(This blog post is part 3 of 4 in a short mini-series about therapy processes)

The Evaluation Process can be an exciting time for a patient. Exciting for them to get to experience a new place and meet new people, exciting for their parents/guardians to know that they will be able to get answers to questions and help if needed. This process can be little confusing though with all the moving parts and questions you may have regarding your concerns, scheduling, insurance, etc. Hopefully this blog post will be able to answer some of your questions and get you excited for your evaluation at Sonoran Sun Therapy.

Sonoran Sun Pediatric Therapy offers Speech Therapy, Feeding Therapy, and Occupational Therapy. All disciplines have specific evaluation protocols they follow and standardized assessments they can administer. During the Evaluation process the patient and their parents/guardians will come back to the evaluating therapist’s treatment room. The evaluating therapist may have toys and/or materials laid out in their room that will be utilized during the evaluation process. The evaluating therapist may decide to use a combination of standardized and unstandardized assessments during this evaluation process. During the evaluation, the evaluating therapist will probably be taking notes regarding the patient’s abilities. This information along with the parents/ guardians concerns and standardized & unstandardized assessments will be analyzed at the end of the patient’s evaluation and typed up into an evaluation report. The evaluation report gives information regarding the patient’s current abilities, any concerns regarding the patient’s abilities, in addition to the plan of care and goals for the patient. Once the evaluation report is complete, the report is submitted to the patient’s parents/guardians, patient’s doctor, treating therapist, and patient’s insurance company if needed.

It is important to note that evaluations are not like typical treatment sessions. Evaluations require the patient to do more sitting, and completion of test materials. Patient’s ongoing sessions will incorporate play, exploration, movement, problem solving, and will be more fun. The evaluation is simply a way for the evaluating therapist to collect data to come up with a plan of care and goals for the patient.

Once the evaluation is complete, if the patient would benefit from therapy the evaluating therapist will make that recommendation and will have the patient’s parents/guardians discuss scheduling with the office staff. It is important to note that due to scheduling and therapist availability, the evaluating therapist may not always be the therapist who treats the patient. It is not uncommon for this to happen, and if it does, the treating therapist/ assistant will be given a copy of the patient’s evaluation and plan of care, so the treating therapist/assistant know how to set up for the patient’s sessions.

Michael Jankowski, MS, OTR/L
Occupational Therapy Director

(This blog post is part 2 of 4 in a short mini-series about therapy processes)

Sonoran Sun Pediatric Therapy offers Free Screenings for all of our therapies (Occupational Therapy, Speech Therapy, and Feeding Therapy)

A screening is simply when a Therapist or Assistant will observe a patient, ask clarifying questions to the parents/guardians, answer any questions the parents/guardians may have, and determine whether the patient would benefit from a formal Evaluation and ongoing therapy. The screening process if FREE and usually takes 10-15 minutes.  Think of a screening as a FREE “pre-evaluation” and determination of whether the patient requires ongoing therapy or whether the Therapist or Assistant may be able to make some suggestions to the parents/guardians to help with their concerns.

It is also possible that a current patient receiving therapy may be recommended for a screening by another discipline of therapy. For example, a Speech Therapist may notice that one of their patients potentially has some sensory concerns and may recommend the patient receive a Free Occupational Therapy Screening. If this happens, this is nothing to be alarmed or concerned about. This simply means that the patient’s therapist wants to make sure the patient has all the tools they need for success, and that the patient may benefit from guidance or therapy from another discipline.

Since Screenings are FREE, they do not require any insurance authorization. You can simply call or email Sonoran Sun Pediatric Therapy to schedule a screening with which discipline you think the patient may benefit from. Not sure what discipline the patient may benefit from? Then simply give us a call and we’ll steer you in the right direction.

Michael Jankowski, MS, OTR/L
Occupational Therapy Director

(This blog post is part 1 of 4 in a short mini-series about Occupational Therapist)

While there are some differences between an Occupational Therapist (OT) and a Certified Occupational Therapy Assistant (COTA) there are much more similarities. OT’s and COTA’s work together as a team to make sure that a patient receives the best possible care and is provided with the tools to help them meet their goals and engage in meaningful occupations. OT’s are required to have a Master’s Degree, and COTA’s are required to have an Associate’s Degree. OT’s are involved in the process of evaluating a patient, establishing a plan of care, and setting goals for a patient. COTA’s take the information the OT gathered from the evaluation then plan and implement the patient’s treatment sessions in addition to working with patients on achieving their goals. OT’s and COTA’s work as a team to make sure every patient gets the help they need. Both OT’s & COTA’s are extensively trained and able to work with patients with all types of diagnoses and from different backgrounds.

It is important to note that:

• Both OT’s & COTA’s have attended a college, university, or institute and have received a degree as an OT or COTA.
• Both OT’s & COTA’s are trained and have received an education in working with the pediatric population.
• Both OT’s & COTA’s are trained and have received an education in working with diagnoses specific to the pediatric population.
• Both OT’s & COTA’s have had to take and pass a board exam regulated by the National Board for Certification in Occupational Therapy (NBCOT)
• Both OT’s & COTA’s have to be licensed as an OT or COTA by the state they are working in (verifying they have graduated from an accredited program, have passed their board exam, and are in good legal standing).
• Both OT’s & COTA’s are required to attend continuing education classes to continue to learn about the pediatric population and to maintain their licensure.

Michael Jankowski, MS, OTR/L
Occupational Therapy Director

Pediatric Occupational Therapist help infants and children reach their maximum potential to live life to the fullest! A child’s occupation consitist of a variety of everyday activities. These activities include playing, learning, getting dressed, self care and interacting with others. Occupational therapy helps children to be independent and successful in everyday activities. Listed below are some of the areas that an occupational therapist can help children.

• Cognition relates to how the brain thinks, processes and learns. Some specific areas of cognition include attention, sequencing activities, time management, memory, problem solving, following directions, and decision making.
• Social Skills are important for children to learn in order to relate and communicate with their peers, teachers, siblings and parents.
• Self-Care is the ability to take care of one’s self. For example, dressing one’s self, bathing, teeth brushing, feeding themself and being able to button or zip a jacket.
• Sensory Processing involves how a person perceives information from their senses, such as sight, taste, touch, and sound. A great example of this is when a child dislikes wearing certain clothes because of the way the clothing feels.
• Coordination for a child is important for all areas of life. There are different types of coordination, including fine motor, gross motor and motor planning.
• Visual Motor Integration involves the coordination of the child’s body movements and visual skills. For example, using scissors, catching a ball or tying their shoes.
• Strength is an important component for children in order to successfully accomplish everyday activities. Some children become fatigued quickly when performing simple task like handwriting.

If you think your child may need help with any of these areas, occupational therapy can be very helpful for your child’s development.

Ways to Incorporated More Oral Input at Home

Exploration of objects via the mouth is a typical part of development and for infants it is crucial for their oral motor and sensory development. However, as we age the amount of oral exploration and input we need typically decreases.

Our oral sensory system does many things; it helps us identify temperature, taste (sweet, bitter, sour, salty, savory), and texture (smooth, hard, crunchy, mixed…).  It plays a role in our food preferences, calming/regulating abilities, speech sounds, teeth brushing, and other areas of our daily lives.  Additionally, our muscles and joints of our mouth and jaw can send a large amount of Proprioceptive to our brains.  Proprioceptive input can play a key role in helping our bodies and brains regulate, attend, focus, and process other information.

Children’s oral sensory needs can vary from seeking to avoiding to mixed; however, today we are going to look broadly at the oral seeker and simple ways to incorporate more oral input at home.

In order to help satisfy the sensory needs of an oral seeker there are some easy ideas to try:

• Crunchy foods (carrots, jicama, pretzels, these increase the proprioceptive input that is sent to the brain which is a go to for regulation
• Gum (for your older children that demonstrate the oral motor skills and safety with it), provides repetitive proprioceptive input
• Straws (coffee straws, cups with straws, thick milkshake straws, crazy straws, you name it), these easy to add suction tubes are great ways to allow a child to utilize many muscles of their mouth to drink. **the thicker the beverage (think smoothie, applesauce or yogurt consistency) or the smaller the straw opening (think coffee straw) the more work the mouth has to do to pull it through the straw thus the heavier work they will require and input that will be sent to the brain.
• Chewy tubes or chewlery, these allow children an appropriate way to channel their NEED to chew verses chewing on objects, shirts, clothes, and other things.
• Vibrating toys or toothbrushes, these allow for increased input and stimulation (it can be as easy as incorporating a vibrating toothbrush into their morning and evening teeth brushing time or having a toy or z-vibe that provides the vibration and chewable surface).
• Allow opportunities for children to do heavy work (this is pushing, pulling, lifting, resistance activities against the body, running, swimming, and things that require muscle/resistance), often times where there are oral sensory needs, there are sensory needs elsewhere in the body as well (and heavy work is a great place to start)
• Change up the temperature, try providing frozen foods (frozen veggies, frozen fruits, smoothie popsicles, yogurt popsicles, etc.) or ice-cold beverages can be alerting and provide more input to the sensory systems of the mouth
• Use the mouth during activities (blow up balloons, blow bubbles, make silly/exaggerated faces, whistles/harmonicas/kazoos, hum, make sounds with the mouth, and use those muscles in different ways).
• And last but not least, know that oral sensory input is a typical way many of us regulate, focus or attend we do it to differing degrees (we all know the person that ALWAYS chews gum, or snacks while they study, or bites their pens/pencils, etc.). Find what works and is an appropriate method of receiving effective and safe input for your child.

If you have kids that overstuff their mouth at the table or seems to gravitate toward only crunchy or chewy foods, you can work on strategically providing increased oral input prior to mealtimes to stimulate, alert, and “feed” the mouth with sensory input.

Also, make sure you talk with your friendly Occupational Therapist or Feeding Therapist so they can individualize and more accurately provide additional strategies and education.

Allison Heitzinger MS., OTR/L

Occupational Therapist and Feeding Therapist

Often parents think that if their child gets in–school Speech and/or Occupational Therapy that their child would not benefit from in-clinic therapy. There are many advantages of getting therapy in-school and in a clinic based setting. Therapists welcome collaboration between school and clinic therapy, which in turn helps your child receive the best care.

The first benefit of your child receiving both in-school and in-clinic therapy is increased frequency. Therapy in the school is usually a group setting of children who are working on individual and group goals. These goals are often academic based and don’t touch on the entire scope of your child’s development.

When your child receives therapy in a clinic based setting, your child is getting one on one therapy. This therapy is based on the whole child’s wellbeing. Children attending multiple therapies per week benefit from having increased frequency of therapy. Children also tend to make greater gains in meeting their goals with multiple therapies and in a shorter period of time.

As your child starts to meet their goals, therapists look across each environment to see if your child has mastered a skill. Having children attend therapy in two environments can aid in their generalization.

Therapists in schools are often limited in regard to which skills they can work on with your child. Clinic based therapists are able to work on more of the functional goals which in turn addresses more areas. Often times clinic-based therapists will reach out to the school therapist and vis-versa. The collaboration between the two therapists can ensure that your child is receiving the best care possible.

As the parent/guardian, it’s important to let each therapist know all the places your child is receiving therapy. The more information given about your child, the more help your child gets to reach their goals!

Problem Feeder vs Picky Eater

Many families often question their child’s food preferences. It is very common for children to become very unpredictable and many go through a picky eating phase.   Sometimes it can be more serious than that and can be more of a feeding problem.  If you suspect it is more of feeding difficulties the best thing to do is keep a food journal and track your child’s eating behavior. You can then bring up your concerns with your healthcare provider. You may be referred to an Occupational Therapist or Feeding Therapist who can provide therapy to discover new and healthy foods. This can also help to improve your child’s overall nutrition so they can continue to grow and thrive.

Here are some great tips to look for when trying to figure out if it’s your child being a picky eater or your child being a problem feeder.

Problem Feeders

• Cannot tolerate being around people eating foods they don’t like.
• Refuses to eat particular food textures or colors.
• Eats less than 20 foods.
• Gags or even vomits when eating certain foods.
• If your child is progressively phasing out foods and their diet is becoming extremely limited in variety and color.

Picky Eaters

• Can manage new food on their plate and will try new food with encouragement.
• If your child gets tired of one particular food, it can usually be reintroduced at a later time,
• Your child may not like a variety of food groups or textures but will eat at least one from each food group.

With a child who is being a picky eater, limit snacks and try meal times at the same time every day. You should never bribe or force your child to try a new food. Simply serve new foods alongside familiar foods and encourage your child to try it. It can take up to 10 times to get a child to try something new and that’s okay!

This information has been sourced from: Copyright 1997 / 2019 – Dr. Kay A. Toomey

Therapist favorite picks

Often as parents of children with special needs you are looking for tools or activities that can keep your child busy while learning. Here is a list of some top therapist picks that are used every day in therapy treatment for children that can also be great to have at home.

Favorite board games for fine motor skills and visual motor:

Jenga

Connect Four

Chutes and Ladders

Eye Spy Games

Operation

Headbandz Game

K’nex

Legos

Rubix Cube

What’s in Ned’s Head

A great sensory calming game is Lite Brite. That’s right, the original Lite Brite game is a great activity your child can sit down and play with quietly.

Other tools that help with sensory sensitivity are Sensory Brushes, Theraputty, Vibration Jigglers and Chewy Tubes.

The soft bristles of the sensory brush provide a therapeutic combination of deep pressure and tactile stimulation to help calm down and improve focus. Theraputty can improve fine motor skills and decrease stress. Vibration Jigglers and Chewy Tubes are also used to assist in calming and regaining focus.

All these items can be found on the internet and are reasonably priced.

No one wants to say the “D” word…..DEDUCTIBLE!

Most everyone knows that their insurance plan has a deductible. A deductible is a set amount of money that is the patient/member/subscriber’s responsibility before the insurance will begin to pay towards covered services.

They either reset every Calendar year (every January) or Fiscal year (anniversary of the effective date of the insurance plan). It is important to know your insurance benefits and deductible amounts. Deductibles range from $50 to $6,000 and sometimes more depending on the company and the plan you choose.

For services that are considered covered benefits of the insurance plan, there will usually be a coinsurance (coinsurance is a shared cost with the insurance company) that comes into effect after the deductible is met. For example, say you have a $500 deductible and it has been met (meaning you have spent $500 on covered services). The out of pocket cost for covered services after $500 has been met, turns into a 90/10, 80/20, 70/30, etc., This means that the insurance company will cover 90% of the charges/costs and you are responsible for the remaining 10%. This will vary depending on the plan you have. If it is the 80/20, insurance covers 80% and you are responsible for 20%….etc.

Don’t confuse coinsurance with a co-pay. They are two different things. Coinsurance is a percentage of the cost for a health service and a co-pay is a flat fee for a service.

Be prepared in the new year for your medical expenses and check your insurance plan’s benefits!

The Benefits of Feeding Therapy

Feeding therapy can help children with special needs such as Autism Spectrum Disorders (ASD), Down Syndrome or Sensory Processing Disorder (SPD) or with a child who may be a “picky eater”. Therapy can also help children with fears of trying anything new. The goal of feeding therapy is to establish regular nutritious meals.

Feeding Therapy can help your child be a more varied eater and have harmonious mealtimes. Therapy can be beneficial to help you get to the root of why your child may be refusing foods. Some children have anxiety about mealtime and that there won’t be foods that they like to eat.

Eating is a developmental process for children. When a child has difficulty eating, it means they have stalled in the midst of learning a new skill.  Regardless of your child’s age, the feeding therapist will begin to teach the step by step process wherever your child is having trouble (e.g. chewing) as a means to reaching the long-term goal of independent, healthy eating.

Feeding therapist can also give you small goals/home programs for you to work with your child each week.