TheraTree Pediatric Therapy - TheraTree Blog #developmentTheraTree Pediatric Therapy - TheraTree Blog #developmenthttps://www.theratreepeds.com/blogs/tag/developmentWed, 12 Nov 2025 18:55:17 -0800http://zoho.com/sites/<![CDATA[Preschool Readiness: What Parents Need To Know]]>https://www.theratreepeds.com/blogs/post/preschoolPreschool Readiness: What Parents Need to Know]]>

By Jessica Hatfield, MS, OTR/L

Preschool is a big step for both parents and child! As a parent of a 3 year old you might be wondering: “Is my child ready?” “Did I do enough?” “Can we please start tomorrow?!?”. Whichever space you’re in is fine! If you learn you child is on track - great! If you learn your child might need some more help - great! Now you know and can take actions on catching them up to their peers. 


It’s important to keep in mind that preschool is more about emotional and developmental readiness than knowing and writing all their numbers and letters. Those traditional educational/cognitive skills can be further taught through preschool. Developmental milestones are critical to establishing your child’s confidence and self esteem. Children who do not perform developmentally appropriate tasks may struggle with preschool. While it doesn’t mean they can’t attend preschool, they may need extra help now to prepare and catch up to their peers from therapists who specialize in child development like at TheraTree. 


Here are the big five areas we help parents look for: Emotional, Motor, Independence, Language, and Cognitive Development  

Emotional Development

Separation: Most children who are emotionally mature are eager to go to school and make friends. They can emotional handle being away from you for short periods of time.  The unknown of how the first day will go might be the most nerve racking part for parents. While it is normal for a preschool to be a little apprehensive or upset while saying goodbye the first day or even week, when they continue to be upset throughout the day it become a problem. A child who demonstrates fear, anxiety, worry, panic, or meltdowns when separating are clear red flag they need some extra support developing their emotional maturity. How to test this: Practice separation. Start with a short period of time (30 minutes) and work up to longer (4 hours). Drop them off at a trusted neighbor while you take a walk about the neighborhood. Leave them with friends while you run to the grocery store. Leave them with close family outside the household for a sleepover. Try out daycare for a day or two.


Willingness to Try New Things: Most children are curious to learn and explore. While they may (and hopefully do) demonstrate some caution in new situations, it’s typical for them to be willing to try something new. They will attempt new tasks knowing it’s ok to make mistakes. If you child refuses new experiences or even the thought of something cause fear or anxiety, this is a red flag they may need some extra help.


Transitions: They can generally transition between tasks quickly. Most preschools have a structure schedule throughout the day. Children are expected to transition between snack time, circle time, or play centers without much notice or verbal cuing. Similarly, when they have a usual routine, they should be able to anticipate what comes next. While is normal to show some disappointment when it’s time to leave their favorite task, they should be able to move fairly smoothly to the next task. If your child stay stuck on a task or demonstrates moderate upset, they may need some additional help. 


Social Skills: Is interested in engaging with peers. Generally children want to make friends. Now, they may not always be great at it, but there should be a desire to connect with others. Look to see if your child will smile, wave, greet others, recognize other’s emotions, take turns, share, follow rules and limits, and cooperates when playing in a group.


Response to Problems: While a 3 year old is clearly not equip to solve problems like an adult, their response can tell you a lot about their emotional maturity. Do they show concern for friends. Will they attempt to use works when they're angry or frustrated or do they first act with physical aggression?  Will they attempt to use please, thank you, and excuse me to help prevent problematic situations. Do they attempt to help friends when needed. Is their behavior is easily redirected.


Need help with any of these skills? Ask for an Occupational Therapy and Behavior Therapy Evaluation to improve your child's skills in this area. 

Motor Development

Gross Motor: These are big body movements, usually move a child across space.

  • Enjoy outdoor play such as: running, jumping, climbing
  • Navigate a set of stairs with alternating pattern
  • Ride a tricycle
  • Bounce a ball
  • Kicks a ball
  • Throw and catch a ball
  • Hops 3-5x on each foot
  • Navigate around obstacles in environment 


Fine Motor Skills: These are smaller more precise movements, usually done with the hands and fingers.

  • Puts together a simple puzzle
  • Makes continuous cuts with child-safe scissors
  • Cuts a piece of paper in half with scissors
  • Draws with a crayon, marker, or pencil
    • Hold using their fingers vs their whole fist
  • Copies a vertical and horizontal lines and circle
  • Traces around the edges of basic shapes
  • Interested in writing letters and numbers (although may not be able to form the correctly)
  • Stacking and building with blocks 
  • Holds a book properly and turns pages
  • Begins to show if they prefer their right or left hand

Need help with any of these skills? Ask for an Occupational Therapy and Physical Therapy Evaluation to improve your child's skills in this area. 

Independence Development

Dressing Self: And enjoys doing this! 

  • Puts shoes on correct feet
  • Fastens large buttons
  • Attempts to smaller buttoning, zip their coat
  • Attempts to tie shoes
  • Putting on their own coat and other cold-weather gear


Brushes Own Teeth: May not be 100% accurate, but engages independently 


Potty trained: Most preschools do expect children to be potty trained. Independence with toileting is a skill that has a great impact on self esteem. Now, it’s not uncommon for children this age to still need help with washing up or even may have an accident on occasion. However, this may not be a requirement at all pre-schools or if your child has extenuating circumstances.


Self feeding: Be able to feed themself a snack or smile meal. This may be a little messy but food should not everywhere. Attempts to use a napkin to wipe their face and clean up dropped food (even if they’re not accurate) 


Independent Play Skills: 

  • Play on their own without needing interaction or constant redirection from adults. 
  • Find their way around the space/room.
  • Pick an activity from choices in a learning/play center. 
  • Clean up their toys when asked 
  • Uses realistic toys in pretend play or to imitate household routines 
  • Engages in dramatic play with others to act out simple play scripts, such as playing house

Need help with any of these skills? Ask for an Occupational Therapy Evaluation to improve your child's skills in this area. 

Language Development

    Expressive Language: 

    • Talk in complete sentences 
    • Talk about everyday experiences
    • Begins to use descriptive language such as adjectives for color and size (“That’s a big dog with brown spots”)
    • Asks for help  
    • Tells or retells a story


    Receptive Language: 

    • Responds to “wh-“ questions (who, what, where, when, why) 
    • Understand expectations 
    • Remembers short sequences of events of 2 to 3 steps
    • Follows simple 3-step related commands ( ie, get your coat off the hook, put it on and get in line)


    Speech and Sound Production:

    • Uses most speech sounds correctly
    • Likes to imitate sounds and rhythm; might have a favorite song
    • Able to express themselves in a way that an unfamiliar adult can understand

Need help with any of these skills? Ask for a Speech Therapy Evaluation to improve your child's skills in this area. 

Cognitive Development

Literacy Skills:

  • Recognizes first name when written
  • Recite the ABC’s
  • Able to name capital letters
  • Able to name lowercase letters
  • Knows letter sounds 
  • Knows the main characters in familiar stories
  • Identifies rhyming words (ie, cat / hat) 
  • Enjoys reading books with others 


Math Skills: 

  • Knows their colors
  • Identifies shapes
  • Able to count to 10
  • Identifies numbers 1-10
  • Recognizes and matches small quantities to the number words 1, 2 and 3 
  • Shows interests in patterns and sequences
  • Match / sort / group /compare items 
    • by color and shape
    • bigger, smaller, 
    • heavier, lighter
    • over, under, above, below, through, front and back
  • Understands the order of the day, and begins to use some time words such as "morning" and “night"
  • Show an understanding of the passing of time


Science Skills:  

  • Identifies all the parts of the body
  • Draw a picture of himself/herself that includes a head, body, arms and legs?
  • Identifies all 5 senses (sight, smell, taste, touch and hearing)
  • Asks many questions about how things work 
  • Shows interests in tinkering with objects by taking things apart and putting them back together 
  • Considers and offers explanations of how things might work
  • Develops object permanence and understands that objects continue to exist even when out of sight 
  • Understands and explores empty containers and full containers

Need help with any of these skills? Ask for an Occupational Therapy, Behavior Therapy, and Speech Therapy Evaluation to improve your child's skills in this area. 

Next Steps

If you've learned you child needs more help, you're in the right place. At TheraTree we believe in partnering with parents to best help your child. Sometimes parents come in with guilt that they didn't ask for help sooner or they were more persistent with getting a referral. We're committed that no parent should feel like they missed the bus on an opportunity to help their child. When parents come in for an evaluation or one of our free screenings, it's always perfecting time because you're getting the help right now in the present moment. If you have any concerns about your child's developmental don't hesitate to ask for help! 


Call or Text 270-688-8449

Email: newpatients@theratreepeds.com 

Or click the button below! 
Get help now!
]]>Fri, 20 May 2022 19:21:59 -0500<![CDATA[The 4 Functions of Behavior]]>https://www.theratreepeds.com/blogs/post/the-4-functions-of-behaviorImagine this: You are grocery shopping and, in the aisle, next to you, you hear a child arguing with their parents. They won’t stay seated, and they a ]]>

by Lauren Haire, RBT

Imagine this: You are grocery shopping and, in the aisle, next to you, you hear a child arguing with their parents. They won’t stay seated, and they are yelling. It is very common to watch a child “act out” in public with their parents. You sometimes think, “can they just tell them to stop and be quiet?” It is not always as simple as that. 

As a parent and professional that works with children, it’s important for you to understand the 4 functions that drive behaviors that you see in children. Children with Autism can often struggle to communicate and engage in problem behavior to get their point across. 

ABC's of Behavior

Behavior can be broken down into 3 parts to determine the function: 

  • The antecedent is what happened prior to the behavior of concern.
  • The behavior is the behavior of concern.
  • The consequence is what happened after the behavior was demonstrated. 
Example: Lauren saw the toy on the counter and began to cry. Her mom gives her the toy. 

The antecedent is that Lauren saw the toy, the behavior is when she began to cry, and the consequence was her mom giving her the toy. The function here is that Lauren was looking for access to a tangible (to get something.) Her mom gave her the toy which extinguished her crying behavior. 

4 Functions: SEAT

A child's behavior is always functional - they're behaving a certain way for a reason. There are four main functions/reasons for a child's behavior. The easiest way to remember the functions of behavior is with this simple acronym. SEAT. Sensory, Escape, Attention, and Tangibles. 

Sensory

The sensory function provides stimulation from the world to the brain. Sensory information can be in the form of touch, sound, visual, smell, taste, movement, or pressure. 

When does it happen? Children seek out this sensory information because their body can’t get enough of it to use functionally OR they’re overriding a different sensation. In many children with Autism, this shows up as stimming. It can occur at any time, especially when anxious or excited. 

How can I help? Redirect to more appropriate behavior that offers similar sensation. If you notice any behaviors that indicate a sensory deficit, you may benefit from receiving a free screening from one of our occupational therapists to address sensory needs. Occupational Therapy can address deficits related to sensory modulation (I.e. sensory over responsiveness or under responsiveness), sensory discrimination(i.e. attention), and sensory based motor(i.e. motor planning, balance, and postural adjustments.)

Example, a child may exhibit signs of overexcitement. You can relieve that need to release energy by allowing the child to go for a walk or riding a bike. 

Escape

The function of escape removes undesired activities, interactions, or situations. The child is getting out or away from the situation, environment, or task. 

When does it happen? It can occur when the tasks are understimulating, too easy, too hard, boring, or just completely undesired. 

How can I help? Provide a “first, then” prompt, offer choices, or alter the length of task. 

Example: “First clean up, then you may go watch tv.”

Attention

The function of attention provides access or awareness to/from people or interactions. It’s important to consider what kinds of attention the child likes and how much and when they’re currently getting attention.

When does it happen? It occurs when social attention is desired. 

How can I help? You can provide positive reinforcement or attention before the behavior occurs, so they don’t “need” to do the problematic behavior. 

Example: “Great job picking up. I like that you are following my directions.” 

This statement gives positive reinforcement for picking up and following directions while feeding the potential attention seeking behavior. If we reinforce the negative attention seeking behavior, we could risk making the behavior worse. So, it’s important to reinforce only the positive things your child is doing during a difficult situation. 

Tangibles

The function of access to tangibles provides preferred activities/items. This is what we usually think of as a “reward”. Although rewards don’t always need to be tangible to be considered reinforcing. We can use tangible rewards to help each then fade them. 

When does it happen? It occurs when there is a preferred activity or item desired. 

How can I help? There are several different ways you can approach this.


- You may teach the child to verbalize their wants and needs.

- If your child is nonverbal, teach sign language, use pictures to communicate (ABA uses Picture Exchange Communication), or assistive device like an iPad. 

- Contrive teaching situations at home and this goes along with teaching the child to verbalize wants and needs. 

For instance, let’s say your child loves to listen to songs on their iPad/tablet. As you listen to the song, try to pause and play the song. When the song is paused, verbally prompt the child to say ‘Play it.’ Praise the child heavily: ‘Great saying play it.’ And then immediately play the song. Again, this is just an example of how to use a highly preferred item as a teaching moment. 

You can prompt your child to request based on their needs and level of language skills, then gradually fade the prompt. Remember, reinforcement increases the occurrence of behavior whether it is positive or negative. 


We're Here to Help!

Don’t forget that “SEAT” is your go-to acronym when deciphering your child’s function of behavior. By contriving teaching situations in the natural environment, you can help your child practice communication skills, social skills, and give them the ability to communicate their sensory needs. Take ABC Data to keep track of behavior and present data to your pediatrician and/or your Board Certified Behavior Analyst (BCBA.) Your child may benefit from ABA Therapy or Occupational Therapy to assist in these behaviors!

Behavior can be complex! That’s why professionals have specialized in this science and are devoted to educate and help. If your child engages in challenging behaviors, you don’t have to figure it all out on your own!

We want to help. Call or text us at 270-688-8449 or email newpatients@theratreepeds.com to schedule a free screening or comprehensive evaluation. Let’s decrease your overwhelm and increase your relationship with your child together!

Get Started Now
]]>Thu, 13 Jan 2022 11:34:00 -0600<![CDATA[5 Signs Your Child May Benefit from ABA Therapy]]>https://www.theratreepeds.com/blogs/post/5-Signs-Your-Child-May-Benefit-from-ABA-TherapyApplied Behavioral Analysis (ABA) is a therapy based on the science of understanding and improving learning and behavior. It helps us to understand how behavior works, how behavior is affected by the environment, and how learning takes place.]]>

5 Signs Your Child May Benefit from ABA Therapy

By Lauren Haire, RBT

Applied Behavioral Analysis (ABA) is a therapy based on the science of understanding and improving learning and behavior. It helps us to understand how behavior works, how behavior is affected by the environment, and how learning takes place. 


Below are some of the signs that your child may benefit from ABA Therapy: 

  1. Autism Spectrum Disorder 

If your child has been diagnosed with Autism, we are here to help your child acquire skills or decrease those behaviors of concern. ABA Therapy can break down skills to smaller, discrete tasks to help a child learn. 

  1. Delay of Social Skills

Through ABA Therapy, your child will be able to increase their social skills and build meaningful relationships. If your child has difficulties making eye contact, taking turns with peers, or identifying their coping strategies, it could be a sign they could benefit from receiving ABA services to help increase those skills. 

  1. Delay of Receptive/Expressive Language

If your child has difficulties with “out of the box” thinking, ABA Therapy can be used to spark creativity. It can help a child to follow those simple to multi step instructions, comprehend who/what/where/why questions based on stories or pictures, or even increase imitation skills. 

  1. Delay of Communication/Speech

You may have noticed that your child is delayed in their communication skills. ABA can help increase their ability to express their wants and needs. While using motivating operations and positive reinforcement, ABA will teach the child to mand, or request, as well as engage in conversation. 

  1. Problem Behavior 

The four functions of behavior include sensory, escape, attention, and tangibles. These functions help Behavior Analysts to create a proper treatment plan based on the behavior function presented. While there are many examples of problem behavior, if your child exhibits tantrums, self-injury, non-compliance, or eating nonedible items, ABA may be able to decrease these behaviors by using replacement behavior that can serve as the same function. 

Difficulties and Diagnoses ABA Therapy Can Help With Include:

  • Aggression
  • Self Injury
  • Noncompliance
  • Tantrums and Outbursts
  • Decreased attention
  • Poor social skills
  • Poor Memory
  • Challenges with academics
  • Depression
  • Autism Spectrum Disorder (ASD)
  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Obsessive-compulsive disorder (OCD)
  • Fears and phobias
  • Anxiety
  • Traumatic brain injury 

Techniques Used in ABA Therapy:

  • Positive Reinforcement
  • Prompts
  • Task Analysis
  • Generalization
  • Picture Exchange Communication
  • Errorless Teaching
  • Social Skills Training
  • Discrete Trial Training (DTT)
  • Natural Environment Training (NET)

If you have any questions or concerns about your child, please reach out to us at TheraTree. We provide free screenings! You can reach us by phone/text at 270-688-8449 or email at newpatients@theratreepeds.com.

Together we grow minds, bodies, and spirits! 


Get Started Now
]]>Tue, 09 Nov 2021 17:41:52 -0600<![CDATA[Children's Mental Health: Experiencing a Life They Love]]>https://www.theratreepeds.com/blogs/post/children-s-mental-health-experiencing-a-life-they-love

Mental Health Therapy is not the easiest for parents to discuss. Mental health continues to be an area most are hesitant to ask for help with. Nobody wants their child to “need therapy”. Whether a child has a history of trauma or is simply struggling with being human, we can help.


It makes sense that parents and guardians need and benefit from professional insight. This is especially true for sensitive subjects or developmentally appropriate issues of growing up. Growing up is hard work! Many assume therapy is only reserved for big problems like abuse, neglect, and trauma. However, therapy can be focused on positive growth, strengths, and experiencing a life they love without one specific life event causing the interruption.

Almost 4 million children and youth experience mental health challenges. Mental, emotional, and behavioral disorders in childhood can cause long-term problems affecting  development, health, education and well-being. If left untreated, these delays may persist and greatly effect adulthood.  A 2009 study found only half of children and youth with anxiety, disordered eating, depression, and ADHD received care. That's why we've added this way to help.

When to Get Help

Many times these “glitches” in a child's  life may not be glaringly obvious to the people closest to the child. The good news is you can play an important part in your child’s mental health by being observant and seeking a professional evaluation to determine if help is needed. Children and youth need mental health therapy when they have mental, emotional, or behavioral challenges that they are not effectively cope with alone. This means their challenges are affecting how well they do, feel, or act. 

We get that as a parent, you want nothing but health and happiness for your child. When your child is distressed, that can be hard to cope with as a parent. Particularly when you feel like nothing is working or there’s nothing you can do to “fix” it. Sometimes you simply can’t “fix” it on your own – especially when you are emotionally invested in the situation yourself. That’s when it’s best to ask for professional help.

Red Flags

It is important to understand that children who are experiencing distress, may not directly share it with their parents. That doesn’t mean your child doesn’t love or trust you.  The truth is many children are unable to fully process and explain the complexities that accompany the emotional and/or psychological challenges they are experiencing. Sometimes children even withhold communication in fear of disappointing their loved ones. Therefore, caregiver observation is key to getting help.


Treating mental health challenges as soon as possible can help children reduce problems at home, school, and healthy development into adulthood. It truly sets them up to experience a life they love. 

Behavioral Signs

  • Unprovoked aggression
  • Unusual, unexpected, or sudden changes in behavior
  • Distressed easily and quickly over little things
  • Low grades or a sudden academic decline
  • Refusal/strong resistance to attend school
  • Repetitively performing rituals and routines like hand-washing
  • Your child responds to voices he/she hears in his/her head
  • Alcohol / drug use, abuse, or addiction
  • Excessive neglect of personal appearance or hygiene
  • Dangerous or illegal thrill-seeking behavior
  • Paranoia and excessive secrecy
  • Excessive perfectionism 
  • Excessive avoidance to protect self


Emotional Signs 

  • Worry, anxiety, or fear
  • Anticipating worries well in advance
  • Feeling down, or sad more often than not
  • Suicidal ideations (thoughts) or attempts
  • Not feeling worthy, or “good enough”
  • Having “rollercoaster” moods
  • Feelings of hopelessness 


Cognitive Signs 

  • Difficulty concentrating on important tasks
  • Problems with memory 
  • Intrusive, obsessive, or racing thoughts
  • Unable to communicate feelings; shutting down
  • Delusions or hallucinations

Social Signs

  • Difficulty adjusting to social situations and/or new situations
  • Social withdraw from activities your child once liked or loved to do
  • Marked decrease in enjoyment and time spent with friends and family
  • Spending most of his/her time alone or engaging in voluntary social isolation
  • Trouble starting and maintaining relationships 
  • Overly suspicious of others
  • Constant Need for Reassurance


Physiological Signs

  • Too much/little sleep, nightmares, bed wetting
  • Changes in eating patterns, too much/little, weight loss/gain
  • Changes in their energy levels, energetic vs fatigued
  • Stomach aches, nausea, headaches, backaches without a medical explanation (constantly going to the nurse - but a legitimate need for medical care is ruled out)

Environmental Factors 

  • Grief and the death of a loved one, pet, home, etc.
  • Bullying
  • Sexual, emotional, and/or physical abuse
  • Witnessed abuse and/or intimidation
  • Relocation issues (i.e. changing schools, homes, families, and/or cities/states)
  • Family substance abuse or addiction

Keep in mind that children of all ages and abilities, from toddlers to teens and verbal to non-verbal, can benefit from mental health therapy.

Who Can Help?

Mental health Therapists include: Licensed Professional Counselors, Licensed Clinical Social Workers, and Licensed Marriage and Family Therapists. These professionals offer invaluable insight into your child’s social and emotional development and mental health. Mental health specialists have the knowledge and expertise to recognize, identify root cause, assess, diagnose, and treat a wide range of mental health conditions, adjustment issues (divorce, new school, bullying, grief, etc.), and psychological distress.

Their purpose is to help children better interpret what they are dealing with and/or the trauma that occurred – in a way they can process and understand. This helps children work through their emotions and experiences so that they can live life without the lasting effects of fear, confusion, anxiety, or trauma. Ultimately, Mental Health Therapists help your child to resolve his/her challenges and resume a healthy and productive life.

How Therapy Works

Children learn by doing and therapy is no different. While therapy greatly differs based on the age of the child, most therapy sessions work through problem-solving skills and talking about feelings. With younger children, this looks like working with the whole family, drawing, playing, and talking. For older youth, they work through sharing and directly learning to develop the skills needed to work through problems. Therapy looks different for each patient; there is no one-size-fits-all treatment. Therapy is designed to identify the root cause of the child’s challenge. Then, the therapist can work with the child/family to develop skills to cope, problem-solve, and create healthy thinking patterns. 

Therapy will usually be future-oriented. Meaning there will be little looking back or digging up the past. Instead, they will be working towards an optimistic future, developing positive coping methods, as well as boosting self-esteem, self-confidence, and other positive states and traits. Therapists give praise and support as children learn. They help children and youth believe in themselves and find their strengths. Therapy builds helpful thinking patterns and healthy behavioral habits. Therapy can provide them with opportunities to not just survive after trauma but thrive in life.


A therapist might meet with the child and parent together or meet with the child alone. It depends on the child's age and their specific situation.  When children are young, it is common for therapy to include the parent. Parent-focused approaches typically mean that parents talk with the therapist about the child’s behavior and feelings then the parent implements with their child at home. Regardless of the age or structure established, therapists do want to meet with the parent/caregiver within the appointment to give tips and ideas for how to help their child at home.  Therapists may also observe parents and children together and then make suggestions for finding different ways to react. Sometimes, entire families need support while trying to communicate, learn, and create boundaries. Sometimes  other important adults in the child’s life (for example, a teacher) are included as well.


Parents are usually concerned with how long treatment will take and how soon they will see progress. How quickly your child makes progress will depend on the complexity of his challenges, how long the problem has had to take root, and the established goals of therapy. Being aware of the factors that affect results can help you form realistic expectations and avoid frustration. For example, a child who is severely anxious may have difficulty participating in therapy. A teenager with depression may resist treatment, and need help to see how they might benefit from it. Missed appointments and conflicts between parents over the need for therapy can also undermine and limit progress. One overwhelmingly positive influence is having a supportive and involved family and regularly kept appointments.

What's Next...

If you have any questions or concerns about your child please reach out to us at TheraTree. We provide free screenings and full mental health evaluations. You can reach us by phone/text at 270-688-8449 or email at newpatients@theratreepeds.com.

Get Started Now
]]>Tue, 19 Oct 2021 23:09:17 -0500<![CDATA[Anxiety in Children ]]>https://www.theratreepeds.com/blogs/post/anxiety However, some children consistently demonstrate difficulty adapting because of a perception of danger surrounding a task. Particularly if there is un ]]>

By Jessica Hatfield, Ms, OTR/L

Children are constantly learning, growing, and adapting to their environment. Even when we give the most stable and routine environment, things still always and inevitably change. Change is normal and children seek to feel safe and secure.


It is important to note that some worry and stress is normal and even needed for survival. The primary purpose of our ‘fight or flight’ response is to keep us safe. Stress and worry are also useful to our growth because we are challenged to try different things. We want our children to grow and adapt for the ever changing pace of life.

However, some children consistently demonstrate difficulty adapting because of a perception of danger surrounding a task. Particularly if there is uncertainty or there has been a previously negative association. At time several less intense events can build up to cause an overwhelm. Both of these negatively affect their daily living. Pediatric anxiety has grown to be one of the major mental health issues facing children. Anxiety is experienced in the pediatric population at increasing rates. 7.1% of children aged 3-17 years (approximately 4.4 million) have diagnosed anxiety. (Ghandour 2018) 

What is Anxiety?

Anxiety is apprehension about the future. Behaviors will also begin to affect thinking processes. For example an expectation is unrealistic and in turn leads to ruminating or negative thoughts. Anxiety can cause negative mood and physical tension. There are many different types of anxiety including separation anxiety, OCD, perfectionism, social phobias, or generalized anxiety etc. Anxiety is different than fear and panic, although a person can experience these as well. Fear is an immediate alarm to current danger, physical arousal, and avoidance. Panic is fear at an inappropriate time. It’s abrupt, intense, and physically arousing.

What Causes Anxiety?

A variety factors can contribute to anxiety in children. Children may observe and replicate anxious behaviors of others. Life experiences may also trigger anxious feelings and behaviors. For example loss, serious illness, bullying, or other types of abuse. Genetic factors that effect brain chemistry can cause a child to be more predisposed to developing anxiety. 

What Causes Anxiety?

  • Agitation, jittery, or restlessness
  • Sleep Deprivation or nightmares
  • Easily upset or crying on a regular basis
  • Panic Attacks, heart pounding, palms sweaty, trouble breathing
  • Somatic symptoms of physical pains, e.g. headaches, tummy aches, nausea
  • Repeated behaviors or phrases that are familiar
  • Tantrums, including meltdowns before school about inconsequential issues like socks
  • Clingy to the point it is disruptive
  • Constantly seeking the reassurance from others
  • Tries to get others, particularly adults, to do things for them
  • Asks for assistance for tasks they can complete independently

Children  may say phrases like: 

  • Something terrible will happen. 
  • I don’t have any control over it. 
  • It will be my fault if it happens. 
  • I don’t know what to do!
  • I have to get out of here!
  • I need to know for sure that it’s okay
  • I can’t make any mistakes
  • Always on the lookout for danger and checking to make sure things are safe.
  • Dislike or avoidance of new or difficult tasks
  • Avoidance behaviors or trying to stay home from school
  • High expectations of self
  • Low self-esteem and confidence 
  • Delayed social skill development and difficulty maintaining relationships
  • Decreased motivation for certain tasks

Child might demonstrate a few of these behaviors occasionally and some of these signs may be cause by other factors not related to anxiety. However when negative, anxious behaviors become more common or intense, your child may qualify for an anxiety diagnosis. When experiences these frequently or at extremes, the natural protective responses triggered no longer serve as protective and become debilitating. High levels of anxiety can make it difficult for a child to participate everyday activities including school, play and friendships. When anxiety interferes with your child’s ability to play and learn, it’s time to talk to a professional.

What Causes Anxiety?

For children experiencing anxiety, it is a natural response for parents to want to step in and solve the problem. However this is not the best long term strategy to actually help your child with their anxiety. By removing or allowing your child to avoid, you are unintentionally reinforcing their anxieties and removing opportunities to develop coping skills and resilience. Therefore it is important to give your child the opportunity to work through their fears in order to develop these highly important skills. This is best done by working with professionals. There are several profession who help with anxiety: 

  • Occupational Therapists to apply concrete strategies. 
  • Psychiatrists and nurse practitioners to prescribe medication. 
  • Psychologists, social workers, and counselors to provide emotional support.

How Occupational Therapy Helps

Occupational Therapy (OT) can be thought of as the therapy of taking action! There are many ways we can talk to our children about their worries and fears, but by teaching them concrete strategies we empower children to become independent in their own lives! Occupational therapy providers step in to bridge the gap so children can learn to function and feel how powerful they really are when it comes to their thoughts and abilities. Occupational Therapy intervention addresses anxiety through the followings ways:


Proactive strategies

The purpose of proactive strategies is to prevent the anxiety from occurring. This provides a short term benefit but is not helpful long term as our environment is always changing and adaptability is a survival skill. Some proactive strategies include establishing routines, visual schedules, and adapting the environment (ex sensory-friendly environments, fidget toys, quiet corners etc). 


Teaching, Thinking, and Applying Strategies 

The purpose of these strategies are to increase both interoception and communication strategies so children can manage themselves to identify and prevent anxiety. These provide the most long term benefits in their life. These strategies include interoception, effective education, cognitive restructuring, and communication to adults about what they are experiencing and their wants/needs. 


Reactive Strategies

The purpose of reactive strategies is to help in the moment while a child is experiencing anxiety. This has both short and long term benefits. However the difficulty with teaching reactive strategies is bridging the concept of “what to do” with actually being able to recall and apply them in the moment. Generally these skills take longer to develop because of this. These strategies include Guided Imagery, deep breathing, distraction, quiet time, calm/comfort techniques


Parenting Strategies

As with all Occupational Therapy intervention, parent education is important. Parents have a big influence on how their child with learn and respond by the tone they set. Occupational Therapy Providers teach parents how to be both proactive and reactive with their child. They teach what not to do. Often parents need to utilize calming strategies of their own when interacting with their child who is in a heightened state of arousal. When children are in a heightened state, they may have difficulty understanding complex language. So simplifying the words spoken to them can have a big impact on their reaction. Occupational Therapy Providers also teach parents by example and self reliance. 


What's Next?

If you have any questions or concerns about your child please reach out to an occupational therapist at TheraTree. You can reach us by phone at 270-688-8449 or email at newpatients@theratreepeds.com.

Get Started Now

References:


Ghandour RM, Sherman LJ, Vladutiu CJ, Ali MM, Lynch SE, Bitsko RH, Blumberg SJ. Prevalence and treatment of depression, anxiety, and conduct problems in U.S. children. The Journal of Pediatrics, 2018. Published online before print  October 12, 2018 


Gobrial, E., & Raghavan, R. (2017). Calm child programme: Parental programme for anxiety in children and young people with autism spectrum disorder and intellectual disabilities. Journal of Intellectual Disabilities, 1744629517704536.

]]>Wed, 21 Jul 2021 17:32:20 -0500<![CDATA[Successful Developmental Milestones, Occupational Therapy Can Help! ]]>https://www.theratreepeds.com/blogs/post/developmentalOTChildren develop many important life skills during their first 5 years. If your child is not meeting the milestones expected for his or her age - Don’t wait! The earlier that a child’s developmental delay is identified and supports are put into place, the better the outcome will be for the child.]]>

By: Kaitlin Kralj, MS, OTR/L, ACSM-EP

Children develop many important life skills during the first 5 years of life. These skills are commonly referred to as “developmental milestones.”

   

Skills such as rolling over, smiling for the first time, babbling, waving goodbye, pointing, and taking first steps are examples of just a few of these developmental milestones. 

   

Even though children will develop at their own pace, most kids will reach these developmental milestones at around the same age. When a child is consistently reaching the developmental milestones at the normative age, it can be a good indicator that the child is developing as expected.

Performance Areas: 

Developmental milestones include several performance areas, such as:


Fine Motor Skills

- Small movements that are made with the fingers, wrist, toes, lips, and tongue

- Needed for eating, drawing, dressing self, writing, playing, etc.


Gross Motor Skills

- Moving, controlling, and coordinating our arms and legs with large muscle groups
- Important for sitting, standing, walking, running, balance, etc.


Cognition

- Thinking, learning, reasoning, remembering and problem solving


Social and Emotional Skills

- The ability to relate to others and express emotions
- Important for developing relationships, cooperating with others, and responding to the feelings of others.


Daily Living Activities

- Personal hygiene, eating, dressing, toileting


Communication

- Using body language, gestures, and speech


Common Developmental Milestones: 

3 Months 

  • Raise their head and chest while laying on their stomach
  • Turn their head towards a sound
  • Bring hands to mouth
  • Swipe at dangling objects with hands
  • Begin to imitate sounds or babble

6 Months

  • Roll both ways
  • Use their voice to express pleasure and displeasure
  • Sit with support
  • Respond to others’ emotions and enjoy social games (such as peek-a-boo)

1 Year

  • Pull up to stand on furniture

  • Use simple gestures (shaking head no, waving bye)
  • Poke with index fingeroke with index finger

2 Years

  • Use simple phrases
  • Walk without assistance
  • Point at objects
  • Follow simple instructions
  • Pull toys behind him or her while walking

3 Years

  • Begin sorting by shapes and colors
  • Play make-believe
  • Uses simple phrases
  • Walk up and down stairs
  • Run  
  • Pedal a tricycle

4 Years

  • Follow 3 step commands
  • Draw circles and squares
  • Name some colors
  • Understand counting
  • Share and take turns with others
  • Dress and undress themselves
  • Know opposites (big and small; hot and cold)

The cause of developmental delay is not always known. Some common factors include heredity, pregnancy complications, and premature birth.

 

Signs and symptoms of developmental delay will often vary. While signs can sometimes be recognized in infancy, there are also instances where the delay is not noticeable until the child is in school.


Reaching milestones earlier than expected means that a child may be advanced in comparison to peers of the same age. When a child is not reaching milestones during the expected time frame, or if they are reaching milestones later than their peers, their development may be termed as ‘“delayed.”  A developmental delay is more than being “a little behind” their peers. Children that are facing challenges with reaching developmental milestones may require extra support to help them reach their full potential.

Occupational Therapy Can Help

Occupational therapy practitioners work with children of all ages throughout the rehabilitative process. After collaborating with caregivers to identify the child’s needs and any potential barriers that may be impacting functional performance, the intervention process begins. Occupational therapy practitioners possess the skill and knowledge required to provide skilled intervention, parent education, and make equipment recommendations as needed to help your child’s development. Occupational therapists have skilled training in helping your child develop motor skills, self-help skills, problem solving skills, social interactions skills, and play skills.  


An occupational therapy practitioner will teach skills and/or strategies to help children and their families in all aspects of their daily lives. This process may include adaptations of activities, materials, and even environmental conditions so that children are able to participate in a variety of settings (including schools, homes, sporting events, community programs, etc).

Get Started Now

Fine Motor Skills

  • Manipulating toys and puzzles
  • Grasping a pencil
  • Coloring, drawing, tracing, prewriting strokes
  • Handwriting, letter/number formation
  • Cutting with scissors
  • Using silverware at an age-appropriate time
  • Using zippers, buttons, and shoelaces

Gross Motor Skills

  • Coordinating both sides of the body
  • Understanding the concept of right and left
  • Navigating up and down stairs
  • Upper extremity strength
  • Balance
  • Milestones such as rolling, sitting unsupported, crawling, pulling to stand, etc.
  • Using appropriate force
  • Throwing/Catching
  • Core strength
  • Crossing midline play activities and school related taskss

Visual Processing 

  • Recognizing letters, numbers, or shapes
  • Copying shapes or letters
  • Visual tracking
  • Stacking blocks
  • Copying from the board or another paper
  • Completing puzzles
  • Concept of right and left
  • Putting things in appropriate sized containers

Sensory Processing

  • Designing and implementing a sensory diet to decrease things such as toe walking, constantly jumping or crashing,
  • Responsiveness to certain sensations
  • Responsiveness to touch, sound, and movement
  • Calming self when upset
  • Therapeutic listening
  • Copying with change
  • Gravitational insecurities
  • Body awareness

Social Interaction

  • Interacting and engaging with family members and peers
  • Adapting to new environments
  • Coping skills
  • Following instructions
  • Social appropriateness
  • Conversation skills
  • Recognizing emotions
  • Impulse control

Executive Functioning

  • Organization
  • Attention
  • Flexible thinking
  • Problem solving
  • Time management

Play Skills

  • Sharing and turn taking
  • Imaginative play
  • Sustained attention
  • Exploring toys appropriately

Self Care Skills

  • Toileting
  • Bathing
  • Self-Feeding
  • Dressing
  • Tying shoes
  • Brushing teeth
  • Brushing hair

Early identification of developmental delay is key! 


It is important to remember that all children are different, and each child will develop these skill sets at their own pace. However, as a parent, you know your child best! If your child is not meeting the milestones expected for his or her age - Don’t wait! The earlier that a child’s developmental delay is identified and supports are put into place, the better the outcome will be for the child.

 

 If you are concerned about your child’s development, speak with your physician and check out our developmental screening tool here: 

Click Here: Developmental Screening Tool
]]>Tue, 09 Feb 2021 15:59:10 -0600<![CDATA[Tips for Supporting Children and Teens during this Holiday Season]]>https://www.theratreepeds.com/blogs/post/Holiday-2020Links from article:  Check out CDC guidance to make holiday gather ings safer. Understanding & Coping with Reactions in a Pandemic ]]>

Links from article: 

]]>Thu, 10 Dec 2020 12:56:22 -0600<![CDATA[What You Need to Know About Speech & Language]]>https://www.theratreepeds.com/blogs/post/What-You-Need-to-Know-About-Speech-Languageby Taylor Wathen M.S. CF-SLP Could my child benefit from speech therapy? On the surface level, the process of speaking seems very simple. However, it is ]]>

by Taylor Wathen M.S. CF-SLP

Could my child benefit from speech therapy?

On the surface level, the process of speaking seems very simple. However, it is actually a very complex process. Breakdowns in speaking can happen at many levels. When breakdowns happen, a child may have difficulty developing age appropriate speech or language skills. Often this causes children frustration and even sadness when they are not understood. Speech therapy can help children meet their age appropriate goals in what we call the “Big 9 Areas”.

1. Speech Sound Production - This is the area most individuals think about when they think about speech. Speech sound production is how we use the motor movements needed to make a sound. For example, to make the “f” sound you must touch your top teeth on your bottom lip. If these movements do not occur, then the “f” sound would not sound correct. Speech sound production can also be impacted by a child’s phonological system. A child’s phonological system includes the skills necessary to use different sounds to make words. It also includes the natural process of speech development patterns that a toddler goes through. For example, it would be completely normal for a young toddler to say “da” for the word “dad”. This is called final consonant deletion. When a child gets older it could become increasingly difficult to understand their speech if some of their words did not have the final consonant.

What to look for?

  • Sounds are replaced by different sounds. Ex: The word “cat” sounds like “tat”
  • Syllables are missing. Ex: “Banana” sounds like “nana”
  • Sounds are missing Ex: “pan” sounds like “pa” or “top” sounds like “op”


2. Language - The area of language includes how an individual understands spoken speech, how an individual puts words together for speech, and literacy. A child may have difficulty understanding what is being said to them. For example, they may have difficulty following directions or answering yes/no questions because they do not understand what was said. Speech therapy can work to improve these receptive language skills. On the other hand, a child may understand what was said to them but have difficulty forming phrases to respond. Some children have difficulty putting together sentences with noun, verbs, and adjectives. Vocabulary and sentence structure are also included in these expressive language skills. Children with language disorders sometimes also have difficulty with literacy, reading, and writing.

What to look for?

  • Difficulty answering yes/no or “wh” questions
  • Difficulty following directions
  • Difficulty telling age appropriate stories
  • Difficulty combining words into age appropriate sentences
  • Difficulty with reading, writing, and spelling


3. Social Communication - To have effective communication you share a message with a communication partner. When you speak with a communication partner it will likely follow a pattern of speaking and listening. There are a set of rules established by a culture that everyone follows in order to communicate. When a child has difficulty understanding and following this pattern of rules then they may have difficulty with social communication or social skills.

What to look for?

  • Difficulty staying on topic/ inappropriate topic for a given situation
  • Difficulty starting or ending a conversation
  • Inappropriate conversational turn taking (interrupting frequently)
  • Inappropriate volume
  • Inappropriate conversation with teacher vs. peer
  • Difficulty understanding body language and emotions


4. Alternative and Augmentative Communication (AAC) - Sometimes children have difficulty with verbal communication. When a child has difficulty with verbally producing language, they may need another method to communicate their thoughts, wants, needs, and ideas. A SLP can help a child and his/her family find an alternative way to communicate. Some examples include sign language, picture exchange system, or electronic “talking” devices. SLPs also help with augmentative communication. This means they establish a way to communicate that aids the child’s verbal speech. For example, if a child wants a soda they may say “want” and then use a picture of a soda to hand to their caregiver.

What to look for?

  • Your child may have a motor disorder that results in making the muscle movements necessary for speech challenging
  • Limited verbal speech


5. Fluency - Stuttering is when a child has difficulty with the flow of speech. They may repeat sounds, syllables, or full words when speaking. The child may pause during a word or insert um or uh frequently in speech. A child having difficulty with fluency may have a facial grimace when speaking or other indicators that they are struggling to speak.

What to look for?

  • Ex. The word baseball may sound like “b-b-b-baseball”
  • Sentences may sound like “I um like uh uh soccer practice.”
  • Facial grimace while speaking


6. Hearing/ Aural Rehabilitation - If a child has hearing loss, or chronic otitis media (chronic ear infections), this can affect their speech and language development. Hearing the sounds in a child’s environment promotes speech and language growth. Aural rehabilitation can also assist a child who has recently received hearing aids or cochlear implants. SLP’s can complete hearing screenings. (However, full hearing evaluation would need to be completed by an audiologist.)

What to look for?

  • Hearing loss
  • Chronic otitis media (ear infections)
  • Difficulty with speech production due to hearing loss


7. Cognitive - SLP’s can assist children with cognitive communication disorders. These are language difficulties as a result of an underlying cognitive difficulty. Examples of things SLP’s could work on with your child include problem solving, attention, memory, orientation, executive functioning, planning, reasoning, and many more.

What to look for?

  • Difficulty problem solving age appropriate situations
  • Short term or delayed memory difficulty
  • Difficulty telling stories with events in the correct order
  • Difficulty providing a reason to “why” questions


8. Voice - Voice is the sound we produce when we speak. It is how we sound including pitch and tone. A child’s voice could sound harsh, hoarse, too quiet “lost voice”, or sound as if to much air is coming out of their nose. Children can have a voice disorder due to an organic cause or due to overuse and misuse.

What to look for?

  • Loss of voice without apparent cause
  • Hoarse or harsh voice for more than a few days
  • When the child speaks does it sound nasally or as if air is coming out of the nose inappropriately?
  •  When the child speaks does their voice sound as if they have a stuffy nose (without present of sickness or sinus concerns)?


9. Swallowing and Feeding – SLPs are also trained to evaluate and treat swallowing disorders. A swallowing disorder is when you have difficulty chewing or swallowing. Sometimes food “goes down the wrong way” and travels towards the airway and not the esophagus (food tube). SLPs can also work on feeding skills. Some children have difficulty with new foods or sensory feeding difficulties.

What to look for?

  • Very limited diet
  • Your child may become very upset about trying to foods or refuse new foods.
  • Coughing with food
  • Coughing with liquids
  • It appears “food goes down the wrong way” frequently


What can I do if I think my child needs speech therapy?

A great first step to help decide if your child needs speech therapy would be to complete a developmental checklist. Although the categories listed above are great things to look for, every child is different, and every age is different. You can complete the checklist here.


You can also call Theratree today at 270-688-8449. We can help you get paired with a great Speech-Language Pathologist!

Who is a Speech- Language Pathologist?

  A Speech-Language Pathologist is an individual that is trained and licensed to evaluate and treat speech and language difficulties. They are experts in communication development and disorders. Speech-Language Pathologists are often called speech therapists or SLPs for short. SLPs commonly work in private practice, schools, and hospitals. They can work with newborns to adults. When SLPs work with individuals it is called speech therapy. At Theratree, SLP’s use strategies tailored to each child to help them reach their speech therapy goals.

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