Occupational Therapist Charlotte

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! 

About: Melissa Bradley, Pediatric Occupational Therapist at Child and Family Development in Charlotte:

"Melissa shows a genuine interest and caring for my daughter and our family. She is very knowledgeable and consistent and consistent in her treatment of my child which is wonderful! Very intuitive and goes out of her way to help parents understand what is going on in treatment and gives appropriate and recommendations. Office staff is polite and helpful too! Thank you!"

Today I am celebrating that I can be a fully hands on Occupational Therapist again. Two months ago I broke my left arm which caused me to have much greater empathy for all of the children that I meet who have a left side weakness due to Hemiplegic Cerebral Palsy. Many of them welcomed me to their impaired "Lefty" club. Here are some of the challenges that I experienced while my left arm was in a cast: 

• It is hard to orient your clothing properly on your body when you can't reach one side.
• Opening all types of containers is a challenge including jars, ziploc bags, and chip/candy wrappers.
• You can't dry your hair properly if you can't hold both a hairdryer and a brush.
• You can't carry heavy or bulky objects with only one hand
• It really is hard to close the snaps and buttons on your pants.
• Everything takes longer to do with only one hand.

But, the thing that I missed the most was not having the ability to lay both of my hands on the children to facilitate their movements and help them relax their tight muscles. As a certified NDT (Neuro Developmental Treatment) clinician, my hands serve as a primary tool and allow me to see and feel what is happening in a child's body. 

I relied on the hands of my own peers to aide me in the rehabilitation of my own arm and felt the power of touch move my own muscles in ways that seemed foreign to them after a 2 month period of immobility. Now I have both of my hands back to share the power of touch with the children and I see them change in ways that I couldn't  replicate when a cast or brace created a barrier between us. 

As an Occupational Therapist at Child and Family Development, I regularly assess and treat a child's fine motor abilities, including pre-handwriting and handwriting skills.  This information is a useful summary of development.   

Developmental Sequence of 10 different grasps (according to Schneck and Henderson, 1990). Below is a range of grasps that may be demonstrated over time. Not all will be seen. By ages 5-6 you expect to see a hand dominance and want your child to be using a grasp similar to numbers 7-10, number 10 being the most wanted.

1. Radial cross palmar grasp: pencil positioned across palm projecting radially, held with fisted hand, forearm fully pronated, full arm movement

2. Palmar supinate grasp: pencil positioned across palm projecting ulnarly, held with fisted hand, wrist slightly flexed and supinated away from midposition, full arm movement

3. Digital pronate grasp, only index finger extended: pencil held in palmar grasp with index finger extended along pencil toward tip, arm not supported on table, full arm movement  

4. Brush grasp: pencil held with fingers with eraser end of pencil positioned against palm, hand pronated with wrist movement present, whole arm movement, forearm positioned in air

5. Grasp with extended fingers: pencil held with fingers, wrist straight and pronated with slight ulnar deviation, forearm moves as a unit 

6. Cross thumb grasp: fingers fisted loosely into palm, pencil help against index finger with thumb crossed over pencil toward index finger, finger and wrist movement, forearm positioned on table 

7. Static tripod grasp: pencils stabilized against radial side of third digit by thumb pulp with index pulp on top of shaft, thumb stabilized in full opposition, wrist slightly extended and hand moves as a unit, pencil rests in open webspace, forearm resting on table

8. Four finger grasp: pencil held with four fingers in opposition, wrist and finger movement, forearm positioned on table

9. Lateral tripod grasp: pencil stabilized against radial side of third digit with index pulp on top of shaft of pencil, thumb adducted and braced over or under anywhere along the lateral border of index finger, wrist slightly extended, fourth and fifth digits flexed to stabilize metacarpophalangeal arch and third digit, localized movement of digits of tripod and wrist movements on tall and horizontal strokes, forearm resting on table 

10. Dynamic tripod grasp: pencil stabilized against radial side of third digit by thumb pulp with index pulp on top of shaft of pencil, thumb stabilized in full opposition, wrist slightly extended, fourth and fifth digits flexed to stabilize the metacarpophalangeal arch and third digit, localized movement of digits of tripod and wrist movements on tall and horizontal strokes, forearm resting on table

Examples of Inefficient Pencil Grips:

This month, 2 members of the Occupational Therapy team at our South Charlotte office completed training in Upper Extremity Treatment.

The course was offered by Boehme Workshops with a focus on strategies to improve a child's awareness, alignment, activation, coordination, grading and strength of upper extremities. 

Course participants practiced techniques on one another, so the ladies got to know everyone very well over the 2-day seminar.

Now, Courtney Stanley and Marion Wilm are even more hands on with their clients at Child and Family Development.

A community colleague shared this awesome story with us this week. 

In her role as a CMS Occupational Therapist, our colleague attended an IEP meeting with a family whose child also receives pediatric therapy services at Child and Family Development.  The OT said that Dad raved about Amy Sturkey, Physical Therapist and said, "She is wonderful! There are only two women in this world I can say this about, and one is my wife, but the other is Amy. I really love her and what she does for my boy.  I wish we would have started seeing her sooner."

Thanks for sharing!

Here’s what parents had to say about Child and Family Development this week:

During the Psycho-Educational Assessment, "Mo Froneberger and Dr. Annada Hypes made our daughter feel very comfortable.  Their level of expertise and professionalism was outstanding!”    

At the time of her son's discharge from Occupational Therapy with Abbey Sipp, a mom said “I learned something in every session.”

Thanks for the feedback!

Just as some children can be picky eaters, others with sensory challenges may seek out different types of oral sensory input. This can lead to difficulty with social acceptance when children reach older ages or eating or mouthing dangerous objects.

Signs of oral sensory seeking behaviors can include: 
- craving certain foods
- putting objects in their mouth, like hands or pencils
- licking or chewing on non-food objects
- showing strong preferences for certain tastes or smells
- seeking out certain smells or tastes

If behaviors like these, or other sensory behaviors, are impacting your child's life, an occupational therapist may be able to help. Give us a call to find out more about occupational therapy and speech therapy services at Child and Family Development. We'd be happy to provide you with guidance and information on sensory processing and interventions.

My Disclaimer...

This blog is going to be for a step by step guide to my child's developmental milestones  I have a girl, please note that girls typically develop speech milestones faster, whereas boys typically develop physical milestone faster.  It can be used as a guide for other families, but please keep in mind that all children develop at different rates and should you have any concerns about where your child should be, you should speak to your pediatrician or schedule an appointment with a therapist in our office. 

Her first month...

I want to make sure that as a first time mom I do not wear blinders and miss something in my child's development that might not be normal.  I mean I think my daughter is the cutest, most advanced child on the earth, but does that mean she really is?  Probably not...I know, but it doesn't prevent me from thinking it.

As a speech therapist in Charlotte, NC, I of course want to insure that my child is on target for meeting all of her developmental milestones, and I don't just mean her speech milestones.  Therefor, In her first month of life I brought my daughter to lunch with my friends and collegues to show her off, of course, but also to have them check her and to get confirmation of her gifted abilities.  :-)  I know I am going to be that mom, but I just can't help it.

A little of my reasoning on why I did this...My daughter was born breech and at birth the doctor recommended an ultrasound as a precaution to ensure that the ball and socket joint in her hip had grown appropriately.  Evidently it is common for the socket to not grow around the ball joint when a child is breech, don't know why, just know that is what they told me.  After finding this out, as a psychotic  parent to her her first child, I had Erin Harkins, DPT, one of our Physical Therapist at Child and Family Development, check her hips to see what she thought.  Erin very gently checked my daughter's hips and reflexes, (although she did eventually make her cry) and reassured me that she too thought everything looked great.  We had the ultrasound in December and low and behold nothing is wrong with her hips.

I had Marion Wilm, OTR/L, an occupational therpist at Child and Family Developemt check out her neck control.  I think she is crazy advanced in this department, as when I burp her she picks her head up, turns it and then burps.  It was really crazy to watch her at weeks old do this.  Marion also confirms she has great head control.

So in her first month of life she cried when she was hungry, this really was the only time she cried.  She slept in everyone's arms, which of course makes everyone love her even more.  She slept 3-4 hours a night.  She breast fed like it was her job.  She had very active bowels.  She lifted her own head to burp.  And she began to notice things and people in a room, or is she just staring off into space pretending I am not staring at her?  

It is amazing how little a baby at this age can do, but how much a new parent will stare at them and completely loose a whole day doing so.  I know I did and I was okay with doing it because everyone keeps telling me how fast she is going to grow up so I should be savoring every second, right.  At her 1 month appointment she has aready grown several inches, although some of this is due to her having been breech and she has stretched out her legs some.  She has put on over a pound, making her a little over 8 lbs.

Looking for pediatric therapy services near Weddington, North Carolina?

Child and Family Development has an office in South Charlotte that is just about 10 miles from there and easily accessible from the 485 loop.

Our multi-disciplinary clinic has been helping children and families since 1980. The team of experienced therapists can assess and treat a wide range of childhood concerns, including autism, ADHD, dyslexia, and other learning disabilities or special needs. Our core services include Occupational Therapy, Physical Therapy, Speech Therapy, Child Psychology and Education. In addition, we offer many specialty services, like aquatic therapy, feeding groups and social skills groups.

The Contact Us tab on our website will link you to our address and Mapquest.

Bounce on down the road to see us!
 

I recently read an article about the value of play for development of executive function skills. www.npr.org/templates/story/story.php

I couldn't help but think of all of the other valuable skills that are developed when children are able to truly play.  As an Occupational Therapist here at Child and Family Development, I see many children who have difficulty with various fine motor skills, social skills, and executive function and who can benefit from play. 

Children who have difficulty with fine motor skills can better develop them by utilizing basic toys such as play-doh or putty, coloring, and playing other games. Development of the grasping skills that come naturally with learning to manipulate small or challenging objects in a variety of ways is imperative for appropriate and successful development of the grasping skills needed for writing, dressing, feeding oneself, and a variety of other every day activities including bathing and hygiene performance. 

Children who have difficulty with social skills can often benefit from being given appropriate opportunities and venues for interacting with others their age, participating in activities, developing and executing games and crafts, and completing a variety of tasks which require social interaction for best success. These activities also require development of self-control and self-regulation in order to participate with others, sustain attention to complete a task, and behave appropriately and successfully throughout a task while interacting with others.

Children who have difficulty with executive function can benefit from activities such as those that require appropriate sequencing for success, following directions, and execution of a variety of skills such as cutting, writing, and coloring. There is skill involved in cutting and pasting a picture together. It requires not just the control and coordination to color within the lines, cut on the lines, and then paste the objects to the paper where intended. It also requires developing a plan of what order to best color, cut and paste those items; where to do these things, as well as developing an accurate mental picture of the end product (either by using an example or better yet by using your imagination and problem solving skills) and being able to reach that goal. It requires children to develop a plan and execute it.

We have a lot of fun "playing" here in OT at C&FD.  Your children don't usually even know that they've learned the fine motor control and coordination as well as the self-control and social skills required to execute a plan that they learned how to develop all on their own and couldn't have done before they came to with us. 

This month, 2 more Child and Family Development pediatric therapists have completed the SOS training. 

SOS stands for Sequential Oral Sensory and is a transdisciplinary approach for assessing and treating children with feeding and weight or growth difficulties. It was developed Dr. Kay Toomey, in conjunction with experts across many disciplines including pediatricians, occupational therapists, dietitians, and speech therapists.

• Courtney Stanley, M.S., OTR/L, Occupational Therapist
• Jayne Walton, M.A., CCC-SLP, Speech Therapist

Courtney and Jayne will collaborate with the other SOS-trained therapists at both Charlotte offices to use this knowledge in the evaluation and treatment of children with feeding difficulties. 

Recently, a handful of the Child and Family Development pediatric therapy team members attended a local education course titled Mealtime Success for Kids on the autism spectrum: Holistic Nutrition for Picky Eaters. 

SOUTH CHARLOTTE OFFICE
Kati Berlin, Occupational Therapist               
Hollie Bowling, Speech Therapist
Beth White, Occupational Therapist 

MIDTOWN OFFICE
Melissa Bradley, Occupational Therapist
Abbey Sipp, Occupational Therapist

This training is useful for both Occupational Therapy and Speech Therapy services since we regularly evaluate and treat children with feeding difficulties.

 

Here’s what some parents had to say about Child and Family Development this week:

"Mo Froneberger, Educational Specialist, and Joy Granetz, Child Psychologist, were great. They made my child feel very comfortable."

"Courtney Stanley, Occupational Therapist, and  Joy Granetz, Child Psychologist, were very impressive. We feel encouraged and supported and feel the therapy will greatly benefit our son."

Thanks for the feedback!

Looking for pediatric therapy services near Waxhaw, North Carolina?

Child and Family Development has an office in South Charlotte that is under 20 miles from there and easily accessible from the 485 loop.

Our multi-disciplinary practice has been helping children and families since 1980. The team of experienced therapists can assess and treat a wide range of childhood concerns, including autism, ADHD, dyslexia, and other learning disabilities or special needs. Our core services include Occupational Therapy, Physical Therapy, Speech Therapy, Child Psychology and Education. In addition, we offer specialty services, including aquatic therapy, feeding groups and social skills groups.

The Contact Us tab on our website will link you to our address and Mapquest. 

We are just a hop, skip and jump away!

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.

An NDT Trained or NDT Certified™ therapist's education in neurology, physiology, and current research is translated into daily practice. They work collaboratively with patients, families, caregivers, and other healthcare professionals to develop individualized comprehensive treatment programs based on NDT theory and philosophy.

4 members of the C&FD team are NDT Certified:

1. Gail Fennimore, Physical Therapist
2. Ann Guild, Speech-Language Pathologist
3. Amy Sturkey, Physical Therapist
4. Marion Wilm, Occupational Therapist

Many others on our team have completed some training with this approach.  

For more information about Neuro-Developmental Treatment, visit their website, www.ndta.org

Over the last few years, 3 members of our pediatric therapy team have completed training in Total Motion Release® (TMR).

Occupational Therapy:
Marion Wilm, OTR/L @ South Charlotte office

Physical Therapy:
Erin Harkins, DPT @ South Charlotte office
Leslie Holmes, DPT @ Midtown office 

Per the website, www.totalmotionrelease.com, TMR brings the body back into balance in a slightly different way than what is traditionally thought of for therapy. This approach was developed around 2002 by Physical Therapist, Tom Dalonzo-Baker, MPT and is based on 5 principles and formats. TMR identifies fascial restrictions within the body.  Often times range of motion restrictions are not strictly due to muscular tightness.  By addressing the fascial restrictions, new range of motion may be freed, allowing for improved alignment for increased functional abilities.

To learn more about this approach, call us to schedule a free Intake appointment with one of these therapists.

A Mother emailed Erin Harkins, pediatric Physical Therapist, to say: " I can't thank you enough for taking interest in my situation last Wednesday. I realize you went above and beyond to help us and I really appreciate the help. You are a busy person but you always take each and every client to heart. Your kindness and good heart is truly a blessing to my family."

A parent said of Gail Fennimore, pediatric Physical Therapist, "This is the best evaluation report ever written about my son!"

During a parent conference, a Dad said that he's seen more progress in his son over the last year and a half at Child and Family Development, than any other time and is appreciative of the communications and planning by the three therapists: Jessica Sapel,  pediatric Physical Therapist, Jessica Hoffarth, pediatric Occupational Therapist and Jayne Walton, pediatric Speech Therapist.

Thanks for parents for this wonderful feedback!

February 2012 is an important month for this member of the pediatric therapy team at Child and Family Development:

Melinda Bumgardner, Speech-Language Pathologist – 1 year  Melinda joined the team in 2011, but it seems like she’s been part of the team for much longer. While she’s practiced in the Charlotte community for about 13 years, C&FD gives her the ability to collaborate directly with other professionals and be holistic in her approach. She was accustomed to treating along with Occupational Therapy and Physical Therapy, this has been her first opportunity to work closely with Psychology and Education practitioners. She enjoys using our blog to share information and suggestions with the public. She completed Hanen training a few months ago and is hoping to offer parents groups this year. Melinda stays busy outside of the office too and is teaching a Junior Roller Derby class starting this month.

You are an important part of our mission- to provide comprehensive, quality and integrated services to children and families.

Happy C&FD Anniversary!

Looking for pediatric therapy services near Lancaster, South Carolina?

Child and Family Development has an office in South Charlotte that is less than 5 miles from the border and easily accessible from I-77 and the 485 loop.

Our multi-disciplinary clinic has been helping children and families since 1980. The team of experienced therapists can assess and treat a wide range of childhood concerns, including autism, ADHD, dyslexia, and other learning disabilities or special needs.

We participate in many insurance plans. Also, some of our Occupational Therapy and Physical Therapy providers accept South Carolina Medicaid. 

The Contact Us tab on our website will link you to our address and Mapquest.