Thursday, March 22, 2018

Therapy Tip: 10 Uses for Plastic Eggs

It's Therapy Thursday! Yippee! Today is the day that I share a tip based upon my experiences as a pediatric speech-language pathologist and the mother of a child with special needs. Today's tip is:

10 Uses for Plastic Eggs in Speech Therapy

It's Easter! If there isn't already, there will soon be plastic eggs littered all over yards and homes. I love using these plastic eggs to change up activities for the work that I do with toddlers. Today, I thought I would give you 10 ways you can build speech-language skills with these plastic eggs. Obviously, anything small and plastic should be used with supervision for toddlers, but you knew that.

1. Color matching: Gather 10 eggs (2 of 5 different colors). Show the child how you can sort them out by placing green by green, blue by blue, etc. If it is too hard or too easy, change the number of eggs. You can also use an egg carton to make it a little more structured. On one row in the carton place 6 different colored eggs. Then, ask the child to place the matching color next to the egg in the carton. Still yet, you can get colored construction paper the same color as the eggs. Place the construction paper out and show the child how you can match the eggs to the same color as the paper.

2. Big/Little: You can reinforce the concepts of big and little in a couple of ways. First, you can simply get two different sized eggs to show big and little. Secondly, you can get small items and see which ones are little enough to fit inside the eggs and which ones are too big to fit in the eggs.

3. What's in the egg?: If you look hard enough, you can easily find things to place inside the egg. You can then teach vocabulary with the things that are in the egg. The child will have fun opening the eggs to see what is inside. It is important to pace the child, so that they only open one egg at a time and focus on the object inside. Some things I have placed inside the eggs have been: play money, little animal figures, a beaded necklace, plastic rings, pom-poms, small dinosaur, etc. Children have really enjoyed this activity with me in sessions. Again, anything small enough to fit in the eggs will require strict supervision, and this shouldn't be done with kids who frequently put things in their mouths.

4. Spatial Concepts: By placing eggs in different positions, you can teach many different spatial concepts. You can show the child the spatial concepts ("I'm putting this one in the basket." "I'm putting this one under the basket.") to teach them the concepts. You can "test" the child by telling them where to put the eggs by telling them to put it in/out/on/on top/under/next to/behind/in front of a basket, container, or chair.

5. Counting: This is sort of obvious. Count the eggs! If your child isn't counting very far, then count to 3 over and over with the eggs. If they can go higher, count higher. To make it harder, you can tell the child you hid 5 eggs. Count them out as they find them.

6. Following directions: Use the eggs to work on following 2 and 3 step directions. Examples of 2 step directions: Get the egg, and put it in the basket. Pick up an egg and bring it to me. Go to the couch and find the egg. Examples of 3 step directions: Go to the chair, get the egg, and put it in your basket. Find the egg, put it in your basket, and then come to me. Stand up, get the egg, and come back here.

7. Speech Sound Targeting: If your child is working on a specific sound like p or k, then you can put some things inside the egg that have the target sound for your practice. For instance, if you are doing initial /k/ words, you can put the following things inside the eggs: candy, key, cat, "K," kid, car, etc. If you can't find objects small enough to fit in the egg, then use stickers or find pictures of these objects from Clipart or magazines to stuff in the eggs.

8. Shakers: Fill those plastic eggs with items to turn them into shakers. You can use items that will create a soft noise and some that will create a loud noise so that you can compare items and teach those adjective words. Make sure you secure the egg shut with packing or duct tape so they won't spill out! To make a soft noisemaker, use pom-poms, rice, or gummy bears. For loud noisemakers, use rocks, beans, Legos, coins, and M&Ms. Add music to the activity and dance with these noisemakers as you remark on which ones are loud and soft.

9. Kitchen Fun: If you have pretend play kitchen items, add some plastic eggs to them. I love watching kids imitate me cracking the egg and pretending to cook them. This will work on pretend play, play imitation, and actions (crack, stir, cook, eat, cut).

10. High/low: Without the child present, you can hide eggs up high and down low. As they find the eggs, you can remark on the eggs that are low and up high. The ones that are up high will also create an opportunity for the child to ask for help since they will most likely need you to pick them up and help them get the egg.

Well, now you know what to do with all of those eggs sitting around. Have fun!

Therapy Thursday is for educational purposes only and not intended as therapeutic advice. 
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Tuesday, March 20, 2018

Do You See the Value?

What's the first thing you see with my daughter?

Most adults notice right away she has Down syndrome when they look at her. Others may see that she wears glasses on her face or braces on her feet.

Most children notice within a few minutes of meeting her that she can't speak well. This, above anything else, is the thing that catches their attention and 'bothers' them the most.

Still, other children see a sweet friend.

If they look hard enough, adults may see a child who is loving and happy as they watch her hugging friends or kissing her brother.

Beyond that, what do you see?
Do you see a child with a future and hope?
Do you only see a child with needs and limitations?
Can you see her value?

I know what I see in my daughter.
I see her heart, and it's beautiful. She reflects the attitude of God more than anyone I know. She loves anyone right from the start without reservation. When she sees a child, she sees a friend even when they are uncomfortable with her. She's not ashamed to hug and kiss those she loves. She gives love without expecting anything in return.

I see a child who has worked hard to achieve many things in life. I see a child who has faced challenges, illnesses, and "bad" days better than I would have. I see a child who is driven. I see a child who has overcome.

I see a child who has benefited from programs, therapies, and schools that assist in making her life better, but that betterment of her life isn't what gives her value.

I see a child who has worth simply because she is herself.
She is a living and breathing human being. She has a soul and a mind. She has feelings, preferences, ideas, and dislikes. She has fears. She has things that make her laugh.

She loves the color green, her iPad, her cousins (especially Gabby), and her cat. She loves playing the tambourine while her brother plays guitar. She loves singing along to Skillet, Toby Mac, and the soundtrack to Beauty and the Beast. Her love of Beauty and the Beast is starting to teeter on a full blown obsession. She has a number of funny things that she does such as eating one food on her plate at a time before moving to the next food or making sure her glasses on her nightstand are perfectly parallel to her bed before she gets in it. She is amazing and funny, and I love her so much.

Where am I going with all this?

March 21st is World Down syndrome Day. The date 3/21 is a reference to the 3 copies of chromosome number 21 that individuals with Down syndrome have. Each year this date rolls around, I feel compelled to write a piece on this topic I am passionate about.

This year, I feel a bit tired. I am tired of living in a world where many people simply do not value people like my daughter. I don't know how to teach people to value her life. It seems like it is a fundamental thing, but it is not apparently.

I find that many people say they don't think life is all about getting the best education, having a high-income job, or starting a family, but it seems that these are the things that people use to judge a person's value in society in the end. There's so much more to life than those things. That's a very narrow perspective that some will surely not fit into.

Today, I ask you to look beyond what you may normally see. Look beyond the disabilities and see the abilities. Look beyond the shortcomings and see the unique aspects of a person's personality. See the love. See the human being. See what I see. See the value.
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Thursday, March 15, 2018

Therapy Tip: Easter Sensory Bin

It's Therapy Thursday! This is the day that I share a tip based upon my experience as a pediatric speech-language pathologist and the mother of a child with special needs. Today's tip is:

Easter Sensory Bin

Sensory bins are fun and popular with young children. Sensory bins are simply containers filled with an item meant to provide some sort of texture to the child as they dig and feel around while playing. People often associate these with children with autism or sensory processing disorder, but these are useful and fun for all children. 

Working in homes of toddlers, I try to make up small sensory bins several times a year. Traveling from home to home to conduct therapy sessions, I use a small container to serve as my sensory bin. A small container is perfect for one child to play in and is easy for me transport. I generally don't fill the container completely full since some of the toddlers I work with will end up dumping out the contents.

Generally, the base of the sensory bin contains something like uncooked macaroni noodles, rice, beans, shredded paper, pom-poms, etc. For my Easter sensory bin, I like to use the grass people often put in the bottom of Easter baskets. It has a texture that is a bit different. You could also use the green shredded paper that is found in stores, which you can also replicate easily. 

Next, additional items are placed in the bin based upon the fine motor skills that are being targeted or vocabulary that is being addressed. I collect little Easter related toys I find in dollar stores or on clearance at the end of the season to use in my bins. What you put in the bin can be different, but I'll share what I put in my mine for the work I do with toddlers and why.

For my Easter sensory bin, I use a couple of plastic eggs. One egg is big and one is small to target the size words. You can further reinforce big and little by seeing what will fit inside the eggs. The colors of the eggs can also be a target as well. Then I have a few rabbits in my bin to work on actions like hop, jump, or eat (which is why I have the carrots too). I like to bury the people under the grass for more actions like find and hide. I can line up all the rabbits and count them as they jump in the grass. You can model questions and phrases like, "Where's the bunny?" and "I see you." The vocabulary and phrases that you can target can continue from there. Of course, there are all sorts of targets, but these can hopefully give you an idea for your own bin.

Sensory bins are great for speech therapy because it allows me to use a fun activity to target several language skills. Have fun making one for your child! 

Therapy Thursday is for educational purposes only and not intended for therapeutic advice. 
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Tuesday, March 13, 2018

Me and My Ugly Heart

My child has never been healthy, well not by most people's definition anyway.

She was born with Down syndrome, which by itself did not give Jaycee poor health. Her congenital heart defect did though. Jaycee went into congestive heart failure a few days after birth. I hoped early on that once her heart surgery was performed that her life would not revolve around the medical establishment. But that's not what happened. 

Asthma became an issue when she was a baby and continues to be a problem today. (No, she hasn't outgrown it despite kind-hearted people assuring me that she would.) Then came obstructive sleep apnea, GERD, and a list of other things that I won't go into detail about. These things have made surgeries and hospital admissions a regular part of her life. 

There has always been medicine in the cabinet for her to use daily.
One piece of medical equipment when she was a baby has grown into 4. 
Home oxygen has been on stand-by in our home for years. 
One hundred minutes of each and every day is devoted to Jaycee's airway clearance and medicine regime for the past 4 years

These experiences have made me appreciate the small things in life. They have made me feel blessed by little victories. They have given me compassion and understanding. They have given me a unique viewpoint and perspective on life, which I appreciate. 

There are times, however, when I see my experiences have done something else. 
They can allow my heart to grow hard and ugly.

A few years ago, there was a story about a teenager who died in a freak and unfortunate parasailing accident. The first day the story was on the news I thought it was sad. The second, third, and fourth day the national news ran this story, I started to get mad. I thought: Children die everyday in a hospital. Those parents don't get to tell the world about their amazing children. No national attention is given to them when they die. The parents of this girl took a risk letting her do this activity, and unfortunately, it ended badly for them. The parents probably had several good years with their healthy child before the accident; there are many parents who would have given anything to have a healthy child for so many years. 

The more I saw the story, the more aggravated I got. That was really Christian of me, right? That's when God would whisper to your heart! Behind the story was a hurting mother who didn't deserve what happened to her child. I had some very strong emotions over this story, and they weren't good. They revealed something deep inside of me that was rooted in my experiences with my medically complex child.

I learned that jealousy can rear it's ugly head in strange ways when I hear things like this. Along with it comes judgment as I decide who "really" is getting the short straw. That's terrible of me!

I have opportunities to share my love with others, but my heart reveals more ungodly feelings. In my work, I meet many parents of children with all sorts of histories and problems. Once in awhile, I will talk with a parent who tells me, "I took my child to the ER last weekend. It was the absolute worse thing. She had to have an IV for three hours before we could go home. It was so terrible."

I let the parent talk and express her worries. I say a kind word or two. In my head, I'm thinking: Really? Your child wasn't even admitted to the hospital. Your child only needed an IV for a few hours. Try being in the hospital for weeks lady. 

Of course, I don't say those things. That would be mean and unprofessional. I hold my tongue but my inner dialogue is going crazy. And I hear God whisper your heart! This mother had her first experience with the medical system. She was scared, and I should understand that more than anyone.

Then there's good ol' social media. When I read a post from a worried parent asking for prayers for their feverish child, I think to myself: Your child will be fine. They aren't even in the hospital. I rarely pray for these posts. What does that say about my heart? I don't even need God to point that one out to me. I'm wrong.

Please don't think that every day I am sitting around getting angry with people all the time. I have times when I get very worked up and off track. I am human, and I have struggles. I feel things that show my heart is not the reflection of God's. I have work to do. 

Sometimes, I have to remind myself that my experiences can cloud my viewpoint. I compare situations, make judgements about people's feelings and experiences, and decide who is worth my time and prayers. I let stories in the media keep me from seeing the deeper picture. That's so far off from God's heart. He loves people. He wants to help the hurting and meet people where they are. I should be doing the same. I don't want my heart to be ugly. I want it to be like God's.

I have to be vigilant to not let my life experiences make me bitter, jealous, and cold. I, of all people, should know how to minister compassion, grace, and love to others. I know what it's like to be a scared or hurting mother. I hope I can do better. So, I will caution people that are like me. If you have been through a tragedy, a hardship, or trauma, you too may be at risk for developing an ugly heart. Don't let your experiences keep you from reaching out to others who need some support. 

For more on this topic read Your Worst Thing.
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Thursday, March 8, 2018

Therapy Tip: How to Make Flashcards more Useful

It's therapy tip Thursday here at Special Purposed Life.

On Thursdays, I share an activity, idea, or advice based upon my experience as a pediatric speech-language pathologist and having a child with special needs. Today I'd like to discuss:

Flashcards: How can we make them more useful?  

I will be honest--I love flashcards for vocabulary building and articulation work. Many therapists despise them saying that pictures of objects are poor substitutes for the real thing. I do agree with that, but I do feel they can be useful. Using flashcards for a few minutes in a therapy session can be productive.

You can use flashcards in speech therapy to address several skills. First, flashcards are great for building expressing vocabulary by allowing children to work on naming pictures of objects. Next, by using 2 or more flashcards at once, you can ask the child to identify a picture to work on receptive language. Finally, targeting words in flashcards with specific sounds allows us to work on speech clarity (articulation), which is probably the most common use of flashcards in therapy. 

Let's back up though and talk about how I choose flashcards.

I prefer flashcards of pictures of real objects or real people, especially when teaching vocabulary. I occasionally use cartoon or drawn cards, but these are not my preference. Photographs are more accurate of the real thing than the drawn cards. These cards are fairly easy to find. I buy my cards at dollar stores, big box chain stores, and online at educational or therapy websites. These are some of my favorite sets:

Now that you have your flashcards, the next step is engaging the child.

If you are building vocabulary, then pairing a real object with the flashcard is a great activity that is usually fun for the child. I have thoroughly explained how to do this activity in the post First Words Activity. This takes flashcards to a different level, and I have found it helpful in therapy. But, you don't always have time or the materials available to make this happen.

So how do you make flashcards more entertaining when you are using them with toddlers or young children? 

There are some small children that will happily sit through naming and looking at each picture. Most children need some extra motivation to go through a short set of cards. I have found some pretty easy and motivating things to use with flashcards to make the kids more interested. 

Here's my favorite 3 things to use with flashcards.
1. A Basket: When the child says the word, they can drop the flashcard in the basket. Simple, I know, but this little trick works. It also teaches the child to focus on one picture at a time.

2. The Magic Box: This is a shoebox that I covered in wrapping paper. I made a small slit in the top of the box for a flashcard to slide through. Toddlers and preschool children tend to love this one. They say the word, then they get to put the card into the magic box. As you can tell, my box is well used. 

3. A Holder: This is a flashcard holder that I purchased through a therapy website. This holder is a little difficult for the toddlers I work with to do on their own. The cards slide right in the holder, and the pictures stand up. The flashcards in this holder are ones that I made myself using my digital camera and laminating machine.

If you have flashcards that you use in therapy or at home with your child, I hope this helps you understand how to make them more motivating and useful in therapy. 

This information is provided for educational purposes and not intended for therapeutic advice.

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Tuesday, March 6, 2018

Can We "Win" During Sickness?

A junky cough, a monitor alarming, labored breathing...

I respond with my daughter's emergency medications. I do all the things I have been programmed to do before we leave for the emergency room.

In this moment, I feel like we're losing.
Sometimes, I panic for a few minutes. Sometimes, I muster out a prayer.
The situation is out of my control.
It has happened again and again.

Each time, I feel like we're losing.
Our lives are interrupted by an illness that lands Jaycee in the hospital.
It is scary and unknown. Time and time again her lungs need help during a respiratory event.
Sometimes, she needs oxygen. Other times, it is full-time bi-pap or high-flow nasal cannula. A couple of times it has led to a ventilator.

The worse the hospital stay, the more it feels like we're losing.
The more support she needs to breathe, the more it feels like we're losing.

When we're back home, it feels like we have been in a boxing match that we have barely survived. Jaycee's body shows the marks of the battle. My daughter has bruises from repeated sticks. Her skin is often broken down from tape. She is frightened from the things that were done to her in the hospital and often is hesitant of my touch once home. Sleep evades me as I try to forget about the trials of the past days and weeks, and I often have to work to keep anxiety at bay.

After the chaos is over and life settles down, I briefly feel like we've won. She's alive and back home. That's a bit of a win, but the pain that led up to the win makes it feel very insignificant.

At church recently, a guest speaker made some comments that resonated with me on the topic of spiritual winning.

That's when a thought came to mind. It was a thought that I know was from God.
You think you are losing when you are in health battles with Jaycee, but you aren't. You've always won. When it looks like your losing, you're winning. 

I was astounded by this revelation. I mulled it over and even cried thinking about it.
I had always viewed these battles as losses simply because we were in them. Sickness found its way in her body again and again. Prayer hasn't kept these sicknesses away. I have never felt like a champion. In fact, I have felt battered.

For days, I thought about this idea. You think you are losing when you are in health battles with Jaycee, but you aren't. I even consulted my brother about it. (He's smart!) I've been looking at these hospital stays and health battles all wrong. The sickness isn't the indication of a loss, and that's hard for me to believe.

Somewhere in my upbringing, I became programmed to think that sickness is mostly due to sin or open doors or some problem in our life. I equated sickness with a spiritual failure that's present somewhere, and each illness of Jaycee's made me feel defeated spiritually. If you have been going to church a number of years, you probably understand this line of thought. It grew into my subconscious, and it made me feel like I was on the losing end of this battle simply because we were in them again.

My perspective on our situation is narrow. I'm too close to it. I see my daughter hurting, and I take it personal. I want her healthy-plain and simple. When she's struggling to breathe or turning blue or crying in pain in the hospital, my view of the whole thing can only be one thing....that it's bad and God isn't close in our situation. Oh man, how I need God's perspective!

I've come to understand another option. Jaycee was born in an earthly body with crummy lungs. Period. Her illnesses related to her abnormal lung function may occur simply because we live on a planet that doesn't always give us perfection in our bodies. We aren't in Heaven after all. Therefore, her illness isn't a sign of spiritual defeat but a mere product of living here on the earth. That's not to say God can't intervene in her situation. But, it's a way of seeing her illnesses as something else besides a "spiritual attack" that makes me believe we are on the losing end of things. I had a similar revelation on Jaycee's Down syndrome years ago, but never equated it to her lung issues.

Here's what I have gathered though in the past couple of weeks. If I really believed everything in the Bible, I would be more transformed by Christ and not let these health battles wreck me for weeks. If I can keep my eyes on Jesus, then I can find peace when life is out of control. If I don't look at her illnesses as a sign of losing, then perhaps I can see that I already have victory.

When I sit around feeling defeated because I see my daughter sick again, then I guarantee I am not in a position to effectively minister to her when she needs it the most. 

I have struggled a bit to write this post out. I hope it makes sense to most of you. I suppose I could say the winning occurs in my inner dialogue, my attitude, my point of view, and my emotions. If I think we're losing, I'm going to feel defeated and powerless to do anything. If I see myself for the champ God sees me, then I can be a victor especially when my daughter is struggling to breathe.
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Thursday, March 1, 2018

Therapy Tip: Mistakes to Avoid for Picky Toddlers

It's Therapy Thursday here on the blog. This is the day I share a tip based upon my experience as a mother of a child with special needs and a pediatric speech-language pathologist. Today's tip is:

Mistakes to Avoid for Picky Toddlers

For my job, I often evaluate toddlers with picky eating habits and determine if their eating is extreme enough to qualify for feeding therapy. Over the years, I have talked with many families about their child's food preferences and patterns. I have directly worked with many toddlers who have restrictive diets (eating from only 1 or 2 food groups or a total of less than 5 different foods), gag easily, or avoid certain textures.

Feeding therapy is interesting work. Every child is different and responds uniquely when work is started to expand their diets. The work done during therapy is important but what is done at home is vital as well.

In the years of working with families, I have come to see some common mistakes at home. These mistakes aren't the cause of the child's feeding issues, but we definitely need to correct these mistakes when we get serious about adding new foods to a child's diet.

Mistake #1: Offering the same foods to the child.
This is the number one biggest mistake that I see parents making. I understand how it happens. The child eats only a certain set of foods. In frustration and over time, the parent begins to serve those same foods to the child. Then the child begins expecting these same foods. It's a vicious cycle that happens before a parent realizes it.

It is really important to offer foods to the child that they don't normally eat. This can come formally by putting a new food on their plate or informally by simply offering the child a bite of food from the adult's plate. It can also be offering a new food for a snack before resorting back to the familiar food. Bottom line, even if we know the child won't eat a new food, it's important to keep offering it to remind the child that new foods are a normal part of daily life.

Mistake #2: Letting the child dictate what's on their plate. 
You may think this mistake is like the first, but it's slightly different. In addition to serving the same foods to the child, another mistake is to never put something new on the child's plate. I don't care if a child eats it or not, but I want the child to tolerate something new on their plate. Children who are extremely picky and need me to work with them will often get upset with merely the presence of a new food on their plate.

Before I expect them to eat a new food, first I want them to tolerate it on their plate without pressure to eat it. I want them to be ok with the fact that I have added ketchup next to their chicken nuggets or that I have put raisins next to their crackers. This does a couple of things. First, this will help expose them to new foods in a no pressure situation. If the child seems fine with it on their plate, then I encourage them to touch or smell or even pick it up and throw it away. Secondly, this promotes the child to interact with food in ways besides just eating. You never know too- the child might just decide to try something one day!

Mistake #3: Only having food interactions during mealtimes. 
If your child is a picky eater, it is important to have some interactions with food outside of meal time. These opportunities encourage the child to touch food or simply be around it without any pressure to eat.

Have the child help in the kitchen by preparing food for other people or assisting with snacks. They can help make a sandwich by putting the meat or cheese on the bread. They can put vegetables in a pot before it's heated. You can make a trail mix with the child and let them add cereal, raisins, or pretzels together. If you are familiar with sensory bins, then you can use foods as a base for them as a way for them to engage with food in play. For these bins, I have put cereal, dry noodles, dry beans, pretzels, etc. in a big Tupperware container with spoons, little figures, and other small toys to allow the child to dig in the food for a sensory play experience. (If you need more info on sensory bins, click here or click here for even more.) Generally speaking, eventually these interactions should lead to the child being more comfortable with food and possible deciding to taste something. Usually, the kids I work with in feeding therapy will be very anxious when we are doing these food interactions even though I am not asking them to eat anything, so this is a good activity for them.

The bottom line: Picky and problematic eating often needs some changes at home to promote new additions to the child's diet. Little things like the ones mentioned today should not be discounted. Picky eaters take lots of time to change habits, trial-and-error with foods, repeated exposures, and many changes to help expand diets. If you find yourself making these mistakes with your child, it's not too late to correct them! 

Therapy Thursday is for educational purposes only and not intended as therapeutic advice. 
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