Tag

SLP

Speech-Language Pathology at NESCA with Olivia Rogers, MA, CF-SLP

By | NESCA Notes 2021

Speech-Language Pathologist Olivia Rogers, MA, CF-SLP, joined NESCA in June, working with clients in the Newton, Massachusetts office, and is scheduling new clients now. We sat down with Olivia to learn more about her, what her passions in speech and language are and why she joined NESCA.

By Jane Hauser
Director of Marketing & Outreach

How did you initially get interested in Speech-Language Pathology (SLP)?

I started my undergraduate education as a bioengineering major. A project I was assigned to required me to research devices that related to the medical side of bioengineering. After some research, I came upon cochlear implants, which led me to learn more about Audiology and Speech-Language Pathology (SLP). Ultimately, I knew I desired to work with people and make an impact in the healthcare field, but I didn’t feel like bioengineering was where I belonged. After I switched my major to Communication Sciences and Disorders, I knew I had made the right decision.

Additionally, I am the oldest of five children, so was always around kids. Once I stumbled upon this major, I realized it was a great way to combine my desire to work with kids and a career that really fulfilled me.

In what settings have you worked previously?

I’ve done a few clinical rotations in different settings. I spent a semester in a K-8 public school, and a year in pediatric private practice.  Those opportunities allowed me to work with children with various speech and language challenges. I also spent some time in a hospital working with adults in the inpatient acute care unit. All of these experiences strengthened my passion for working with the pediatric population and implementing therapy that is both functional and personal to each individual.

What brought you to NESCA?

Last summer, I was a student intern with NESCA’s Speech-Language Pathologist Abbey Gray, MS, CCC-SLP, as part of my third clinical placement. When the opportunity to work with Abbey and also some of the kids we worked with together again came to my attention, I jumped at the opportunity to work with all of them again.

It’s exciting to work at NESCA in the clinic setting where the Speech-Language team is expanding, and collaboration is so important. Here, I get to be a part of a great team of therapists, clinicians and neuropsychologists. I also appreciate that NESCA is so open to and supportive of its clinicians continuing to learn. For example, I am hoping to gain feeding therapy experience alongside the other feeding therapists here at NESCA.

What part of being a SLP do you enjoy the most?

Being able to communicate is one of the most important life skills, and giving others the tools they need to do so effectively is amazing in itself. However, no two clients are the same and it is up to me to be creative in catering to each individual to make sure that therapy is motivating and beneficial. As a SLP, creativity and play are not only allowed but encouraged. I really enjoy that part of my job.

I really love all of the work I do with children, especially working with kids on receptive and expressive language therapy. With the older children I work with, I enjoy working on the social pragmatic aspects of communication. With the younger kids, I love play-based therapy and working with parents and families to ensure that the language we are targeting is practical.

How do you partner with families when you are working with a child at NESCA?

Integrating real life and therapy is one of the most important aspects of what I do as a SLP. It’s essential for parents or other family members/caregivers to be involved in a child’s therapy to make sure that there is carryover into the home setting. Building functional language skills is a full-time venture involving therapy sessions and practice at home. I strive to have family involved either in the weekly therapy sessions and/or taking notes on what we are working on to further support that child in reaching their goals.

And regarding goals, it’s so important to have parent/caregiver input on the goals we work toward. With the older kids I work with, they are often able to communicate what they’d like to or need to work on. With the younger children, it’s critical for parents and families to help communicate a child’s challenges in order for us to establish the goals we work toward together.

What is one of the most inspiring milestones you have experienced as a Speech-Language Pathologist?

While I was working in the K-8 school, most of the children I worked with were deaf or hard of hearing. There was one 10-year-old boy who was profoundly deaf and utilized cochlear implants. He was essentially nonverbal, and our goal was to help him to auditorily recognize and verbally produce a couple of functional words that could support him in the classroom and at home. In particular, we were trying to get him to interact verbally with his dog; this was a personal goal of his. After months of work, his mom let us know that at home he said, “Sit,” and his dog followed his command! He was so motivated to learn more words since he saw how language could help him to function more easily and successfully. It was such an inspiration and really solidified my strong desire to work with kids to help them in speech and language, and in life.

 

About Speech-Language Pathologist Olivia Rogers

Olivia Rogers received her Master of Arts in Speech-Language Pathology from the University of Maine, after graduating with a Bachelor of Arts in Communication Sciences and Disorders and concentrations in Childhood Development and Disability Studies.

Ms. Rogers has experience working both in the pediatric clinic setting as well as in public schools, evaluating and treating children 2-18 years of age presenting with a wide range of diagnoses (e.g., language delays and disorders, speech sound disorders, childhood apraxia of speech, autism spectrum disorder, social communication disorder, and Down syndrome). Ms. Rogers enjoys making sure therapy is fun and tailored to each client’s interests.

In her free time, she enjoys listening to podcasts and spending times with friends and families.

 

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.

 

To book an appointment with Olivia Rogers, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

The Importance of Play in Speech-Language Therapy

By | NESCA Notes 2021

By: Abigael Gray, MS, CCC-SLP
NESCA Speech-Language Pathologist

As a speech-language pathologist, I immediately think about toys and games when planning my therapy sessions. Parents may wonder why speech-language therapy often looks like “just playing.” Children learn about their world through play. It facilitates their cognitive, emotional, physical, and social development. As young children develop, they begin understanding, learning how to communicate, and socializing within the context of play.

As I discussed in my last blog post, Five Ways to Facilitate Language Growth at Home, motivation and interest are key in language development, and play is highly motivating and interesting for children. When children learn in the context of play, these new concepts, sounds, and words became relevant and meaningful to the child. This promotes retention and generalization, which both increase learning.

Symbolic play is especially important in the development of language. Symbolic play is the use of objects to represent other objects (e.g., using a block as a phone). Language itself is symbolic since signs, gestures, and words represent ideas, objects, or relationships. Early symbolic play helps children understand that objects can be used to represent another object. Development of symbolic play often correlates with development of language: children often start to use single words when they begin using one object to represent another, and they may begin combining words when they combine two symbolic play actions.

Speech-language pathologists may even use play within assessment. Play in evaluations “is a nonthreatening way to gather information about general symbolic skills, linguistic skills, behaviors skills (i.e., attention and organization), and task persistence in a child-friendly setting” (Fewell & Rich, 1987; Short et al., 2011). I also use play to take language samples, which allows me to look at language understanding and use in a naturalistic environment.

For my older elementary- or middle school-aged clients, play often looks like playing games in therapy. The turn taking of games mimics the social reciprocity that we see in conversation and social communication. This facilitates older children’s understanding of taking the lead when it is their turn and waiting, listening, and watching when it is the other person’s turn. I also find more willingness to participate in therapy when it is fun and centered around specific interests.

In my opinion, we are never too old to play! I’ve found that most people learn and retain information better within the context of fun and enjoyable activities, which is why play is such an important aspect of speech-language therapy.

References:

Jarrold C, Boucher J, Smith P. Symbolic play in autism: a review. J Autism Dev Disord. 1993 Jun;23(2):281-307. doi: 10.1007/BF01046221. PMID: 7687245.

Short EJ, Schindler RC, Obeid R, Noeder MM, Hlavaty LE, Gross SI, Lewis B, Russ S, Manos MM. Examining the Role of Language in Play Among Children With and Without Developmental Disabilities. Lang Speech Hear Serv Sch. 2020 Jul 15;51(3):795-806. doi: 10.1044/2020_LSHSS-19-00084. Epub 2020 May 13. PMID: 32402229.

Terrell, B. Y., Schwartz, R. G., Prelock, P. A., & Messick, C. K. (1984). Symbolic play in normal and language-impaired children. Journal of Speech & Hearing Research, 27(3), 424–429. https://doi.org/10.1044/jshr.2703.424

 

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.

 

To book an appointment with or to learn more about NESCA’s Speech & Language Therapy, please fill out our online Intake Form, email NESCA’s Director of Clinical Services Julie Robinson 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.

 

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.

 

Facilitating Language Growth at Home

By | NESCA Notes 2021

By: Abigael Gray, MS, CCC-SLP
NESCA Speech-Language Pathologist

I recently got to spend time with my 18-month-old nephew, after not having seen him in a year and a half due to the pandemic. It got me thinking about practical ways to help facilitate language throughout the day without feeling like you’re doing anything extra. Play and routines are great times to build language, and you can often find opportunities that are motivating for your child. Motivation and interest are key, because children are much more likely to participate and communicate. Below, I discuss tips to incorporate into your daily routine at home.

Five ways to facilitate language growth at home:

  1. Play!
    • Play the way your child is playing and imitate what they’re doing.
    • Even if you had a plan, don’t be afraid to change it to focus on their interests (i.e., follow their lead, as explained below).
    • Use fun sounds, words and gestures to go with what you’re doing (e.g., “beep beep” when playing with cars, “pop” when popping bubbles, “yummy/mmm” and rubbing your stomach when pretending to eat play food).
  2. Follow your child’s lead
    • Observe what they’re interested in, wait until they initiate or continue interaction, and listen to their words and sounds.
    • Get on their level so they know you are joining in.
    • If they are doing something unsafe, explain why it’s unsafe in simple terms and redirect them to a safe activity.
  3. Get silly
    • Repeat actions they think are funny.
    • Switch up routines in a silly way (e.g., “forget” their favorite bath toy, give them a fork with their yogurt). This encourages language when your child notices and wants to tell you something is different or missing.
    • Change song lyrics or words in stories to be about your child, their interests and/or what is happening around you in the moment.
  4. Pause
    • Slowly sing familiar nursery rhymes and songs and then pause at key words to encourage them to fill in a word or gesture.
    • Pause a familiar activity, such as pushing the swing, and wait for them to ask you to continue using words or gestures (e.g., “more,” “again,” “go”).
    • When looking for a response, stop talking, lean forward and look at them expectantly. You can count slowly to 10 silently, which gives your child time to respond.
  5. Expand
    • When your child uses one to two words, turn it into a short sentence. For example, if they say “up” wanting you to pick them up, you could say, “Ok, I’ll pick you up.”
    • Be sure to use correct grammar when expanding their message, even if your child is still using immature grammar.
    • Use a variety of words (e.g., describing words, action words, words for feelings, location words, etc.). Start with words your child would want to say to talk about the things they are interested in.

Many of these ideas are things you may already be doing throughout the day, but it is good to think about how doing so helps your child learn to understand and use language. If you feel that your child may be behind in their language understanding or production, it is helpful to schedule an evaluation with a speech-language pathologist. If therapy is warranted, your speech-language pathologist can make recommendations specific to your child and family and show you how to best encourage language growth in the home environment.

References:
Weitzman, E. (2017). It takes two to talk: A practical guide for parents of children with language delays (5th ed.). Toronto: Hanen Centre.

 

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.

 

To book an appointment with or to learn more about NESCA’s Speech & Language Therapy, please fill out our online Intake Form, email NESCA’s Director of Clinical Services Julie Robinson 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.

 

Literacy-based Speech Therapy: Winter Edition

By | NESCA Notes 2021

By: Abigael Gray, MS, CCC-SLP

NESCA Speech-Language Pathologist

Books are a great speech-language therapy tool. They can be used to target many different goals for a variety of ages and profiles. With books, children are given context for learning vocabulary, concepts and important story elements. Literacy-based therapy is not only more fun, but research also supports its use in teaching children with speech and language disorders:

  • Teaching story elements has been shown to improve oral language production and reading comprehension.
  • Teaching within a narrative context can make language learning less demanding, more meaningful and more authentic.
  • Students’ comprehension and story retelling/generation skills improved more with contextualized (literacy-based) intervention than decontextualized intervention.

Books can easily be incorporated into life at home, if they are not already a part of the daily routine. Just grab your or your child’s favorite book, or find a YouTube read aloud of it, and have your child help you read it! Be sure to pause throughout the book to talk about the pictures, make inferences about why events are happening and ask a few questions. Don’t be afraid to change the words to match your child’s level of understanding or interests.

My top three favorite winter books to use in speech-language therapy are:

  1. Sneezy the Snowman by Maureen Wright

A story about a cold and sneezy snowman who melts several times while trying to get warm. His human friends help him by rebuilding him and sharing their winter clothes.

Amazon: https://www.amazon.com/Sneezy-Snowman-Maureen-Wright/dp/1477810544

YouTube Read Aloud: https://youtu.be/iUsHnKSyDH0

Skills that I target and can be incorporated into shared book reading at home:

  • Producing subject-verb-object or complex sentences to talk about what is happening.
  • Predicting what will happen before and throughout reading (e.g., “Sneezy is drinking hot chocolate, what do you think will happen?”).
  • Answering detail (what, where, who, when) and inferential (why) questions.
  • Discussing story parts (e.g., characters, setting, problem, solution) and retelling the story.
  • Writing using different prompts, such as “My snowman melted because…” or “When I’m cold, I…”.
  1. The Mitten by Jan Brett

A traditional story about a boy whose grandmother knits him new mittens. He loses one mitten when he is outside playing, and many different animals climb inside to stay warm.

Amazon: https://www.amazon.com/Mitten-Jan-Brett/dp/0399231099

YouTube Read Aloud: https://youtu.be/duhj0Op_slo

Skills that I target and can be incorporated into shared book reading at home:

  • Sequencing events by talking about the order of animals that climbed into the mitten.
  • Creating a craft by printing a mitten and animals, coloring the animals and putting them inside the mitten as you retell the story.
  • Watching a different rendition of The Mitten on Vooks.com and comparing and contrasting the two stories using a Venn diagram.
  • Producing past tense verbs to describe what happened.
  • Making inferences about characters’ emotions and motivations.
  1. The Snowy Day by Ezra Jack Keats

A Caldecott Medal-winning book about a boy’s adventures in the snow when he puts on his snowsuit and goes outside to play.

Amazon: https://www.amazon.com/Snowy-Day-Board-Book/dp/0670867330

YouTube Read Aloud: https://youtu.be/FmZCQfeWjeQ

Skills that I target and can be incorporated into shared book reading at home:

  • Telling an original story together by covering up the words on the pages.
  • Finding words that contain the child’s target speech sound (i.e., if your child is working on producing the “R” sound, find all the words that contain “R” and practice those).
  • Describing character traits of Peter, the main character.
  • Discussing cause and effect (e.g., cause: Peter smacked a snow-covered tree, effect: snow fell on Peter’s head).
  • Writing using different prompts, such as “On a snowy day, I like to…” or “I can save a snowball by…”.

 

References:

Davies, P., Shanks, B., & Davies, K. (2004). Improving narrative skills in young children with delayed language development. Educational Review, 56, 271 – 286.

Gillam, S. L., Gillam, R. B., & Reece, K. (2012). Language outcomes of contextualized and decontextualized language intervention: results of an early efficacy study. Language, speech, and hearing services in schools43(3), 276–291. https://doi.org/10.1044/0161-1461(2011/11-0022)

Tomasello, M. (2003). Constructing a language. A usage-based theory of language acquisition. Cambridge, MA: Harvard University Press

 

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.

 

 

 

To book an appointment or to learn more about NESCA’s Speech & Language Therapy, please fill out our online Intake Form, email NESCA’s Director of Clinical Services Julie Robinson 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.

 

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.