Anne Baum (00:00):
What is a pediatric feeding disorder? How can I help my child progress in their motor skills? Does my child need to see a speech-language pathologist? All that and more on this episode of Because They’re Kids.
(00:17):
Welcome back to Because They’re Kids, the podcast that’s built just for kids and their parents. I’m your host, Anne Baum, mother of two and President of Lehigh Valley Reilly Children’s Hospital, and I’m excited for another episode of our podcast. As children grow up, sometimes they may need additional support with developing certain skills. That’s where specialists in pediatric rehabilitation can help and also equip parents with the tools and resources needed for success. Here to talk about pediatric rehabilitation are Tyler Lawson, Outpatient Pediatric Rehabilitation Manager and Speech-Language Pathologist, and Sarah Smith, Outpatient Pediatric Rehabilitation Physical Therapist. Thank you for joining.
Sarah Smith (01:02):
Thanks for having us.
Tyler Lawson (01:03):
Thank you for having us today.
Anne Baum (01:04):
So we’re looking forward to learning a lot about pediatric rehab. It’s something that parents are aware of but probably don’t know a lot about when to call or check in. So we’re really looking forward to the conversation. So let’s start with a basic question. What is pediatric rehabilitation?
Tyler Lawson (01:25):
Sure. So pediatric rehabilitation can be broken up into two branches. So there’s inpatient pediatric rehab that covers more acute care needs during hospitalizations, following illness or injury. And then there is outpatient pediatric rehabilitation, which is where Sarah and I work, and we provide services such as physical therapy, occupational therapy and speech therapy services.
Anne Baum (01:52):
That’s great. So how many kids will need physical therapy, need a pediatric rehab specialist, and what are some of the common diagnoses?
Sarah Smith (02:02):
So for physical therapy, research has shown that about 2 million children in the United States would need those services. Some common diagnoses that we treat in outpatient rehab are in infants, we see torticollis, which is related to muscle tightness and weakness in the neck. We see things like gross motor delay, balance disorders, some more specific diagnoses like scoliosis and concussion, and many, many more that are referred from primary care physicians who see issues.
Tyler Lawson (02:38):
And about 2 million children will need occupational therapy services from birth to adolescence in the United States. Our occupational therapists, they provide services to support any activity of daily living. So that can involve self-feeding, dressing yourself, hygiene practices, sleep training. They also address concussion, fine motor skills, handwriting skill development, as well as emotional regulation and play skills. And for pediatric speech therapy, about 5 million children in the United States receive speech therapy services, and speech therapy can cover a wide array of skills. We see a lot of expressive and receptive language delays, we see speech sound disorders, so any difficulty with pronouncing sounds, we see fluency and stuttering disorders. So some of those sound repetitions, voice disorders, social communication skills, as well as pediatric feeding disorders.
Anne Baum (03:41):
Wow. So there are so many little pieces that help kids succeed, and if they could get that therapy early, it probably makes a huge difference in their life, their learning. That’s amazing. Tell me a little bit more about feeding disorders. How would you know your child had a feeding disorder? What are they?
Tyler Lawson (04:00):
Pediatric feeding disorder is difficulty with oral intake related to any [of] four facets of either medical complexity, nutritional deficits, impaired feeding skills or oral motor skills, or psychosocial complications that might impact their ability to feed.
Anne Baum (04:20):
Wow. That’s a lot of pieces that go into that. So what are some of the symptoms? What should parents watch for? When do they speak to their pediatrician about it?
Tyler Lawson (04:30):
Yeah. I find it easiest to walk through some important feeding milestones to look at when families should be looking for referrals to see a feeding specialist. So around 3 months of age, infants should start with mouthing items, whether it be teethers, their hands, showing interest in holding their bottle, bringing items to their mouth. Around 6 months of age, children should start incorporating pureed food into their diets or doing baby-led weaning. So you want to see part of that transition away from strictly only bottle feeding. Around 9 months, you’ll start to see more tongue movements, side to side, and controlling food within their mouth. And around 12 months of age, children should be doing a lot of self-feeding, finger-feeding and incorporating a larger variety of table foods into their repertoire. By 2 years of age, they should be having pretty refined oral motor skills and using utensils, open-cup drinking, straw drinking and mimicking more of that adult feeding pattern.
Anne Baum (05:41):
So wow, that’s a lot of milestones, a lot of things to think about. Are there resources that parents can use to find this information? When they’re visiting their pediatrician, I’m assuming they’re asking these types of questions.
Tyler Lawson (05:57):
Yes, absolutely. I think a great resource that I often refer parents to is the ASHA website, the American Speech-Language-Hearing Association website. They have an excellent milestone chart that checks off what your child should be doing at each age range, and then it does give suggestions for if they’re not, how you can help support that at home.
Anne Baum (06:16):
Oh, that’s great. And that was going to be my next question. So if your child is diagnosed with a feeding disorder, obviously there’s rehab that they can participate with, but what can you do as a parent to help support them learning these skills? Because clearly, that’s an important life skill.
Tyler Lawson (06:35):
Yeah, absolutely. I think it would really have to be individualized to the child. Every pediatric feeding disorder is different. The cause is different, the way it presents is different, so it does need an individualized approach. I will say some recommendations for parents who are having kids who are having more of those picky-eating or selective-feeding habits would be, contrary to popular belief, you should play with your food. So allow your child to have that experience to explore with food, different sensations, textures, temperatures with their hands. It can be a little messy, but it is good for future development.
(07:18):
I also recommend that families model their own exploration of new types of foods, and you can do that using all of your senses. So sitting with your child and practice just touching foods, squeezing it, let’s smell it, let’s kiss it, lick it, do small baby-bites before you do big bites and build up on those skills. And more importantly, it’s important to go at your child’s pace. We want them to always be comfortable with their food exploration as to not lead to more anxiety in the future.
Anne Baum (07:51):
So I must admit, I would’ve never thought of any of those things. And when you’re trying to teach kids manners and dining skills, you’re really not touching your food, playing with it, squeezing it, smelling it, but that’s really interesting to help them find their way in it. I bet you can make it pretty fun doing that around the table.
Tyler Lawson (08:12):
Definitely. I like to sometimes build towers with food. We use trucks and kind of push pudding around. It’s a construction vehicle. So there are a lot of ways that you can incorporate a child exploring food without it needing to be a stressful experience if they’re having avoidant behaviors to eating a certain type of texture.
Anne Baum (08:33):
So Sarah, is there anything you’d like to add about feeding disorders and physical therapy?
Sarah Smith (08:39):
Yes, there actually is something that I wanted to point out that can get overlooked or certainly something that parents might not think about immediately, and that’s their positioning when their child is feeding. So something that’s really important to be able to be a successful eater is making sure that you’re in a good position and supportive for your posture. So that idea of when is a baby able to be more upright and in their highchair to start to eat solid foods. All of that comes into play and is something that we’re looking for as far as are they strong enough to maintain those upright postures that are going to promote an ideal setting for them to be an effective eater.
Anne Baum (09:26):
And that positioning helps with swallowing, digestion?
Sarah Smith (09:30):
All of those things, yes. So something that you would look for would be if your child is in their highchair, and they seem to be slouching or leaning to one side versus the other, or just seeming like they’re working a little bit too hard to maintain that seated positions. Then that’s probably not the best situation for them to be working on a higher-level feeding skill, such as starting a new food or moving from a soft food to a more solid food, because they’re not able to focus on that because they’re already working too hard to maintain their sitting position. So things as simple as giving extra support using towel rolls and propping them in their seat to help to make sure that they’re in the best upright position and alignment when they’re feeding.
Anne Baum (10:18):
Oh, that’s great. So they might not be physically ready, but they’re ready to try, and if you can give them that extra physical support, then they can have more success.
Sarah Smith (10:28):
Yes, and I would certainly say, again, if there’s any question or concern that you’re not sure your child is looking like they’re appropriately sitting on the highchair, that you can certainly ask your pediatrician first to see if they have suggestions. It might just be a matter of a different type of a chair or, again, a different way that you can be reinforcing their position to help give them more support.
Anne Baum (10:53):
That’s really interesting and great. So how do you know when it’s truly a feeding disorder versus just a tantrum? And I must admit, my mom would make liver and onions with lima beans when I was a kid, and when we would walk in from school and that was the smell, boy, I didn’t have a tantrum, but I knew I was going to go to bed hungry. So how do you know when that food avoidance is an issue versus it’s just gross?
Tyler Lawson (11:26):
Yeah, I had a similar experience with scrambled eggs, so I understand that.
Anne Baum (11:30):
OK, so you can relate.
Tyler Lawson (11:31):
Yeah. I think that the important thing that I advise to families is what’s best for your child is what’s feeding your child. Nutrition is so important for cognitive and physical development, so at times, we need to meet them where they’re at and maybe incorporate a food that might not be more preferred, but also have preferred options on their plate to kind of build up that comfort and skill.
(11:56):
It’s difficult to say where it would just be a tantrum versus a true health concern. More often than not, that behavior is stemming from a health concern or an experience that the child had that’s resulting in that behavior in the future. Some examples of that would be with younger children who had an experience with gastroesophageal reflux or acid reflux. When they’re older, they may show food aversions, but it’s related to an unpleasant experience that they had when they were younger.
Anne Baum (12:28):
Got it. And it could be an allergy and things like that too, right?
Tyler Lawson (12:31):
Yeah, anything uncomfortable.
Anne Baum (12:33):
OK. Well, very, very interesting. What are some other common speech disorders that you need to really pay attention and let your pediatrician know about? What are those flags that you should raise it to, especially with your first child?
Tyler Lawson (12:54):
Yeah, absolutely. Probably, the most common disorder that I see is expressive language delays or expressive language disorders, which is how children can communicate. So are they using gestures at expected ages, starting to babble, using single words? Some examples of milestones are you would want to see different consonant sounds around 7 months of age and starting to do some animal sounds and vocal play, like, “uh-oh,” or, “pop,” when they’re playing with bubbles around that time frame, and using single words by one year and combining words by two years.
Anne Baum (13:35):
OK, great, great. And again, lots of resources, pediatricians are helping.
Tyler Lawson (13:41):
Yes.
Anne Baum (13:41):
Lots of things that help you along the way. OK. Parents worry about all the things that can go wrong, and there are so many resources. You can be aware of every possible thing that’s going wrong, and it might not be something that’s that delay. So how do you know what that difference is in just normal motor-skill development versus something is significantly delayed in therapy, and rehab is necessary?
Sarah Smith (14:12):
I think that’s a great question. It’s very easy as a parent to see something and create a concern that might not need to be a concern. So typically, when I’m talking to parents, I’m letting them know to try to look at the overall function of their child. And if the skill that they’re seeing or that they’re worried about is really impacting that child’s ability to be successful in a play routine or in an activity that they need to do within their day, then that would be a reason for them to seek additional information about it and see if it’s something that would require therapy or more support.
Anne Baum (14:53):
That’s great. And what are some of those examples of motor skills that would be those red flags where you would say they should be doing X by this point? They’re not.
Sarah Smith (15:05):
Sure. So for gross motor skills, which are those bigger movements, using your trunk, your arms, your legs to move your body, we’re typically looking at things like rolling by 6 months of age, usually some independent sitting starting around 6 months and being a good independent sitter by 8 to 9 months of age. Another important milestone would be crawling, and that’s happening anywhere between 6 to 12 months of age. Obviously, walking is a big one. We get a lot of questions about that, as parents feel that that 12 months is sort of the marker for my child needs to be walking. But really, there’s such a wide range of typical developing children, achieving walking skills, early walkers at 9 months of age, and then those later walkers at 15 months of age that are all still completely typically developing. So keeping in mind that those normal ranges of when skills come in can be a very large range and not something to necessarily worry about right at that date that you have in mind.
(16:15):
Twelve to 18 months, they should be up on their feet, pulling up to surfaces, cruising along surfaces and starting to stand and walk. And recognizing that new walkers don’t look great, they’re wobbly, they’re not balanced, they’re not coordinated, and they sometimes need quite a few months to really explore being upright and on their feet before they’re looking more coordinated in their walking patterns.
Anne Baum (16:43):
So that parental and grandparental competition of, “Oh, well, my baby walked at 8 months, and they crawled at 3,” you need to give your kids some grace, right?
Sarah Smith (16:56):
Absolutely.
Anne Baum (16:56):
And let them develop.
Sarah Smith (16:58):
Yes. And I also encourage parents to recognize the importance that each skill plays on the next skill that they’re going to achieve. So don’t be in such a rush to get them to that next skill. A baby who just started crawling can spend two, three months crawling and getting all the benefits that that skill gives them as far as strengthening in their core and their extremities that will ultimately help them become better standers and walkers. So kind of embracing each skill and letting them get from that what that skill was meant to provide for them. We’re looking more so at the order rather than necessarily the time frame, and saying are they getting those skills in the developmental order that we would want so that it’s building them up for success in that next skill that we’re wanting to see.
Anne Baum (17:52):
That’s really great advice. I had never really thought about it that sitting builds the strength for the crawling that builds the strength for walking. So that’s really great. And maybe give yourself a break, too, as the parent, just because it takes them a little longer. It’s just they’re not ready.
Sarah Smith (18:12):
Right. And that’s part of, if you’re not sure about that, that’s something to certainly speak to your pediatrician about to get more information, whether it’s reassurance that, “No, we think your child is doing just fine, and just give them some time,” versus maybe there is an underlying reason, a muscle weakness or a balance or a coordination issue that’s making it a little harder for them to get this skill. And that would be something that getting outpatient therapy could help them with.
Anne Baum (18:43):
And so tell me a little bit more about that, the red flags, some of the treatment that they would be getting if in fact they need that extra help in that physical development.
Sarah Smith (18:53):
Sure. So when we’re seeing infants and working on gross motor skills, we’re really just incorporating play-based therapy, putting them through situations where they’re needing to learn how to use their body and move their body. So setting up their environment to encourage exploration, and then coming in and helping them with their movement patterns, sometimes showing them where we want them to move their body, how we want them to move their body, and through those repetitive experiences, seeing that they’re picking up on that and starting to understand it and being able to do that skill on their own.
Anne Baum (19:31):
Great. And they’re supposed to practice at home, not just wait for a visit.
Sarah Smith (19:36):
They are supposed to practice at home, yeah. So part of our job is not just to treat the child and then send them off, but to also be educating the parents, giving them the tools that they need so they can leave their session, go home and have a great understanding of how to play with their child and promote all of those skills to continue to progress on all the days that they don’t come to therapy.
Anne Baum (19:58):
That’s really great.
Tyler Lawson (19:59):
Yeah. Absolutely I feel like in our speech therapy sessions, oftentimes I have the family physically involved with us. So not only are they in the room, they’re watching, I’m giving them examples of strategies to do, and then having them jump in and [have] them implement it so that they can carry it over at home, because that really is the most important piece of pediatric therapy.
Anne Baum (20:19):
So you’re providing the education and the training, but it’s really the family that helps the child build the skills, grow and develop.
Sarah Smith (20:28):
Yeah, I always describe it as it’s a team approach. So we are part of that team. The parent is an integral part of that team. The pediatrician is a part of that team. And together, we’re all giving resources and providing help to that child.
Anne Baum (20:43):
I always see in our billboards that we have a number of programs through Lehigh Valley Reilly Children’s Hospital specifically focused on motor skills and evaluation. Could you tell me a little bit more about those programs and how people get involved?
Tyler Lawson (20:59):
So we have been offering monthly screening events that cover a variety of skills. They are free community-based screening events where parents can bring their child and talk with a specialist and ask any questions, discuss any concerns that they have, and the specialist themselves can say to the parent, “Oh, well, maybe you would benefit from getting a full speech-therapy evaluation or a full physical-therapy evaluation.” We’ve been doing some events with hearing screenings as well, because that is a very big part of language and communication development. That’s a good tip for parents. I often say if you have concerns about their language, make sure you go and get their hearing screened first.
Anne Baum (21:39):
Great advice.
Tyler Lawson (21:40):
Yes. We’ve done some early language screenings, gross motor development screenings, play skill screenings and sensory processing skills.
Anne Baum (21:50):
Excellent. That’s great.
Sarah Smith (21:51):
Yeah, and I think the screens are a great opportunity for parents who maybe are in that questioning period of is this something to be concerned about or not, because you’re not committing to a formal evaluation, but it can lead to that if necessary. So it’s just a quick, easy way to have someone take a peek and give you some suggestions or recommendations. And again, maybe put your mind at ease if it’s nothing to be concerned about or give some strategies to work on if there is something that they determine might need some further assistance.
Anne Baum (22:25):
That’s great. And I loved what you said earlier about the team approach, that there’s pediatric rehab, we have our pediatricians, we have our specialists, like our ear, nose and throat physicians. We’ve got that whole team that can work to support the family, support the child and really help them have the best life that they possibly can.
Tyler Lawson (22:47):
Yeah. That is a great strength of Lehigh Valley Reilly Children’s Hospital, that we, as rehab specialists, have access to a lot of pediatric specialties if we need to refer out for any other medical needs that our patients have.
Anne Baum (23:00):
All right. So we talked a lot about gross motor skills. Tell me a little bit more about fine motor skills.
Sarah Smith (23:07):
Right. So gross motor, again, is those larger muscle groups in our trunk and our arms and legs helping to move our body for things like sitting and walking and running and jumping. Fine motor, you’re thinking about more refined movements, and that’s typically the smaller muscle groups specific to our hands and fingers. So occupational therapy works a lot with fine motor skills, things like handwriting, using hands for manipulating objects, feeding, all different types of fasteners related to getting yourself dressed, buttons and zippers, those types of things.
(23:47):
And so there are certain milestones to look for in your child to make sure fine motor skills are coming in appropriately. The biggest things are, typically in a 3-month-old, you want to really start seeing that they’re beginning to use their hands to reach for objects. Even if their accuracy in reaching isn’t there yet, that they’re attempting to reach for something and attempting to maintain a grasp on an object.
(24:12):
And then typically by 6 months, that grasp is getting a little bit more refined as far as their ability to hold different sizes and shapes of toys. A purposeful release of a toy or transferring toys between hands is something that we’re really looking for to make sure they’re using both sides of their body and have that coordination between their hands. As a child gets older, more like 6 to 12 months, you’re also looking for the emergence of more of that refined pincer grasp. So a great example would be a baby starting to pick up their Cheerios or their puffs off their tray and finger-feed themselves, seeing that they can isolate their hands and not do more of that raking or grasping and getting that food stuck in their palm and not to their mouth effectively. After the age of 1, starting to see that they can do things like stacking blocks to make a tower, putting pegs in a pegboard, or a shape sorter where they can start to put those blocks in the right hole to match those shapes.
(25:20):
As far as handwriting types of skills, a toddler, so an 18-month-old should be scribbling on paper, not necessarily making specific shapes, but holding a crayon and making lines and circles, starting to use a scissor, which I know is always scary for parents ...
Anne Baum (25:42):
Very.
Sarah Smith (25:42):
... but letting them explore that grasp of holding and snipping with a scissor. You don’t think about the strength and the coordination that you need to see in a child’s hand to be able to do a skill like that, which is important for them as they might be going into a preschool setting. And then 3 years old, you should start to see more purposeful strokes as far as horizontal and vertical lines, which is all leading toward starting to write letters and being able to do those higher-level skills related to handwriting. So those are just a few examples that you can be looking for.
Anne Baum (26:18):
So things that we really take for granted as parents, playing and giving them access to tools is really how they develop those skills. And I know every parent that was listening when you said ...
Sarah Smith (26:34):
Scissor.
Anne Baum (26:34):
... scissor and what? Twelve months? That sounds scary, and yet clearly, these are skills that make a difference in the life of a child becoming a successful student in school and then ultimately a successful adult. So thank you for that awareness.
Sarah Smith (26:53):
Sure. It’s sort of similar to how Tyler talked about letting them play with their food and how that exploration is important for feeding skills. The same thing with gross motor and fine motor skills. It’s just you can’t replicate having a child explore, problem solve, try things over and over again. That’s how they’re learning. And so the best thing that you can do is give them those open-play opportunities, whether it’s indoors or outdoors, but letting them play in a variety of ways where they’re having to problem solve and learn how they’re using their body.
Anne Baum (27:30):
All right. So let’s talk a little bit more about speech. How do you know when your child is in need of speech or language support?
Tyler Lawson (27:40):
A general rule of thumb that I give to parents is that you want your child to be using as many words in a sentence as years old they are, and that’s just a very broad idea.
Anne Baum (27:53):
I love that.
Tyler Lawson (27:53):
So it’s not a hard and fast rule, but it is something good to go by. So 1 year, using single words, 2 years, putting two words together, 3 years, three words together. Some earlier milestones to look at are from birth to 3 months, they should be starting to smile or calm to your voice. They should be cooing a variety of vowel sounds. And then moving to 4 to 6 six months, children will start to enjoy music, song play, a little bit more smiling to their caregiver, and will be doing a larger variety of babbling, including some consonant sounds. The earliest sounds we see are usually the P sound, the B sound, the M sound, and you’ll hear it kind of duplicated, like the ma-ma-ma, da-da-da that you hear.
Anne Baum (28:43):
Yeah, every parent wants that one, and if they’re the mom, they want mama. If they’re the dad, they want dada.
Tyler Lawson (28:50):
I always say that you can’t take it personally because they’re going to do whatever sound is coming easiest to them at that time.
Anne Baum (28:56):
Right. And they probably don’t know which one it’s targeted to, right?
Tyler Lawson (29:00):
Yeah. At least not yet. That usually happens more around the 7-to-12-month age range. So you’ll start to see more engagement in reciprocal play routines, like peek-a-boo or patty cake, enjoying things like that, and imitating more sounds in play, like car sounds, animal sounds. I always say animal sounds are such a big part of communication development because it covers a lot of consonant sounds as well as consonant-vowel combinations. So it helps with that speech production, that sound production development as well.
Anne Baum (29:34):
Excellent. And how about the physical therapy angle on speech therapy? Are there things to consider? Like we talked about postures, are there things like that related to speech?
Sarah Smith (29:45):
There are. So again, going back to strength, looking at their core strength, their trunk control. If a child is weak in their core, it can affect their breath production. So we would certainly step in and do some strengthening if we felt like a child was having some speech delays associated with that.
Anne Baum (30:05):
Right. And as far as if a child requires speech therapy, I think I know the answer to this is going to be the team approach. But as a parent, how do you help your child with their speech development and speech therapy?
Tyler Lawson (30:20):
Yeah, definitely the team approach. We like to have a lot of collaboration with our parents, and we’re also lucky enough to have a lot of collaboration with other rehab specialists, like occupational therapists and physical therapists in our clinic as well. But some suggestions that I give to parents with children with early language delays would be parallel talk. So think of yourself as a radio commentator or sports commentator and narrating what your child is doing as they’re playing. So, “You’re making the car go up. You’re making the car go down,” and commenting on what they’re doing. You could also comment on what you’re doing throughout the day. So if your baby is sitting in a bouncer and you’re washing dishes, just commenting on what you’re doing, giving them that vocabulary exposure and pairing a lot of gestures with single, repetitive short words and phrases.
Anne Baum (31:15):
That’s great. So you’re not crazy if you’re having a conversation with your child, getting yourself through the day.
Tyler Lawson (31:22):
No. You should be.
Anne Baum (31:22):
We should be. That’s great. That’s very refreshing.
Tyler Lawson (31:24):
Yes. As much vocabulary exposure as you can give your child as possible. Another great resource for that would be book reading, so daily book reading, pointing out things. You don’t need to read the book exactly as it is. You can just comment on the pictures, point to them, make animal sounds. And I also advise a lot of families to do nature walks, so something easy to do in your neighborhood.
Anne Baum (31:49):
Great.
Tyler Lawson (31:49):
So if you’re in a stroller or a carrier, walking around and pointing out your environment, taking a minute to sit there, look at it, let them explore and describe it to them, give them a lot of different vocabulary exposure.
Sarah Smith (32:03):
Excellent. And just to sort of piggyback on what Tyler just said, we do see that children who are moving and who are more active in their play are more likely to be more vocal, so sort of thinking about those things together. If you’re wanting to stimulate language or even sound production, think about what type of activity you can do to help promote that through them getting movement.
Anne Baum (32:31):
That’s great. So I hear a lot about talking to your kids, doing things with your kids, giving them the chance to experiment, playing with your food with kids. This is really an exciting way to help them develop. And when they need that extra support, that support is available through our amazing team at Lehigh Valley Reilly Children’s Hospital.
Sarah Smith (32:54):
Exactly.
Anne Baum (32:55):
So, screening events, that’s great, but it sounds a little bit scary. So what happens in a screening event?
Tyler Lawson (33:02):
Our screening events are fairly informal. So you will have your 15-to-30-minute appointment time, and you will come in and meet the therapist. And the beginning of it is very conversational. Usually, we have some toys for your child to play with. We talk to the parent, hear from them. “OK. What concerns did you have that brought you to look into coming to the screening event today?” And we’ll give them some education on what milestones we’d be looking at. If they’re reporting anything to us that we think could use further evaluation, we’ll let them know, and we can schedule that evaluation there before they leave, so they have their plan and next steps ready for them.
Anne Baum (33:40):
Oh, that’s great. So that doesn’t sound scary at all.
Tyler Lawson (33:43):
No, no.
Anne Baum (33:44):
Now, I know one of the other things that we offer at Lehigh Valley Reilly Children’s Hospital is group therapy. What does group therapy look like?
Tyler Lawson (33:52):
Yeah. So we offer pediatric group therapy for all of our disciplines. So there are physical therapy groups that cover sports readiness skills or gross motor development skills, occupational therapy groups that work on early cooperative play skills for our toddler age ranges, as well as emotional regulation and school-age handwriting skills. And then we have speech therapy group services. The primary area with speech therapy is social communication skills. So we do see some school-age and older children who might have ADHD or autism spectrum disorder and want to improve their peer interactions. So we provide a small-group social communication opportunity to work on those skills.
Anne Baum (34:38):
Oh, that’s great. And do we do that for physical therapy too?
Sarah Smith (34:42):
We do. So physical therapy groups can be pairing children together with similar needs as far as strengthening opportunities, as Tyler mentioned, a sports readiness group. We also often would pair children together who are coming for the same impairment if we feel that maybe the group situation would be more motivating for them. Children who are dealing with chronic pain symptoms who sometimes just need extra support or that it’s just beneficial for them to see there’s someone else who’s dealing with the same thing that I am. We can pair them together in a group so that they’re doing their therapy together and supporting one another through their therapy process.
Anne Baum (35:26):
Oh, that sounds great. I love the theme of team effort on so many levels.
Tyler Lawson (35:31):
Yeah. Some of the main benefits that we see from the pediatric group therapy are that peer motivation and support. Especially with some older kids, who have been going to therapy for several years, it gives them that feeling that they’re not alone. They have somebody to work with, and they feel like they have more of a community.
Anne Baum (35:51):
And it probably helps the parents and guardians too, that they, too, are not alone and they can share that advice. So a little bit of support for the caregivers as well.
Tyler Lawson (36:00):
Yes. Our families definitely find their community as well.
Sarah Smith (36:03):
While the kids are in the group, the parents are in the waiting room, forming their own group and talking about things. So it’s a nice opportunity, again, to have that community and recognize there’s someone else in this situation and maybe what can you offer? Tell me about your experience to help from that parental approach as well.
Anne Baum (36:23):
That’s wonderful. Tyler and Sarah, thank you so much for joining us today. Are there any final thoughts you’d like to add for our audience?
Tyler Lawson (36:32):
Thank you so much for having us. It’s been wonderful. My last piece of wisdom would be to parents to remember that you’re your child’s best resource and teacher.
Anne Baum (36:41):
Great. Great advice.
Sarah Smith (36:43):
Yeah. Thank you, Anne. It was a pleasure to be here. And again, just to let parents know it’s OK to not have all of the answers and recognize that there are lots of people out there willing to support you in that scary journey of parenthood. So don’t hesitate to reach out if you have a question.
Anne Baum (37:03):
That’s really excellent advice. So thank you so much for your wisdom and your knowledge. We really appreciate it.
Sarah Smith (37:09):
Thank you.
Anne Baum (37:10):
For more kid-focused health tips, advice and must-know news about Lehigh Valley Reilly Children’s Hospital, follow us on Facebook and Instagram at LVHNChildren. To learn more information about pediatric rehab services, go to LVHN.org/pedsrehab. And remember, every parent needs a partner through parenthood, so make sure to subscribe or follow Because They’re Kids wherever you get your podcasts so you never miss an episode.
