Milestones In A Child's Development

All About Kids Newsletter by Synergy Healthcare

All About Kids The Newsletter About Taking Care of the Ones That Matter Most

“When Should I Be Looking for SpecificDevelopments in My Child? ” Milestones in Your Child’s Development: What to Expect Any pediatrician or child care expert will tell you: No two children are alike, and there’s no used fretting if she isn’t able to do what your friend’s baby or toddler of the same age is doing. Nonetheless, there are some milestones for various stages of early childhood that can serve as general guidelines. 2 MONTHS By the time your baby reaches her two-month milestone, she will be responding to the sound of your voice, when she hears it, by smiling and looking around for you. She will also be following people with her eyes as they move around the room, and will begin to get bored and fussy if left on her own too long. She can hold also her head up unsupported by now. 6 MONTHS At the half-year mark, your baby’s life is really rolling, and so is she! Aside from being able to roll herself over from any position, she also likes to play, and may be able to sit

unsupported. She can pass toys and objects from one hand to another, and exerts herself to get things that are beyond her reach. You’ll also be able to pick out vowels and consonants in her “babbling.” 1 YEAR At 12 months, your baby is aware enough of her surroundings and the comings and goings of her family members to get emotional about them. She can be shy with strangers, fearful at unfamiliar sights and sounds, and downright sorrowful when her loved ones say goodbye. She will probably also be pulling herself to a standing position, and “cruising” by walking about while holding onto furniture.

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All About Kids The Newsletter About Taking Care of the Ones That Matter Most

“IsMy Child Developing Appropriately for Their Age? ” Milestones in Your Child’s Development: What to Expect

2 YEARS By the time your child has reached her second birthday, she will have entered the wonderful world of make believe, in terms of the type of imaginative playing she’s starting to do. She most likely is already running and jumping, and putting together simple sentences. She can follow basic instructions -- at least when she’s not cranky. In fact, the “terrible twos” are actually a normal part of development, so don’t let those defiant moments throw you too much. 3 YEARS Watch out! Your three-year-old will soon be climbing everything in the house, if she hasn’t started already. She can also group objects by shape and color, and followmulti-step instructions.Shecanprobablymanage stairs now, in her own way. Her sentences are getting longer, and she can identify herself and her loved ones by name and tell you how old she is. 4 YEARS At the four-year mark, your child will truly be exploring the world outside her immediate family. Even if she

doesn’tgotopreschool,she’llbe interested in interacting with kids about her own age. She can memorize songs and nursery rhymes, can draw a bit, and use scissors. In terms of major muscle groups, your child will probably be able to balance on one foot briefly, as well as hop and catch a gently-bouncing ball. 5 YEARS Byherfifthbirthday,orsoonafter,youchildcanprobably count to 10 or higher, especially when counting items. She may be able to print numbers and letters, as well as draw shapes and people. She can tell a story with full sentences. On the physical front, your five-year-old is probably skipping and doing somersaults. Again, don’t panic if your child hasn’t reached any of these milestones at the exact age noted. These general guidelines are just that -- a guide. But if you do have any concerns, contact us for a consultation. Sources: https://www.cdc.gov/ncbddd/actearly/milestones/ https://childmind.org/guide/developmental-milestones/ http://www.med.umich.edu/yourchild/topics/devmile.htm

Inside This Newsletter • Staff Spotlight • Patient Success Spotlights • Animal Assisted Therapy for Your Child • Autism Intervention

Do you know a child who needs therapy? Pass this on to a friend! Does Your Child Need Help with hand writing, speech, language, balance, feeding, walking, running, jumping, playing with others, or just being a kid? New Patients! Schedule today for a FREE Screening for Speech or Occupational Therapy

SPECIALIZED JUST FOR YOUR CHILD

We can help by providing: Occupational Therapy & Speech Therapy Evaluations & Treatment. Synergy Healthcare can further assess your child’s needs. Contact us today!

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ANIMAL-ASSISTED THERAPY FOR YOUR CHILD

Animals can be great companions to kids and adults alike. Animals show both loyalty and love. They can help in different situations by assisting youwitha task,alertingyou todanger,orprotecting you fromharm.Thespecialbondbetweenhumans and animals is one of comfort, acceptance, and warmth—all reasonswhyanimalsmakegreatpets and great “assistants” in therapy. Animal-Assisted Therapy (AAT) utilizes animals in the therapeutic process. Animals can provide motivation and decrease stress for individuals as they work to improve skills like walking (physical therapy), self-care (occupational therapy), and speaking fluently (speech therapy). In these goal- directed therapies, and other such therapies, “an animal is incorporated as an integral part of the clinical health-care treatment process” (American Humane Association, 2009, para. 2). What Are Some Ways Animal-Assisted Therapy CanHelpPeople? Animalsthatarepartofatherapy programcan help individuals feelcomfortable and feel less pressure to perform tasks. Animals are nonjudgmental, so their presence may help ease

some of the anxiety that comes with practicing different skills. The animals can also help as individuals work through difficult emotional times. They can also help individuals learn patience with the animal and care skills for the animal. As they work on these skills, you may see transfer of this careandcompassion tootherareasof life.Aswell, dealingwithanimalsmayhelppeoplewithsensory issues tolerate the presence of an animal in the room and regulate their emotions accordingly. What Conditions/Disorders Does Animal- Assisted Therapy Treat? People with a variety of conditions can benefit from animal-assisted therapy, including: • Autism spectrum disorders • Addiction • Cancer • Heart disease • Dementia • Developmental disorders • Psychiatric disorders such as schizophrenia • Emotional and behavioral disorders • Chronic pain

If your child or someone you know may benefit from Animal Assisted Therapy, consider fostering a therapeutically trained animal. Other options include attending our facility, which offers these services as often as your child may need them by appointment. Contact our office for more information today at (208) 666-0611.

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Staff Spotlight Kerri Lewis, MA, OTR/L Pediatric Occupational Therapist

Kerri graduated with her Bachelor’s Degree in Special Education from University of North Carolina at Charlotte in May of 1997. She graduated fromNew York University School of Occupational Therapy with a Master’s of Arts in December of 1999. Kerri has practiced occupational therapy in a variety of settings, including early intervention, rehabilitation, school district, NICU, acute care, and pediatric outpatient practice. Kerri has extensive knowledge and experience working with children who have sensory processing disorder, feeding difficulties, and visual motor delays. She iscertified in IntegratedListeningSystemsandTherapeuticListening. Kerri is passionate about helping improve function and success using a variety of real life, functional and holistic treatment approaches. Kerri has had particular interest in learning and integrating CranioSacral Therapy and Manual Lymphatic Drainage Therapy techniques into her toolbox of

Kerri and family

therapeutic interventions; she is pleased to see the positive benefits this has had for her clients with noted improvements in self-regulation, sleep, muscle tone and range of motion, and sensory processing. Her long time vision has been to create a therapeutic environment that offers functional yet fun activities, such as gardening, cooking, and animal assisted therapy. Kerri,herhusband,and their6childrenenjoyoutdooractivitiessuchasskiing, biking, being on the water, having movie nights together, and spending time with their 3 dogs and 2 cats!

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Patient Success Spotlights

Dear Ms. Kerri, “We came to Synergy Healthcare for O.T. help with handwriting, but we are getting so much more. Two months ago, when we started, our son’s handwriting was illegible. It drove us crazy that our 6 year old was not taking pride in his work. We harped on him for not slowing down to connect his capital “F’s,” to give one example. If fine motor was our only problem, certainly more military-type practice would fix the issue. Well, all the harping and reminding wasn’t helping, and you taught us why. His ocular motor skills were weak; his eyes get tired tracking. You taught us there’s a link between fine motor and eye tracking.The fun, simple games you gave us to do at home have helped. Every week you have something new for us to try. We aren’t through yet, but we see a huge difference in his letter formation. And the grandparents can now read his notes. What surprised me most is you’re addressing the “ants in his pants.” Coming up on second grade, he’s going to have a lot more handwriting. It’s easier to succeed at handwriting if you’re sitting still. Unlike well meaning I finally feel like I know how to be his mom! “Since Romi has been at Synergy, my son has looked forward to seeing her every week. Donny has high energy and trouble calming when it’s time to pay attention. Romi calms Donny and soothes him so quickly. You can just see his anxiety and tension melt away.” – Wendy M. You can just see his anxiety and tension melt away!

friends, you’ve got constructive tools forus tomitigate thespinning- wiggles when we need to. We love playing for 15 minutes before doing our handwriting homework. If we do the whole 15 minutes, he

doesn’t change his body position while doing his workbook. It’s amazing. I finally feel like I know how to be his mom. Before dinner, we do some of the other things you suggested: scrub down the table, vacuum the living room, pushup challenge, or pretend to be different animals on the floor. We don’t always do one, but when we do it always works. You’ll hear a lot less nagging around our house now; unless there are dirty dishes. I wish every kid could do handwriting through your program. It’s brought pride to our son’s work, and predictable peace to our homework time. I can’t thank you enough!” - N. Adams

Always learning…Always growing…

AUTISM INTERVENTION

Understanding what treatment is best for your child on the autism spectrum can be overwhelming. As time has passed, we have begun to understand autism better and the research is backing up what we haveknownclinically forsome time. Therearea lotofdifferent treatment names that you may have run into as a parent while researching the bestplan foryourchild.Manyof the available treatments can be used together to focus on your child’s unique profile of strengths and weaknesses. Will Strong, one of our speech- language pathologists, recently attended a continuing education seminar on the SCERTS model

autism spectrum disorder often have difficulty regulating their own emotionalstates.Transitionperiods and changes in routine throughout the day can be very difficult and lead toemotionalmeltdowns if there are no strategies to deal with these times; the SCERTS model helps by providing strategies for emotional regulation. Transactional supports: Lastly, we therapists need to work together with teachers,parents,andeveryone involved in your child’s care, to provide supports that best help the child to learn. The SCERTS model suggests thatchildrenoftenbenefit from visual supports to promote social communication and learning

like visual schedules, timers, and communication boards. These are called transactional supports. The SCERTS model guides us in creating a developmentally appropriateplanofcare forourkids (or adults). SCERTS emphasizes the importance of working within natural routines throughout theday. It is not an exclusive model. Other treatments thatarewell-researched can be used to meet SCERTS goals. This means that strategies such as using picture exchange systems, or building skills using applied behavioral analysis, or structured teaching utilizing visual supports, can all be used to fit your child’s unique needs.

for autism intervention. SCERTS stands for Social Communication, Emotional Regulation, and Transactional Supports. Social communication: We know that children on the spectrum have difficultywithsocialcommunication. They have difficulty relating to their peers, thinking flexibly, thinking about others’ perspectives, and identifying emotions in themselves and others, amongst other things. The SCERTS model helps clinicians and parents by telling them where to start with treatment based on your child’s ability to communicate verbally and nonverbally. Emotionalregulation: Childrenwith

What are PANS and PANDAS Conditions?

PANS and PANDAS are infection-induced autoimmune conditions that disrupt a patient’s normal neurologic functioning, resulting in a sudden onset of Obsessive Compulsive Disorder (OCD) and/or motor tics. PANS and PANDAS can include a variety of other symptoms, such as anorexia (food restrictions), anxiety, irritability, hyperactivity, sleep disturbances, mood swings, and urinary problems. PANDAS is an acronym for Pediatric Autoimmune Neuropsychiatric Disorder AssociatedwithStreptococcal infection. It isanautoimmunecondition initially triggeredbystrep infections,whichdisruptsachild’snormalneurologicactivity. PANS is an acronym for Pediatric Acute-onset Neuropsychiatric Syndrome, which is associated with a variety of different infections, whereas PANDAS is a disorder associated with only streptococcal infections—specifically group A strep. Although the etiology for PANS is different from PANDAS, the symptom presentation is nearly identical. The Difference Between PANS and PANDAS PANDAS is when specifically strep is connected to the sudden onset of OCD and/or tics along with other listed clinical symptoms. PANS removes the emphasis on the etiologic factor and concentrates on the clinical symptoms. PANS can be triggered by any infectious agent (NOT only strep) in addition to non-infectious triggers which are yet to fully determined, but may include metabolicdisordersandenvironmental factors.Symptomscannotbeexplained by any other neurological or medical disorder. Children with PANS and PANDAS Are Often Misdiagnosed All too often, children with PANS and PANDAS are misdiagnosed as having a psychiatric illnessandmaybe treatedsolelywithpsychotropicdrugs tomanage their symptoms. Unfortunately, for PANS and PANDAS patients this does not address the root cause of the symptoms, which is an infection-triggered autoimmune condition. Studies have shown that when given appropriate anti-infective and/or immunological treatment, PANS and PANDAS patients experience symptom resolution, or their symptoms are dramatically reduced. Obtaining a correct diagnosis can be challenging, because PANS and PANDAS symptoms can mimic other illnesses. What Should I Do If I Think My Child Has PANS or PANDAS? ParentswhosechildhasadramaticonsetofOCD,suddenly restricts their food intake,exhibits tics,and/or isalsoexperiencingsuddensevereneuropsychiatric conditions – anxiety, irritability, uncontrolled emotions, and/or depression – should have their pediatrician refer their child to our clinic for an urgent visit, and test their child for both a throat strep culture and a peri-anal rapid strep test. If the rapid strep is negative, ask for a strep culture. If any of these tests are positive, the child needs to be put on antibiotics for strep. If strep is

negative, the child should have blood tests for strep. If the child has had or been exposed to an illness with prolonged coughing, then your pediatrician may consider testing for a bacteria called mycoplasma. What is the Prognosis for a Child with PANS/PANDAS? For children who are diagnosed early and a cause has been identified, the prognosis can be very good. Some patients respond quickly and are back to 100 percent normal function, but that doesn’t happen for everybody. For those in whom the cause is unknown and who don’t respond as well to antibiotics, we continue to treat the children and work with their families to address their illnesses. Synergy Healthcare offers effective services for children suffering from neurologic conditions, like PANS and PANDAS. Our therapists are well experienced and trained in treating your child. We can also perform tests to determine if the brain is processing what your child is hearing. We offer age-appropriate tests for infants and children. From about 6 months of age and older, behavioral testing can be conducted. The testing process is safe, painless, and fast! Contact our office today to start treatment.

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Identifying the Signs of Communication Disorders

Signs of Speech & Language Disorders Signs of common speech and language disorders in adults and children between birth to 4 years of age, an important stage in early detection of communication disorders: Signs of a Language Disorder • Does not smile or interact with others (birth and older) • Does not babble (4-7 months) • Makes only a few sounds or gestures, like pointing (7-12 months) • Does not understand what others say (7 months-2 years) • Says only a few words (12-18 months) • Words are not easily understood (18 months-2 years) • Does not put words together to make sentences (1.5-3 years) • Has trouble playing and talking with other children (2-3 years) • Has trouble with early reading and writing skills (2.5-3 years)

What Parents Can Do • Listen and respond to your child • Talk, read, and play with your child

• Talk with your child in the language you are most comfortable using • Know it is good to teach your child to speak a second language • Talk about what you are doing and what your child is doing

• Use a lot of different words with your child • Use longer sentences as your child gets older • Have your child play with other children

• Socially isolated and unhappy in school • Persistent ear discomfort after exposure to loud noise (regular and constant listening to electronics at high volumes) What Parents Can Do • See a therapist if your child did not pass the newborn hearing screening • See a therapist if you have any concerns about your child’s hearing (some hearing losses can begin months or years after birth) • Ask your therapist about the need for hearing aids or cochlear implants At Synergy Healthcare, we offer a broad range of testing and evaluation services for infants, children, and adolescents. These tests can assess whether your child’s speech and language development is appropriate for their age. We look at children’s ability to understand spoken language and to use spoken language. We may also make referrals if we suspect that your child may have a hearing loss. We offer age-appropriate tests for infants and children. From about 6 months of age and older, behavioral testing can be conducted. The testing process is safe, painless, and fast! Contact our office today to schedule an appointment!

Know the Signs of Hearing Loss Your child may be having difficulties in communication because they’re suffering from hearing loss. Children learn to communicate by imitating the sounds they hear. If they have a hearing loss that is undetected and untreated, they can miss much of the speech and language around them. This results in delayed speech/language development, social problems, and academic difficulties. A possible hearing loss is more difficult to identify in older children, whose speech skills are already developed. Nevertheless, the following guidelines can help parents detect a possible acquired hearing loss. Signs of Hearing Loss • Lack of attention to sounds (birth-1 year) • Does not respond when you call his/her name (7 months-1 year) • Does not follow simple directions (1-2 years) • Shows delays in speech and language development (birth-3 years) • Pulls or scratches at his/her ears • Difficulty achieving academically, especially in reading and math

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