Kids Making Strides
News From TLC's Pediatric Outpatient Services
Summer 2021
What's New
"If you can’t fly then run; if you can’t run then walk; if you can’t walk then crawl; but whatever you do - you have to keep moving forward." – Martin Luther King Jr.

This quote, a favorite of mine, may resonate with many as we enter the summer months in our new normal, post-pandemic world. At TLC, our outpatient programs have, without a doubt, kept moving forward throughout all of the challenges of 2021 and have emerged stronger. This summer looks very different from the last one and our summer programs are in full swing! Our Speech-Language and Occupational Therapy camps, and our Interaction Groups are all in-person and everyone is happy to be having fun with friends again. In-person and virtual services continue to be offered in the rest of our departments including Speech-Language Therapy, Testing, Tutoring and Counseling and Occupational Therapy.

We hope that you and your families enjoy a relaxing and safe summer. Continue reading for exciting information from our team!

Brigid Baker
Director of TLC's Clinical Programs
Occupational Therapy Department
Turning Everyday Activities Into Opportunities
Gross motor skills. Fine motor skills. Sensory regulation. Coordination and strength. Motor planning. What do these skills have in common? They are all areas of development that Occupational Therapy targets, and summertime is a great time to have fun doing it! It is easy to turn everyday activities into opportunities to develop these skills.

  • Sidewalk chalk can be used for both fine and gross motor skill development – drawing hopscotch on the pavement and jumping forward or backward to each square.
  • Blowing bubbles and popping them with hands and/or feet creates fun opportunities for eye-hand coordination and regulation.
  • Decreasing screen time and exploring outside to climb trees, ride trikes and bikes and go for a swim builds strong muscles.
  • Cooking and baking favorite recipes helps to develop coordination, sensory and fine motor skills. Below are some fun recipes to try!
Home Made Playdough Recipe:
  • 1 cup all-purpose flour 
  • 1 cup water
  • 2 teaspoons cream of tartar 
  • 1/3 cup salt 
  • 1 tablespoon vegetable oil 
  • Food coloring

INSTRUCTIONS
  1. Mix together all the ingredients in a 2-quart saucepan.
  2. Cook over low/medium heat, stirring. 
  3. Continue stirring until the mixture is thickened and begins to gather around the spoon.
  4. Remove the dough onto wax paper or a plate to cool.

NOTES
Cool completely before storing in a Ziplock bag or sealed container.
Homemade Slime Recipe:
  • Plastic tub or bin
  • Glass bowl
  • Glue
  • Warm water
  • Food coloring (optional)
  • Borax (it is a soap and is toxic; adult supervision required)

INSTRUCTIONS
Squeeze 4 ounces of glue into a glass bowl; mix in 4 ounces of warm water. Add food coloring in desired. Mix 1 teaspoon of Borax into ½ cup water and slowly add the solutions ot the glue mixture. Stir/knead the slime with your hands. At first it will be wet and gooey, then stringy and floppy, until it finally holds together.

NOTES
Cool completely before storing in a Ziplock bag or sealed container.
Speech-Language Pathology Department
The Speech-Language Pathology Department at TLC Has New Services Starting This Summer! 
Spanish Speech-Language Evaluations and Treatment is now available at TLC! We are excited to offer these services to children of all ages. They are available for articulation, feeding, augmentative alternative communication (AAC), language, and fluency evaluations and treatment.

Feeding Therapy and Evaluations for newborns through teenagers. We are expanding our feeding therapy to include newborns and infants. We are also now offering more after school hours for services. Our feeding program can address concerns with sensory and food aversions, failure to thrive, dysphagia, and oral motor difficulties. We offer a fun, play-based approach that is child-focused and we support parents by providing strategies to try at home.

Virtual Speech-Language evaluations, screenings, and therapy will continue to be offered. Look out for our free screenings coming in the fall! We offer teletherapy services to children of all ages and with a variety of different diagnoses. We strive to keep all of our services engaging and fun for our clients, and are especially mindful of screen fatigue that many children are experiencing after several months of virtual school. We keep adding to our toolbox to keep children interested and participating. Check out our new green screens!
Feeding Therapy Department
Mealtime Fun With Puppets
Every child wants to enjoy themselves at all times. Why let the fun stop after they are done playing with toys? You can make mealtimes a more fun-filled experience by introducing puppets! Children, especially the young ones, often like puppets. Think about Sesame Street and how many people enjoyed Big Bird and Elmo during their childhood.

In feeding therapy, I use a puppet in most of my sessions. You can find puppets online and in stores. I named my puppet, Fuzzy. One of my favorite things about Fuzzy is that it has a belly. Children can feed it and watch the food disappear. You may wonder how the two go together or just curious to see what else you could try at home. Check out two ways you can use a puppet at mealtimes:
Help children try new foods. Challenging mealtimes.
If you plan to introduce new food and anticipate that your child will show some resistance, try bringing a puppet to the table! Show the child that it is okay to try something new. You can pretend to make the puppet bite, chew, and swallow the food! If the puppet comes with a ball, like my Fuzzy, you can pretend that the ball is a new food and the puppet is excited to try it.

Increase engagement. 
You can use a puppet to sing songs to motivate or reward your child during mealtimes. Fuzzy and I sing with clients in all therapy sessions. We sing about actions they perform, such as chewing or biting. Be sure to personalize your song, make it repetitive, and use any tune you like. I use the tune from the “Bits of paper” song most of the time. Sometimes I pretend to be the voice of the puppet. Other times, I use my natural voice and make the puppet dance while we sing. You can also use the puppet to join in on a special clean-up song after meals.
My clients and I have so much fun with puppets. You can have fun at home too!
Here’s a picture of Fuzzy trying a slice of its favorite pizza.

For more information including Tips for Picky Eaters, visit the TLC
Testing, Tutoring, and Counseling Department
Now Offering Educational Neuropsychological Evaluations!
The Testing, Tutoring and Counseling Department now offers educational neuropsychological evaluations as part of our assessments, which can provide additional information to an evaluation! Dr. Melissa N. Smith, Director of Testing, Tutoring, and Counseling is board certified in School Neuropsychology. Dr. Smith believes that educational neuropsychological evaluations help families better understand the link between our mental processes and academic difficulties. Using a School Neuropsychology conceptual framework, these evaluations determine how foundational skills such as attention, processing, and sensorimotor functions, impact higher level cognitive processes as well as acquired knowledge skills in school. The educational neuropsychological evaluations break down each component in an easily understood way, while providing targeted intervention recommendations for the school and your child. This additional evaluation adds to the many customized psychoeducational evaluations we currently offer.
Top 5 Reasons Behavior Charts Fail
Ever started a behavior chart only to see it crash and burn at school or at home? Here are the top 5 reasons that Behavior charts fail:

1. The Reward Is Unmotivating
Getting the child involved in their own rewards will enhance their motivation. Also, for some children novelty is everything. Rotate rewards and introduce new rewards often to keep their motivation high. But remember: just because a child says they don’t care about a reward (especially when they are angry) does not mean they ACTUALLY don’t care about the reward. Listen to their actions as well as their words. Are they upset when they lose the reward? Do they change the behavior next time? Do they ask about the reward? These are all indicators that they like the reward.

2. The Expectation Is Too Hard
Rewarding at the end of the week can sometimes feel like an eternity to a child. Plan rewards that can be given daily. Another way charts can be self defeating is if the expected behavior is too difficult for the child to attain. Behavior charts work best if children can earn the reward 80% of the time. So, 4 days out of 5 a child should be able to earn the reward. That will keep their hope going when they don’t earn and are working to improve their behavior. Once they are earning the incentive all the time, you can consider increasing the expectations.

3. The Reward Is Not Given Consistently
Sometimes we promise rewards that we can’t provide when they’re due. That will eventually make a child feel they will not be rewarded at all and become unmotivated. It is better to have a simple reward that can be administered whenever it is earned, rather than a complex one that only gets delivered intermittently.

4. Behaviors Are Vague
Be kind and be safe sound like great goals, but children don’t actually know what they mean. Use kind words is more specific, but only if you are first teaching the child examples of kind words or not kind words. For example, parents may feel “use kind words” means don’t name call, or talk in a self-defeating manner, or don’t yell in anger. Those are all very different behaviors. Write behavior charts that are very specific and limit the number of behaviors expected. Even if it is not getting at all you want to accomplish, so you can use these goals as steppingstones to improve behavior over time.

5. Chart Is Not Used Regularly
Maybe you’ve tried the chart diligently for two weeks to no avail. So, you stop using it and bring it out only during holidays or other times you want increased behavior. I call this the Wile E. Coyote approach. Couldn’t he have just timed his fireworks a little better instead of throwing them in the trash? Did you know it can take 4 weeks for a behavior charts to begin to work? Don’t give up, try your chart for at least a month. If it’s not working, try some of the strategies above and tweak you chart. 

Behavior does not show up overnight, neither does it go away in a week or two. But with hard work on your part and the child, along with warmth and positive encouragement, behaviors can be improved, and children can feel happier and more successful in their environments. 
2021 TLC SUMMER CAMP
Led by an Occupational Therapist and
Speech-Language Pathologist
Camp is in session for children ages 4-10! We are offering both in-person and virtual program options. Camp targets gross motor, sensory processing, communication and social interaction skills in a fun and age-appropriate manner!
WANT TO SEE MORE OF TLC? PROGRAM UPDATES, EVENTS, AND NEW INFORMATION?