By: Citlaly Gonzalez Psy.D Clinical Psychologist

Winter brings chillier temperatures, twinkling lights, extra family time and the opportunity for holiday shopping and gift-giving. There are many gift guides out there. Big City Readers put together this one that includes toys to support learning and development, and sensory play and of course books!  There’s this one by Buzzfeed for kids with endless energy. Easterseals DuPage & Fox Valley offers something unique- a holiday gift guide carefully curated with the needs of our families in mind and offered through the lens of mental health and wellness for the whole family.

Many of the links included in this guide take you to Amazon, so add Easterseals DuPage & Fox Valley as your selected charity through smile.amazon.com and get ready to shop!

Family Time at Home

The old adage your presence is the best present is never truer than during the holidays. This is a great time to think of ways to spend time together during the winter months and look toward ways to create memories throughout the year. Board games bring the family together and there are many great options for even the youngest children. Worried about the meltdowns that happen when a child is still learning to lose graciously? Stick with cooperative games such as those by Peaceable Kingdom. The Race to the Treasure is in heavy rotation in the Social Services department as is Monkey Around, a non-competitive game that includes gross motor play, imitation, vocabulary, and social-emotional skills through a card game that prompts players to do movements together.

There’s no rule that therapy games have to stay in the therapy room. Consider adding some Social Services classics to your own toybox at home and normalize talking about mental health. These Kimochis provide a cute way to talk about feelings and Create a Story cards support sequencing and story-telling. To support calm feelings this card deck introduces mindfulness while this expandable breathing ball brings deep breathing to life.

Winter is long so think of games that keep you moving indoors. Painter’s tape in the multi-color pack is great for creating homemade obstacle courses with little equipment. Add in stepping stones, wobble boards, a figure-eight balance beam, or even tunnels and ball pits to level up the fun indoors.

The Tricky Spots

Not every routine at home brings smiles to children and caregivers. But what if we could provide some tools to support these “tricky spots?” What if we could identify toys that we could integrate into daily routines and incorporate them in ways that help? Think of what part of the day feels challenging and add in some gifts to help make those tasks feel more exciting or run more smoothly.

Bath-time: Put together a Bath bin to make bath time more appealing. “Time for bath” and “Time to choose a bath toy” have a different ring to them. Consider bath crayons, bath paint, bath bombs, bath confetti, color drops, glow-sticks, –any of which would make great stocking stuffers, or you can choose something like this interactive set that lights up and has music parts or a bath-time basketball hoop.

Bedtime: Help create a calm environment and support a healthy bedtime routine with these recommendations that might make your child look forward to bedtime! Create a soothing and distraction-free environment with this bed tent or try a light projector such as this one that creates dinosaur images on the ceiling, this huggable turtle, or this brave bear with his flashlight and book.

Mealtimes: Take some of the struggles out of mealtimes with some of these fun gifts. Which food to try next? Depends on the spinner or the order of this path or these fun plates that are sure to make meals fun.  You can also help promote self-help skills and independence with gifts that help your child participate in cooking –not to mention the gift of time and memories made together in the kitchen. Both of these wooden knife and wooden knife set are safe for most novice chefs whereas this one might be more appropriate for children who are ready to use a real knife that is still child-safe.

The classics

It would be remiss to make a holiday gift guide without mentioning “the classics” –open-ended toys, art supplies, and books. Here are some Easterseals Dupage & Fox Valley favorites:

Must-Have-Toys: Dolls and dollhouses, blocks, and play food are the play trifecta. If you have these, your play kit is complete! Dolls are great for both boys and girls and help foster pretend play, teach routines, and promote caregiving. Melissa & Doug has a beautiful wooden one while Woodzies offers an option at a lower price point. (Hint: Woodzies have a lot of other settings you can add like the school set to help your child share and tell you about their day). There are many options for play food, with Melissa & Doug offering a wide variety of beautiful sets, some that invite “cutting” or with Velcro pieces to assemble. Speaking of building, blocks are always a hit! Whether it’s Legos, wooden blocks, or a fun option like these, blocks are a great open-ended toy that provides endless possibilities for creative play.

Art: Art provides not only the opportunity to create but also to connect and express thoughts, feelings, and experiences. Some favorites include Crayola Slick Sticks which provide rich color with minimal pressure, perfect for toddler hands and those with motor challenges and Sharing journals such as this one provide a great way to connect with your children through art.

Books: Every book has its perks and particular uses and reasons to recommend it. Poke-a-dot books help support pointing and the Indestructible book series is perfect for children still learning to be gentle with books. Two of my all-time favorite books are The Rabbit Listened which reminds us to stop and listen to what children really need and All the Ways to Be Smart which celebrates the many ways kids learn, play, and explore. Remember, books are not just bound paper, they’re the promise of time spent together bonding and reading with your child.

We have a wonderful library at Easterseals and a carefully curated book list. Ask your therapist for recommendations or contact the Social Services Team. Two favorite resources for book recommendations are Miss Beth and her team at Big City Readers and Kido.

Let’s not forget the caregiver

While the focus of the holidays is often on the children, let’s not forget the gift of a healthy, happy, and well-taken care of parent. I recently saw a post of Mothercould (highly recommend for ideas of activities and sensory play!) where Myriam, the blogger, shared the idea of a gift basket she made for herself for self-care following the birth of her youngest daughter. What an amazing idea! So, this last recommendation is to put together some of your own favorites. Your favorite snacks, gift cards for your favorite store (who doesn’t love a solo trip to Target?), and a note to remember to take care of yourself this holiday season and into the new year.

The best gift for your child . . .

Of course, the focus of any gift should be the recipient and what brings them joy. You are the expert on your child and what they like most! Grant yourself the permission to fill their stocking with the Guaranteed Wins! Confession: my child’s stocking includes a bottle of eczema cream because he loves this part of our nightly routine and a wooden McDonalds food set –a Frankenmixture of trendy wooden toys and the food parents don’t always want to admit their kids love. Those items aren’t likely to be found on anyone else’s gift guide, but they are things I know will bring a smile to his face and will be immediately put to use, and that makes them good gifts!

To determine the best gifts for your child, think of the parts of your day where you could use some support and choose a gift that will grant it. Reflect on your favorite routines and memories with your child and consider ways to incorporate these into your gift. Consider how the gifts you select will be used in a way that supports your family’s health and happiness and above all the time you share together.

Amazon Wishlists

While you complete your holiday shopping, don’t forget to checkout at smile.amazon.com with Easterseals DuPage & Fox Valley as your selected charity. You can also take a look at our wishlists for therapist and teacher requested items to send to our centers. Both efforts on Amazon can provide year-round support of our services and programs. The featured items make great developmental toys and gift ideas for children of all ages too. Thank you for supporting us this holiday!

• Villa Park Wishlist
  • Features pretend play toys, art supplies, bubbles and baby and toddler toys
• Elgin Wishlist
  • Features books, movement and baby toys for use in therapy
• Naperville Wishlist
  • Features board games and sensory materials to use in therapy
• Lily Garden Wishlist
  • Features kinetic sand, paint and playdoh supplies, fidget toys and more for our infant, toddler, preschool, and pre-k classrooms.

By: Jodi Hoppensteadt MS, RDN, LDN

Why Track Added Sugar?

It’s Kids Eat Right Month this August, and below is the skinny on added sugar. It can be tough to track and understand labels and how much is added into our daily food products. The easiest method is for families to focus on foods and beverages that do not contain added sugars.

Too much sugar in a child’s diet can lead to adverse health conditions, including tooth decay, obesity, heart disease, high cholesterol, type two diabetes, and high blood pressure. According to the American Academy of Pediatrics (AAP), children under two years of age should avoid added sugars. Children two years and older should limit their daily intake of added sugars to less than 25g (approximately six teaspoons) each day.

How to Identify Added Sugar on Food Labels

There are two ways to read a food label. One way is to check the Nutrition Facts Panel and look for the line titled: Includes XXg Added Sugars. Focus on foods that contain less than 5% of the Daily Value for added sugars.

The second way to read a label for added sugars is to read the ingredient labels. Added sugars come in many forms and go by many names, including sugar, brown sugar, corn syrup, high fructose corn syrup, fruit juice concentrates, fructose, dextrose, honey, molasses, malt, turbinado, and any ingredients ending in -ose.

Tips to Reduce Added Sugars

The following suggestions are other tips on how to avoid added sugars in your child’s diet:

• Limit foods containing added sugars for children over two years of age and avoid beverages with added sugars for children two and under.
• In place of foods with added sugars, try offering foods with natural sugar, which is the sugar naturally found in foods such as fructose found in fruits or lactose found in milk and milk products.
• Limit 100% fruit juice for children and it is a good practice to dilute with water. Do not give fruit juice to children under the age of one.
  • 1-3 years of age up to 4 ounces daily.
  • 4-6 years of age up to 6 ounces daily.
  • 7-14 years of age up to 8 ounces daily.
• Read labels for added sugars in all packaged and/or processed foods and drinks, including crackers, flavored milk (chocolate or strawberry), condiments, cookies, bread/baked goods, and cereals.

Added Sugar Replacements/Substitutes Tips

Here are some food replacements/substitutes to reduce added sugars in specific foods:

• Serve water or milk in place of soft drinks, sports drinks, fruit drinks, sweetened coffees, or teas. Try naturally flavored water at home by adding berries, lemon, lime, cucumber slices, or mint.
• When looking for something sweet, try fresh fruits, frozen fruits, dried fruits, or canned fruits. Canned fruits should be canned in water or natural fruit juice and drained and rinsed. Read food labels for added sugars in both canned and dried fruits.
• Many cold cereals are high in sugar. Look for low sugar cereals such as Chex (Corn or Rice), Cheerios (unflavored), or Kix (unflavored).
• Applesauce often has added sugar but unsweetened applesauce is available.
• Offer only 100% real juice, fresh-squeezed juice, or homemade juice with no sugar added.
• Cookies/cupcakes/baked goods are often high in added sugars but can be homemade with less sugar by substituting part of the sugar with applesauce or reducing the amount of sugar in a recipe by ¼ to ½ of the amount.
• Popsicles and ice cream can be replaced with 100% real fruit popsicles or dark chocolate-covered frozen bananas. Popsicles can also be made at home using fresh fruit, pureeing, and freezing in popsicle molds.
• Peanut butter and jelly sandwiches can be made with less added sugars by replacing the jam or jelly with fresh fruit such as sliced bananas, apples, or strawberries, or low sugar jelly jams are available. No sugar-added peanut butter is also available.
• Syrup for pancakes and waffles can be replaced with fresh fruit, or frozen blueberries can be heated and pureed to make a “fresh fruit syrup”.
• Read labels for condiments and chose lower sugar varieties or reduce the amount used.
• Granola bars/cereal bars/yogurts look for low added sugar on the nutrition facts panel or ingredient label. There are also many recipes for breakfast cookies online that are low-sugar and easy to make.

Notes on Artificial Sweeteners

Artificial sweeteners (nonnutritive sweeteners) such as Aspartame, Acesulfame-K, Neotame, Saccharin, Sucralose are found in many food and beverages. The AAP recommends that the amount of artificial sweetener be listed on the nutrition facts label to better help parents and researchers understand how much children are consuming and the possible health effects. There is still a lot to learn about the impact of nonnutritive sweeteners on children’s health. Children under the age of 2 should not be consuming artificial sweeteners.

Notes on Milk and Supplemental Diets

There is no need to limit milk as it contains natural sugars, not added sugars, and provides necessary nutrients, including calcium and vitamin D. Supplemental nutritional beverages such as Pediasure, Boost, and Carnation Breakfast Essentials should not be limited when used to supplement diets to provide additional calories or nutrients or when recommended by a doctor and dietitian. Lower added sugar supplemental nutritional beverages can be purchased from companies such as Kate Farms or Else. Ask your doctor or dietitian if a lower added sugar formula is right for your child.

Comprehensive Pediatric Nutrition Services

If you have any questions or any concerns about your child’s nutrition visit our nutrition therapy page or contact us at info@eastersealsdfvr.org. Our nutrition team is comprised of RDN’s (Registered Dietitian Nutritionist) who have years of specialty experience working in pediatric nutrition and are ready to help!

By: Yvonne D. Anderson, LCSW, CADC, CODP II

All parents want to protect their children. And all children are vulnerable online, whether they’re using email or chatting on social media sites. When your child has a disability or developmental delay, those protective instincts switch into high gear. Identifying potential threats online is more challenging than, for instance, spotting a danger on the playground. Additionally, many children with disabilities struggle with reading social cues, managing emotions/ behavior, and making judgment calls about others. As a result, they are at a higher risk for cyberbullying and online victimization. As a parent or caregiver, you are your child’s first line of defense. Use the following guidelines to navigate the online world and keep your child safe.

Make your home network safe.

Avoidance is the best policy when it comes to sexual content, violent images, online predators, malware, and cyberbullying on the Internet.

• Increase your security. Use updated virus protection and other safety measures, such as firewalls, to protect your computer from hackers and other cyberattacks.
• Make it public. Keep smart phones, iPads, and computers in shared places where it’s easy for you to monitor online behavior.
• Filter content. Install filters to block unapproved websites and images.
• Set up parental controls. Limits can be set in multiple ways, such as through your internet or mobile service provider, directly on the device itself, and through site-specific services, including YouTube, Netflix, and Facebook.
• Use child-friendly browsers. Some browsers are designed specifically to allow young Internet users to explore and learn without coming across offensive or dangerous content.
• Review the browsing history regularly.
• Disable location-tagging. A GPS-enabled smartphone or computer can reveal your child’s location through online posts and uploaded photos.

Teach your child how to behave online.

Educating your child about appropriate online behavior is vital if you want to keep her safe no matter where she accesses the Internet.

• Establish ground rules. Identify what is OK to do online and what activities are prohibited. When it comes to content, use the same guidelines that you employ for television viewing: if they can’t watch it on TV, they shouldn’t look it up online either.
• Teach your child that information shared on the Internet becomes and stays public forever.
• Review information that should not be shared. Help your child understand what types of information are unsafe to share online, such as their full name, address, phone number, school, or other images/ information that could help someone identify them. To help your child remember, post a “Do Not Share” list by the computer or on the device.
• Explain the limits to online relationships. Emphasize that it is okay to say “No” to requests for personal information, photos, money, and joining social media networks.
• Be smart about emails. Let your child know how dangerous it can be to open an email or attachment from someone they don’t know. Reinforce the importance of checking with you or another trusted adult if they get a message that they’re unsure about.
• Encourage your child not to delete messages. Tell them to save anything that they’re not sure about, doesn’t feel right, or seems hurtful. Set aside time to review the messages together.
• Explain cyberbullying, predatory behavior, and sexting. Although it may feel uncomfortable to talk about, your children can’t protect themselves from what they don’t know about. Rehearse “what to do if…” scenarios.

Provide resources and support.

Children also need to know how to identify when someone else is behaving inappropriately online and what to do about it.

• Use online tools. Websites such as InternetMatters.org or NetSmartz.org provide a wealth of resources for both parents and children. InternetMatters is a resource hub specifically designed for children with additional learning needs and their families. These sites offer tools help children learn about online dangers using role-playing, pictures, and other strategies. NetSmartz resources also include the SymbolStix safety pledge, a visual online safety contract designed with support from the National Autism Association.
• Encourage them to trust their gut. Teach your children to be skeptical and listen to their own instincts. Use role-play to practice recognizing and responding to several different scenarios your child may encounter online.
• Give them a lifeline. Make sure your children know that you and other trusted adults are available for them if they run across something online that makes them uncomfortable. Even if they’ve done something they shouldn’t have, it’s important for them to be able to reach out to adults they can rely on.
• Find safe online spaces. Seek out social networks and peer support that are focused on activities and interactions that match your child’s interests and developmental level.
• Be curious and ask questions. Find out what websites your child likes to visit. Have they ever seen something online that made them feel sad, scared, or confused? What would they do if they saw something online that made them uncomfortable?
• Connect with your child by learning how to use the technology and social media that s/he is using. Ask them to show you how it works and specifically how they use it.

Reach out to Easterseals’ Social Services team for more ideas about how to support your child’s social and emotional development. You can contact us at socialservices@eastersealsdfvr.org.

By: Joanna Nasiadka, M.S., CCC-SLP

Speech-Language Therapy strengthens children’s communication and feeding skills so they can participate fully in daily activities and achieve success. Easterseals DuPage & Fox Valley therapists have numerous years of experience in typical and atypical speech and language development and offer a fun and engaging environment for children to learn and develop their skills. We also have a number of therapists fluent in several language such as Polish (myself), Korean and Tagalog. There are often questions shared about raising a bilingual child and I wanted to discuss the many benefits and what to look for if you suspect a speech delay below.

Q1: Does bilingualism mean my child is equally proficient in two languages?

Being bilingual does not mean that the child has equal proficiency in both languages. It is common for children to have a dominant language. Children can also have a dominant language for specific contexts. For example, a child might speak English at school and communicate most effectively in English when the context is academics but might prefer to talk in their family’s native language while talking about a sport, religion, or while talking to their family members. The dominance of language fluctuates depending on the amount and nature of exposure. There are two types of bilingualism:

Simultaneous Bilingualism:

This type of bilingualism is the acquisition of 2 languages at the same time, typically before age 3.​ Early language milestones are met in typical time and manner in both languages.​

Sequential Bilingualism:

This type of bilingualism occurs when the second language is introduced AFTER 3 years old.

Q2: Will my child be confused if we use two languages at home?

Many studies on bilingualism have shown that using two languages does not confuse a child, even when they are young and learning two languages simultaneously.

Q3: What if my child has a language delay or disorder?

There is no evidence that using two languages confuses a typically developing child OR a child with a disability. Bilingualism can actually be beneficial for children who have disabilities, and it allows them to be active participants in their daily activities. It also allows them to have full social-emotional growth since it will enable them to communicate with family members and friends who have a shared language and culture.

Q4: Will bilingualism cause my child to have a language delay or academic difficulties? Will he or she be behind other kids?

Bilingualism does not cause language delay or disorders in children. It also does not exacerbate delays or disorders that are already present. If a child presents a disorder in one language, they will have the disorder in the second language as well. If the difficulties only arise in one language, this could be a sign of limited language proficiency.

Bilingual children develop language similarly to their monolingual peers. However, bilingual children may have lower proficiency in one of the languages until they catch up to fluent speakers.

• Average time to achieve social proficiency (conversations, social interactions): 2-3 years
• Average time to reach academic proficiency:  5-7 years

Q5: What are some pros and cons of raising a bilingual speaker?

Q6: What is the best way to support two languages? Should I wait for my child to be proficient in one language before introducing a second one?

The best time for a child to learn two languages to be proficient is before 3. Younger children are more likely to develop a natural accent, more likely to become proficient and achieve higher syntax levels in the long run. Therefore, there is no need to wait for your child to learn one language before introducing a new one.

Many families have found success in speaking both languages at home. Other families prefer to speak both languages and spend time reading, writing, or doing activities in each language. A very effective way to help a child learn both languages is to have one caregiver speak one language and a second caregiver speaks the other language. This choice depends on the family dynamic and your preferences.

Q7: My child started to mix the two languages together in the same sentences. Is this normal?

Using both languages or alternating between languages in the same utterance or conversation is very common for bilingual speakers and is called code-switching. Competent bilingual speakers often code-switch for many reasons, including using a word that is not present in the other language, quoting ideas, emphasizing, excluding others from conversation, showing status, or adding authority. Code-switching can happen more in certain cultures and contexts.

Code-switching does require rules to be done appropriately:

1. Must follow the grammatical structure of both languages
2. The word order has to make sense

Q8: How will a speech-language pathologist evaluate and treat my bilingual child with a language disorder or delay?

A speech-language therapist can help determine a speech-language disorder from a limited language proficiency by considering the sound and language rules of both languages that your child speaks. Your therapist will administer evidence-based methods of testing that are adjusted for your child’s needs as a bilingual speaker. These tests include speech-language samples, writing samples, play-based observations and assessments, standardized measures (if appropriate and adjusted), and assessments of ability to learn new skills. If your child benefits from services, treatment will focus on improving speech and language skills while supporting both languages.

Take our Free Developmental Screening

If you are concerned about your child’s language or other development, take our free online developmental screening tool for children birth to age five. The Ages and Stages Questionnaire (ASQ) will showcase your child’s developmental milestones while uncovering any potential delays. Learn more at askeasterseals.com. 

To learn more about Speech Language services at Easterseals DuPage & Fox Valley, call us at 630.282.2022.

By – Cindy Baranoski MS, RDN, LDN and Laura Van Zandt OTR/L

Updated February 2021

In January 2019, a groundbreaking article was published in the Journal of Pediatric Gastroenterology and Nutrition describing children challenged with feeding problems and their care. Pediatric Feeding Disorders (PFD) is the term the expert team of authors define as “impaired oral intake that is not age-appropriate, and is associated with medical, nutrition, feeding skill, and/or psycho-social dysfunction.” It establishes the basis for creating and implementing a medical diagnosis code that would support children identified as having problems in any of these four areas, which are impaired by or impairing a child’s ability to eat a diet that is expected for age.

It concludes with the primary need for children to be identified early and receive interdisciplinary evaluations and interventions instead of seeing one practitioner alone to try and help all areas. Interdisciplinary thinking, evaluations, and treatment have been the core practice of Easterseals DuPage & Fox Valley’s Feeding Clinic for the past 21 years, since its inception in 2000.

What Brings You Here

From the moment we are born, feeding and eating is something that is supposed to come naturally to everyone. When a baby is born, we feel an overwhelming sense of love and a strong desire to watch over, protect, and nourish to grow. When it’s time for feeding, our bodies are already preparing the necessary tools to breakdown and process what is provided. Feeding involves more than just our mouths. At play are the sights (color, shape, size), feelings (warm, hot, cold, crunchy, chewy, soft, sticky), smells (sweet, stinky), sounds (loud, quiet), and most significantly, the way our body works. From how our muscles work together to align our trunk in sitting, allowing our arms to reach, grasp, and explore, to coordination of suck, swallow, and breathe, and manipulating the food in our mouths, everything sets the foundation for a good relationship with mealtimes and foods. Our past and current experiences all shape our belief around feeding and nutrition. Your body must work all together to receive and process nourishment.

For some children, however, this process isn’t easy and doesn’t always come naturally. Many children struggle to coordinate their bodies to eat or drink and have GI systems that do not process foods well, leading to constipation, diarrhea, vomiting, and gastroesophageal reflux, which then leads to poor growth, frustrations, fear, and worry. For children with respiratory conditions, poor coordination of breathing, overall weakness, eating a meal like other children their age is nearly impossible. Yet, they still need what other children need – nourishment, socialization, variety, scheduled mealtimes, and interaction with foods. For children, who may be fed through a tube, eating may not be the primary mode of nourishment, but all the other factors promote development, health, and good growth.

As a parent, there is nothing more important than watching your child grow and thrive, and nothing is more heart-wrenching than watching them struggle. When a child does not eat, parents feel blame and guilt. We ask ourselves why? Did I do this? What could I have done differently? We try a host of different strategies. We Google and seek advice from family, friends, and medical providers. We fall back to what we know, which may or may not work.

Who We Are

Our Feeding Clinic at Easterseals DuPage & Fox Valley consists of a team of individuals who have a passion for helping kids with feeding, mealtimes, tolerance, health, and growth. Our team assesses the many different reasons why a child might be struggling. We are not just looking at their ‘behavior’ but dig deeper and aim to understand the core source of the behavior and what it is communicating. Eating is so much more than bringing food to the mouth, chewing, and swallowing.

Our Clinic consists of a pediatric gastroenterologist/integrative medical practitioner, registered dietitian nutritionist, speech and language pathologist, occupational therapist, and parent liaison. The team has over 230+ years of combined expertise and has gone on for extensive training in many areas, such as NeuroDevelopmental Therapy (NDT), Sequential Oral Sensory (SOS) Approach, DIR/Floortime, Respiratory and Rib Cage Development, Homeopathy, and Chinese medicine.

As a team, we review your child’s birth and developmental history before the appointment, with a thorough analysis of the diet record you submit. We ask you to let us know your evaluation expectations when filling out the paperwork, both online and written forms. Our goal is to meet these expectations. During the actual meeting we are looking and listening for red flags that clue us into issues driving the challenges your child is having. A list of possible reasons why your child might be seen by our feeding clinic is found in Table 1.

Table 1

What Happens, What We Do, and What’s Next

In this unexpected time of a pandemic, Easterseals DuPage & Fox Valley has seamlessly moved to a more virtual experience for nearly all services, including our Feeding Clinic. Keeping our clients, their families, and our staff safe is a number one priority while continuing to be one of the most impactful Feeding Clinics around. Our clinic has been providing virtual evaluations since April 2020, and our use of HIPPA compliant Microsoft Teams platform has allowed everyone to participate fully. When your child is referred for an evaluation by the team, our Clinical Admissions Coordinator will guide you through our secure system of the intake process. We have revamped the process to make it easier for you and provide written suggestions to help you prepare for the evaluation day. Being in your own home for the evaluation has so many benefits but also can seem overwhelming, so we offer tips on setting up your space to allow a more successful evaluation of your child with the least amount of stress for you.

During the interdisciplinary evaluation, the full team meets with your family virtually. Engaging with and helping your child feel comfortable, the speech and language pathologist and occupational therapist will give suggestions while listening and performing their physical assessment. We have worked hard to create a safe, calm, effortless process to continue to successfully support our Feeding Clinic evaluations, which continue to be very much in demand even in a pandemic. Parent’s positive comments and impactful outcomes of our evaluations speak for themselves.

Medical & Nutrition

First the team reviews and establishes your child’s medical health and overall nutrition status. Many medical complications from birth can impact a child. Undiagnosed medical and gastrointestinal (GI) problems often come to light in the clinic.

Think of your child’s health as the foundation of your house. If your foundation is weak, then the floors above it will compensate for weakness. If your child struggles from constipation, diarrhea, dysmotility, gagging, GE reflux, they are most likely subconsciously learning to connect food and drink to feeling poorly. Additionally, understanding your child’s nutrition helps the team understand what might be contributing to what is not medical, allowing the team to make appropriate recommendations to ensure optimal growth and health. Analysis of current nutrition includes what is expected for your child, balance, the timing of meals/snacks, calories, protein, fluid, hydration, vitamins/minerals, route of nutrition, and growth. Understanding both medical health and nutrition status allows for changes from the foundation first and foremost.

Speech and Language Pathology & Occupational Therapy

Observing how your child interacts and engages during the evaluation can help the speech and language pathologist and occupational therapist before they move on to assess the physical portion of eating and drinking. No matter where your child is in their journey with food and feeding, our goal is to have a positive relationship during the process. While observing your child, both therapists also look at their underlying motor skills and evaluate if any postural supports might be beneficial. Mary Massery, a well-known physical therapist, has said “breathing always wins”, and she is not wrong. Breathing dominates. Where your body is in space and stability is its second priority. Swallowing and feeding behavior must continually adapt to changing respiratory and postural systems.

The speech and language pathologist works to get a better sense of your child’s oral motor skills while the occupational therapist observes potential underlying sensory processing difficulties and relationship issues with food. Anxiety around meals and feeding can increase adrenaline which suppresses our desire to eat. Assisting with overall regulation is essential for comfort at mealtimes.

Social Services

The emotion with feeding and nutrition difficulties can be overwhelming for both the parents and child. Often, a child’s survival from birth and medical health is the primary focus, as it should be. When a child becomes more stable, a parent can start to see beyond the medical fears and begin to focus on other things such as the experience of feeding. With this new focus, the emotions, fear, concerns, and hope are still there. Whether your child is struggling to be an oral eater or being fed by tube, the emotions can be immobilizing. Our parent liaison is a vital team member in our clinic, helping every parent know they are not alone. She provides support, empathy, and connections to any number of resources.

Wrapping Up

By the end of the evaluation, the team confers together, with immediate and long-term recommendations being made. Often, these recommendations focus on gut health, breathing, positioning, or establishing improved nutrition, before working on some of the more therapeutic needs such as oral motor skills or sensory processing/relationship interactions. Sometimes recommendations are made to work on several key things simultaneously to help your child be more clinically stable, or a single recommendation that may be central to all other concerns identified. Returning to our 90-minute clinic for a follow-up visit may be one of the recommendations made.

Final Thoughts

Wherever you are at in your child’s journey, there are many aspects to feeding disorders in the pediatric population. Therefore, identifying and addressing all of them is a priority that should not be overlooked. Easterseals DuPage & Fox Valley’s Feeding Clinic has been and continues to view your child and his care from this interdisciplinary “Pediatric Feeding Disorders” approach, involving a skilled and expert team of professionals. Nutrition issues is an area that brings an enormous amount of stress and anxiety to a child and his caregivers. Our team is uniquely qualified and experienced to assist children at all levels of feeding, instilling hope and helping them be their very best.

Every child is unique, and each intervention is tailored to fit your child and family. While you research options you have, consider the following –

• Aim to help your child feel their best. They need to feel well – this is key for success in any area.
• Ensure your child is receiving sound nutrition, regardless of what they are currently receiving. There are many ways around getting your child good nutrition.
• Assess their positioning with mealtimes and feeding to be sure they are fully supported. Positioning is key. Seated on a firm surface with feet flat on the floor or chair rail, with head and shoulders aligned over hips, equal weight bearing, is the most optimal positioning. Allow her arms to rest on her tray or table with shoulders down.
• Ensure a regular schedule. Regardless of if your child is orally fed or through a tube, a mealtime plan is essential, and helps your child learn hunger and fullness, allows their bodies to sustain through the day, can improve their overall tolerance, and should have a positive beginning and end.
• Patience – feeding therapy is a journey with bumps and curves along the road. Share your compassion and empathy. Learning to eat and mealtimes, after a rough beginning, might involve reshaping many memories. You might have to start over to build trust. Remember even the tortoise finished the race with the hare.
• Expose, expose, expose and don’t limit opportunities for exposure. Have fun and play with food. Model appropriate food reactions – don’t “yuck someone else’s yum.” Continue to find ways to present food to your child even if he is not ready to taste them. You can read books together about food, visit different grocery stores and markets, kids cooking classes, and find ways to get them involved in mealtime preparation without eating. And even if it involves a tube feeding.

To learn more on our Feeding Clinic and Nutrition Department at Easterseals DuPage & Fox Valley visit our website at: https://www.easterseals.com/dfv/our-programs/medical-rehabilitation/specialized-clinics/feeding-clinic.html.  Contact Clinical Admissions at 630.261.6287 or mscholtes@eastersealsdfvr.org  for questions or to schedule an appointment.