialization. We believe that once a child is identified, time becomes the most critical component.
When we are able to begin treatment with these children before the age of 3, progress often occurs more rapidly. Families find their stress and concern lessened because of the support they receive from our team of clinicians. There are agencies in the area that offer services in a home or natural environment, but Child and Family Development offers clinic-based therapy.
Our clinics are equipped with the tools, toys and equipment that are needed to evaluate and treat children. Parents and caregivers are encouraged to participate in the sessions and are trained to promote continuous progress in the other settings. We find that many children benefit from working directly with a therapist in a therapeutic setting which is designed to support new learning techniques.
We have about 30 physical therapists, occupational therapists, and speech therapists on our staff with two locations to serve the
Our practice accepts NC Medicaid, SC Medicaid, BCBS,
Infants and toddlers are given a priority at our practice and we are able to schedule evaluations, and treatment within just a few weeks.
Contact us to learn more about our early intervention services for infants and young children.
With diverse clinical expertise, interests and experiences, the Child and Family Development team of psychologists is ready to provide a wide range of evaluation and treatment services.
MIDTOWN OFFICE
Carol Capehart, MA, LPA, is a licensed psychological associate with
about 20 years of clinical experience. Carol has extensive training and
experience in the assessment and treatment of individuals with autism
spectrum disorders (ASD) and founded our ASD evaluative services in
2006. Prior to that, she spent many years working in public schools with
children of all ages and learning abilities.
Gretchen Hunter, Ph.D., CRC, is a licensed psychologist and Certified
Rehabilitation Counselor with a specialty in neuropsychology. She has
experience providing neuropsychological evaluations to children and
adolescents with neurodevelopmental and behavioral disorders, learning
disabilities and attention related disorders. She provides individual,
family and group psychotherapy and behavior intervention to children
and adolescents.
Kristina Murphy, Psy.D, HSP-P, is a licensed psychologist who
provides psychotherapy and evaluations to children, adolescents and
young adults. Her specialized focus is adolescents and transitions to
High School and College. Areas of clinical expertise include anxiety,
depression, attention disorders, learning disabilities, life transitions and
adjustment issues.
SOUTH CHARLOTTE OFFICE
Annada Hypes, Ph.D., is a licensed psychologist specializing in
the treatment of adolescents and young adults. Dr. Hypes specializes in
treating mood and impulse-control disorders, including depression, self harm,
substance abuse, disordered eating and attention disorders. She regularly offers social skills groups for girls.
Joy Granetz, Ph.D., is a licensed psychologist with over thirteen years
of experience. She provides neuropsychological and psychoeducational
evaluations with special focus in working with children and adolescents
with learning disabilities, attention disorders, head injury, tic disorders
and epilepsy. Dr. Granetz is one of a few practitioners in North Carolina
offering Cogmed Working Memory Training, an innovative computer based
training program to help children with attention difficulties.
Chris Vrabel, Psy.D., is a licensed psychologist specializing in child
evaluation and child and family therapy. He has expertise in the assessment of
autism spectrum disorders (ASD), attention disorders, learning disabilities and
other developmental, behavioral and emotional problems. Dr. Vrabel also
provides therapy to children and families with concerns regarding ADHD,
behavior problems, depression, anxiety, social difficulties and other issues.
Read the blog, visit the website, or contact the offices to learn more about our child psychology services.
The Family Clinic: Multi-Modal Management of ADHD and Related Emotional Issues was founded in February 1991, a joint effort of Carolina Neurological Clinic and Child and Family Development, to provide services to children diagnosed with attention disorders.
Since 2001, Dr. Pleas Geyer of Carolinas Medical Center has led the collaboration. The Family Clinic has broadened it’s scope to include not only children with ADD/ADHD, but also autism spectrum disorders, developmental disorders, anxiety, depression, Oppositional Defiant Disorder, and other emotional issues.
The Family Clinic meets at our Midtown office on most Wednesday afternoons.
The treatment goal is to carefully monitor and support children with diagnosed ADHD/ADD, anxiety, depression, developmental disorders, Oppositional Defiant Disorder, and related emotional disorders, including medication therapy, focusing on the impact on development and school performance.
Pleas R. Geyer, M.D.. is a child and adolescent psychiatrist who provides care and medication management of children and adolescents diagnosed with emotional and developmental disorders. Dr. Geyer is in the Division of Child and Adolescent Psychiatry at Carolinas Medical Center, and is a Clinical Associate Professor in the Departments of Psychiatry and Pediatrics at the University of North Carolina School of Medicine in Chapel Hill, North Carolina. He brings a depth of experience in his treatment of our child and adolescent population. Dr. Geyer is board certified by the American Board of Psychiatry and Neurology in General Psychiatry, Child and Adolescent Psychiatry, and Forensic Psychiatry.
Contact Jenny at our Midtown office to learn more about The Family Clinic.
Hello!
I am recently a new member to the Occupational Therapy team at Child and Family Development located at the South Charlotte office! I was born and raised in Charleston, SC. Upon graduating from Clemson University with my BS in Health Science, I decided to go back to Charleston to obtain my Masters degree in Occupational Therapy at the Medical University of South Carolina. Following this graduation and passing my boards, I ventured off to the city of Charlotte, NC to begin working as a Pediatric Occupational Therapist. I have prior experience working with children with autism, fine motor delays and handwriting difficulties, developmental delays, sensory processing disorders, cerebral palsy and down syndrome through my clinical rotations during school. Since joining the C&FD team, I have gained an even wider knowledge of the practice from working and collaborating with the wonderful staff members in their different areas of expertise. I am looking forward to what the future brings at Child and Family Development!
Mary Helen Bailey, M.S., OTR/L
Occupational Therapist
Child and Family Development
As the holidays approach, I am often asked by parents for ideas about what kinds of toys would be helpful for their children. There are many new toys such as electronic learning toys and video games that are available; however, the best toys to promote your child's speech and language development are toys that encourage turn taking and interaction. Examples of toys that encourage interaction include: - Mr. Potato Head
- Puzzles
- Blocks
- Books
- Play sets (i.e. Fisher Price - Farm set or house set)
- Cars with toy garage
- Kitchen play set with toy foods
- Dress up clothes
- Board games
Keep in mind that while there are many new toys that do lots of exciting things, it doesn't necessarily mean that those toys are the best if you want to work on your child's speech and language or other developmental skills. If you have a question about whether a particular toy would be helpful for your child, ask a pediatric speech therapist, physical therapist or occupational therapist for input!
Th
ere are a number of benefits of having a dress up box for all children, particularly kids with developmental delays, autism, fine motor coordination difficulties, or sensory processing challenges.Self-Care: One benefit is having a fun way to work on self-care skills like dressing, buttoning, and Velcro. Increasing the ability to dress yourself and work small fasteners is a skill that requires alot of repetition, but using a dress up box as a PLAY activity masks the challenges of these skills and makes practice fun!
Touch Processing: Fill your dress up box with a variety of materials and sensory challenges. Dressing up is often more motivating than trying to address tactile sensitives directly. Provide items like frilly petticoats, feathers, fringe, leggings, princess gloves, animal gloves, masks, crowns, hats, shoes, and other costumes that stretches your child's sensitivity to textures.
Imagination: Imaginative play can be a challenge for children on the autism spectrum, so use dressing up as an opportunity to increase play skills!
Independence: Another challenge for some children, especially those with developmental delays, cognitive deficits or autism can be knowing what is an appropriate article of clothing for the different seasons. A dress up box geared toward this area, could include clothing appropriate for specific seasons and then help your child select his own outfit.
As an occupational therapist at Child and Family Development, one of my goals is to make therapy and learning fun!
Child and Family Development is now accepting
South Carolina Medicaid referrals
for physical therapy and occupational therapy
at both of our Charlotte clinics
Our mulit-disciplinary pediatric therapy team includes occupational therapists and physical therapists with extensive training and experience to evaluate and treat a wide variety of concerns with children, including developmental delays as well as genetic syndromes, neuromuscular and musculoskeletal diagnoses, torticollis and praxis difficulties.
Treatment approaches include aquatic therapy, sensory integration, neuro- developmental treatment (NDT), fine and gross motor coordination, strength and balance and assessment and ordering of orthotics and adaptive equipment.
These therapists are credentialed by South Carolina Medicaid and are now accepting referrals:
Midtown clinic | South Charlotte clinic |
• Amy Sturkey, LPT | • Erin Harkins, DPT |
• Ellen Bruce, M.S. OTR/L | • Jessica Sapel, MPT |
| • Marion Wilm, OTR/L |
We offer a free telephone consult to parents prior to the initial evaluation, and are available to consult with physicians and nurse practitioners about referrals.
In addition, we accept all insurance plans and are in-network with many other plans including Aetna, BCBS and NC Medicaid.
Contact our office for additional information or to schedule an appointment.
We have many specialized programs here at Child and Family Development. One of the programs is called Handwriting Without Tears®.
This program presents handwriting in a developmental, multisensory manner and has proven to be successful for a variety of children. Handwriting Without Tears® was developed by an occupational therapist by the name of Jan Olsen. It helps children learn to write in print and cursive and is appropriate for grades Pre-K through 5th grade. Using wooden pieces for building letters, magnadoodles and chalkboards, play doh, and music, children learn how to form letters in a fun and educational way.
Handwriting is such an important means of communication and should not be a tearful experience for any child. If your child is struggling with handwriting, this program could help them succeed.
For more information about Handwriting Without Tears ®, visit www.hwtears.com or talk to an occupational therapist at Child and Family Development.
Check out this article on the American Occupational Therapy Association's webpage for some more information about what you can do as a parent to be an advocate for your child.
www.aota.org/Consumers/consumers/Youth/Autism.aspx
Another helpful website that provides you with a wealth of information is www.autismspeaks.org.
For more information or to schedule an occupational therapy evaluation for your child, please visit our website at www.childandfamilydevelopment.com or call or office at (704)541-9080.
A speech-language evaluation measures a child’s communication skills. It is completed by a Speech-Language Pathologist. A referral from the primary care physician is typically required prior to the evaluation.
Before your child is seen for an evaluation, information is gathered, including medical history, developmental history, family history, educational history, therapeutic history, and primary concerns.
Formal tests may be completed during the evaluation, which is a way to compare your child to other children of the same age. A Speech-Language Pathologist may also informally assess your child. Informal tasks can include parental interview, discussion with other professionals (i.e. teacher, occupational therapist, etc.), observing how the child plays, and observing how the child interacts with adults/peers.
During a speech-language evaluation, the following areas may be assessed:
1) Receptive language-what the child understands
2) Expressive language-what the child says
3) Articulation-production of speech sounds
4) Pragmatic language-social use of language
5) Voice
6) Fluency
7) Oral peripheral examination-looks at structure and function of the face, lips, teeth, tongue, and palate
8) Hearing screening
A written report will follow the evaluation, and may include the following information: child’s history, speech-language testing results and recommendations.
At Child and Family Development in Charlotte, NC, an Interpretive Parent Conference is held after the evaluation to discuss findings, recommendations, and discuss normal speech-language skills. The Speech-Language Pathologist and parent/s are present during the meeting.
If you suspect that your child has a communication disorder, please contact your local Speech-Language Pathologist.
**Information shared from The Speech and Language Evaluation by Leslie S. McColgin
Children thrive on structure and look to you as a parent to keep them safe and give them guidance to get through life. Telling them "no" lets them know that you care for them enough to set some boundaries so that they are safe. Even if they don't appreciate your "no" right then, they will later.
Saying "no" does not mean you have to be extremely strict, but children learn what their boundaries are by testing them. If you don't say "no", they won't learn their boundaires and their behavior will become worse.
As I discussed in one of my previous blogs, routine is very important for children. Children of all ages need to know what to expect and what is expected of them. Consistency is key!
If you only say no when you are angry or overwhelmed, you are sending your child very mixed signals. Now, they won't know when they can/can't have or do something because your response is unpredictable and they will continue to test the limits.
What about my child who has temper tantrums when I tell him/her "no"?
The more consistent your are, the more your child will learn the boundaires and the temper tantrums will decrease. You may have to put up with some bad temper tantrums before you get there, but they will learn!
What if my child has a disorder or diagnosis?
Children with Sensory Processing Disorder, Autism, ADHD, and other developmental delays still need to hear the word "no" so that they can learn what is expected of them. Often, these children need even more structure and boundaries to guide them through life. Many people make the mistake of saying, "Well that child has Autism, so it's OK for him/her to act that way". Just like any other child, children with Autism and other developmental delays will rise to the expectations they are given.
For more information on this topic, check out:
www.empoweringparents.com/blog/consequences-rewards/dr-joan-its-ok-to-say-no/#
The handedness of a person is an expression of an inborn natural lateralization of the brain hemispheres where one side dominates. Typical children go through a period where they use both hands equally; then as they start to use a spoon or a crayon, they start to show a preference for one hand over the other. During development in the toddler years, they may occasionally switch hands but will usually go back to using a consistent hand preference which establishes itself as a dominance by age 5 or 6.
In my experience as a pediatric occupational therapist, the children who do not develop a hand preference during the toddler years often exhibit some delays in their fine motor skill development. Is this because of lack of practice in developing refined skills or because of immaturity in brain development? In my experience, a delay in developing a hand dominance is often linked with other developmental delays including: weak core body strength, poor attention, delays in language development, and overall weak coordination skills. Many children who are later diagnosed with attention disorder or learning disabilities often struggled to establish a hand dominance in the early years.
Thus, when our brains and our bodies develop within the natural pattern of lateralization and dominance, there are fewer developmental delays. A delay in establishing a hand preference should be a red flag to look at other areas of development. Once a dominance is established then many people do go on later to develop skills using either hand (such as a switch hitter in baseball), but skill in the dominant hand is essential for normal development.
It is an exciting time when your baby starts to explore the world of food. Most pediatricians recommend starting of offer rice/oatmeal cereals and pureed fruits and veggies between 4-6 months of age. Keep in mind, breast milk or formula are still your baby’s primary source of nutrition at this time. So look at this time as a wonderful opportunity for sensory exploration! Here are some tips when starting solids with your baby:
- Does your baby still demonstrate a strong tongue-thrust reflex (pushing things out with the tongue)? If so, he/she may not be ready.
- Position your baby in a high-chair with a harness strap. Be sure they are positioned upright and use some towel rolls to help prop them.
- Minimize environmental distractions (TV, busy room)
- Show them the spoon- but be careful to supervise play with the spoon. At this age they will mouth anything and can make themselves gag. Typically, your child will see the spoon and move his/her head towards it with mouth open.
- It is good to start with rice baby cereal mixed with breastmilk or formula, then try pureed veggies and fruit. Making your own baby food is easy and healthy for your baby (steam, mash puree/blend, place in ice cube trays, and freeze). Follow your pediatrician’s guidelines about introducing new foods and allergies.
- Go against your “mommy intuition” to clean up your child between bites. Prepare and allow for a fun and messy feeding! Feeding is a mutli-sensory experience to be enjoyed by your baby!
- If you have concerns with your baby’s readiness to start exploring puree foods, contact your local speech therapist or occupational therapist in Charlotte for an evaluation!
Looking back on my days in elementary school, I remember the banging of erasers and washing the board as a special job. The cringing of someone scratching a chalkboard is long over. These days, students may ask "What's a chalkboard?". Classrooms now are filled with an amazing amount of technology, from computers, laptops and smart boards. Schools are constantly trying to keep up with the endless amount of technology available to them.
As a Pediatric Speech Language Pathologist, I have had to put away some of my dittos and articulation cards and move forward with the technology. When working on expressive and receptive language skills, Powerpoints and SmartBoard Activities have become the norm. Flip Videos are now used for teaching social skill lessons to children with Autism.
I purchased an Ipad a few months ago and have found that children with disabilities can do things on an Ipad that most adults cannot. I have seen a child who is non-verbal increase expressive language skills by using the Ipad to communicate. A 2 year old with a developmental delay was able to navigate through an activity, gaining a sense of independence while increasing receptive language skills.
We have to face it. Our world is more technologically based than it has ever been. Children with Autism, Attention Deficit Disorder, Learning Disabilities or Developmental Delays will benefit from early use and exposure to computers and other forms of technology.
If you are interested in learning more about how technology can help your child, please contact me at jwalton@childandfamilydevelopment.com.
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