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What COVID-19 Has Done to Me

COVID-19 has shifted our equilibrium and forced us to reassess our priorities. It seemed like only yesterday that I rushed to get to the gym for my hour workout, rushed to respond to emails, rushed to drop off my son Joshua at school and rushed to make it in time to the office so I could have a little quiet moment to pray and meditate. The first few weeks of the quarantine were scary, especially being a small business owner.  I was not sure how I could survive the major changes.  What has COVID-19  not done to me? It has robbed me of interacting directly with my clients on a daily basis, robbed me of watching my first born receive her bachelor’s degree with distinguished honors. It has robbed me of my summer camp, planned trips, and much more. However, it has not robbed me of my life. I am still here strong and ready for what lies ahead.

On one hand COVID-19  has created so many disasters, but it has also forced many of us to shift our thinking of constantly running towards endless goals.  During the first week of the shelter in place, I would grab my coffee, put in a little home exercise, try to wake my son to get ready for his zoom school sessions. I was trying to make something that is abnormal appear normal. Yes, you can imagine how that worked out. I panicked, I could barely sleep from worrying. What could I control? I had to regain my footing, not sure how to control the chaos around me, I let myself cry. Gradually I began to shift my mental focus to little things I could control.

I shifted my morning routine from getting up and trying to pretend that things were still the same, to focusing my energy on staying safe and healthy. With my mental shift, I was able to create simple goals of going for walks and gradually deciding to run. I would wake up at 4 and by 4:45 am I was on the road running. The reason I choose to run that early is to avoid being with people, since I am a heart patient. I put on music that inspires and calms my spirit as I run. It has calmed my overanxious brain. During these unprecedented times, why prioritize the areas of your life that you cannot control? Make decisions based on things that are within your control.  When I attempted to hold on to what was, I was not allowing myself the mental shift needed to learn new things.

We are now forced to make decisions that may be in direct conflict with what we had originally planned. As painful as that may be, choose to accept the changes and free your mind for new opportunities. Start your day with something that focuses your energy on you, and not on the things that have to get done. Whether you do a few easy exercises to wake up or jump right into a tough workout is up to you. The important thing is to give yourself something to focus on and something you can control and look forward to.

fun 2015-01-21 022Uduak (Udie) Osom holds a Bachelor’s and a Master’s degree in Speech and Language Pathology from San Jose State University. Udie has served students of all ability levels from preschool through grade 12, for over 20 years. She is very passionate about neuro-developmental disabilities and social-cognitive disabilities. She is the owner/director of Innovative Therapy Services, a pediatric speech, language and social skills clinic in Santa Clara, CA. She can be reached at http://www.pediatricspeech.com

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Part 5: Using Daily Tasks to Build Your Child’s Language comprehension During COVID-19

Sequencing is one of many skills that helps a child learn and understand events in his or her environment. For some children, sequencing can be a hard concept to grasp, especially when they have language challenges. When a child learns to sequence basic things around them, it makes events easier to understand and accept. Sequencing is also for problem-solving, especially for children with learning differences. To build the concept of telling simple stories, you don’t need to spend money buying sequence cards.  Use your child’s personal experiences, take pictures of your child performing daily tasks and events. Print and create a photo album and use them as needed to help your child learn to tell and answer questions about personal events and daily activities. The following activities are fun to use to practice sequencing and answering questions.

  • eating breakfast,
  • putting on shoes,
  • taking a bath
  • washing hair
  • eating lunch
  • setting the table

To help the child understand that events have orders, use key words “first,” “next,” “then,” and “last.” If your child has not yet done two panel sequence, you should begin with two panels representing beginning/end or first/last, and then progress to three panels, then four, etc. For example, First, put toothpaste on the toothbrush and last brush your teeth. The more language your child understand and uses the more panels he/she should be able to arrange in correct order and then share with others. Try to teach it in a dialogue style by making it a little “mini conversation.”

Parent: Did you brush your teeth today?

Child: Yes or Yah

Parent: Tell me what you did

Child:  First get my toothbrush (Put the picture on the panel), next, I put toothpaste on my tooth brush (put picture on the panel) and last, I brush my teeth (put last picture on the panel). 

Parent: Great job!

Parent: Who helped you brush your teeth (show or point to the picture of the person)

Child: Mom or dad etc.

sequencingdailyroutinesequencing blocks

Sequeningorganizer

Five Finger sequence taken Education.com. For older children you can use the Five finger story sequencing concept to help with recalling and sharing stories and daily events in a cohesive organizer style.

fun 2015-01-21 022Uduak (Udie) Osom holds a Bachelor’s and a Master’s degree in Speech and Language Pathology from San Jose State University. Udie has served students of all ability levels from preschool through grade 12, for over 20 years. She is very passionate about neuro-developmental disabilities and social-cognitive disabilities. She is the owner/director of Innovative Therapy Services, a pediatric speech, language and social skills clinic in Santa Clara, CA. She can be reached at http://www.pediatricspeech.com

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Part 4: Use Virtual Scavenger Hunt to Expand on Your Child’s Social Skill and Language While Social Distancing

During my sessions with some of the clients this week, we played virtual scavenger hunt. It was socially entertaining and also a great way to work on language skills. When I played it with my clients, I modified the objectives depending on the child or the group. The idea is to increase the child’s language while also keeping them busy and entertained. First decide on the number of children you want to invite. My advice is to keep it simple by just inviting 2 children and their parents. You can use Google Hangout, Skype, Zoom and others. Be sure you also discuss your goals with the families you invite. I have included the prompts and suggestions I used that helped facilitate language. Write on a piece of paper what you want your child to learn from the scavenger hunt. Some of my objectives were:

  • the child will identify objects when described by functions,
  • the child will describe objects by functions or by attributes etc.

How To Virtual Scavenger Hunt-(simplified for younger players)

  1. Send invitations to your children’s friends or even encourage your child to invite the friends
  2. If you are having your child invite friends, rehearse what to say with your child
  3. Decide on the Category (birthday party, things you find in the bedroom, things in the kitchen)
  4. Take the lead and moderate as you are the host
  5. You call out and item, the children run to get it
  6. The first person to find the item and bring and shows it first, gets the point.

When I played with the clients, we took turns giving each other clues. It gave the children the opportunity to use language to describe the items by functions or by attributes. For example, “Find something that you can wear under your shoes and it has to be white,” “Find something in your bathroom that you can use to wash your hair.” Another example, “Find salt in your house and bring it to me,” “Find your mom’s shoes.” Decide on the number of items that has to be hunted and when to declare a winner.

Prompts that Can Help with Recall

  • Rehearsal to a song is a great way to help children with learning differences keep information. I had the children singing to “Old McDonald Had a Farm.” “Old McDonald had a farm E-I-E-I-O, and on that farm he saw something you wear on your eyes E-I-E-I-O.”
  • Clapping and humming also works for some children.

staff_54_2223410517Uduak (Udie) Osom holds a Bachelor’s and a Master’s degree in Speech and Language Pathology from San Jose State University. Udie has served students of all ability levels from preschool through grade 12, for over 20 years. She is very passionate about neuro-developmental disabilities and social-cognitive disabilities. She is the owner/director of Innovative Therapy Services, a pediatric speech, language and social skills clinic in Santa Clara, CA. She can be reached at ussom@pediatricspeech.com.

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Part 4: Flash and See Language Game to Keep Your Child Learning-COVID-19

This is a fun game that can be played with the entire family. Collect a bunch of your child’s toys and put them in small boxes or sandwich bags and hide them in different corners of the house. When I played the game with my clients via zoom, the bags were hidden behind furniture’s, under the bed, on top of the desk, inside drawers, in the bathroom nook and corners etc.

Define Your Goals:

  • For some clients, I worked on comprehension of concepts such as: under, behind and inside.
  • Some children, I worked on the goal of expressive language. For example, “the child will use “in, on, under and behind.”
  •  Some children, I used this game to work on speech sounds.
  • Some children, I used this game to work on asking and answering questions. For example, “Where is the bag?”

What You Need?
8 toys
1 or 2 flashlights
8 sandwich bags or boxes (grocery bags work too)
A box (to collect the toys and put them in)

When you are ready, have the child carry the flashlight and look around the house and find the bags and put them in the big box. If you are working on responding to questions, when your child finds the hidden objects, you can ask, “Where did you find the bag?” If your child does not immediately respond, give your child a little time and then repeat the question, but this time you can use a gesture, by pointing to the place your child found the bag. If your child still cannot answer, use a carrier phrase or an initial sound cue, “I found it…(pause and wait 30 seconds and then add the sound cue) unn…,” for the word “under.” If your child is unable to respond even after giving above cues, your child may not be quite ready to say it. It is okay for you to model the correct response for your child to hear.
• What is a carrier phrase? A carrier phrase is a sentence that you start and pause, and the child fills in the blank. For example, “The boy is _______.”
• What is an initial sound cue? An initial sound cue is saying the first sound or first syllable of a word to aid in recollection of the target word.
If your goal is to help your child say specific speech sounds, collect toys that have the sounds that your child is working on. For example, my client was working on the “b,” sound, so I had his mother collect the, “b” toys for this game. Be sure to mix it up, hide about 5 toys with “b” at the beginning and along with other toys, so your child does not become frustrated with the game being only about “b” sounds. It is okay if your child says only 3 correct “b,” as you model the others. Model the correct way to say the “b” sound, but do not keep correcting the child. Hearing you say it the correct way is also teaching the child how the sound is made.

staff_54_2223410517Uduak (Udie) Osom holds a Bachelor’s and a Master’s degree in Speech and Language Pathology from San Jose State University. Udie has served students of all ability levels from preschool through grade 12, for over 20 years. She is very passionate about neuro-developmental disabilities and social-cognitive disabilities. She is the owner/director of Innovative Therapy Services, a pediatric speech, language and social skills clinic in Santa Clara, CA. She can be reached at ussom@pediatricspeech.com.

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How to Schedule Playdates Via Video Chat for a Special Needs Child

In a perfect world, we want to give our children with special needs the most natural social inclusive environment as possible, but our new world is anything but natural nor normal. Most likely, we are going to be on lockdown for a few months.  Unlike their neurotypical peers, who are already hanging out with friends via gaming apps or virtual hangouts such as, Snapchat, your child may need a little support and guidance.  Video playdates will be one way to make things exciting and social for your child and it will help with practicing conversations.

First step, contact your child’s classmate’s parents to arrange video chat  “Playdate.”  Most likely other parents are also looking for fun activities to break away from the cabin fever. Contact parents that already understand your child’s challenges and children that your child had formed a relationship with. Make your plan simple and straight to the point, see example below.

“Hi….,

I hope everyone is safe and finding ways to stay active. We are finally beginning to get settled with the social distancing changes. I wanted to start a fun video chat/playdates for the kids.  We can use Zoom, Skype, FACETIME, whichever one you have. We just have to plan ahead and make sure we all have similar games and snacks at our homes.  Maybe, on the first playdate we can play BINGO, I Spy and then have snacks together just to keep it simple. I  have the following days and times as a possibility, but if none of the days or times work, we are flexible, just send 3 alternative dates and times. Thanks”

Once you have received confirmations, send your playdate details 3 days before the actual date. This allows parents to plan and be sure to prepare their child. The day before the playdate, send a polite text with simple ground rules so parents know what is expected of them. Remind parents, that the first hangout may not turn out that great , but it will get better. Be sure to mention that they have to give the children time to think and warm up to the idea and parents should not intervene unless necessary. Send a thank you note after the playdate.

Games I have played with my clients on Zoom

Bingo (not every person will have two IPADS or Printer) so get creative

  • Have each parent send you a list of items they have at home
  • When you call out the item, the child goes and brings it and shows the item to everyone
  • The first person to show it gets a point
  • The person with 3 or 6 items (collected first) is the winner

I Spy

  • Have a child walk to a busy area with the camera and another child looks and, says “I spy…,” the person holding the camera cannot turn, but will have to rely on the description from the other player
  • Next the winner also walks to a busy area in their house and the other child says, “I spy… and has to describe until the other child guesses.

Interactive Apps to use for Turn-Taking https://play.google.com/store/apps/details?id=com.budgestudios.StrawberryShortcakeBakeShare&hl=en_US,

This app is especially fun for giving directions and also having the child give you directions. The children will have opportunity to also practice sequencing with peers.

Reminders:

  • Keep it fun and entertaining
  • Some children will not want to stay on the camera too long, so make it quick until they adapt
  • Invite your children’s friend (not more than 1-2 kids total)

fun 2015-01-21 022About the Author:  Uduak (Udie) Osom,  was one of those students who entered college searching for her calling. In 1990, she discovered that her passion was in helping others. As the saying goes, “The rest is history.” In 1992, Udie graduated with her bachelor’s degree in communication disorders and science. In 1997, she received her Master’s degree in communication disorders and science from San Jose State University. She has more than 20 years of experience working with children with various disabilities. Udie is very passionate about neuro-developmental disabilities and social-cognitive disabilities. In 2000, she developed a social skills program that pairs typical developing students with students diagnosed with social cognitive disabilities (Autism, Pragmatic Language, ADD etc). She went on to develop a secondary program “All for 3’s.” Her other specialty is Pediatric Feeding Disorder, emphasis in premature babies and kids. Udie has worked as a consultant for several schools, conducted numerous workshops for schools, written and published articles.  Visit Innovative Therapy Services to Learn About Our Programs

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Using Social Media to Continue Social Skills  with Your Child  

Conversation is sharing or exchanging of ideas. Despite COVID-19, your child can still practice social skills with your support using social media. You can use FACETIME, WhatsApp or other video platforms to practice conversations with your child, family members and friends. First establish safety rules and boundaries  on when your child can be on social media. Make sure you put a time limit on how long your child can connect with friends etc.  Have your child practice with familiar people first, then classmates, and extended family members. Encourage your child to use the following conversation starters

  1. What are you doing this________?
  2. Did you do anything fun this past weekend?
  3. Did you see that viral ____ YouTube video?
  4. Hey, guess what?______________
  5. I was like wondering____________________
  6. Tell me about your weekend.

To keep the conversation going write down a list of open-ended questions that will help your child share ideas and also ask topic related questions.

What would happen if you …?

How do you think it is going to end?

Have you thought about……

Have your child play online social games that are safe so you can have time to catchup. For example, UNO, Monopoly, Don’t Starve Together

https://www.ubisoft.com/en-us/game/uno/

Don’t Starve Together on Steam

 

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Teach Children to Share their Feelings

Children respond differently to feelings than adults do. Depending maturity, some children are able to share about their feelings and what you as an adult can do to support them. Emotional maturity does not always correlate with intelligence or age. You can have a very intelligent child, but social and emotionally they are not able to share or understand their emotions. Children respond to different feelings based on their day to day experiences and also based on their emotional maturity. Their ability to cope and share these feelings is crucial to forming and sharing relationships. Emotional language development involves learning what feelings are and how these feelings impact us and others.

Create An Emotional Language Chain
When your child is upset, take simple steps to acknowledge their feelings and sequence what happened, acknowledge how they feel and talk about what to do about their feeling. An emotional language chain simply means making a list of feeling vocabulary words or using simple feeling phrases frequently. It is similar to how people use daily affirmation words and phrases. For example, “I am sad because mommy did not buy candy, I am okay because I can play with my favorite teddy, ” “I am angry because I bumped my head, I feel better because mommy put ice pack on it.” To reduce emotional breakdowns, try to follow the  simple tips:

  • Routines should be predictable and flexible
  • Balance active times with quiet times
  • Make time to deal with feelings if routine changes
  • Talk about feelings – what, where, why

It is important to have a ready to use emotional language vocabulary words or phrases during emotionally challenging situations. It helps the child calm down and reduces our tendency to negatively respond to the child’s emotions or tantrums. For example, you needed to rush out of a store and had very little time to take your child to go visit his favorite isle in the store and this caused a meltdown, instead of giving your child a long explanation , you can simple state, “I am sorry I made you sad.” “I know you are sad,” “It is okay.” “I know mommy did not take you to look at…” Encourage your child to share their feeling in a similar manner. The more you use these phrases, the more your child will become familiar with the phrases and connects the phrases and vocabulary to his or her difficult situations. Your child will eventually learn to connect those words and phrases to his/her emotions and become a better communicator.

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2019- Was A Truth Revealing Year

In 2019, I learned about survival, compassion, love, community, and most importantly, I learned that life is worth all the pain.  In 2019, I had a cancer scare, blood bacterial infection that nearly killed me, I had an open heart surgery and a lung surgery. Yes, it was a year like no other, but I cannot help but smile.  Some people see me surviving all that and not being bitter or depressed as a strength, but it is because I allowed myself to be vulnerable, I allowed others to show me compassion. This is not my first open heart surgery, nor my first brush with death. I guess am like a cat with 9 lives. The difference this time around was I had so much I wanted to live for. I had so much riding on staying alive.

In 1978, when I had my first open heart surgery, I had no idea what death meant to those I loved, I was a child. In 1992, when I had my second open heart surgery, I was a college student and I also was struggling with insecurities of life, so I was indifferent about dying, don’t get me wrong, I was scared of the unknown about death, but I was not thinking about my love ones. This time around, not only were the surgeries more complicated and the chances of dying more significant, but for the first time in my life I cared about living.

I was vulnerable to the truth of why death matters. I was vulnerable to the truth that life is not just about the person living it. It is not just about us; it is about the community that has made us who we are. It is that community, that you must fight for, it is the community that makes it worth smiling about.  It is that community, that told me, you are going to make it, we are here for you. It is that community that I wanted to live for. For the first time in my life I recognized how much I meant to so many people. Parents, my neighbors, relatives, friends, colleagues, doctors and nurses all assured me that my life was worth smiling about. Their compassion gave me the strength and took away the bitterness.

I am now able to answer the question about not being bitter, nor depressed, it is because my community has said I am worth more than Tetralogy of Fallot. I am worth more than a cancer scare. I am worth more than a blood born bacterial infection.  Life is about the lessons we learn, not the pain we have suffered. The pain allows us to be vulnerable, it allows us to cultivate our truth, it allows us to love and be loved. Thank you 2019 for giving me a lesson in vulnerability and human kindness. I am not sure what lessons awaits me in 2020, but I am taking the lesson of vulnerability, compassion, and human kindness into 2020. Happy New Year and Wishing you the Best in 2020!!

fun 2015-01-21 022About the Author:  Uduak (Udie) Osom,  was one of those students who entered college searching for her calling. In 1990, she discovered that her passion was in helping others. As the saying goes, “The rest is history.” In 1992, Udie graduated with her bachelor’s degree in communication disorders and science. In 1997, she received her Master’s degree in communication disorders and science from San Jose State University. She has more than 20 years of experience working with children with various disabilities. Udie is very passionate about neuro-developmental disabilities and social-cognitive disabilities. In 2000, she developed a social skills program that pairs typical developing students with students diagnosed with social cognitive disabilities (Autism, Pragmatic Language, ADD etc). She went on to develop a secondary program “All for 3’s.” Her other specialty is Pediatric Feeding Disorder, emphasis in premature babies and kids. Udie has worked as a consultant for several schools, conducted numerous workshops for schools, written and published articles.  Visit Innovative Therapy Services to Learn About Our Programs

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Learning Language through Play

Play helps children learn language and communication skills. Children are motivated to connect and learn when it is functional and meaningful and fun to them. The language used in play, for example encourages the development of turn-taking and conversation. When children are engaged in play, they use language to interact with others. Turn your daily routine into fun play. Your daily routine offers many opportunities for you to help your child learn to play and develop language.

  • Loading Dishes: A simple task like loading the dishes offers an opportunity for you and your child use language, take turns and play. For example, when loading the dishes or unloading the dishes talk to your child. Improve your child’s language by labeling your actions and naming the items/objects. You can say, “Papa is putting the fork in the dish washer.” When it’s your child’s turn, you can say, “Your turn. Put the fork in the dishwasher.” Be patient, if your child does not do it correctly. Do it with your, remember your child and don’t do it for them. Remember your child is watching to see what you are doing.
  • Grocery Shopping: Grocery shopping can be a fun way to build your child’s language, play and memory. Before going to the grocery store, take out your smart phone and with the help of your child, take pictures of the things you need from the store. Help your child learn the names of the items by taking turns when taking the pictures. At the store encourage your child to remember the names of the items that you took pictures off. It is also a fun way to help your child learn about categories by going isle by isle. Label the isles, fruits, vegetables, breakfast etc.
  • Waiting at the Restaurant: Encourage your child with positive language when you see your child waiting before your order is taken. Waiting can be hard, especially if they are hungry, but teach them that waiting can be fun, by playing a fun game such as, “I spy with ….” If you have never played this game before here is a link to get you started https://www.tripsavvy.com/how-to-play-i-spy-3267651.

About the author:

fun 2015-01-21 022Uduak (Udie) Osom holds a Bachelor’s and a Master’s degree in Speech and Language Pathology from San Jose State University. Udie has served students of all ability levels from preschool through grade 12, for over 20 years. She is very passionate about neuro-developmental disabilities and social-cognitive disabilities. She is the owner/director of Innovative Therapy Services, a pediatric speech, language and social skills clinic in Santa Clara, CA. She can be reached at: ussom@pediatricspeech.com.

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Three Tips to Promote Active Listening

Active listening is the key in having effective communication with anyone, especially children. Listening helps us understand what the speaker is saying, understand how the person is thinking, or feeling and helps us ask the right questions. Therefore, it is important that we teach children to use active listening as it is the key to getting along with others. When I work with my clients on the following skills: understanding directions, sharing ideas, problem solving, and conversations, I always start with three key steps of active listening.

  • Listen with an open mind: I teach my clients how to listen so that they pickup details and intent of what is being communicate. I teach my clients that they have to understand what the person said and what the person wants. I teach them that listening means you have to be present. I teach my clients that listening takes time from you, it takes caring and it takes being patient.
    • Reflective Listening: With my older clients, I teach them that they must reflect back what they have heard. My clients learn to understand that reflecting is when you understand that the statement requires that you are truly thinking about the person and what the person is saying to you. When you reflect back what the person is saying, you are inviting the person to say more, and you are willing to pay attention and you are willing to truly understand them. I teach my clients to show that you are reflecting, be sure to repeat back to the person what you heard. With my clients we practice using words or phrases such as, “Let be sure I understand…,” ” I am just making sure that I hear you, did you say…,” “I heard…, but I am not sure if you meant…,” etc. Reflecting on the intended message allows you to verify that you are hearing and accurately getting the message. You can use reflective listening to help reduce emotionally charged conversation. It also allows the speaker to calming clarify and feel validated by you.
    Ask open-ended questions: The final part of our lesson is generally learning to ask open-ended questions versus closed ended questions. Open-ended question encourages the speaker give more explanation. They are conversation encourager, inviting the speaker to share details.

fun 2015-01-21 022About the Author:  Uduak (Udie) Osom,  was one of those students who entered college searching for her calling. In 1990, she discovered that her passion was in helping others. As the saying goes, “The rest is history.” In 1992, Udie graduated with her bachelor’s degree in communication disorders and science. In 1997, she received her Master’s degree in communication disorders and science from San Jose State University. She has more than 20 years of experience working with children with various disabilities. Udie is very passionate about neuro-developmental disabilities and social-cognitive disabilities. In 2000, she developed a social skills program that pairs typical developing students with students diagnosed with social cognitive disabilities (Autism, Pragmatic Language, ADD etc). She went on to develop a secondary program “All for 3’s.” Her other specialty is Pediatric Feeding Disorder, emphasis in premature babies and kids. Udie has worked as a consultant for several schools, conducted numerous workshops for schools, written and published articlesVisit Innovative Therapy Services to Learn About Our Programs

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Dream Differently, Reduce Stress, Relax!

If you are a parent of a child with any disability, you know your child’s life has become your life. From the moment you wake up to the time you fall back asleep, you are thinking and worrying about your child. You are continually researching and attending therapy programs you have heard that can help your child. Your family time is limited to drive through, or special meals that are extremely costly! You are doing and redoing your budget because you forgot to add the new recommended therapy technique that your child’s specialist feels is a technique that will deliver results.

Here is the truth, you don’t have to do it all! You know you it might be time to start prioritizing when you walk into a building, exhausted and then find out whoops, you are at the wrong therapy clinic! Something needs to give when you are constantly changing your therapy dates and times because Johnny has to squeeze more time for another program within a 24-hour day. You know you need a break when you walk into your child’s therapy on a day that your child is not scheduled for treatment! If you cannot handle your current schedule, then your child cannot handle it either!If you feel stressed out to the point where you keep spinning your wheels, it is time to prioritize.

Your family and health are important, therefore making them a priority by making changes. Acknowledge to yourself and your family that you cannot do it all, regardless of your child’s needs. Carrying on with limited time to breathe is not healthy for you or child. Packing on more therapy with limited time to spend with your child, family, and friends is not fair to anyone. Just because your child has a special need does not mean you should carry the load all by yourself. Let go of the guilt and take charge of your life.  Take time to simplify your schedule. Create a structure,

  1. Hold a monthly discussion about schedules: Discuss your schedule with important family members and prioritize what to keep and what put off for next month.
  2. Review the recommended treatments with your family: Regardless of what therapy is recommended, it is your choice on how you schedule it and if you should schedule it.
  3. Create a maximum and a minimum therapy time table: Before starting any therapy program, discuss with your significant other (s) the maximum time and minimum time you are willing to commit to attending the programs. Be honest with the clinicians (ABA, Speech, OT, Physical, etc.) about your times.  Don’t commit out of guilt or pressure. If you can’t do it, you just can’t do it!
  4. Make a timeline plan: If you are not able to fit the recommended therapy into your current schedule, that is okay, maybe in another three months or six months you will be able to add another session or therapy.
  5. Prioritize your therapy: What is the most critical need for your child at present?
  6. Give yourself permission to cut back or take a break: Cutting back allows you time to incorporate things and streamline treatment or learn simple techniques that you can use daily with your child.
  7. Learn to Say NO! You can say no even if professionals feel your child needs more hours of treatment.  Do the best you can, given your income and time.
  8. Ask for Help! Allow others into your world, train friends to step in and support you so you can take a much-needed break.
  9. Look for respite support: Find cheap affordable respite care through your neighborhood or parent programs.

List of available affordable respite programs in Santa Clara, County
http://www.ggrc.org/
parentsplace.jfcs.org/location/peninsula/
http://www.sarc.org/

fun 2015-01-21 022About the Author:  Uduak (Udie) Osom,  was one of those students who entered college searching for her calling. In 1990, she discovered that her passion was in helping others. As the saying goes, “The rest is history.” In 1992, Udie graduated with her bachelor’s degree in communication disorders and science. In 1997, she received her Master’s degree in communication disorders and science from San Jose State University. She has more than 20 years of experience working with children with various disabilities. Udie is very passionate about neuro-developmental disabilities and social-cognitive disabilities. In 2000, she developed a social skills program that pairs typical developing students with students diagnosed with social cognitive disabilities (Autism, Pragmatic Language, ADD etc). She went on to develop a secondary program “All for 3’s.” Her other specialty is Pediatric Feeding Disorder, emphasis in premature babies and kids. Udie has worked as a consultant for several schools, conducted numerous workshops for schools, written and published articles.  Visit Innovative Therapy Services to Learn About Our Programs

 

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Your are Not Alone:Childhood Feeding Problems

 I just recently came back from a 3 day pediatric conference put on by Feeding Matters  association made up of experts Pediatricians, Nurses, Speech Pathologists Occupational Therapists and Parent. One course struck a cord with me, “What Happens After “Graduating” From Feeding Treatment? presented by: Mary Beth Feuling, MS, RD, CSP, CD; Amanda Herrmann, CCC-SLP; Chris Linn; Kay A. Toomey, PhD; Ronald Serbin MD.
Related imageDealing with feeding disorder issues at home is quite complex and can be very frustrating! 

Childhood  feeding related can go undetected by your pediatrician and others for several reasons, especially if your child appears to be growing normally and is not exhibit severe food aversion. Children with oral sensory aversion  or feeding difficulty often exhibit very difficult behaviors around meal times. Typically the behaviors may include:

  • Prefer only one type (e.g., dry, crunchy) of textured foods
  • Excessive oral habits (e.g., bite sleeves and buttons from shirt and other toys)
  • Abnormal tongue posture ( often sucking their tongue)
  • Mouth breathing
  • Teeth brushing is can be a nightmare for some children
  • Easily gags on food

Related image

Looking at the above list you can see why some children with oral sensory related issues may go unidentified, given that some of the listed behaviors can apply to any child at any given time in their life. That is very true! While some of the above behaviors can be seen during the infant years, and even at early toddler years, it is expected as the child’s motor system matures, so should the oral sensory system.

It is often thought that the child will out grow the problem.  Kids exerting their will power and also going through the “I am not hungry stage,” is completely different from a kid that has always had problems eating. It is true children have their own internal developmental time line. However, looking at a child’s oral motor developmental history can help parents address feeding issues early.  A good oral motor history must include

  1. Birth history,
  2. Breastfeeding/bottle feeding history,
  3. Motor developmental history,
  4. Rule out history of reflux,
  5. Frequent upper respiratory infections,
  6. Food  allergies,
  7. Adverse reactions to different textures to the body and face,
  8. History of choking/gagging on food ,
  9. Difficulty transitioning to different textured foods (stage 1, stage 2 etc.),
  10. Tongue thrust

Oral motor sensory issues can occur with children who have had prolonged hospitalization, Tube feeding, neuro-developmental delays and it can occur without the existence of other developmental disabilities.

https://www.feedingmatters.org/parents

fun 2015-01-21 022Uduak (Udie) Osom holds a Bachelor’s and a Master’s degree in Speech and Language Pathology from San Jose State University. Udie has served students of all ability levels from preschool through grade 12, for over 20 years. She is very passionate about neuro-developmental disabilities and social-cognitive disabilities. She is the owner/director of Innovative Therapy Services, a pediatric speech, language and social skills clinic in Santa Clara, CA. She can be reached at ussom@pediatricspeech.com

Telepractice Challenges for Children with Significant Special Needs

Recently, I have heard many clinicians complain about having to work with a child with severe disability via telepractice. I have to confess, I once thought it impossible to conduct therapy this way, but it is working out better than I expected. Parents have been so kind to allow me into their homes. The idea of telepractice is easy when you have a child that does not have severe disability and can sit through the entire session without you having to jump up and down. My hat goes off to the parents that I have been zooming with for the last 3 weeks. We have had some good days and some bad days and through it all, most of the parents have remarkably stayed calm and are willing to work with me, despite all that they have to juggle on a daily basis. I can say I am thankful I stuck with it, because we are now finding things that work.

At the initial start, keep your goals simple, keep your energy high and take every moment as it comes. Make parents your partner, encourage one another and be consistent. Tune out the doubts and the noise around you and focus on what you want to accomplish with your client. Your therapy or teaching should not be any different,  except you have a new partner, someone who loves your client  beyond measures. It is an amazing opportunity for your clients to generalize skills quickly. When planning your lesson, keep in mind that the family may need to prepare things in advance, therefore, send your activities early.

This week I had such a fun time seeing clients use their AAC to play with siblings and also make sensory toys. Here is a fun activity that I used this week. How I did it: I sent the following instructions to the family 2 days prior to my lesson.

Dear Parent,

We are going to make therapy fun by making sensory bottles that your child can play with   during his schoolwork. During this activity, we will work with your child on the followings skills:

  • Following 1-2 part directions ( In, one, more and all)
  • Taking turns
  • Using AAC to make sentences and also to request turns.

Please  kindly assist me in getting the following items ready for our lesson.

  • 3 empty plastic water bottles and peel off the label (for each family member)
  • place 4 tablespoon of oil in a cup with a lid
  • food coloring (different colors)
  • Put 4 cups of water in a cup with a lid or 2 cups
  • 1 cup of dry beans (put in the bottle)
  • I sheet of foil ( to cut and put in the bottle)

Further Directions:

  • Put all of the above items in a big baking pan and put to the side that child cannot reach.
  • Make sure that we have nothing reachable at the work area, only the child’s sensory toy.
  • Next place our other toys in a clear box so child can request as needed.
  • I will guide you step by step.
  • While working, I will remind you when to his reward on his chart.
  • When he has earned 5 stars, he gets a 3 minutes break and it will allow us to cleanup and get ready for our next activity.

fun 2015-01-21 022Uduak (Udie) Osom holds a Bachelor’s and a Master’s degree in Speech and Language Pathology from San Jose State University. Udie has served students of all ability levels from preschool through grade 12, for over 20 years. She is very passionate about neuro-developmental disabilities and social-cognitive disabilities. She is the owner/director of Innovative Therapy Services, a pediatric speech, language and social skills clinic in Santa Clara, CA. She can be reached at ussom@pediatricspeech.com

Ready to Learn Part 2: Teaching Your Child During COVID-19

COVID-19 has not only disrupted your life, but your child’s educational needs. We know definitively that your child is not returning to school in mid- April, so what now? You have to help your child maintain some semblance of normalcy. This week we will work on setting realistic goals and expectations for your child’s learning and daily needs during this lock down. The first step is to create a realistic  Weekly Event Calendar for your child. The calendar will now become your child’s daily routine.  Below you will see a replica calendar that was created for a client. For privacy reason, I changed the name to Imeh. Imeh means peace in my language (Ibibio).  We did not put a set time on Imeh’s calendar because there will be off and on days.  There may be days Imeh will not want to wakeup at 8:00am and we kept that in mind as we created the calendar. For example, on a day Imeh decides to wake up at 11:00am and not at 8:00am, Imeh still has to brush her teeth, but if Imeh sees that on her Calendar, 11:00am is schoolwork time, Imeh may insist on doing schoolwork. Your child may refuse to wake up on your set time, and because you had written time into the Calendar, it may confuse your child. Therefore, it is best to  focus on establishing consistency and not focus on time management at this time.

Imeh’s Daily

Weekly Events

Simplifying the Steps to Brushing Teeth

Prior to COVID-19,  you and your child’s ABA providers or special education teacher may have been working on independently brushing her teeth, or independently getting dressed but you are not able to maintain that goal.  It is okay to modify that goal. Below is how we modified Imeh’s goals .

  1. Imeh will follow her mom to the bathroom independently with less than 6 verbal prompts with 80% consistency.
  2. Imeh will identify her toothbrush and will allow mom to assist her in brushing her teeth with 7 verbal encouragements with 70% consistency.

How will you reward your child for completing her goals?

Reward system

  1. Plan with your child on what she wants to earn, after completing each task.
  2. Be sure the reward last long enough for you to be able to get ready for the next activity on the schedule ( give about 15 to 20 minutes break).
  3. While I am not a big fan of putting a child on the screen first thing in the morning, desperate times do require flexibility, therefore, your child should be allowed to earn her TV time for anything that is completed successfully.
  4. Put a time limit on the TV watching, she can earn time back after completing more work.
  5. Consult with your ABA or other providers, what they used as a reinforcement that worked.
  6. Use a timer on your phone or download a time timer https://www.commonsense.org/education/app/time-timer
  7. When it comes close to transitioning time, start reminding your child that the time is almost up.
  8. Remind your child that when the timer goes off, it will be time to eat breakfast.
  9. Don’t walk over and turn off the TV, as it may upset your child and cause meltdown, rather encourage your child to check the calendar.

How We Simplified Imeh’s Breakfast Expectations

  1. Imeh will transition to the breakfast table when her timer goes off with less than 6-8 reminders
  2. With encouragements, Imeh will eat 60% of her food prior to the timer going off.
  3. Imeh will finish her breakfast when the timer goes off (make sure to give your child 30 minutes, before you encourage her to cleanup).
  4. With verbal prompts and hand over hand (if needed), Imeh will assist in cleanup of breakfast utensils with 70% consistency with 6 verbal reminders.

Your child is probably doing all  of  the above skills independently and if so make your goals slightly higher. However, because we are working towards having consistency and making our lives easier to manage, starting with lowering our expectations reduces our stress.

How will you reward your child for completing her goals?

  1. Be sure to give room between each routine of about 10-20 minutes.
  2. Your child may need to go to the bathroom before schoolwork starts, that gap between activities allows for the bathroom break.
  3. During the reward break, it is also time for you to collect your activities and be ready to support your child’s educational needs.
  4. Include a mental break for yourself. Make sure the reward last long enough for you to be able to get ready for the next activity on the schedule and also have a coffee or tea break.
  5. Given that your child is about to work on cognitive tasks (learning), this maybe a great opportunity to have a calm quiet reward.
  6. Your child can listen to her favorite music and jump around etc., in a safe area until you are ready.

Setting Up your Learning Station

This will be different for each child. Some children work best at the table and others work best on the floor.  Your child’s work area should be clear of any distractions. It should only have items needed for learning. Please don’t setup work area in the room most traveled or near the area your child plays at.

childon ipadThis child learns best working on computer

This child learns best on a table with no clutter tablework

sittingbeansThis child learns best with sitting on a bean bag

 

 

Essential Tools for Any Child’s Learning Area

  • Preferred sensory toys (please consult with your OT)
  • Visual schedule of intended work
  • Break Schedule and type of breaks
  • Timer
  • Boxes for storing the tasks.

How to Work with Your Child

It is important to start from the bottom to the top. This means use this week as a setting up routine and reviewing work week. Go through the packages the teacher sent home and take out things you know your child is familiar with and has done in the past. Keep things simple

Simple Learning Goals for this Week

  1. Imeh will sit and complete 3 peg board with less than 7 reminders
  2. Imeh will complete 3 sorting trays with less than 5 reminders prior to taking a break.

This has not been an easy week, but I hope by sharing some of these ideas, I am helping in some ways. Know that we are all going through a defining moment. There are numerous online resources that has great ideas. Please click on the links below for more resources.

https://www.superduperinc.com/landing/onlinelearning.aspx

https://teach.com/online-ed/psychology-degrees/online-masters-applied-behavior-analysis/aba-digital-autism-resources/

https://www.commonsense.org/education/app/time-timer

https://www.commonsense.org/education/app/choiceworks-calendar

staff_54_2223410517
Uduak (Udie) Osom holds a Bachelor’s and a Master’s degree in Speech and Language Pathology from San Jose State University. Udie has served students of all ability levels from preschool through grade 12, for over 20 years. She is very passionate about neuro-developmental disabilities and social-cognitive disabilities. She is the owner/director of Innovative Therapy Services, a pediatric speech, language and social skills clinic in Santa Clara, CA. She can be reached at ussom@pediatricspeech.com.

How to Implement Visual Schedule for Learning At Home Due to COVID-19

I am sure most teachers have given children packages and are probably expecting you to implement them, but how do you start when you are so overwhelmed, working and also trying to calm your child down? First things first, it is okay to feel overwhelmed, COVID-19, has taken  the world by storm.  Let’s start by simply using this week to create a schedule and a routine.  I know it is not what we had all hoped for, but it has happened and so we must all work together to make this transition as smoothly as possible for our children.  Many are back on track with teachers and are working via online learning with your teachers. However, not all of our children are that fortunate, some children are going to have a rough patch for a couple of weeks, unless they have consistent schedule and routines. If we can create some normal daily routines for those kids that rely heavily on sameness or are have a tough time with transitioning it will make teaching  easier.

Let’s start with the basics of a visual schedule. A visual schedule is a set of pictures or words that shows what is happening daily. Parents with children diagnosed with Autism are familiar with visual schedules, but most of them have not had to take on the teacher roll. We are going to work first on creating visual schedule so to assist in establishing routines for school work at home.  The visual schedule will help your child  know what activities he is going to engage in daily. This will help you and your child feel less anxious and feel more in control.

How to create your schedule?

Schedule2

schedule3

Step 1: Make a list of your daily routine and also the schoolwork you plan to implement daily.  It is important to start with the schoolwork your child enjoys and is successful at and in the future you add new assignment. Start your list with familiar routines. Your routine will include common occurring tasks and instead of school put “School work.”

Math2

Math1

 

 

 

 

Soting

My advice is to cut out the pictures so you can move them around on your Calendar, because when things change, and the routine on the Calendar stays the same, you may end up with a very unhappy child.

Step 2

I am hoping you have a laminator at home to cut out the pictures and laminate, but if you don’t, just tape the pictures onto an index card or card stock or any hard surface paper. Then Velcro as shown  above and if you do not have Velcro use tape.  During work time also have a schedule for expected work and along with  the work a reward system to help the child stay on task.  There are lots of resources out there.  You can make your own reward board or order  you can buy from Amazon. More ideas to come. To find ideas and pictures for your schedule  or activities below:

https://lessonpix.com/clipart,

http://www.silverliningmm.com/

https://www.lakeshorelearning.com/resources/free-resources?ref=hpS2

staff_54_2223410517
Uduak (Udie) Osom holds a Bachelor’s and a Master’s degree in Speech and Language Pathology from San Jose State University. Udie has served students of all ability levels from preschool through grade 12, for over 20 years. She is very passionate about neuro-developmental disabilities and social-cognitive disabilities. She is the owner/director of Innovative Therapy Services, a pediatric speech, language and social skills clinic in Santa Clara, CA. She can be reached at ussom@pediatricspeech.com.

A Successful Play Date for A Child with Social Challenges

In our Lions group we have been teaching the kids how to engage in dramatic play (pretend play) related to meal planning.  We began our group using unstructured dramatic play themes and quickly realized that our clients needed more of a systematic frame work. We moved from unstructured dramatic play to a more structured dramatic play,  but the goals remained the same. With  structured dramatic play, children can be given specific guidance. This allows opportunity for them to fill in the missing steps in their play. Using the structured approach, we are able to create pre-determined scenarios and then the children are able to make choices and discover solutions. You can easily do this at home too.

First step, create visuals to front load your child on expectations and addressing conflicts. Front Loading is a strategy  that is commonly used to provide students predetermined guidance and reminders for applying necessary skills, strategies, and behaviors to be successful in the day’s learning.  Secondly, do not bring too many children into the scene, I suggest just 1-2 children (children that match your child’s personality or are patient). Different children will need different levels of facilitation during play dates.   Your child may need assistance with waiting his or her turn (i.e., recognize whose turn it is, verbalize when it is his turn, and notify his friend when it’s his or her turn), request items from a friend (i.e., ask for a card or a game piece that he needs), give his peers eye contact during play, increase pretend play, and increase sharing and showing toys to peers. Keep the play date loosely structured and be sure it is not longer than 60 minutes for the first 3 sessions. Build the play date around a theme, like making things together. Create a simple outline or objective that you are able to tract progress. See below some objectives.

  • My child will  use her/his phrases to give instructions to her/his partner or protest during the activities.
  • My child will send he/his partner to go and retrieve the needed items using the appropriate phrases, body language and proximity
  • My child and her/his friend will take turns making the sandwiches
  • My child will engage in pretend play while eating the sandwich, making comments to the animal and play partner.

Create Visual for Boundaries:

  • Set clear boundaries for all the kids.
  • Offer materials that are motivating all kids
  • Provide visual cues in the environment that support and
  • Have scripts that will help promote ways to address social conflict resolution.

Example: Make real sandwiches together and Invite Animals stuffed animals to join in the fun.

  1.  Making something together will hold both  of the children’s interest (play doh, sensory low key to regulate your child) 15 minutes (semi-structured) and use the play doh to bake or build things around a central theme.
  2.  A simple dramatic play can making sandwiches  (bring bears, dinosaurs, dolls to eat with you guys).

 

 

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