Occupational Therapy Charlotte

The Child & Family Development team in Charlotte, NC, is growing! We have two Full-Time clinical opportunities:

Occupational Therapist

Physical Therapist

Click here to visit the Careers tab on our website for more information.

In an occupational therapy evaluation at Child and Family Development, we use a holistic approach and look at the whole child. This may mean that we will include a vision screening.

In a screening, we don't determine whether or not a child's vision is 20/20 or if their eyes are healthy. We determine whether or not the eyes work together as a team, such as while tracking moving objects while the head remains still or moving smoothly without any jumps.

If we do suspect that eye movements may be a contributing factor to a child's skill difficulties or visual understanding of what they see, we may recommend a full developmental optometry evaluation.

One of the community providers who our team works closely with is Dr. Philip Bugaiski at the Developmental Vision Center in Charlotte. Click here to read some information that Dr. Bugaiski offers parents about vision therapy and vision assessments. 

If you are concerned about your child's handwriting, fine motor coordination, cutting, or visual skills, an occupational therapy evaluation may be helpful to narrow down the contributing factors. After we find the underlying difficulties, skill develoment can be targeted so that your child can be more successful.

Click here to visit Child & Family Development's website and learn more about the Occupational Therapy services and staff at our Midtown and South Charlotte offices. 

Click here to download a brochure about Occupational Therapy Services at Child & Family Development.

An recent article on Medline Plus, a service of the U.S. National Library of Medicine and National Institutes of Health, examine the value of regular physical activity for children. This article highlights objective research that shows without a doubt that there are big benefits to this heavy work activity that we recommend for our kids. The benefits are not just for the kids with sensory or self-regulation challenges, but for all kids. 

Click the following link to read the full article: http://www.nlm.nih.gov/medlineplus/news/fullstory_137130.html
 

Here is an excerpt: “Since the No Child Left Behind Act was passed in 2001, 44 percent of school officials have cut back on physical education to devote more time to reading and mathematics in the classroom," according to the report.

However, research suggests that regular physical activity may actually improve academic performance, the Institute of Medicine (IOM) noted. For instance, aerobic fitness is linked to working memory and problem solving. Recess offers children the opportunity to develop social skills and use their imaginations. Benefits of physical activity during the school day are greater than the benefits of exclusive use of classroom time for academics, the authors concluded.”

This is especially relevant to OT because we frequently treat children who have difficulty with self-regulation. These are kids who are getting all of the sensory inputs that the world has to offer but they can’t seem to handle it all and so their systems get disorganized. This results in all kinds of challenges for them to function successfully in their daily settings. We frequently recommend what we call “heavy work” activities to help with this outside of what we do in the clinic environment. 

Heavy work is essentially physical activity that grown-ups would call exercise. It’s generally anything that makes your heart beat faster, makes you sweat, and makes you breathe heavier. 

In my work as an Occupational Therapist at Child and Family Development, I hear often from children that they “didn’t have to do anything” in gym class or they didn’t have to participate. Even if your child has a regular hour of gym class every day, which is not so common anymore it seems, it is still important to help them move around outside of school. 

Tips for getting more exercise in

• Try to go for a walk after dinner or right when you get home. It doesn’t have to feel like work to count as exercise, any movement is good movement. That exercise will actually help them sit better for homework time. It may be beneficial to delay homework time for 30 minutes to go for a walk. I know it’s hard to work full time, take care of everything else in your child’s schedule and still even find time to feed yourself something decent let alone to add something to that schedule. 
• Start small, start by just going outside in the yard to play catch or basketball for 5 or 10 minutes at a quiet point in the day. Work your way up from there. 

The research shows exercise is not just good for your children’s physical health but perhaps even more importantly it’s beneficial for their emotional and mental health as well.

We are glad to be celebrating 3 years in our South Charlotte office.

We moved into the 7000 square foot space back in 2010 and have covered every inch of it with therapy materials and equipment for kids, adolescents and young adults.

All 5 of our core services- Education, Psychology, Occupational Therapy, Physical Therapy and Speech Therapy- are offered here from the team of about 16 therapists.

Give us a call if you like a tour.

An intervention plan for the treatment of Autism Spectrum Disorders requires a multidisciplinary team of professionals to create and tailor a plan to fit a child with ASD. This team approach typically includes speech and language therapy and occupational therapy.

Physical therapy is often a missing piece in a child with ASDs treatment intervention. I believe children are often are not referred to physical therapy because gross motor skills are not uncommonly their highest area of function. However, they cannot perform these skills on request or imitation. This affects their ability to play interactively with other children. Gross motor skills are critical on the “playing ground” of learning socially and interactively with other children. Physical therapy is an excellent option in addressing the core deficits of autism.

These limitations can include:

Sensory processing: These challenges can cause a child to be overly or under sensitive to certain areas of the environment such as light, touch, noise, smell or movement. They may avoid or excessively seek out certain sensations.

Communication: Expressive and Receptive language limitations with both verbal and nonverbal behavior can be associated with a delay or total lack of spoken language, involving initiating or sustaining a conversation with others.

Social interaction: Deficits in nonverbal behavior such as eye to eye contact, referencing, learning imitation skills and turn taking.

Motor planning: Motor planning delays may limit a child’s ability to conceive of movements, retrieve the correct plans for that movement from the brain, perform that movement especially in interaction with others, correct errors in that movement, and remember what worked in the plan so the movement could be more accurately and efficiently performed in the future.

Decreased muscle tone: Decreased or low muscle tone causes poor body mechanics. Low tone or muscle stiffness requires a child to expend more energy to perform movements. This can result in lack of coordination, clumsiness, gross motor skill delays, poor posture, poor walking mechanics, etc.

Physical Therapy Evaluations

When I perform a physical therapy evaluation with an individual on the spectrum, I usually perform a standardized gross motor skills assessment. I pay particular attention to the following:

• How much sensory preparation/heavy work/aerobic activity is required to organize my client to get them to an optimal state for concentrated work? How often do I need to return to sensory work to keep them organized? Do I need to embed the activity itself with sensory input to keep them focused?
• What types of sensory input calms or organizes them and what types of sensory input excites or disorganizes them?  Which type do I need to perform more?  Are they under aroused or over aroused?
• How hard I have to work to gain the child’s attention to give them a meaningful demonstration?
• Do they know to look at the most relevant detail of the demonstration?  For example, if I am walking on my tiptoes, do they look at my feet?
• Can they perform an activity on request? What level of complexity of an activity can they perform?  Bilateral only or unilateral?  Symmetrical only or asymmetrical as well?  Upper body only or lower body as well?  Do the upper and lower body movements need to mirror each other?  How many steps in a sequence can they copy?
• Do they understand movement in relationship to themselves, another person, or things in their environment? For example, can they stand behind a line, behind a person, raise their right hand, or lay on their belly?
• What support do they need to imitate an activity?  Do they need to be physically taken through the activity first? And then support faded? Do they need an immediate model? Can they copy an activity with a previous model? Do they perform better if a familiar caregiver or parent performs the activity first?
• Do they reference me or their caregiver to check in and see if they are doing an activity correctly?
• Do they understand implied cues (including gestural, facial, contextual, postural, tone/inflexion related) that a typical child would understand?  If I say, “Stand over there (while pointing) and catch the ball.”  Do they understand where to stand, what direction to face, and what basic body position to get into, i.e. they don’t face the wrong direction and don’t sit unless I am sitting.
• Do they have a history of interactional play with other children?  If so, what types of play can they engage in?  Parallel? Interactive? Pretend? Flexible? Rule bound games or sports?  

Need help?

If you want help with these suggestions or notice any of the above mentioned difficulties, a Physical Therapy evaluation can determine if your child is simply showing normal variability in gross motor development or if your child can benefit from intervention. Call me today at (704) 332-4834 ext. 114 to set up an evaluation. 

The American Occupational Therapy Association (AOTA) has been working on a project to help OTs begin to organize all of the research we’ve done over the course of our profession. The goal of the AOTA Critically Appraised Topics (CAT) and Papers Series is to allow us to reference this research and use it to show evidence -- which insurance companies look for -- of what types of treatments are effective for what types of difficulties and disabilities.

This CAT is focused on finding out: What types of treatment are effective for children with Sensory Processing Disorder?

It is important to remember, as is the case with much of current research, that when there is a lot of diversity within a study -- i.e. kids have different needs and different settings to learn in and different diagnoses -- it limits the way that we can apply research.  Basically, it’s harder to say “it worked for those kids, it will work for this one”.  Rather, we can say “it seemed to work for those kids, it might work for this one”. 

The research shows that, depending on the needs and circumstances for the child, two general methods of providing or delivering treatment can be equally effective: directly treating a child, and providing consultative services such as to a teacher or parent to allow them to treat the child.

One perspective to treating children begins with a motor learning approach. Motor learning is an approach in which we teach a child a specific movement pattern, such as specifically how to make a letter "a," and then we repeat that movement or motor plan until the child begins to memorize it and can do it “on autopilot” or it becomes natural for them.

Another perspective is to begin with an impairment-oriented approach which looks at the underlying cause for a difficulty. An example of an impairment-oriented approach would be the perspective that a child can’t write their letters because their arm or hand is too weak to control the pencil.  Treatment would focus on strengthening those weak muscles with the view that the child will ultimately be able to write their letters if their muscles are made stronger.

The research in this review is the strongest to support motor learning approaches, but says that impairment-oriented approaches should not be ignored.  It is important to understand that, typically in practice, OTs use a bit of both approaches. With handwriting we will not only teach the motor plan for letters, we will also work to strengthen the muscles needed to make those letters. So we not only direct the child along the path to a successful outcome, we also ensure that we’ve set them up with the needed equipment to achieve that outcome. This is why you may hear us working on the same skill or activity over many sessions and asking you to do the same thing at home.

Ultimately the evidence shows that occupational therapy intervention is beneficial for children having sensory processing dysfunction which is impacting their performance in daily life. Motor learning approaches can be used to address specific skill deficits, and impairment oriented approaches can be used to address the underlying difficulties such as self-regulation and organization; and both types of approaches appear to be effective in treating this diagnosis.

Many years ago I chose to become an occupational therapist working in the field of pediatrics. Occupational Therapy is a medical profession that uses engaging and everyday activities to help children and adults either recover skills that were lost due to accident or injury or gain skills that are slow to develop.

I engage with children who have Autism, Down Syndrome, Cerebral Palsy, feeding disorders, genetic disorders, metabolic disorders, sensory processing disorders and even children with mild handwriting difficulties. 

Occupation refers to everyday activitie including self-care skills, school readiness skills (i.e., handwriting and cutting), play, and how we participate in family and community activities. As therapists we promote skill development in motor skills, visual skills, sensory processing skills, attention and other higher level cognitive and social skills.

With children, much of our treatment includes fun, play-based activities because this is highly motivating and the children are sometimes unaware that they are engaged in exercise or work activities that promote skill development. 

If you have questions or concerns about any area of your child's development, talk to your pediatrician about referring you for an Occupational Therapy evaluation or call us at Child and Family Development (click here for locations and phone numbers) to schedule a screening or evaluation.

Click here for more information on the occupational therapists at Child and Family Development!

If you know an Occupational Therapist already, please wish them  a "HAPPY OT MONTH!"

Child and Family Development therapists recently attended a great two-day course called A Dynamic Base of Support --  The Key To Enhancing Function.

The course was sponsored by Neuro-Developmental Treatment Association™ (NDTA) at Integrative Therapy Concepts near Charlotte.

It offered instruction and information about graded handling techniques and pediatric therapy strategies.

Among the therapists who attended:

• Mary Helen Bailey, Occupational Therapist
• Megan Bevington, Occupational Therapist
• Jessica Hoffarth, Occupational Therapist
• Michelle Pentz, Speech Therapist
• Courtney Stanley, Occupational Therapist 

Looking for a social skills group for your child this summer? Check out Social Butterflies Club™ at the South Charlotte office of Child and Family Development!

Social Butterflies Club™, founded in 2004 by Rhonda Osisek M.S., CCC-SLP in Virginia, helps children learn how to interact with peers while having fun with sensory and speech activities combined.

Both an occupational therapist and speech therapist leads this club at CFD. The children in the group may have a variety of diagnoses, such as expressive and/or receptive language problems, sensory processing difficulties, and fine motor deficits. The goal of the Social Butterflies Club™ is to teach the kids how to communicate with peers in a positive way that allows them to thrive outside of therapy.

Each child is screened as part of placement. Clubs are formed based on each child’s communication skills, social ability and age. The Club meets for 1-hour sessions for four consecutive days. Several schedule options are offered this summer.

We will be offering some fun themes including Going on a Picnic, Fourth of July, Under the Sea and Back to School. The club will be led by speech therapist Michelle Pentz, MS, CCC-SLP, and  occupational therapist Courtney Stanley, MS, OTR/L. 

Contact  Michelle Pentz, 704-541-9080 x214, mpentz@childandfamilydevelopment.com to register your child.

Click here for more details about the Social Butterflies Club™.

Click here for more information about the C&FD.

At least once a week, I hear bedtime woes from clients: “My daughter is never tired at bedtime” or “My son takes hours to fall asleep.” Given that a child’s development relies on restorative sleep patterns, these concerns about bedtime are more than matters of convenience. Unhealthy sleep patterns can cause behavioral issues, changes in appetite and difficulty acquiring new skills, to name a few things.

To improve bedtime, tap into your child’s sensory system. Children with atypical sensory processing or modulation can have an even harder time calming themselves for bed.  I recently attended a course titled Effective Neurological Management of Sensory Processing Disorder presented by Charlene Young, OTR/L, CEAS.  In this course, Young provided some fresh, useful sensory suggestions to prepare your child for bedtime whether they have sensory difficulties or not. Here are some of her suggestions as well as my tried-and-true methods to improve bedtime routines:

To get to sleep

• Move your body. Before the bedtime routine even begins, make sure that the child has used his energy. Try to do 10-20 minutes of: 1) movement (running, jumping, skipping, rolling) and 2) heavy work (muscle work – e.g. carrying laundry baskets, rearranging chairs after dinner, doing wall push ups).  The movement will get out the child’s energy and the heavy work will reorganize his system.
• Stick to a routine. All children -- and most adults -- find comfort in routines. When you prepare for bedtime with the same steps every night – school night, weekend night, or summertime – you will put your child at ease.  Consider using a picture schedule to help both you and your little one stay on track.  A picture schedule also helps remind mom and dad - even grandma and grandpa - of the routine.
• Put down the iPad. Turn off electronics at least 30 minutes before bedtime. The blue lights in electronics facilitate wakefulness.  Also, fluorescent lighting can negatively affect the nervous system. Turn these lights off before bedtime or, if needed, cover in green tissue paper to better calm. 
• Cool the body. Bathe your child in a hot bath for about 20 minutes. The drop in body temperature that follows when you take him out of the bath will calm his body. 

To stay asleep

• Lower the thermostat. Just as a drop in body temperature calms, cooler temperatures at night can help the body regulated and asleep.  Cooling pillows are also a good option.
• Left ear to the wall. Position your child’s left ear next to the wall to decrease noise.  The right ear needs to remain accessible to access the left side of the brain, which is the language-based area.
• Turn off the nightlight. Complete darkness facilitates melatonin production and aids with sleep

If you child still cannot regulate his sleep patterns, there may be a more significant medical issue.  Consult your pediatrician and/or occupational therapist.

Sweet dreams…zzzzzz

Have you been curious about the Dexteria app to help develop fine motor skills? The three-part app, which costs $3.99, assists fine motor training including isolated finger movements, pinching, and letter tracing. It is popular among Occupational Therapists and won an Editor's Child Award from Apps for Children with Special Needs.

Abbey Sipp, an Occupational Therapist at Child and Family Development's Midtown office, reviewed the app for the "Checking the Pulse" blog on the American Occupational Therapy Association's website.

Abbey explains in the review about her use of the app in therapy.  "Children aged approximately 4 to 6 enjoyed fine tuning their skills with, especially, the “Pinch It” section of the app. Watching the crabs disappear provides invaluable reinforcement of skills and promotes endurance," she said. 

While she praised two parts of the app, the "Write It" section isn't one she uses.  "In practice, however, the tracing required is significantly too precise. There were even times when I became frustrated tracing the letters!"

Click here to read the full review. Have you used the app? What do you think?

Click here to read some of Abbey's Fine Motor Favorites, a collection of toys and activities which range from Play-Doh to Tennis Ball Mouth.

Want to schedule an appointment with Abbey or learn more about our Occupational Therapy services?

Visit our website or call 704.332.4834 to set up an evaluation.

Child and Family Development is thrilled to return at The John Crosland School to provide Occupational Therapy and Speech Therapy on campus.  Ellen Bruce, MS, OTR/L and Stephanie Gerlich, MS, CCC-SLP are leading our efforts.

Want to schedule a visit from our professionals? Click here to contact us. 

Did you know that Child and Family Development's office in South Charlotte is less than 5 miles from the state line and easily accessible from I-77 and the I-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.

Have you noticed if your child struggles with opening things, holding a writing utensil, difficulty manipulating small items? He/she could be struggling due to decreased strength in the hands and/or fingers. Lacking strength in the hands and fingers affects a child's fine motor skills, writing skills, dressing skills and much more. Belwo are easy at home activities your child can do to increase their strength.

• Play-doh:  have the child knead it, roll into logs or small balls with their finger tips, squash it with open palms and use their fingers to mold it into a larger ball; use cookie cutters and scissors
• Theraputty: more resistive than play-doh; comes in a variety of resistances ranging from soft to extra firm; hide small items (buttons, coins, beads, etc) inside and have the child pull it apart with their hands and fingers to locate the items; roll the putty into a log and have the child snip it with scissors. This activity can be graded by changing the thickness of the log or using varied levels of resistive putty.
• Pinching activities: tongs, tweezers, chopsticks, and clothespin activities use muscles for pinch strength in the hands and subsequently for the muscles use in holding writing tools properly. Always make sure a neutral wrist position and proper pinch grasp are used to maximize strengthening of hand and finger muscles.
  • Clothespins with letters or numbers written on them; clip them onto fabric or a clothes line hung slightly above shoulder height of child to incorporate wrist and shoulder muscles in this activity
• Weight-bearing activities: when children crawl as infants the arches within the palm of the hand develop and strengthen, which allow us to cup a dice and shake it with our hand; crawling on all fours through a tunnel or over uneven surfaces, propelling themselves prone on scooter board, and wheelbarrow walking
• Squeezing activities: include use of stress balls, large chip bag clips, crumbling large pieces of paper to make snowballs, spray bottles and water squirt bottles to create chores for your child to clean the table after a meal and water plants

Your child may also benefit from Occupational Therapy if they struggle with finger and grip strength. Contact our office to schedule a free Intake if you have concerns.