Synergy Healthcare: Tips On Vacationing With Children

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

“Your Child Deserves the Best Vacation Experience Possible! ” Effective Tips on Vacationingwith Your Children

Inside This Newsletter • Staff Spotlight • Patient Success Spotlights • Leading a Healthy Eating Lifestyle for Your Child • Practice News

Vacationing with kids isn’t quite the same as vacationing on your own, or just with friends. As adults, the idea of jetting off into the sunset and enjoying the sights, while having lots of downtime to recharge and relax, is thrilling and enticing. Add a few kids to the mix and the idea of scheduled downtime can be one of the most intimidating concepts out there. Kids require planning. There needs to be activities, there needs to be proper accommodations, and there needs to be easy access to food, bathrooms and a proper napping location. As difficult as it can be to plan a vacation that is enjoyable and relaxing for parents and kids, doing so with a child who has special needs makes the accomplishment that much more

of a challenge. The Key to Success: Plan Ahead!

Planning your vacation ahead of time is the only way to ensure that you will have the accommodations you need for everyone to have a good time. Think of your schedule at home. So much of what helps a special needs child have a good day is repetition and predictability. When you remove “home” from the equation, you are automatically removing familiarity. Keeping as much of the schedule intact as possible will help your child thrive. As great as it may be to fly by the seat of your pants and to go where the wind takes you, this is not ideal for a child with special needs, and if your child is unhappy, you are not likely to enjoy your vacation.

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

“What Precautions Should I Take in Preparing for a Child-Friendly Vacation? ” Effective Tips on Vacationingwith Your Children

The best thing to do for everyone involved is to plan everything ahead of time. Know where you are going, where you are staying, where you can eat, what you are doing, what time you’ll be done and what you’ll need to accommodate everyone in your family to ensure that you all have a great time, wherever you end up. Take Medical Precautions Once you know what to expect, consult your child’s physician. Being prepared means having a long list of contingencies. Before leaving town, you need to checkwithyourchild’spediatricianandensure thatyouhaveallof the following: • A list of any prescription drugs your child is taking, with a copy of each prescription in case you need more or you need to show someone proof • A physician’s description of your child’s condition, which will be helpful in the event you need to seek emergency care •Phonenumbers,e-mailaddresses,oranyothernecessarycontact information for your child’s physician, as well as the best numbers to call in the place you are going. Ask your child’s doctor for a recommendation in case you need care on the road. Of course, make sure that you have your health insurance cards and phone numbers. If you are traveling overseas, you may want to investigate travel insurance thatwouldexpediteyouraccess tomedicalcareatyourdestination. Pack, and Then Pack More It is a good idea when you are traveling with any children to over-pack, but this is especially important when preparing for a vacation with your special needs child. Think of contingencies, consider emergencies, and always be prepared for the worst. One good idea is to pack a separate emergency bag that has essentials in it, and to keep it with you as you travel. If you rent a car, keep this smaller duffle with you instead of having everything in the hotel. That way, if you need to seek emergency care you won’t find yourself racing around an unknown city trying to gather the belongings you need to care for your child. Finally, keep in mind that a family vacation is for the entire family. You don’t need to pick a spot that is tailored to your special needs child, you just need to think about what you and your family will need to do in order to keep everyone in the family happy and healthy throughout your stay. Go for

happiness and comfort over perfection. Planning a vacation like this can be very stressful, so keep that in mind and try to plan outings for yourself that will help you have a good time while you are away from the office, too. Make arrangements ahead of time for child-care with someone who is capable of caring for your special needs child and make the most of an evening or day seeing the sights and enjoying yourself away from the kids, then jump back into enjoying your family time with gusto. Having the right attitude and being willing to do a little extra work in the best interest of your children will help your vacation go off just right. Sources myfamilytravels.com/content/11177-10-tips-traveling-special-needs-kids www.familyvacationcritic.com/special-needs-travel/art/ www.friendshipcircle.org/blog/2012/07/20/a-comprehensive-guide-to- special-needs-travel

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LEADING A HEALTHY EATING LIFESTYLE FOR YOUR CHILD

3. The family table is about FAMILY. Food is secondary. It’snoteasy—especiallywhenaparent isconcernedabout thechild’snutritionalhealth— but it helps the entire family enjoy mealtimes. 4. Vow that holiday parties will be healthy parties. Shortly after we strive to be healthy in the New Year, the sweetness of Valentine’s Day might sabotage our resolution. Use or suggest fun and healthy food activities for the family during the holidays. 5. Play with food. Kids learn from other kids and often interact with new foods when the focus is on play and not on taking a bite. Try some food- play thatgetskidsexperiencingavarietyof foods in a fun and relaxed manner such as “Go Fish” with vegetables or painting with spices! Shareyour ideas forhelpinghesitanteaters “play” with food while introducing them to new and healthy ingredients!

Many parents of picky eaters reflect on what they can do to help their families lead a healthier lifestyle. If you treat a child stuck in the chicken nugget rut, share these five resolutions with the parents, so they can better guide their child toward more adventurous eating. 1. Make the kitchen the heart of the home. One of the best ways to connect as a family is what I call “parenting in the kitchen.” Ask parents to encourage their kids to chop veggies, mix a dip, or line up sweet potato fries on a pan. Teaching children to be adventurous eaters starts by introducing theirbrains to the feelofnew foodsby firstgetting those foods into theirhands.Even the youngestcanget involvedwithadultsupervision. The point is to gather everyone around once a day and be a part of the process – even if it’s just to assemble a new snack. 2.Walkdownthekitchentoolaisleonceaweek. Go to a dollar store, grocery store, or a fancy cookingshop.Awhisk,egg,andupbeat “whisking” musicmayprovide just the right impetus topique a child’s interest in eggs. Eggs too challenging? Start with water and a drop or two of dish soap then whisk a bowl full of bubbles.

http://blog.asha.org/2015/12/31/five-resolutions-to-share- with-parents-of-picky-eaters/

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Staff Spotlight Shauna Burchett, OTR/L Owner

Shauna Burchett is the owner of Synergy Healthcare in Spokane Valley and in Coeur d’Alene. She graduated from University of Alberta, Faculty of Rehabilitation Medicine, Department of Occupational Therapy in 1993. Shauna has been in private practice since 1998. She began her career as an occupational therapist specializing in traumatic head injuries. She fell in love with that population and continues to develop her skills with post concussive injuries, strokes, and traumatic brain injuries. She describes herself as a “nose to toes” kind of therapist. She’s always up for a challenge – perhaps that’s why she is the owner. She loves craniosacral therapy, visceral manipulation, and lymphatic drainage. Her perspective on healing and recovery has been influenced by many osteopaths whose classes she has taken, but more importantly by the clients who have taught her through their injuries and illnesses.

ShaunaBurchett,OT (owner)and family

She loves the expression “If you listen hard enough to a patient they will tell you what is wrong with them, but if you listen even harder they will tell you how to fix it.” It is the framework on which she built the clinic. The perspective she tries to lead from and from which she tries to live her life is: “I think we don’t listen enough”. Shauna enjoys spending time with her husband, Robin, and three sons, Ethan, Parker, and Sawyer. She also enjoys traveling, playing the piano, and studying yoga.

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Practice News

Autism Walk

Synergy Healthcare was a proud sponsor of the 7th Annual Walk for Autism Awareness in North Idaho organized by the Panhandle Autism Society. Most of the Synergycrewwerealsopresent toparticipate in thewalkandanswerquestionsabout anything and everything development related. We were happy to be a part of such a great gathering of people and thank the Panhandle Autism Society for putting on this yearly event. They are an important part of our community in helping families managinganewdiagnosisandspreadingautismacceptance.Theyareguidedby the principles of meaningful participation and self-determination for individuals on the autism spectrum and their families. They also offer a lending library that supports thesensoryneedsof individualswithsensory integration issuesaswellasbooksand DVDs to educate on autism, social skills, Asperger’s, sensory integration, behavioral approaches, and teaching strategies. You can find other resources and contact information on their website: https://panhandleautismsociety.org Autism Facts: Autism isabio-neurologicaldevelopmentaldisability thatgenerally appears before the age of 3. Autism now affects 1 in 68 children. Boysare four timesmore likely tohaveautism thangirls.More than3.5millionAmericans live with an autism spectrum disorder. Autism impacts the normal development of the brain in the areas of social interaction, communication skills, and cognitive function. Individuals with autism typically have difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities.

(left to right)Samantha,William,Kerri,MarkandHenry thebunny

Individuals with autism often suffer from numerous co-morbid medical conditionswhichmay include:allergies,asthma,epilepsy,digestivedisorders, persistentviral infections, feedingdisorders,sensory integrationdysfunction, sleeping disorders, and more. Autismgreatlyvaries fromperson toperson (no twopeoplewithautismare alike).Childrenwithautismdoprogress–early intervention iskey.Prevalence of autism in U.S. children increased by 119.4 percent from 2000 (1 in 150) to 2010 (1 in 68).

Always learning…Always growing…

Specialized Just For Your Child Do you know a child that who needs therapy? Pass this on to a friend!

“We love Synergy! The amazing therapists and staff are the best around. They genuinely care for your child, and even you. We’ve had great progress with working towards the goals set by speech and OT. Miss Kerri and Mr. Will are two of the best. My child really loves them, as do I. I love that they help you learn strategies to help your child.They interact with you and help you understand why this helps or doesn’t help. I 100% recommend them to anyone. We are so lucky to have found them.” – Jaime C. Patient Success Spotlight They help you learn strategies to help your child!

FREE SCREENING DoesYourChildNeedHelpwith handwriting,speech, language,balance, feeding,walking,running, jumping,playingwithothers,or justbeingakid?

We can help by providing: Occupational Therapy & Speech Therapy Evaluations & Treatment. New Patients! Schedule today for a FREE Screening for Speech or Occupational Therapy

6270N.GovernmentWay DaltonGardens,ID83815 synergyspokane.com P: 208-666-0611

Synergy Healthcare can further assess your child’s needs. Contact us today!

Early Intervention and AutismDiagnosis Ismy18-month-oldsontooyoungtobeevaluated for autism? This is a common question with a complicated answer because there can be a lot of variation in how and when the symptoms of autism become apparent. It’s never too early for a general developmental evaluation. According to the American Academy of Pediatrics, pediatricians should screen babies and young children for developmental delays at every checkup. Many of these delays – including the language and social delays associated with autism – can be identified at 18 months, if not earlier. be difficult, since there is no medical test, like a blood test, to diagnose the disorder. Doctors look at the child’s behavior and development to make a diagnosis. ASD can sometimes be detected at 18 months or younger. By age 2, a diagnosis by an experienced professional can be considered very reliable. However, many children do not receive a final diagnosis until much older. This delay means that children with an ASD might not get the help they need. Diagnosing an ASD takes two steps: • Developmental Screening • Comprehensive Diagnostic Evaluation

Understand the Changeable First Year As for autism, studies demonstrate that behavioral signs can begin to emerge as early as 6 to 12 months. However, most professionals who specialize in diagnosing the disorder won’t attempt to make a definite diagnosis until 18 months. This is because autism symptoms can continue to emerge – or fade away – until around 24 months. At that time, we say that an autism diagnosis tends to become “stable.” Consider the example of a toddler who is meeting all his or her developmental milestones at 18 months, but then begins to lose skills, or “regress.” In other words, autism can’t be ruled out at 18 months. Conversely some babies show early signs and delays, but then catch up with their peers by 24 months. Recognize the Range That said, some children can be diagnosed earlier than 24 months. It’s also important to remember that many high-functioning children with autism aren’t diagnosed until they enter school and start struggling socially. Trust Your Parental Instincts Importantly, research shows that parents are good at picking up on early signs of autism. So if you’re concerned, ask your doctor for a referral to a developmental pediatrician or psychologist who specializes in the disorder. Even if your child is too young to be assessed for autism, you can still request an evaluation for developmental delays.

Developmental Screening Developmental screening is a short test to tell if children are learning basic skills when they should, or if they might have delays. During developmental screening the doctor might ask the parent some questions or talk and play with the child during an exam to see how she learns, speaks, behaves, and moves. A delay in any of these areas could be a sign of a problem. All children should be screened for developmental delays and disabilities during regular well-child doctor visits at: • 9 months • 18 months • 24 or 30 months Additional screening might be needed if a child is at high risk for developmental problems due to pre-termbirth, lowbirth weight, or other reasons. In addition,allchildrenshouldbescreenedspecifically for ASD during regular well-child doctor visits at: If your child’s doctor does not routinely check your child with this type of developmental screening test, ask that it be done. If the doctor sees any signs of a problem, a comprehensive diagnostic evaluation is needed. Comprehensive Diagnostic Evaluation The second step of diagnosis is a comprehensive evaluation. This thorough review may include • 18 months • 24 months

looking at the child’s behavior and development and interviewing the parents. It may also include a hearing and vision screening, genetic testing, neurological testing, and other medical testing. In some cases, the primary care doctor might choose to refer the child and family to a specialist for further assessment and diagnosis. Specialists who can do this type of evaluation include: • Developmental Pediatricians (doctors who have special training in child development and children with special needs) •ChildNeurologists (doctorswhoworkon thebrain, spine, and nerves) • Child Psychologists or Psychiatrists (doctors who know about the human mind) References https://www.autismspeaks.org/blog/2013/03/15/how-early- can-autism-be-diagnosed Lord C, Risi S, DiLavore PS, Shulman C, Thurm A, Pickles A. Autism from 2 to 9 years of age. Arch Gen Psychiatry. 2006 Jun;63(6):694-701.

Diagnosing autism spectrum disorder (ASD) can

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Visual Supports Help Children with Autism Spectrum Disorder Learn

What are visual supports? A visual support refers to using a picture or other visual item to communicate with a child who has difficulty understanding or using language. Visual supports can be photographs, drawings, objects, written words, or lists. Research has shown that visual supports work well as a way to communicate. Visual supports are used with children who have autism spectrum disorders (ASD) for two main purposes. They help parents communicate better with their child, and they help their child communicate better with others. Visual supports can be used with persons of any age. Also, visual supports can be used by caregivers other than parents. Why are visual supports important? The main features of ASD are challenges in interactingsocially,using language,andhaving limited interestsor repetitive behaviors. Visual supports help in all three areas. First, children with ASD may not understand social cues as they interact with others in daily activities. They may not grasp social expectations, like how to start a conversation, how to respond when others make social approaches, or how to change behavior based on unspoken social rules. Visual supports can help teach social skills and help children with ASD use them on their own in social situations. Second, children with ASD often find it difficult to understand and follow spoken instructions. They may not be able to express well what they want or need. Visuals can help parents communicate what they expect. This decreases frustration and may help decrease problem behaviors that result from difficulty communicating. Visuals can promote appropriate, positive ways to communicate. Finally, some children with ASD are anxious or act out when their routines change or they are in unfamiliar situations. Visuals can help them understand what to expect and will happen next and also reduce anxiety. Visuals can help them pay attention to important details and help them cope with change. First-Then Board. What is it? A First-Then Board is a visual display of something your child prefers that will happen after completing a task that is less preferred. When is it helpful? A First-Then Board is helpful in teaching children with ASD to follow directions and learn new skills. It motivates them to do activities that they do not like and clarifies when they can do what they like. A First-Then Board lays the language foundation needed to complete multi-step directions and activities and to use more complex visual systems.

How do I teach it and use it? Decide what task you want your child to complete first (what goes in the “first” box) and the preferred item or activity (what goes in the “then” box) that your child can have immediately after the “first” task is done. This preferred item/activity should be motivating enough to increase the likelihood that your child will follow your direction. Put the visuals on the board (e.g. photos, drawings, written words) that represent the activity you identified. Present the board to the child with a brief, verbal instruction. Try to use the least amount of words possible. For example, before beginning the “first” task, say, “First, put on shoes, then swing.” If needed, refer to the board while your child is doing the task. For example, say “One more shoe, then swing” when your child is almost done. When the “first” task is completed, refer back to the board. For example, say “All done putting on shoes, now swing!” and immediately provide the preferred, reinforcing item or activity. In order to teach children with ASD the value of the First-Then Board, you must give them the reinforcing activity or item after they complete the “first” task. Otherwise, your child may not trust the board the next time you use it. What if challenging behaviors occur? If challenging behaviors occur, continue by physically prompting your child to complete the “first” task. Keep your focus on the task rather than on the challenging behavior. Then it is important to still provide the reinforcing item or activity, since the focus of the board is on completing the “first” task, and not on addressing challenging behaviors. If you think challenging behaviors may happen, begin by introducing the First-Then Board for a task that your child usually completes willingly and successfully. If challenging behaviors become more difficult to control, it may be appropriate to consider behavioral consultation with a professional to address these behaviors directly. Resources: www.do2learn.com card.ufl.edu/content/visual.html www.kidaccess.com/index.html Eckenrode, L., Fennell, P., & Hearsey, K. (2004). Tasks Galore for the Real World. Raleigh, NC: Tasks Galore.