Tag

feeding therapy

Mind the Gap: Why You Should Consider Summer OT and Speech Services at NESCA

By | NESCA Notes 2021

By: Julie Robinson, OT
Director of Clinical Services; Occupational Therapist, NESCA

It has been a challenging school year, with ever-changing schedules, routines, and unfortunately with a good deal of inconsistency in the provision of therapeutic services through the schools, due to the many impacts of COVID. Parents, caregivers and students have all experienced differing levels of anxiety about what progress has been and is being made, with many children experiencing some level of regression with regard to behavior, self-regulation, motor skills or language development. In anticipation of many of our children returning to school in-person in April, parents have expressed concerns that their children may be lagging behind or that they have not had ample support throughout the earlier parts of their school year to ensure they can keep up with the other children in their class. Over the months of April, May and June, we will all get to see firsthand where the gaps might arise. And then when school is over, many of us might be concerned that the gains of just a few short months will be lost again over summer. This is why those of us at NESCA perceive that the benefits of summer services will be an important part of ensuring progress and the ability to jump right back into learning – as we hope all school will be in-person again in the fall.

NESCA is available to provide summer services, as we do consistently for our weekly patients. In addition, we are offering short-term services to those children who may not qualify for them through their school systems, or for those families who would simply like to supplement what their children are receiving in-district to give them a boost before school begins again in the fall.

Our occupational therapists (OTs) can work on the following areas of focus with your child:

  • self-regulation and coping skills
  • how best to transition from the quiet of home to the multiple stimuli of a classroom full of children
  • how to cope with longer hours of wearing a mask
  • how to follow social distancing requirements, when they long for a closer physical connection with their peers

We can also help to ease the anxiety some children may have about becoming sick or how NOT to feel fearful of getting back into the classroom when sensory processing issues push them to feel uneasy. Our OTs can continue work on handwriting and motor development work started throughout the school year to ensure there is no regression or to improve the speed and automaticity of written expression and legibility. We can teach organizational and executive functioning skills to encourage kids to be independent, prioritize assignments and manage their time. OTs can address self-care skills of dressing, shoe tying, feeding and hygiene, which are likely to require more independence with social distancing requirements. While it’s summer, we help build outdoor skills, such as bike riding and greater self-confidence on the playground to elicit more social connections with peers. Our OTs are providing services in-person in our Newton and Plainville, Massachusetts clinics, by teletherapy or outdoors in the community as appropriate.

Our speech therapists at NESCA can also help to continue and supplement the hard work children have been putting in throughout the school year. They can work on social pragmatics and help with the skills needed to transition from so much time alone, to being in groups with their peers once again. NESCA’s speech therapists can support children on how to:

  • initiate play
  • find shared interests
  • be flexible thinkers
  • communicate with kindness and an appropriate level of voice
  • read gestures and non-verbal communication (especially while wearing masks, which can impede the ability to properly read another person’s mood, reactions or emotions)

We can continue to work on the established goals from school, regarding both expressive and receptive communication, language articulation and language as it pertains to written communication. Our speech therapists are currently providing all services via teletherapy while we work on a transition back to in-person therapy.

If you are interested in seeking out summer services at NESCA, or any of our assessments and services, please contact NESCA’s Director of Clinical Services Julie A. Robinson. She can be reached at jrobinson@nesca-newton.org and will conduct a phone intake with you to help you best determine your needs.

 

About the Author

Julie Robinson is an occupational therapist with over 25 years of experience as a clinician. The work Julie does is integral to human development, wellness and a solid family unit. She particularly enjoys supporting families through the process of adoption and in working with children who are victims of trauma. Julie has extensive experience working with children diagnosed with an Autism Spectrum Disorder (ASD), or who have learning or emotional disabilities. She provides services that address Sensory Processing Disorder (SPD) and self-regulation challenges, as well as development of motor and executive functioning skills.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services or other clinical therapies, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

A Feeding Therapist’s Guide to Cups, Bowls, and Utensils – Part 1

By | NESCA Notes 2021

By Lauren Zeitler, MSOT, OTR/L
NESCA Occupational Therapist; Feeding Specialist

As an important area of development, feeding and eating time is a special opportunity for children to not only grow, but also interact with their environment. This includes transitioning from breast and bottle feeding to cups, bowls, and utensils. With so many options available on the market, it can be hard to decide what to buy. If you are unsure where to start, this blog will introduce different tools to help promote a more independent eater in your child.

In this week’s OT Tuesday blog, we provide suggestions on utensils and bowls for new eaters, toddlers, and more. In our Part 2 of the blog, we will focus on different styles of cups for all stages of child drinkers.

Recommended Utensils throughout Developmental Ages and Stages

Vital Baby Soft Tip ‘n’ Grip Feeding Spoons

Designed with a flexible, spatula-like tip, this spoon is great for scooping food out of the bowl – and off a little one’s cheek! Great for first-time feeders, this spoon holds the perfect amount of food and fits comfortably in their mouths. It is easy to wash and BPA- free.

Soft Tip Infant Spoon by Munchkin

When introducing solids to a baby, it is important to have a smaller spoon belly to fit comfortably in their mouth. The soft tips and rounded shapes of this spoon are gentle on their gums as they adjust to utensil eating. This spoon also has a long, ergonomic handle which makes it easy for caregivers to hold.

Nuby Fun Feeding Spoons & Forks

Lightweight and easy to grasp, this set of cutlery provides a traditional spoon as well as a spork (fork and spoon combination). Compared to other brands, the belly of this spoon appears deeper and has more success holding foods, such as soup. This set is recommended for children ages 12 months and up, encouraging independent eating.

NUK First Essentials Kiddy Cutlery

Made with rubber handles and stainless steel tips, this set is made to fit right in a toddler’s hands. Dishwasher-safe and BPA-free, it comes in a variety of colors and is best for children ages 18 months and up. This is a great starter set to later introduce children to adult utensils.

Nuby 9 Piece Mealtime Travel Set Spoon

Made for developed self-feeders, this set makes eating out a little easier. Pop this travel set into lunch boxes, purses, etc. This is BPA-free and dishwasher-safe.

 

Recommended Bowls and Plates throughout Developmental Ages and Stages

Baby B Suction Baby Bowls

BPA-free, this bowl set suctions to the table to firmly stay in place and decrease floor clean-up time. With built in handles, this bowl is easier for babies to grasp while learning to scoop and self-feed. It also comes with snap-on lids to quickly throw the leftovers in the refrigerator!

MUNCHKIN Stay Put Suction Bowls

Dishwasher- and microwave-safe, this bowl suctions to the table with a modern look. This bowl works well with new feeders, because the suction remains in place while children are learning to use a spoon.

EZPZ Happy Bowl

Built with a 12 ounce bowl, this product serves as an all in one style device. Great for toddlers and preschoolers, it suctions to the table to reduce throwing and has a placemat surrounding the bowl. It is easy to wash both in the sink and dishwasher.

EZPZ Happy Mat with sections

Made with the same great suction material, this mat provides sections to place different food items. This tool can be used this with eaters who do not like their foods to touch. It is also a fun way to teach about food groups and portion control.

Re-Play Divided Plates for Toddlers

Designed to easily stack in the cabinet or drawer, these plates are deep and durable. Each plate has three sections: two 3oz. sections and one 8 oz. section ready for a well balanced meal. Ready to graduate to an older plate, this option is recommended for children who do not need the throw-proof suction. This plate is dishwasher- and microwave-safe.

If you have any concerns about your child’s feeding or questions about feeding or occupational therapy, please complete our online intake form, or email NESCA’s Director of Clinical Services Julie Robinson at jrobinson@nesca-newton.com.

 

Reference:
Elliott, C. & Clawson, E. (2018). Mealtime Miseries: Management of Complex Feeding Disorders. All workshop materials © Pediatric Feeding Institute, Inc

The product information in this blog is provided for educational purposes only. NESCA, nor Lauren Zeitler, accepts any incentives or payments from the manufacturers. The recommendations made come only from the professional experiences of NESCA’s occupational and feeding therapists and the personal experiences of clients.

 

About the Author

Lauren Zeitler is a licensed Occupational Therapist in Massachusetts, specializing in pediatric occupational and feeding therapy. Ms. Zeitler joined NESCA full-time in the fall of 2020 to offer occupational therapy assessment and treatment for children of all ages, as well as to work in conjunction with Abigael Gray, MS, CCC-SLP, on the feeding team.

 

 

 

 

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

The Intention to Thrive

By | NESCA Notes 2021

By: Ann Helmus, Ph.D.
NESCA Founder/Director

As I reflect on the year that we have all come through, my overwhelming emotion (aside from exhaustion) is pride in the NESCA team for working together in an extraordinary manner under incredibly challenging circumstances. Just before closing the doors at NESCA in mid-March, I wrote to all staff:

NESCA is going to not only survive through this pandemic but we are going to thrive as an organization and show leadership in the special education community. The needs of our clients have not gone away; in fact, they are likely increasing.  School systems are scrambling to meet their obligations for students with special needs. We will continue to do the work we have always done, albeit in a somewhat modified fashion. 

Each of the NESCA staff—clinical and administrative—immediately rose to the occasion to help me realize this vision for navigating the pandemic. We increased the frequency our blog posts and introduced regular webinars, gearing them towards the needs of parents facing the challenges of the pandemic and increased our social media following from 4,000 to more than 40,000 by offering supportive and helpful content. NESCA clinicians offered multiple, free online support groups for parents and professionals related to topics they were now experiencing due to COVID-19. We acknowledged and addressed the unprecedented COVID-19-related concerns and challenges professionals and educators who support those with autism were experiencing through our free Autism Educator Hangouts.

After a great deal of research and discussion about how to conduct evaluations in a manner that ensured the safety of staff and clients while producing valid results, we settled on our “two office model,” renovating our space with plexiglass panes so that clients and clinicians would be able to work together in separate but adjoining offices. We collaborated with Massachusetts Advocates for Children (MAC), Massachusetts Department of Elementary and Secondary Education (DESE), The Federation for Children with Special Needs (FCSN) and the Massachusetts Urban Project, Inc., providing information about assessments and other services during the pandemic.

NESCA grew by adding new staff and service offerings this past year. We welcomed Dr. Moira Creedon to our pediatric neuropsychology staff. Tabitha Monahan, M.A., CRC, and Becki Lauzon, M.A., CRC, both joined NESCA’s Transition Services team. Julie Robinson, OT, joined NESCA in September with three occupational therapists to offer insurance-based, sensory-motor therapy. Abigael Gray, MS, CCC-SLP, also joined at that time to offer insurance-based speech/language and feeding therapy at NESCA. These staff have been incredibly innovative in their use of teletherapy to continue providing services to clients remotely.  And, they and their clients have experienced some surprising benefits stemming from the delivery of services via telehealth. 2020 also saw the introduction of NESCA’s ASD Diagnostic Clinic, helping families to diagnose children with Autism Spectrum Disorder as early as possible so they may gain access to critically important interventions.

Over the last decade, NESCA has had a strong commitment to international work, seeing clients for evaluation and consultation in the NESCA offices as well as abroad. With travel severely limited by the pandemic, we have instituted teletherapy for international work and are pleased to continue to assist  families abroad. NESCA was honored to be a Gold Sponsor for the annual SENIA conference (Special Education Network & Inclusion Association) that was held virtually. I was pleased to present about the differences between testing and assessment with professionals from schools all over Asia.

In the midst of the global pandemic, we continued to do the work that we have always done. We continued to support each other and became even more closely bonded as a team. We contributed to the community. No matter how challenging it has been, we are motivated by the knowledge that children with special needs and their parents need our support now more than ever.

 

About the Author: 

NESCA Founder/Director Ann Helmus, Ph.D. is a licensed clinical neuropsychologist who has been practicing for almost 20 years. In 1996, she jointly founded the  Children’s Evaluation Center (CEC) in Newton, Massachusetts, serving as co-director there for almost ten years. During that time, CEC emerged as a leading regional center for the diagnosis and remediation of both learning disabilities and Autism Spectrum Disorders.

In September of 2007, Dr. Helmus established NESCA (Neuropsychology & Education Services for Children & Adolescents), a client and family-centered group of seasoned neuropsychologists and allied staff, many of whom she trained, striving to create and refine innovative clinical protocols and dedicated to setting new standards of care in the field.

Dr. Helmus specializes in the evaluation of children with learning disabilities, attention and executive function deficits and primary neurological disorders. In addition to assessing children, she also provides consultation and training to both public and private school systems. She frequently makes presentations to groups of parents, particularly on the topics of non-verbal learning disability and executive functioning.

To book an evaluation with Dr. Helmus, NESCA Founder and Director, or one of our many other expert neuropsychologists or therapists, complete NESCA’s online intake form

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, as well as Londonderry, New Hampshire. NESCA serves clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Teletherapy at NESCA – Benefits and How It Works

By | NESCA Notes 2021

By: Julie Robinson, OT

Director of Clinical Services; Occupational Therapist, NESCA

Now that the second  COVID-19 surge is upon us, many families are again opting to receive occupational, speech-language and feeding therapy services through teletherapy. While COVID-19 is interrupting so many things in our lives, it does not have to interrupt important therapy services. Our clinicians at NESCA encourage teletherapy as a powerful tool to impact progress for your children and foster a smooth family dynamic.

It’s important to note that teletherapy IS covered by insurance, so just because you cannot or may not want to come into the office to be seen in-person, you do not need to put your services on hold.

While some people may not think teletherapy packs the same punch as in-person therapy, we’ve seen some unexpected and valuable benefits stem from this shift in how we deliver services remotely.

Some of the benefits of teletherapy that we’ve observed are:

  • There’s less travel time and more efficiency of service delivery with teletherapy. There’s also more flexibility and scheduling convenience for both the parents and clinicians. We see so many families trying to juggle the responsibilities of remote learning, working from home and managing the needs of multiple kids. Teletherapy can offer the supports that are necessary in an easily accessible way to help families establish consistent and organized routines.
  • Teletherapy allows parents to be more involved in sessions with their child, also allowing the opportunity for clinicians to educate them about activities that can be done at home to facilitate progress. On top of the child receiving therapy, parents get 1:1 real-time training and consultation with a clinician. If parents cannot be involved in sessions, sitters, nannies and other caretakers can participate.
  • For parents who feel that their child is struggling with their experience in school since COVID-19, teletherapy can also be a way to supplement IEP services. Teletherapy as a modality provides more individualized attention to goals that have been established or can fill in gaps in services you feel your child may not be accessing as easily.
  • Clinicians are able to see your children at home—in their natural environment—and to even see some of the daily challenges experienced at home, right in the moment. This allows us to actively problem solve with parents around behavioral challenges and the difficulty their children are having in staying focused during remote learning. Via teletherapy, we can model responses and approaches right in the midst of real-life situations as they are unfolding.
  • Teletherapy allows our occupational therapists to do a virtual house tour with you to suggest modifications or accommodations to your physical environment/space to support sensory needs or motor development with items and areas you already have. Building a home program with our guidance helps to reinforce the work we do with them.
  • In all teletherapy sessions, the child must be present for at least a brief period. But in moments where a child is not able to stay engaged in the process, the clinician is able to stay in the session to provide parent consultation and problem solve.
  • When appropriate and agreed upon by all parties, your clinician can engage other children in the household into teletherapy sessions to incorporate social teaching and positive sibling interactions, as well as structured activity for the family unit.
  • Teletherapy has been a huge plus for our feeding therapists and their clients, as we can work with children in their own kitchens and with food that is typically available and prepared. We can also see how a child behaves throughout the mealtime process in their natural environment as they interact with family members. Therapists report that some of their feeding therapy clients have made more progress via virtual sessions than in their in-clinic sessions.
  • Because teletherapy gives occupational therapists a window into the home setting, we can work with our clients on self-care and hygiene tasks, support learning of chores and other daily household activities in a more natural setting to them.

How a teletherapy session works

Teletherapy is a little different than just showing up for a session in the office and does require some advanced preparation for both the client and the clinician.

  • Initially, your clinician will talk with you to gather information about your home environment, the setting for remote work, and what tools or equipment you may have around at home to incorporate into your sessions.
  • Each week, your clinician will send you an email with a list of items to get ready for your virtual visit, possibly a specific schedule or plan for the session, if needed. This will include a link to access your teletherapy session.
  • In most cases, parents need to be present to facilitate the process, or at the very least accessible to assist with any technology glitches that may arise during the session. We encourage participation from caregivers to ensure that they are educated about our goals as well as the things that can be done at home throughout the week to encourage progress.
  • We try to keep therapy sessions as play-based as possible, often engaging with visual supports or other tools that may help your child to focus and have fun.
  • There may be times when your child is overloaded with remote learning, before our session even begins, or there may be distracting factors in the household at any given moment that can limit their focus on therapeutic tasks. Therapists are able to maintain a flexible approach to end a session early, to give the child a break and talk to a caregiver instead, or to provide parent consultation instead of direct therapy activity. All are benefits to the child and family unit.

To learn more about NESCA’s new clinical therapy services, watch this video interview between NESCA’s Sophie Bellenis, OTD, OTR/L, and Julie Robinson, OT, who oversees the new clinical therapy offerings.

About the Author

Julie Robinson is an occupational therapist with over 25 years of experience as a clinician. The work Julie does is integral to human development, wellness and a solid family unit. She particularly enjoys supporting families through the process of adoption and in working with children who are victims of trauma. Julie has extensive experience working with children diagnosed with an Autism Spectrum Disorder (ASD), or who have learning or emotional disabilities. She provides services that address Sensory Processing Disorder (SPD) and self-regulation challenges, as well as development of motor and executive functioning skills.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services or other clinical therapies, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

Meet Abigael Gray, NESCA’s Speech-Language Pathologist & Feeding Specialist

By | NESCA Notes 2020

This Fall, NESCA debuted its new feeding, speech and language and direct sensory/motor occupational therapy services. Leading NESCA’s feeding and speech and language therapy is Abigael Gray, MS, CCC-SLP. In today’s blog, we sat down with Abbey to learn about her role as a Feeding Specialist; Speech-Language Pathologist.

What led you to your interest in speech and language and feeding, in particular?

I received an undergraduate degree in psychology from Syracuse University. After graduating, I worked in a preschool for children with autism and developmental delays. This is really what made me interested in speech and language pathology (SLP), since all of the children there were receiving speech-language therapy. While I was working there, I observed quite a bit and decided I wanted to learn and do more in this area. After five years of working there, I enrolled at Emerson College to earn my Master’s in Communications Sciences and Disorders. While there, I discovered that Emerson has a great program for feeding. Many schools don’t have a focus on swallowing and feeding in pediatrics, like Emerson does. I had a placement with one of my professors at her practice in Needham. I eventually took a position with this clinic and received great training in pediatric feeding therapy there during my clinical fellowship. This is where I became passionate about feeding therapy. I eventually moved into a multidisciplinary practice for two more years and then joined the team at NESCA.

Why were you attracted to NESCA?

I saw this as a great opportunity to bring speech-language pathology and feeding therapy to NESCA. I loved the  multidisciplinary aspect to the practice and thought I could strengthen what NESCA already offers by adding feeding and SLP to it. I like how all of the various services are built into one practice right here. Many of the  kids being seen at NESCA can also benefit from the therapies that I offer. Having those services available to parents and children right in the same location is a huge plus for them.

After meeting Ann Helmus, Ph.D., NESCA’s founder and director, I knew that it was the right cultural fit for me, being so collaborative. It also gave me the opportunity to continue to work with Julie Robinson, OT, who oversees this new clinical offering. It’s great to be able to continue with my working relationships with the occupational therapists who also joined when I did. The seamless communication between all of us in the clinical therapy practice makes for really well-rounded therapy for the children we treat as well as more convenient for their parents/caregivers.

What are the most exciting and the most challenging parts of your role?

The most exciting part of my new role at NESCA is being able to offer speech-language and feeding  services in-house. Often the recommendations from neuropsychologists through their assessment is to have some SLP support, whether it’s having to do with reading, writing, social skills, expression or comprehension. Being able to offer that right in the same practice allows for continuity of care among clinicians on behalf of the child. It’s exciting for me because I can go back to the neuropsychologist or other clinician at NESCA who referred the client with any new observations or questions I may have. This makes the process much smoother for the parents and our clinicians. There’s just a lot less “red tape” to go through to be able to communicate and collaborate.

It’s also exciting to build this service offering from the ground up. I can take all of the experiences I have had and knowledge I’ve gained through my years in various positions and make our services our own at NESCA.

As far as challenges go, right now as we build out this new service, I am currently the only SLP on board. While that is the case for now, I have a great network of past colleagues and friends who are SLPs to bounce thoughts off of. Our plan is to have other SLPs join our team as we grow the practice.

What are your clinical interests?

Feeding is my big passion area. Within feeding, I am currently completing a lactation counseling training to become a certified lactation counselor. Babies can struggle with breast feeding, then can have even more difficulties transitioning from the breast to solid foods. I love working with infants and toddlers, and having this certification will round out my knowledge about feeding for this age range.

Within speech, I love working on articulation with kids who have speech sound disorders, phonological disorders and childhood apraxia of speech. Within language, I really enjoy working on social pragmatic communication with kids who are on the higher functioning side of the autism spectrum, or Asperger’s, or those who have social pragmatics difficulties.

I also really enjoy working on early literacy skills, sound letters, identification, rhyming and phonological awareness. When it comes to kids who may be in their older elementary school or early middle school years, I love to work on writing skills with them.

One characteristic among NESCA clinicians is that they are all lifelong learners. In what ways are you a lifelong learner?

I loved that having the curiosity to continue to learn is a draw here at NESCA! That’s really important to me. Right now, I’m currently working my way through three different courses:

  • The lactation counseling certification that I mentioned previously
  • A “Feed the Peds” course, which is a refresher course on feeding therapy with some new approaches in the areas of tethered oral tissues (i.e., tongue ties, lip ties) and how those impact feeding. The course covers how to assess and treat these issues. What’s interesting is that these new approaches are appropriate for people across the lifespan – not just for young children. There is also a module on treating those with medical complexities. Often times, medically complex patients have issues with feeding and/or are tube-fed, and can then go on to have challenges progressing through age-appropriate feeding skills or transitioning off of tube-feeding.
  • The third area I am currently in training for is with orofacial myofunctional disorders, including tethered oral tissues and the impact on speech and feeding. This covers anything that structurally or functionally impairs speech, the airway or feeding. This is a growing area in our field, so it’s important to be current and well-informed on this topic.

How has Covid-19 impacted the way you treat patients and families?

Right now, we are delivering speech-language and feeding therapy via teletherapy. While it’s always great to work with a child and/or family in-person, the plus side of teletherapy is that we get to see the child in their natural home environment as well as how the child communicates with family members. Sometimes, when we see the child in this setting, we can detect and observe a feeding or speech-language issue as the family sees it on a regular basis. It’s also nice to be able to work with parents in their own setting. We can better understand their priorities for therapy since we are talking directly with them. It also allows the child to generalize the skills they would normally learn in the clinic setting right into their home. As therapists, we can see what a typical meal at home looks like, which is obviously a more natural setting than the clinic. We used to have to ask parents to send us videos of mealtimes. Now, it’s like we are at a meal with them over Zoom!

Covid-19 was the catalyst for us to offer teletherapy, which has helped parents who work and have to travel to get to therapy tremendously. They are now able to be more hands-on in the therapy sessions. Also, for some medically complex kids, it’s just hard to get out of the house and drive to therapy. And, parents don’t have to cancel appointments if a sibling is home sick or even quarantining. And, we can stay on track with therapy via telehealth even in inclement weather that makes it challenging to drive to the clinic.

Covid-19 has certainly had its drawbacks, but we’re seeing some of the upsides in teletherapy as well.

 

About the Author

Abigael Gray has over six years of experience in assessment and treatment of a variety of disorders, including dysphagia, childhood apraxia of speech, speech sound disorder, receptive and expressive language disorder, autism spectrum disorder and attention deficit hyperactivity disorder. She has a special interest and experience in working with children with feeding and swallowing disorders, including transitioning infants to solid foods, weaning from tube feeding, improving sensory tolerance, developing chewing skills, increasing variety and volume of nutritional intake and reducing avoidance behaviors during mealtimes.

 

 

 

 

If you are interested in learning more about NESCA’s speech-language therapy or feeding therapy, please complete our online intake form, or email NESCA’s Director of Clinical Services Julie Robinson at jrobinson@nesca-newton.com.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

Is My Child a Picky Eater or Problem Feeder?

By | NESCA Notes 2020

Co-authored by: Abigael Gray, MS, CCC-SLP, NESCA Speech-Language Pathologist; Feeding Specialist, and Lauren Zeitler, MSOT, OTR/L, NESCA Occupational Therapist; Feeding Specialist

Do you have a child who presents as a picky eater? Have you ever wondered if their difficulties are more than just “picky eating”? Are mealtimes stressful for your family? There is someone out there who can help you!

Many children may be perceived as “picky eaters” while they are figuring out their food preferences. The important thing to understand is when your child would no longer be considered a “picky eater,” but instead a “problem feeder,” and therefore may benefit from feeding therapy. The chart below describes the general differences between the two. Every situation and child is different. If you have concerns, we always recommend reaching out.

There are other concerns that indicate a child may benefit from feeding therapy beyond the variety of food they accept, as described above. These concerns include:

  • Gagging, vomiting or choking when eating or drinking or shortly after
  • Poor posture while sitting at the table for meals
  • Difficulty using utensils within age-appropriate timeline
  • Issues with food control involving the mouth (e.g., chewing, closing lips around spoon or straw, drooling, pocketing food in cheeks, etc.)
  • Eating small volumes of food or taking more than 30 minutes to eat
  • Only eating certain textures of food (e.g., purees, crunchy solids, fluids)
  • Difficulty weaning from a bottle to solid foods
  • Transitioning from tube to oral feeding

Feeding therapy involves:

  1. Intake: you will be asked questions about your concerns to match you with a feeding therapist.
  2. Evaluation: before the evaluation, you will fill out a questionnaire about your concerns and goals for therapy as well as your child’s medical/developmental history. To obtain information about skills and behaviors, the feeding therapist will observe your child eating a variety of foods/textures and gain input from parents/caregivers. This will help the therapist determine whether your child presents with a feeding disorder and would benefit from feeding therapy. Recommendations will be made in a written report.
  3. Therapy: ongoing weekly therapy will be child-driven, and goals will incorporate your family’s priorities. Therapy will be individualized to address your child’s specific needs and goals.

For more in-depth information on this topic, register for the upcoming free webinar, “Is My Child a Picky Eater or Problem Feeder?” on November 18, 2020 from 10:30 – 11:30 AM Eastern Time. Register in advance for this webinar here.

If you have any concerns about your child’s feeding or questions about feeding therapy, please complete our online intake form, or email NESCA’s Director of Clinical Services Julie Robinson at jrobinson@nesca-newton.com.

 

About the Co-authors:

Abigael Gray has over six years of experience in assessment and treatment of a variety of disorders, including dysphagia, childhood apraxia of speech, speech sound disorder, receptive and expressive language disorder, autism spectrum disorder and attention deficit hyperactivity disorder. She has a special interest and experience in working with children with feeding and swallowing disorders, including transitioning infants to solid foods, weaning from tube feeding, improving sensory tolerance, developing chewing skills, increasing variety and volume of nutritional intake and reducing avoidance behaviors during mealtimes.

 

 

 

 

 

Lauren Zeitler is a licensed Occupational Therapist in Massachusetts, specializing in pediatric occupational and feeding therapy. Ms. Zeitler joined NESCA full-time in the fall of 2020 to offer occupational therapy assessment and treatment for children of all ages, as well as to work in conjunction with Abigael Gray, MS, CCC-SLP, on the feeding team.

 

 

 

 

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

NESCA’s New OT, Speech & Language and Feeding Services

By | NESCA Notes 2020

An interview between Sophie Bellenis, OTD, OTR/L, NESCA Occupational Therapist; Real-life Skills Program Manager and Coach, and Julie Robinson, OT, NESCA

NESCA just announced that it has expanded its Occupational Therapy (OT) services to include Direct Sensory-/Motor-based OT for its existing and new clients.

As you may know, NESCA already offers educational OT assessments and consultation along with Executive Functioning (EF) and Real-life Skills Coaching, mainly for those students in grades 6 and up. Now, NESCA broadens the range of students it can provide with OT, feeding, speech, language and social skills.

To introduce NESCA families and community members to the new team and its services, NESCA’s Sophie Bellenis, OTD, OTR/L, sat down for an interview with Julie Robinson, OT, to learn more.

What is the main focus of the new OT services that we are adding here at NESCA?

We are so excited to be on board and collaborating with the existing clinical team at NESCA to bring these new services to our community. The main focus of the new OT services is to provide instruction and practice, through teletherapy, and when appropriate at the home or in the community, in order to promote the best functionality kids can achieve on a daily basis. Where academic-based occupational therapy is focused on accessing the curriculum and receiving services while at school, Direct Sensory-/Motor-based OT services really look at giving our clients those wrap-around services outside of school to help with sensory processing, self-regulation, attention/following directions, fine and gross motor skill development, social pragmatics, managing routines, feeding and independence in carrying out daily activities, such as dressing, hygiene and sleep.

Who is a candidate for these new OT services?

We work with children of all ages, but our team typically works with children who are in the fifth grade or below. Many of the skills we are working on are skills that should be targeted and developed early on. Ideally, we are working with children from a young age or as soon as the challenges noted above come to light. Children with motor delays or sensory processing disorders, delays with play skills, and/or feeding difficulties are appropriate for these services.

How does the process of getting OT services start?

We usually start with an OT assessment that is focused on function. Insurance typically covers a 45-minute in-office screening. We would typically conduct a phone intake with the family, then look at the child’s skills using standardized tests for motor/sensory performance. With COVID-19, we are gathering sensory information from The Sensory Processing Measure and assessing other skill levels through interviews and checklists from parents, as well as 1:1 observation either virtually or in-person, as determined through the phone intake.

After an initial assessment is conducted, we work with families on a once or twice weekly basis. Each OT session is 45 minutes long and generally either begins or ends with a conversation with parents.

How do the services work?

We would typically provide services in-person inside the OT clinic at NESCA. Due to COVID-19, we are primarily providing services through telehealth, on a HIPAA-compliant virtual platform on a weekly basis. Sessions are 45 minutes each, with parents involved in part of each session to facilitate engagement of the child, to be coached by the clinician and for education about activities to incorporate in the days before the next session for follow through.

A small number of patients are being seen outdoors at their home or in the community, mainly when online engagement is too challenging, and when it can fit accordingly into clinician schedules. All patients are being seen individually for their services.

How do you set goals for the children you work with?

We get some of our background information for goal-setting from the assessment, but much of the real information on goals, strengths and weaknesses is revealed through observation during our sessions.

From the initial evaluation, we develop a brief report identifying the areas that we need to work on and collaborate with the parents to help achieve those goals and potentially target other areas that arise through ongoing observation and informal assessment during sessions and in parent consults.

When can families expect to see progress with goals being achieved?

We like to see our established goals being achieved in a three to six month time period. While every child is different, many kids go on to work with us for approximately 12 to 18 months, focusing on various goals throughout that period.

What are the related services that have just been introduced at NESCA?

Along with our new occupational therapy services, we are also now providing assessment and treatment of a variety of Speech & Language disorders, including dysphagia, childhood apraxia of speech, phonology/articulation disorder, receptive and expressive language disorder, social pragmatic communication disorder, autism spectrum disorder and language-based learning disabilities.

In addition, our therapists work with children with feeding and swallowing disorders, including transitioning infants to solid foods, weaning from tube feeding, improving sensory tolerance, developing chewing skills, increasing variety and volume of nutritional intake, and reducing avoidance behaviors during mealtimes. Our feeding therapists work with families to make mealtimes easier and more enjoyable for everyone using a systematic desensitization approach to increase sensory comfort with foods. We also employ the TR-eat®—Transdisciplinary Effective Assessment and Treatment—method for highly challenging feeding and eating issues.

Does NESCA accept insurance for its new services?

Direct Sensory-/Motor-based OT at NESCA (not academically-focused), is covered by BCBS and AllWays. Speech therapy at NESCA is covered by BCBS, AllWays and Harvard Pilgrim.

NESCA can provide receipts for Direct Sensory-/Motor-based OT sessions for clients to attempt to submit to their insurance carrier, should they not have insurance through the above carriers. NESCA does not submit claims to any carrier other than those outlined above and cannot guarantee any reimbursement when claims are submitted to them by the client.

It is also worth noting that Educational OT assessment, consultation and treatment is less often, or less completely, covered by insurance because insurance carriers typically only cover treatments that are deemed “medically necessary.” However, this can be a vital service because students spend such a significant amount of their day and week in school programming.

To learn more about NESCA’s Occupational Therapy and Related Services, please click here.

 

About the Interviewer

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as a part of the Real-life Skills Program within NESCA’s Transition Services team. Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists. Having spent years delivering direct services at the elementary, middle school and high school levels, Dr. Bellenis has extensive background with school-based occupational therapy services.  She believes that individual sensory needs and visual skills must be taken into account to create comprehensive educational programming.

About the Interviewee
Julie Robinson is an occupational therapist with over 25 years of experience as a clinician. The work Julie does is integral to human development, wellness and a solid family unit. She particularly enjoys supporting families through the process of adoption and in working with children who are victims of trauma. Julie has extensive experience working with children diagnosed with an Autism Spectrum Disorder (ASD), or who have learning or emotional disabilities. She provides services that address Sensory Processing Disorder (SPD) and self-regulation challenges, as well as development of motor and executive functioning skills.

 

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.