Summer 2014 - Better Speech with

An Integrated Approach
to Pediatric Therapies
Celia Z. Padron, MD, FAAP
Medical Director
Pediatric Gastroenterologist
Dianne Lazer, MA/CCC-SLP/COM
Speech-Language Pathologist
Certified Orofacial Myologist
Jennifer Bergman, MS/CCC-SLP
Lisa R. Cohen, MA/CCC-SLP
Speech-Language Pathologists
Articulation, Language, Swallowing, Feeding,
Cognitive Therapy
Kate Guzzetti, OTR/L, SIPT
Carol McVey, MS, OTR/L
Occupational Therapists
Sensory Integration,
iLS Integrated Listening Systems
School/Home Based Consultations
Catherine Chase, MA, LDTC
Psycho-Educational Diagnostician
Bobbie Gallagher, BCBA
Board Certified Behavioral Analyst
Epic Health Services Clinical Supervisor
Rael LaPenta
Relationship Development Interventions (RDI)
Laurie Storms, Behaviorist
from The Learning Well LLC
Terry Rosiak
Certified MnemeTherapist
Kelly Dorfman, MS, LDN
Health Program Planner and Nutritionist
Stacy Clarke
Chef/Owner, Crave Catering
r
e
m
m
u
S
Inside this Issue:
Pg. 2
Functional Constipation
by Celia Padron, MD, FAAP
Pg. 3
The Green Monsters to the
Rescue - Feeding Team Case
Study
by Dianne Lazer, MA, CCC-SLP/
COM
Pg. 5
Post-Traumatic Ear Infection
Syndrome
by Kelly Dorfman, M.S., L.N.D.
Pg. 6
Successful Interventions and
Learning Characteristics of
Dyslexia
by Catherine R. Chase, MA,
LDTC
901-B Route 73 North
Marlton, NJ 08053
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Pg, 8
Epic Health Services &
Applied Behavior Analysis
by Bobbie Gallagher
Pg, 9
Neuroplacticity
by Terry Rosiak, Certified Mneme
Therapist
Pg. 10
Homemade Putty (Gak!!)
by Katrina L Guzzetti, OTR/L
Pg. 11
Grad Students at PWN
by Jennifer Uhl-Bergman, MS,
CCC-SLP
Open Daily with Weekend and
Evening Hours Available
856.751.1937
Summer 2014
856-596-6333
Functional Constipation
By Celia Padron, MD, FAAP
C
onstipation
accounts for
5% of visits to the
pediatrician - and is
the most common
problem in children
who come to
see a pediatric
gastroenterologist.
The most common
type of constipation
in children is
“functional,” a type
of constipation that
can be managed or
Celia Padron, MD, FAAP
prevented with the
help of parents and, sometimes, a healthcare
professional. With functional constipation, there
is no sign of illness or anatomical abnormality to
explain the real symptoms.
There is no precise definition of constipation
that will apply to all individuals. In children,
constipation can be defined as passing painful
stools and decreased frequency of producing a
bowel movement. Regardless of the frequency,
an important feature in the definition is the
perception of pain or difficulty when passing the
stools. When children experience pain during
bowel movements, they start avoiding having
bowel movements and develop the withholding
behavior that aggravates the constipation,
making this a vicious cycle.
There is really no right number of bowel
movements per week - and it is not correct
to assume that one bowel movement a day is
normal. The number of bowel movements a day
depends on many factors but, in general, two
or less bowel movements per week is a sign of
constipation. In healthy children, the number
of bowel movements changes with age and
diet. Breast-fed infants average several bowel
movements a day - but these movements are
soft. Few breast-fed infants have infrequent
bowel movements. By the age of four, a child
should average one bowel movement a day.
What causes functional constipation?
Constipation in children is generally caused by
1) a change in diet and fluid intake 2) during
toilet training 3) changes in the usual toileting
routines and 4) avoiding bowel movements
www.pedgastrocenter.com
because of pain due to anal irritation, fissures or rashes. Children often
avoid having a bowel movement after a frightening and painful experience
they had passing a bowel movement.
Prevention and Treatment
◆◆ Watch what the child eats and drinks
◆◆ Help the child exercise
◆◆ Provide guidance to prevent withholding of stools
◆◆ Set up regular times for going to the bathroom
Foods to avoid
◆◆ High fat foods
◆◆ High sugar foods
◆◆ Processed foods (instant mashed potato or frozen foods)
◆◆ Limit foods with little or no fiber (dairy products, white refined grains,
meats)
Eat More Fiber
Adding fiber to the diet helps form soft and bulky stools. Fiber is found in
many vegetables, fruits and whole grains. Fiber should be added a little at a
time to help the body get used to it slowly.
Drink more liquids
Help your child to drink plenty of water and other liquids such as fruit and
vegetable juices and clear soups. Be aware that the American Academy of
Pediatrics (AAP) warns of possible gastrointestinal effects of fruit juices. Their
statement contains a suggestion for daily consumption and also includes
a warning that too much fruit juice can cause gastrointestinal and other
problems. The AAP recommends that children between the ages of one and
six years old drink no more than 4 to 6 ounces per day. For children between
the ages of 7 and 18 years, it recommends no more than 8 to 12 ounces per
day. Fruit juices should not be given to infants before six months of age. After
six months of age, infants should not get juice from bottles or cups that allow
them to drink constantly throughout the day. Infants should not get juices at
bedtime. All children should be encouraged to eat more fruits.
Exercising
Exercise helps the digestive system to stay active and healthy. A bike ride or 20
minute walk every day can help. Encourage your child to exercise daily.
Allow times for bowel movements
It is important not to ignore the urge to have a bowel movement. Waiting
and withholding the stools make the constipation worse. Try getting the
child up early in the morning to give him time to use the bathroom before
school. Regular times on the toilet after meals can help children with bowel
movements avoid the need to withhold the stools while in school or playing.
The Scoop On Poop book available in my office was written especially for
children with constipation issues and has helped many families with this
problem. (See page 11 for book details.)
When to see a doctor
◆◆ If the constipation keeps coming back.
◆◆ If the constipation starts interfering with daily activities.
◆◆ If the child complains of pain or cramping.
◆◆ If the child is irritable.
◆◆ If the child is straining or there is blood in the stools.
◆◆ If the child is soiling their underclothes.
◆◆ Fevers or vomiting after many days without a bowel movement.
Your doctor may recommend laxatives. Only take laxatives directed by your
doctor and as directed.
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Page 2
The Green Monsters to the Rescue - Feeding Team Case Study
www.betterspeech.com
By Dianne Lazer, MA, CCC-SLP/COM
T
his case study is an example
of the many success stories
we have had working together
with parents, pediatricians, GI
specialists, ENTs, nutritionists
and behaviorists that make up
our feeding team. Many of
our patients’ chief complaint is
restricting foods at meals and
although they appear robust and
healthy with good height and
weight percentages on the growth
curve, they are actually nutrient
Dianne Lazer
MA, CCC-SLP/COM
deficient due to their limited diet.
Speech-Language Pathologist/
For example, a child eating mainly
Certified Orofacial Myologist
a “white diet” or one primarily
consisting of processed foods like
breads, crackers, cookies, juice and dairy, are not getting
the necessary zinc and vitamin B nutrients they need and
this can often change the child’s sense of taste and smell. In
addition, these foods are easily melted down by their saliva
and are easier to chew and swallow which can limit their
oral motor skill development for higher-level foods such
as fruits, vegetables and meats. Children may not look
“malnourished” because they are gaining weight but the
calories they are eating aren’t providing the nutrients they
need for optimal development. The lack of nutrients in their
diet could cause permanent damage to their neurological
system and, therefore, are a possible cause of their food
restrictions and sensory integration and regulation
difficulties they present. Working with a nutritionist who
understands the need to take away what’s bothering the
patient and/or closing
the gap of nutritional
deficiency is an essential
step in the success of our
program (Dorfman, K.,
2013).
*Please note NS’s parents gave
us permission to post his picture
and are very happy with his
improvements during the last 6
months especially when he joins
the family at the table for meals
daily without worrying if he
will eat or not!
Patient’s Name: NS
DOB: 3/01/06
Date of Evaluation: 9/05/13
issues, loose stools and frequent burping (parents also
reported that he took reflux medication for over a year after
starting to eat table foods). He was referred for a speech
and swallowing evaluation due to parental and pediatrician’s
concern for his increasing food refusals at meals and
assistance in evaluating his feeding and swallowing skills
and recommend therapy as needed.
A multi-system approach was taken that included feeding
therapy 1x/week for a total of 25 sessions, nutrition
consultation with supplement recommendations and
behavior management sessions during the feeding sessions
x3 visits.
The following supplements were added to his diet to help
close the gap of nutritional deficiency due to his diet
restrictions. Often the nutritionist will recommend a
compounded vitamin but in NS’s case she recommended
Kirkman chewable wafer with xylitol x2/day, Omega Cure
fish oil x1tsp/day, Phoscal by Nutasal x1/2 tsp/day.
Ryan Fights the Green Monsters book was used to initially
introduce the goals of therapy (why healthy eating is
important and how much fun it is to start trying new
foods) and established a starting point for therapy. Feeding
therapy focused on proper chewing techniques on lateral
margins with closed lips, properly forming a cohesive bolus,
transferring the bolus with a mature swallow pattern and
increasing variety and texture of solid foods. He required
behavior modification techniques to help increase his
chewing and swallowing rate and responded well to home
therapy practice.
NS was discharged from therapy after 25 sessions of feeding
therapy on a full rotation of 4-5 healthy, complete meal
choices for each meal and snacks.
He will be followed in two months and 6-month intervals
for follow up checkups to insure he maintains a healthy diet.
Feeding Team Case Study Medical Information:
CA: 8 years 2 months old
End of Therapy: 6/22/14
Summary: Patient is an 8.2 year old boy with a medical
history of feeding difficulties since 14-18 months old. His
parents reported he has grass, pollen and mold allergies
related to seasonal changes and takes Singulair daily. They
further reported that he has a mild asthma diagnosis that
occurs during the change of seasons (takes Flovent as a
preventer) and Prevacid medication x2 weeks for reflux
Medical Diagnosis: Normally developing boy with no
developmental delays; Feeding difficulties since 14-18
months old, environmental allergies to grass, pollen, mold
and takes Singulair daily, mild asthma occurring during
the change of seasons and treated with Flovent as needed,
loose stools, burping and took Prevacid x2 weeks at start of
program.
Prenatal and Birth History: Remarkable for mother taking
Levothyroxin, Metphormin and Prevacid prenatally. NS was
her first and only child born full term via Caesarian birth
due to long labor weighing 8 lbs. 13 oz. Due to mother
having a fever, the patient was in the NICU on antibiotics
for less than 48 hours.
Continued on page 4
*Dorfman, K. Cure Your Child with Food, Workman Press, NY, 2013.
Page 3
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The Green Monsters to the Rescue - Feeding Team Case Study
(continued)
Continued from page 3
◆◆
Respiratory History: Environmental and seasonal allergies
(pollen, mold) treated with Singulair daily, mild asthma
reported during seasonal allergies treated with Flovent when
needed.
◆◆
◆◆
Diet at Start of Therapy:
Developmental History: Motor and language development
was within normal ranges although he was seen for feeding
and OT services in North Jersey for two months for feeding
issues (no report of services available).
Breakfast:
◆◆ Croissant, dry cereal (Fruit Loops,
Cocoa Krispies)
Family History: Remarkable for father having speech
therapy for stuttering (currently not noticeable during
conversational speech) and for being a picky eater. The father
reports he is lactose intolerant. Mother also reported feeding
and texture issues and is diagnosed with Hashimoto’s Disease
(polycystic anemia)
◆◆
◆◆
◆◆
◆◆
Growth History: At the start of therapy, his weight was 68 lbs
corresponding to 94% and 97% on the growth chart for height.
◆◆
Initial Feeding Status: Afraid to try new foods, gags and
cries during meals; Restricts fruits, vegetables and meats.
Oral Motor Exam: He demonstrated an anterior munch
chewing pattern with open mouth, reduced bolus formation
before transferring the bolus to initiate a timely swallow
indicative of reduced lingual retraction and lateralization
skills reducing his chewing effectiveness on higher level foods.
In addition, an anterior tongue thrust swallowing pattern
was also noted on solids, liquids and saliva swallows. He
also had difficulties with continuous liquid drinking (only
sip by sip) and was found to bite down on the cup and straw
indicating reduced jaw stability and immature oral motor
skill development. His mother further reported he sucked a
pacifier until 3 years old and often sucked on clothing but that
has since resolved.
Feeding Observations: ◆◆
◆◆
◆◆
◆◆
Good head posture but needs verbal cues to maintain
upright positioning at times while eating (possible
reduced upper body tone).
Self feeds using utensils without difficulty.
Demonstrated an anterior munch chewing pattern,
reduced cohesive bolus and transfer skills on all
textures.
Demonstrated an immature swallow pattern (tongue
thrust).
Lunch:
PB sandwich on white bread
Chocolate granola (sometimes)
Veggie Straw, potato chips, pretzels
Water
*Does not eat fruits, vegetables, cheese
Diet History
GI and Feeding History: According to parents’ report, the
patient was breastfed for 10 months and bottle fed alone on a
number of formulas due to reflux issues and then settled on a
lactose free formula. His mother also reported he moves his
bowels once per day and they are often loose.
Reduced lip protrusion on cup and straw drinking;
bites on straw and cup indicative of reduced jaw
stability and immature oral motor skill development.
Drinking only sip by sip; no continuous drinking
noted.
Voice clear after all solid and liquid swallows indicating
good pharyngeal/laryngeal coordination during and
after the swallow.
Dinner:
Chicken nuggets, loves breaded flounder,
Smiley Baked Potatoes or French Fries baked
◆◆ Vanilla ice cream (just started eating)
◆◆ Water or passion fruit drink diluted in water
*Does not eat rice or pasta
Diet at End of Therapy
Breakfast:
◆◆ Scrambled
eggs with
spinach
◆◆ French toast
◆◆ Omelet with
veggies
◆◆ Sprouted
bread with PB
◆◆ Protein shake
Lunch: ◆◆ Chicken or
beef taquitos
◆◆ Chicken on sprouted bread or whole grain bread
◆◆ Turkey sandwich with lettuce
◆◆ Sprouted bread with PB
Dinner:
◆◆ Meatballs with tomato sauce and veggies
◆◆ Hamburgers with lettuce and potatoes
◆◆ Fish and vegetables (flounder)
◆◆ Roast chicken with vegetables
◆◆ Roast beef with vegetables (sweet potato
fries, fresh carrots, roasted cauliflower
and broccoli, spaghetti squash, corn)
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Page 4
Post-Traumatic Ear Infection Syndrome By Kelly Dorfman, M.S., L.N.D.
www.kellydorfman.com and www.cureyourchildwithfood.com
A
subgroup of children with
attention problems or autistic
spectrum characteristics have
a condition I have named PostTraumatic Ear Infection Syndrome
(PTEIS). These kids, apparently
normal at birth, develop subsequent
auditory processing issues,
distractibility and developmental
delays as a result of complications
from sustained damage to the middle
ear from both otitis media and its
treatment.
Kelly Dorfman, M.S., L.N.D.
◆◆
◆◆
Between birth and three, children learn to distinguish
sounds and interpret them in context. They must filter out
unimportant sounds, such as the air conditioner, and focus
on important ones, such as a mother’s voice. Distracted
and inattentive behavior is the result of the inability to sort
significant auditory input from the extraneous. Studies
have found that middle and high school students who are
more distracted than their peers experienced early ear
infections.
Frequent ear infections are a sign of weak immune
function.
A classic study done by Tala Nsouli,1994, an allergist in the
Washington, D.C. area, found that about 90% of children
with ear infections and fluid have food allergies. When the
offenders are eliminated, ear infections subside. Kids with
food allergies get sick more often because their immune
systems focus on reacting to foods, rather than fighting
germs.
The antibiotics used to treat ear infections may make
children more susceptible to mercury damage.
Preliminary studies by Dr. Boyd Haley, a world authority
on mercury at the University of Kentucky, found that
ampicillin and tetracycline increase thimerosol-induced
neuronal death. In other words, less mercury does more
damage in the presence of these antibiotics. Further, all
antibiotics kill good gut bacteria, essential to resist mercury
uptake.
Allergies, ear infections, thimerosal and antibiotics are
a toxic cocktail for the nervous system. A child eats an
allergic food and develops an ear infection. The doctor
prescribes an antibiotic, killing both good and bad bacteria,
leaving the gut lining irritated and further stimulating an
allergic response. Now the child is more reactive to foods
and develops additional ear infections, thus perpetuating an
illness cycle.
Ear infections are associated with auditory
processing problems.
Children are born with hearing but they must learn
how to listen. Ear infections that occur during critical
developmental periods negatively affect auditory
processing. Youngsters whose ears are clogged up with
fluid cannot interact appropriately with their environments.
Why Ear Infections Are Such a
Problem
Most children on the autistic spectrum have underlying
immune problems. Either they are born with weak
immunity and are thus more reactive to foods - or they
react to foods, thus weakening their immune systems.
Resultant ear infections are the symptom of a deeper
underlying problem.
◆◆
years than typical kids. Almost 20% also experienced a
severe vaccine reaction. Another study, Fallon, 2005, linked
Augmentin (broad based antibiotic) to the development of
autism.
What to Do about Ear Infections
◆◆
◆◆
Remove problematic foods. The four problem foods most
associated with ear infections are dairy products, wheat,
soy and eggs. Before trying an extreme elimination diet,
consider taking foods made from cow’s milk out of the diet
first. This change alone is often sufficient to reduce or stop
infections.
Use good bacteria. Probiotics, available in the refrigerator
section of the health food stores, balance the digestive tract
and reduce allergic tendencies. It may take some trial and
error to find the right product for your individual situation.
Some are too strong and will increase gas and irritability;
others are not potent enough. If symptoms do not alleviate
in a few days, reduce the dose or change brands.
PTEIS is very common and mostly preventable. If you have a
child who has had three or more ear infections and you need
more information, check out Dr. Michael Schmidt’s “Healing
Childhood Ear Infections.” An ounce of prevention is worth
years of distractions.
This article was originally published in New Developments, Vol 9 (3).
References:
Fallon, J. “Could one of the most widely prescribed antibiotics amoxicillin/culvulanate
‘Augmentin ™, be a risk factor for autism?” Medical Hypotheses, Vol. 64, 312-15, 2005.
Nsouli, TM, MD, Nsouli, SM, MD, Linde, RE, MD, O’Maro, F, PHD, Scalon, RT, MD
and Bellant, JA, MD, Role of Food Allergy in Serous Otitius Media, Annals of Allergy,
73(3), 215-219, 1994.
Introduce into this disturbing spiral a thimerosalcontaining vaccine or one that acts on the gut lining,
like measles. Who will be more likely to sustain vaccine
damage: the toddler with an already irritated gut lining and
reactive immune system, or a healthy child?
Dr. James Adams recently found that children with autism
had ten times more ear infections during their first three
Page 5
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Read more about Post Traumatic Ear Infection
Syndrome in Kelly Dorfman’s book Cure Your
Child with Food, 2013 available on Amazon.
com and in the Pediatric Wellness Network
office for special low price of $10.00
Successful Interventions and Learning Characteristics
I, myself, was always recognized…
as the “slow one” in the family. It
was quite true, and I knew it and
accepted it. Writing and spelling were always terribly difficult
for me. My letters were without
originality. I was an extraordinarily bad speller and have remained
so until this day.
-Dyslexic.org
W
hy does a student struggle significantly with learning
to read, when so many others seem to be at ease with
reading?
Reading disability is the most widely known and most
carefully studied of the learning differences, affecting 80%
of all those designated as learning disabled. Dyslexia is
a specific learning difficulty in reading that often affects
spelling, and may depress reading comprehension, written
language and applied math problem solving. “Dyslexia
stems from differences in the biology of the brain as
demonstrated in the research of Drs. Sally and Bennett
Shaywitz. Their studies reveal evidence demonstrating a
neurological basis for dyslexia” (Patterson, 2011).
Drs. Sally and Bennett Shaywitz and many other researchers
have discussed the phonologic model. Numerous research
studies have shown that reading problems result from
children’s inability to recognize and break up phonemes,
the tiny sounds that make up language, and further, to
connect those sounds to written letters. The English
language has 44 phonemes, represented by 26 letters. The
doctors explained that phonology (the mapping of sounds
to letters) is what takes reading out of the realm of pure
memory and allows readers to decode words they don’t yet
know (Moore, 2012).
The Shaywitzs have studied the correlation between reading
and IQ in dyslexia and typical students. “Their research
shows how regions and systems of the brain are used for
fast, fluent automatic reading; however, the scans show that
dyslexic individuals are neurobiologically wired to read
slowly. The results reveal that the paradox of dyslexia is
slow reading, fast thinking! Although they are slow readers,
dyslexic students have strengths in higher order thinking and
reasoning skills. In fact, the 2009 Nobel Laureate in medicine,
molecular biologist, Dr. Carol Greider, is dyslexic” (Patterson,
2011).
– Agatha Christie
What are the learning characteristics displayed by students
with dyslexia?
There are many learning characteristics that parents,
physicians, clinicians, teachers and others working with
students can look for, which include but is not limited to the
following:
Preschool Children
◆◆ Delayed speech development in comparison with others
of same age
◆◆ Speech problems, such as not being able to pronounce
words
◆◆ Unable to remember the right word to use, incorrect
sentence structure ◆◆ Little understanding of rhyming words ◆◆ Little interest in learning letters of alphabet
◆◆ Early School Years 5-7 years old
◆◆ Delayed speech development (pronunciation, jumbling
phrases)
◆◆ Verbal expression problems (using spoken language and
putting sentences together)
◆◆ Difficulty learning alphabet ◆◆ Poor phonological awareness and word attack skills
Middle School Years
◆◆ Slow reading speed
◆◆ Problems with the correct spelling of words
◆◆ Problems recognizing and understanding new words
◆◆ Problems with writing skills such as sentence structure
◆◆ Problems with reading comprehension (may include
math word problems
Teenagers and Adults
◆◆ Slow writing speed ◆◆ Poorly organized written work-lack of expression
◆◆ Problems with reading fluency ◆◆ Reading and language comprehension problems ◆◆ Poor spelling and avoidance of reading and writing
◆◆ Relying on memory and verbal skills, rather than
reading and writing ◆◆ Difficulty with foreign language course work
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Page 6
of Dyslexia
[email protected]
There are many other associated
learning characteristics and symptoms
of dyslexia that may not be directly
related to reading or writing; however,
they can affect some people with
dyslexia: problems with number
skills (counting, carrying out sums),
weakness with short-term and
executive function (active working
memory, problems concentrating, selfregulation and time management
problems), and physical coordination
problems (NHS Choices, Your Health,
Your Choices, 2012). A deeper
understanding of the underlying
process and behavioral characteristics
of students with dyslexia will help
parents, teachers, and others assess
the most appropriate instructional
interventions to help the learner
succeed in the classroom and the
community.
What social and academic
interventions have been successful for
students with dyslexia?
There are numerous interventions
available that have been most
successful in maximizing social and
educational performance for students
with dyslexia, which include but is not
limited to the following:
◆◆
Technology has the capacity to
◆◆
present information in multiple
formats and media, to pace,
customize, support and challenge
individual students, especially the
dyslexic student. Students have
more opportunities to engage on
an equal platform in the classroom.
◆◆
Strategic teaching of systematic
multisensory and meta-cognitive
methods and programs involving
phonemic awareness, spelling,
writing, reading fluency,
vocabulary, comprehension and
phonics instruction.
◆◆
◆◆
◆◆
Recording (text to speech) and
video-taping lectures can be played
back later for depth of memory
and comprehension processing,
thus, lending to compensation
strategies with regard to reading
and processing speed weaknesses.
Empowerment counseling sessions
for the purpose of breaking
down emotional and social and
psychological barriers
Demystification strategies
are crucial in decreasing and
eliminating feelings of anxiety,
frustration and low confidence.
About the Author
Catherine R. Chase, MA, LDTC
Psycho-educational Diagnostician
Page 7
Qualified professionals such as
teachers, physicians, speech and
language pathologists, educational
strategists, counselors, and private
tutors are essential personnel in
assisting parents and the learners
with dyslexia to meet with
educational, social and emotional
success.
References:
◆◆
◆◆
◆◆
◆◆
Moore, D. (2012). Brain Research,
Reading and Dyslexia. San Francisco,
CA: Great Schools Inc.
NHS Choices, Your Health, Your
Choices, 2012
Patterson, M. (2011). The Paradox
of Dyslexia: Slow Reading, Fast
Thinking. Online: www.paradox of
dyslexia.com.
Shaywitz, S. & Shaywitz, B. (2010).
Uncoupling of Reading and IQ over
Time: Empirical Evidence for a
Definition of Dyslexia. Psychological
Science, 21 (1) 93-101, 2010.
Recommended Websites
◆◆
◆◆
◆◆
◆◆
◆◆
◆◆
www.internationaldyslexiaassociation.com
www.pediatricwellnessnetwork.com
www.interventioncentral.com
www.autismexpressed.com
www.researchILD.org
www.dyslexic.org
Catherine R. Chase, M.A., LDTC, a Psycho- Educational Diagnostician and
Learning Consultant/Reading Specialist, currently holds appointments as a
Curriculum Director for Autism Expressed and is an Associate Practitioner &
Interventionist at the Pediatric Wellness Network in Cherry Hill, New Jersey.
Catherine has over 25 years of experience in the field of education, which
includes fellowship training at the Harvard Medical School. As a private
Learning Specialist, she provides assessment and strategy intervention, and can
be reached directly at 609-390-1149,in Cape May County, New Jersey or by
email: [email protected].
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Epic Health Services & Applied Behavior Analysis (ABA)
www.epichealthservices.com
By Bobbie Gallagher, BCBA, Clinical Supervisor
T
Bobbie Gallagher, BCBA
Board Certified Behavioral Analyst
Epic Health Services Clinical
Supervisor
he Pediatric Wellness
Network recently teamed
with Epic Health Services, a
leading provider of pediatric
skilled nursing, outpatient
and therapy services with
31 offices in Texas, New
Jersey, Pennsylvania,
Massachusetts and Delaware.
Epic specializes in Applied
Behavior Analysis (ABA)
Therapy in the clinic and
home, focusing on children
with Autism Spectrum
Disorder.
What is ABA?
ABA is the use of researched techniques and
principles, including positive reinforcement, to
bring about meaningful changes in behavior. ABA
includes the use of direct observation, measurement,
and functional analysis of the relations between
environment and behavior. All services are
supervised by a Board Certified Behavior Analyst.
In addition to 1:1 care, Epic will also be
providing a variety of social skill groups to
address the below:
◆◆
Regulating emotions and feelings
◆◆
Social Skills (friendships; perspective taking)
◆◆
Conversation skills
◆◆
Cognition skills (thinking skills; problem
solving)
◆◆
Social Competence (facial cues; self-esteem)
We are in-network with most major
insurance carriers and ABA, 1:1 or group,
may be a covered benefit.
Why Choose Epic?
◆◆
Our 40 hour pre-requisite behavior aide
training is delivered face-to-face, classroom
style by a BCBA (no online learning) and
in line with the BACB upcoming registered
behavior technician certification
◆◆
QBS crisis intervention/safety certification for
all behavior aides
◆◆
An in-network provider with most commercial
insurances
◆◆
Able to provide complementary services such
as private duty nursing
Key areas of focus include, but are not limited to:
◆◆
◆◆
Adaptive and Self-help skills – Getting dressed,
tying shoes, preparing a meal, toileting,
grooming, brushing teeth and safety skills.
Language and communication – Encouraging
communication in non-verbal children through
alternative treatment methods (pictures) or
encouraging increased communication in
verbal children.
◆◆
Reduction of interfering or inappropriate
behaviors – Self-injury, aggression, running
away
◆◆
Social skills – Taking turns, sharing, eye contact
◆◆
Empowering parents/caregivers to support
their child’s behavior and learning in various
environments
For questions or appointments please contact us at
732-828-8244
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Page 8
Neuroplacticity
Terry Rosiak, Certified MnemeTherapist
www.artwithoutboundaries.org
N
EUROPLACTICITY. What does
that word mean to you and your
child? It should mean POSSIBILITY!.
Neuroplacticity is a big word that translates
into a very positive thing. It means that the
brain is capable of making changes! That is
huge! That is exciting!
The best way I can explain it is if you think
of the brain having thousands of roadways.
For some, getting to road Z is as simple as
following A, B and C to the end. A super
Terry Rosiak
Certified Mneme Therapist
highway that connects all the roads needed
Art Without Boundaries Association
to get where they want to go. In others, they
are taking the scenic route. To get to where
they are going they are bypassing the major highway and need to find a different
route to get where they need to be.
A child with special needs is taking the scenic route. Along that route he will need
the love, guidance and support not only of his parents but also different forms of therapy that will help him along
his journey. A child’s brain is still in its formative stage and can benefit greatly from different therapies. But I will
caution here – as parents we want to see immediate results. It takes time to remap the brain. But it is worth it!
As a Master MnemeTherapist® I help build
those new roads (neurons) in your child’s brain
using a multi modality patterning therapy
that includes movement, singing, storytelling,
praise and painting. It is not the painting we
are focusing on but the process. It is directed
painting and I am assessing your child at the
same time. MnemeTherapy normally is a very
calming therapy and lets your child be more
receptive to other therapies offered in the office.
I have been asked what does the name
MnemeTherapist derive from. It was coined by
the founder of Art Without Boundaries in 2005.
Mnemosyne, in Greek Mythology, was the mother
of the nine Muses. Her nickname was Mneme.
All supplies are provided and your child
comes home with a piece of art. I am offering
a free session to all patients of the Pediatric
Wellness Office who have not tried it. I
encourage parents to watch and see for
themselves how this can benefit their child.
Page 9
thier, age 11
” by Billy Clo
ts
oa
B
’s
ly
il
“B
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Homemade Putty (Gak!)
By Katrina L. Guzzetti, OTR/L
L
ooking for something fun to do
with your child this summer?
Try making homemade putty. It is
great activity that also incorporates
sensory, fine motor, and finger
strengthening experiences for your
child!
a
Katrina L. Guzzetti, OTR/L
Pediatric Occupational Therapist
Using putty is a great activity
to strengthen the small
muscles of your child’s hands.
Some ideas of what you can do
with your putty include:
◆◆
Squeeze it, knead it , push it, pull it
◆◆
Flatten it out with a rolling pin
◆◆
Use cookie cutters to make fun shapes/letters
◆◆
Cut it with scissors
◆◆
Roll it into a “snake” to form letters, shapes,
or numbers
◆◆
Make pinch pots
◆◆
Put beads into it and then try to pick them
out
www.klgpeds.com
Homemade Putty (“Gak”)
DO NOT EAT THIS ~ Not Edible
Ingredients:
◆◆ White glue
◆◆ Liquid Starch (available at most
grocery stores/WalMart in the
laundry soap section)
◆◆ Food coloring
Directions:
Mix 2 parts white glue to 1 part
liquid starch in a cup or bowl.
◆◆ Add a few drops of food coloring.
◆◆ Mix with a popsicle stick, plastic
spoon, or with your hands if
using a large bowl.
◆◆ Remove mixture from container
and spend some time kneading,
stretching, and squeezing it.
◆◆
**The solution will start off being watery, but the more
you play with it the more it will eventually turn to a putty
texture**
**Store the putty in a covered container to keep it from
drying out. It should last several weeks if kept covered**
Pediatric Wellness
Network’s stateof-the-art gym.
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Page 10
Grad Students at PWN
By Jennifer Uhl-Bergman, MS, CCC-SLP
T
[email protected].
his semester two new Speech
Graduate students worked with
us; Christine Doll was from Stockton
University and the Ashira GlassenbergSchmalz was from Western Kentucky
University. We would like to thank
them for all their hard work helping
us serve our patients. Good Luck to
you as you complete your course work
and enter the field of speech-language
pathology! Keep in touch!
Christine Doll
Stockton University
Ashira Glassenberg-Schmalz
Western Kentucky University
Jennifer Uhl-Bergman, MS, CCC-SLP
save
20%
Healthy Eating Books for Children
Better Speech and Feeding Center, Inc. recently teamed up with Dr. Celia Padron, pediatric
gastroenterologist, and Rose Payne, Certified Health Coach, to publish a series of four
children’s books that address healthy eating habits. This book series is an excellent teaching
tool that facilitates the treatment of numerous GI issues.
Designed for the four- to eight-year old age group who desperately need to change their
eating patterns, the books are colorful, child-friendly and informative. The first two
titles include a coloring book that features the main characters in both books allowing
children to review the story in a kid-friendly manner. The third book focuses on the
importance of regular bowel movements, which has been very helpful for many young
patients struggling with chronic constipation. The fourth book explains the food/mood
connection of eating processed foods high in sugar and the negative results that may occur
in the child’s everyday life.
Many GI problems can be easily resolved once children and parents are given a better
understanding of how the foods they eat can contribute to their poor growth and
development and might also be the cause of a host of disorders including: reflux, chronic
congestion, constipation and learning disorders, to name a few.
This informative series of books can be ordered from our office (20% discount
when you mention this newsletter) or www.amazon.com.
Page 11
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901-B Route 73 North
Marlton, NJ 08053
Comprehensive
Family-Centered Care
Case Management Services
include referrals to medical
practitioners, chiropractic specialists,
neuropsychologists, psychologists,
audiologists, behaviorists and
educational consultants.
Medical component to therapy helps
improve functional outcomes.
State-of-the art sensory gym.
A Network of Pediatric
Professionals Under One Roof
Pediatric Gastroenterologist
Pediatric Feeding & Swallowing Program
Speech, Language & Cognitive Therapy
Occupational Therapy
Social Skills Play Groups/Behavioral Consultations
Psycho-Educational Diagnostician
Nutrition & Health Programs
Like us on Facebook at www.facebook.com/pediatricwnetwork
For Gastroenterology call: 856-596-6333
For Rehab call: 856-751-1937
Page 12

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