A Therapists Guide to Fix the Developmental Delay of Baby Milestones

Child Mind Institute’s Speak Up for Kids!

National Children’s Mental Health Awareness Week (May 6-12, 2012)

Fifteen million children in the United States have psychiatric and learning disorders, but very few of them will be identified and get the help they need. Stigma, lack of awareness, and misinformation about diagnosis and treatment mean kids miss out on early intervention we know can transform lives. The Child Mind Institute’s Speak Up for Kids is about standing with these kids and families so our message is heard: childhood mental health matters and treatment works.

During National Children’s Mental Health Week (May 6-12, 2012), Speak Up for Kids helps to break down the barriers of that prevent millions of children from getting the early intervention they deserve. Without treatment, children with psychiatric disorders are more at risk for school failure, bullying, substance abuse, incarceration, and suicide.

Join us! Help us to ensure that every child receives the early intervention that we know is crucial to transforming lives. Speaking up is the first step.

Visit childmind.org/speakup to add your voice to this important cause. Our goal is to turn the globe green—the color of children’s mental health.

As part of Speak Up for Kids, mental health professionals will give free talks in their communities to share helpful information about childhood mental health disorders and other topics relating to raising healthy, happy kids. Topics include: ADHD, anxiety, behavioral challenges, bullying,depression, trauma, and social media.

Find a talk near you: childmind.org/map

If you cannot attend a talk, participate in our Live Web Events. On Monday, May 7th, Dr. Steven Kurtz will present “Is it ADHD or Just Inattention?” LIVE on Facebook. We’re also hosting a live Facebook talk on Friday, May 11th with Dr. Melanie Fernandez, who will present “The Difficult Child: Managing Behavior.” The Child … Read more

sensory problems, needs therapy Special needs children are as unique as any other child.  Even children who have the same diagnosis may display different symptoms.

That is why it is very important to choose the therapy which will produce the best results for the child.  Personality, genetic traits, family dynamics and more all influence development.  What works great for one child may fail the next child.

When evaluating a patient, therapists look at motor skills (actions performed by the brain telling the muscles how to move), behavior and sensory integration ability (how the brain interprets all sensory input).

Behavior and sensory issues often go hand-in-hand, as is the case with Autism Spectrum disorder and ADHD and related disorders. Motor skills are divided into gross motor (movements of the large muscles) and fine motor (movements of the upper extremities and especially the hands). There are also visual motor skills, but I will leave those to a later discussion.

In order to simplify the explanation, let’s say that all responses are based on messages coming in to the brain or going out from the brain. We take in messages based on sensory signals from the environment. For example, when you want to pick up a glass of water, your eyes see the glass and your brain automatically calculates how far you need to reach, how firmly you need to grip, how strongly you need to hold, how far you need to lift and how to move your muscles to drink and swallow. Thankfully this all happens in a split second and we don’t even realize it’s happening. For children and adults with motor or sensory problems, the information is either interpreted incorrectly or isn’t sent correctly. And that is it in a nutshell. In order to know exactly where the problem lies, both physicians and therapists … Read more

bay massage and therapyThis week is Infant Massage Awareness Week in certain areas, so it reminded me of the many benefits fo massage.

 Touching therapeutically is physcially and emotionally helpful. Who doesn’t feel better after a relaxing massage? Well, infant massage fosters good parent-child interaction, helps with eye contact, improves sensory responses and can actually help with muscle tone and development.

When my son was a baby, he developed eczema very early. Eczema is always problematic, but was especially so with my son because he had it around his rectum. The skin would be irritated, cracked and often oozing. As a result, he started to hold back his bowel movements because they were painful when they touched his wounded skin. Elimination problems led to constipation and other gastro-intestinal problems. To help calm my son’s distress I would perform tummy massage and he would calm. Interestingly enough, my son constantly asks to have his tummy rubbed or his back massaged. He is now 6.

Although I am primarily my son’s mom, I am also his  therapist. He is ADHD combined type. He is hyperactive and inattentive and spends his days constantly chewing items he shouldn’t be chewing. When his kindergarten nap blanket was sent home at the end of the year, it was misshaped and ragged from chewing. He managed to chew the entire blanket! He seeks the input he senses his body needs. I understand his cravings. Massage is one of my favorite techniques for addressing these needs and helping him to get calm and organized. My son loves getting massaged and the interaction strengthens our relationship. Touch used therapeutically helps my son cope. I credit this to starting massage for him when he was a baby.

I located a blog post which describes why infant massage can make a difference in … Read more

 Parenting a child with special needs can bring joy in unexpected ways.  It can also bring frustration, anger,and denial.  It can make parents question their faith and sensitize them to circumstances they never imagined would be part of theirlives. 

Facing some hard truths about your child who has a developmental problem isn’t easy.  The following is intended to shed some light on different therapies and what they actually can help with.  

This article was originally published a year ago.  It is offered as part of Best of the Best, so I wanted to make it available to those who may not have already read it.

I consider my son to be “special needs” . He was recently diagnosed with ADHD combined type. He has trouble adhering to a structured protocol, and needs re-direction and supervision to ensure that he is paying proper attention. My son has a never ending urge to chew on a variety of things: clothes, blankets, Legos and more. 

I am the first to acknowledge that despite my efforts, it is likely that my son’s issues cannot be cured. Whatever combination of genes produced my wonderful child also wired his brain to work in a certain way. Once coded, the gene pattern is permanent. I can help my son learn to “harness” some of these behaviors in ways that will promote better attention and ultimately better learning. But I cannot fix or cure him of his ADHD. I can help decrease dysfunctional symptoms, and promote improvement in function, but I can’t undo what nature has done.

One of the most difficult parts of being a therapist is in talking to parents of special needs children, and explaining that I could help ameliorate the symptoms, and improve some of the movements, but I couldn’t cure … Read more


Cerebral Palsy is a neurological disorder which affects communication between the brain and the muscles. The disorder results in uncoordinated movement and abnormal muscle tone. The consequence is that children with this disorder have difficulty achieving their developmental milestones and performing ADL’s (activities of daily living).

This particular developmental disorder is hard to treat. Cerebral palsy can take different forms, and it affects each child to varying degrees. At its worst, spastic tone (muscle stiffness) dominates in all the extremities. Children with spastic quadriplegia are often wheelchair bound.

The goal of therapy is to strengthen the core (trunk) muscles and even out the tone as much as possible. When CP is not treated, the affected muscles have either too much tone on movement or too little tone. This inequality of tone causes the limbs to be forced into positions and postures which don’t allow normal function to occur.

In order to treat properly, the therapist needs to somehow facilitate the use of the weak muscles while inhibiting the spastic tone. This requires keeping the child in good alignment while performing the exercises. As anyone who has every tried to inhibit spastic tone is aware, this is a monumental feat.

I have written about CIT (constraint induced therapy) and motor learning and NDT treatment protocols. Since writing about these treatment options, I discovered Therasuit Method. Although I have not seen the results personally, the principles underlying the treatment are sound. I watched a few videos of the treatment, and it looks like Therasuit accomplishes easily the exercises which are so difficult for a therapist to do manually.

Here is what the website has to say: TheraSuit Method® utilizes various tools and exercises. One of them is the soft dynamic proprioceptive orthosis called TheraSuit®. TheraSuit® aligns the body as close to normal … Read more

air pollution and child's healthMoms Clean Air Force (MCAF) is devoted to cleaning up the air our children and unborn babies breathe. While I don’t usually use my blog to tout political causes, I am going to make an exception for this particular issue. Clean air should be a priority if we want our children to have a healthy future.

If you knew that pollutants in the air had a direct link topremature deaths, asthma, decreased lung function, autism, ADHD and developmental delays, would you do something about it? If you had the opportunity to take measures which would improve the air quality for your unborn child or newborn infant, would you grab hold of that opportunity? Or are you the kind of person who thinks something should be done, but would rather leave the solution to others who are willing to get involved?

I am a pediatric occupational therapist with more than 16 years of clinical experience. I also have a 6 year old with ADHD combined type. In the years since I started working, there has been a marked increase in children diagnosed with asthma, autism, cerebral palsy, respiratory problems, ADHD and more. Recently I attended a panel discussion by some of the worlds’ leading experts on ADHD. They unanimously agreed that although it might seem like ADHD is currently over-diagnosed, in actuality it is probably under-diagnosed.

No one really understands the impact of these diagnoses until they have a child who has a developmental problem or who must be on life –saving medication their whole life. I understand not only because I have a son who has ADHD, but also because I treated so many of these children. Some of these problems are insidious. Children with autism and ADHD have behavior problems, socialization issues, sensory issues and cognitive … Read more

Neurofeedback or EEG biofeedback is an off-spring of biofeedback.

It arose out of our growing understanding of the brain and how the brain’s electrical activity, as measured by an EEG readout, plays a role in the creation of symptoms, such as anxiety or inattentiveness. Put another way, our brainwave patterns reveal the brain’s functioning and the field of neurofeedback is looking at how that functioning can be altered to alleviate symptoms. For example, the brainwave patterns of individuals with ADHD will be different than in those without ADHD.

From the point of view of neurofeedback– or “brain training” as some call it—we see that with certain conditions such as ADHD, Post Traumatic Stress Disorder or anxiety disorder, the brain is habitually making maladaptive choices. Those maladaptive choices are visible in EEG patterns.

One way of explaining this habituation is to say that the brain is not reading the environment accurately and therefore, not responding in a way that is appropriate for the individual’s here-and-now needs. Often it is just repeating a “then-and-there” need, a response that was helpful long ago but no longer useful. We have come to understand that the brain gets habituated, in an attempt to be efficient—why reinvent the wheel each time?—not realizing that it is not being effective! Many of our current mental health conditions we could describe as the result of the brain’s misperception of what it needs to do in the present in order to be efficient and effective.

With the latest research on the brain and the brain’s ability to adapt and change (neuroplasticity), we realize that the brain is much more flexible and, given the right conditions, has the ability to re-organize itself to some degree. What it needs in order to do this is 1) to see … Read more

Can hyperbaric oxygen therapy improve some of the symptoms of autism?

Some proponents of the treatment say that it helps foster speech, improves ability to make eye contact, decreases sensitivity to noise and makes kids on the spectrum more sociable. Currently there is not enough research to make a definitive claim, but some studies suggest that as a complementary treatment, HBOT helps.

According to the Mayo Clinic –

Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized room. Hyperbaric oxygen therapy is most commonly used to treat decompression sickness, serious infections, bubbles of air in your blood vessels, and wounds that won’t heal as a result of diabetes or radiation injury.

In a hyperbaric oxygen therapy room, the air pressure is raised up to three times higher than normal air pressure. Under these conditions, your lungs can gather up to three times more oxygen than would be possible breathing pure oxygen at normal air pressure.

The increased oxygen dissolves in your blood during hyperbaric oxygen therapy, and circulates throughout your body. Oxygen-rich blood stimulates your body to release substances called growth factors and stem cells, which promote healing.

Advocates of HBOT believe that children with autism have areas of the brain with less blood flow.

 They contend that by delivering greater amounts of oxygen and blood to the brain via HBOT, neurological function is improved.

I am always skeptical when it comes to alternative treatments. There are many factors which sort of cloud the results. Faith, belief and conviction can strongly influence the way someone views a subject. The placebo effect is well documented. It is the beneficial effect in a patient following a particular treatment that arises from the patient’s expectations concerning the treatment rather than from the treatment itself. What I am saying is that … Read more

Eating and feeding issues can be huge issues during baby and child development.

Healthy eating is essential in order for a baby to thrive and develop and achieve milestones. Refusal to eat or avoidance of food by a baby or child can be a seemingly endless nightmare for parents. The source of the problem can be difficult to determine. It could be related to swallowing problems (dysphagia) or motor planning problems (dyspraxia) or sensory problem or sucking problems or all of the above. Children who were preemies, children with autism, children with SPD, children with ADHD, children with genetic disorders and normally developing children can all make their parents anxious over their refusal to eat or their food pickiness.

Cheri Fraker and Laura Walbert are speech pathologists who specialize in the treatment of pediatric feeding disorders.

They wrote a great article on therapy techniques and suggestions for introducing new foods. Click here to read the article.… Read more

uncoordinated kidChild development is so complicated that it is a wonder most children develop without the need for intervention.

 Many children meet their milestones, and have no cognitive delays, but are challenged when it comes to anything sports related. I am talking about kids with coordination issues which can interfere with their ability to swim, dance, hit a ball, catch a ball, etc. Lack of coordination can be a symptom of motor planning problems (dyspraxia), proprioception (knowing where the body is in space) or processing problems.

My son is one of those kids who can’t seem to integrate movement patterns that are demonstrated. For example, swimming has been very hard for him to learn. The instructor will show him how to reach forward and elongate his body so he can use his arms and legs properly, and inevitably he either moves his arms or his legs, but not both at the same time. He needs hand-over-hand assistance and many repetitions before he is able to form the motor memory.

There are a variety of programs which address these types of developmental coordination issues. 

The programs use movement patterns and auditory (sometimes visual) feedback to help the child improve bilateral integration and improve timing and accuracy of the movements. Motor learning and memory occur after many repetitions of movement patterns. The idea is to teach your child to move in a specific pattern and use both sides uniformly so that a precisely timed and accurate pattern emerges. Clapping hands is a pattern which requires hands to move away from each other and then come together at exactly the same time. If timing is off, the hands don’t meet in the middle and clapping isn’t successful. I have treated many children who clap more to the left or more to … Read more