Changing Colors: The Blog of Spectrum Pediatrics

Archive for the ‘Uncategorized’ Category

February 22, 2017

Tips for Improving Your Child’s Communication

At Spectrum Pediatrics, we often find ourselves talking to parents about small changes they can make during their daily routines to help build their child’s communication skills. Two of our speech therapists are sharing four of their all-time favorite tips for parents. Check out the video below to hear Jamie and Krystina discuss these tips and explain what makes them so important and how to build them into your everyday routine!

Stay posted for more helpful videos on tummy time and feeding behaviors at mealtimes!

February 6, 2017

Trick of the Trade from Tracy Magee, MS, CCC-SLP


Lately, I have been doing yoga with many of my clients, and I have found that it has many benefits for speech and language. Here are a few reasons you should try with your kids today!

1. Attention and Imitation – These skills are necessary to develop verbal speech skills. A child needs to be able to look at someone and copy movements in order to copy lip movements and words.

2. Comprehension – A child must focus on the verbal instructions being given to follow along with the yoga “flow” and assume the correct positioning. This skill helps with processing language and learning new words.

3. Breath Control – Yoga focuses on breath. The deep breaths in and out that are required help a child learn how to control his/her breathing. This is important for controlling breath when producing sounds, too. Deep breaths are also a great way to help kids learn how to stay calm and “regulate” their bodies and emotions.

Some yoga resources that are great for kids are:

  • GoNoodle – available for FREE on their website or on the AppleTV app
  • Yoga Kids by Kirsten Hall
  • Once Upon a Mat… Starring Jessie Forston
  • The Kids’ Yoga Deck: 50 Poses and Games by Annie Buckley


January 20, 2017

Crawling Part 2: The Basics

By Colleen Donley, PT, DPT
  • What does it look like when a baby is learning to crawl?
  • Crawling, either on the tummy or hands and knees, is one of the first times we see a baby piece together “I can move and get to this toy.”
  • True crawling on hands and knees follows a fairly typical progression beginning around 7-8 months and lasting a few weeks.

Belly/commando crawling or creeping: Most babies start with belly crawling as they learn they can move forward to get places, but do not have the strength to maintain a hands and knees position yet.

Rocking on hands and knees: Babies will learn how to push up to a hands and knees position and then begin rocking back and forth. Holding this position and rocking helps babies build stability and strength at the shoulder joint and learn what it feels like to bear weight through their hands and knees.

Inchworm crawling: Sometimes babies will skip this stage, but don’t be alarmed if you see what looks like an inchworm crawling pattern. This looks just like it sounds…baby up on hands and knees, rocking, launching forward onto belly, and pulling legs under them back to hands and knees. Your child has likely learned to use this pattern to move forward because they are still building the stability at the shoulder to pick one arm up at a time.


Hands and knees crawling- Jackpot! The key to know they have mastered crawling is reciprocal arm and leg movements. This means they move the right arm forward while pulling the left knee along and vice versa.

Is your baby stuck at one of these stages and not moving to a new pattern or mastering hands and knees crawling? Stay tuned to the last edition of our crawling series for strategies and tips to make crawling easier and more fun!


January 17, 2017

Crawling Part 1: The Benefits

By: Colleen Donley, PT, DPT

As an early intervention therapist, I often start working with little ones around their first birthday because they are not crawling yet. More times than not, I hear parents ask if we really should address crawling because walking is the ultimate goal and can’t we just start there. Despite popular belief, crawling on hands and knees is still a major motor milestone!

So why do we really want to push crawling on hands and knees? The benefits of crawling extend far beyond the gross motor domain. Crawling on hands and knees stimulates virtually every area of development from gross motor to cognitive, and even, to speech and language.

Here are my Top 10 reasons why not to skip crawling:

1. Development of arches in the hand: All babies are born with fat pads in their hands. While these pudgy hands are super cute, the fat pads need to disintegrate in order for muscles of the hand to develop. Weight bearing through the hands is the most effective way to help those fat pads disintegrate while encouraging all the tiny, but important, muscles in the hand to develop.

2. Integration of primitive reflexes: Maintaining and crawling in a hands and knees position provides input all throughout baby’s body to help primitive reflexes integrate. Two reflexes are key players during crawling- the symmetric tonic neck reflex (STNR) and the asymmetric tonic neck reflex (ATNR). ATNR is present shortly after birth and is seen when baby lays on their back and turns their head to one side, that same-side arm will extend out to the side while the opposite-side arm will bend at the elbow and come up to the shoulder. We see the STNR emerge around this time and help with crawling. With the STNR, baby’s arms will extend in response to neck extension while the legs will bend. This is seen very easily when baby is on hands and knees and looking ahead.

3. Development of visual system: The visual system actually develops in multiple ways with crawling. Baby will learn to keep their eyes fixed while moving and move separate from their motion. As baby is moving, they must be able to stabilize their gaze on an object and hold it steady or else they will just see blurry images as their weight bounces from side to side.

4. Development of the thumb: Shifting weight from hand to hand when crawling helps elongate the space between the thumb and the index finger. This creates more room for toys to be held with maturing grasp patterns. It also promotes development of the muscles of the thumb.

5. Trunk strength for basic activities: With all this hands and knees positioning, the belly is lifted off the ground and muscles of the trunk and core are in constant contraction/relaxation, or co-contraction. Developing muscles of the trunk have massive implications on feeding, talking, and play skills in sitting.

6. Proximal stability: Crawling helps strength and stabilize the muscles close to the center of the body, like neck, shoulders, hips, and back. The muscles close to the joints that help keep them strong and stable are given constant input to contract and thus strengthen. As these joints and muscles strengthen, baby has a stronger base to move and learn new motor skills, both gross and fine.

7. Motor planning: As baby begins to move more in their environment, they will undoubtedly encounter many obstacles. Obstacles can come in all shapes and sizes and can be put in baby’s way intentionally or not. The brain will be stimulated to help baby problem solve how to move around these obstacles. This is one of the first times we see baby begin to motor plan movement strategies, but it is just the very beginning of motor planning.

8. Bilateral coordination:  Remember up top where we talked about what reciprocal crawling looks like? Hint: right arm and left leg move at the same time. This shows us that both sides of the brain and working at the same time and communicating. Activating both sides of the brain at the same time is huge for cognitive development.

9. Exploration of environment: Tied in with motor planning, crawling on hands and knees provides baby with a new independent form of mobility and allows them the opportunity to explore their environment. Babies still learn best at this stage through exploration and experimentation! Let them have the run of the place and see what they get into. So break out those baby gates while encouraging exploration!

10. Of course the best reason for any new skill is to give baby new opportunities for play! We begin to see expansion of baby’s concept of cause and effect with crawling. They begin to engage in more social play, such as peekaboo or hide and seek, now that they can move and find a familiar face around the corner or behind the sofa. Babies also begin to grow their reciprocal interaction skills as they play ball and chase after rolled balls.

Not sure if what baby is doing looks right? Having trouble or feeling frustrated in helping baby master crawling? Stay tuned for parts 2 and 3 on crawling for what typical crawling looks like and how to make it easier to master!


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December 15, 2016

Feeding Friday: Holiday Food Play

Christmas is a season of celebration, gift giving, celebrating family and faith traditions, and food. For picky eaters, non-eaters, and those struggling with their weight, it can become so much about the food that everything else can be pushed aside. Here are a few other thoughts:

  • Giving food as gifts allows kids to see the nurturing side of food. This may be especially helpful for kids who have always found food to be a task.
  • Giving food that kids helped make or serve allows kids to feel pride in their work and get their hands dirty without the pressure to eat it, especially if it is for someone they like to please, such as a teacher or grandparent.
  • Making food platters or gifts is a good together time activity, while also preparing for a party or crossing a name off the shopping list. Making fun foods together allows children to be messy and creative without pressure to eat.
  • Making more than one type of food allows all foods to be seen as fun – fruits, vegetables, cookies and snack foods can all be fun, creative and festive without the pressure of “good food” or “bad food.” It is ok to have some of each, don’t feel pressured to make them all healthy, or all decadent.
  • The time together allows you to talk about what a “treat” it is to work together. Reminding both of you that not all “treats” are something you eat.
  • Making treats can target all kinds of strengths or areas that need help: touching new textures, cutting, rolling, sorting, making designs or patterns, picking up small objects, or counting. There are many ideas to cover each one of these skills.

Here are some ideas to get you started. Roll up your sleeves, clear an area that can get a little messy and have fun! For more resources on these fun food activities check out our Pinterest board here! For other sites with some helpful tips check out this website or here!


December 12, 2016

Trick of the Trade from Tracy Magee, MEd, CCC-SLP

Tips for Transitions

I’m the mom of a two year old, and I am finding this age to be fun yet challenging! Kids in the toddler stage are learning so much everyday about their world, and that is reflected in the child’s changing emotions throughout the day. In this age, a child can get upset or frustrated easily if he sees something he wants, but he may not have the words yet to express himself, or a parent may not feel that the activity is safe. When that is the case, tears inevitably follow. I have found two great tricks that really help easily transition my own toddler when he is upset, and these strategies start to teach him about coping with frustrations and self-calming techniques.

1. Sand Timers – I purchased a set of sand timers online with various time allotments, including 30 seconds, 1 minute, 2 minutes, and 5 minutes. These visuals have been great to give him a “heads up” about moving on to our next activity. Most toddlers do not have an understanding of time yet, so this tool provides something the child can actually see. These visuals help the child mentally and emotionally prepare, and he can feel a little more in control. At my house, we use the timers when transitioning for: clean up, dinnertime, and getting in the car. I’m sure there are tons of other opportunities when these could be used!

2. Time Out Bottles – This DIY tool has been a lifesaver in our house. If my toddler is getting a little too aggressive or needs an emotional break, we bring out this bottle. It motivates the child to sit for a few minutes, and the glitter falling down in the bottle is very calming. When making the bottle, you can add more or less glue and glitter to make the bottle take anywhere from 2 minute to 5 minutes to settle (based on the needs of your child). Simple instructions for this DIY are here!


November 15, 2016

Feeding Friday: Responsive Feeding Presentation

Our clinical coordinator of the Tube Weaning Program, Heidi Moreland, will be presenting at the National American Speech Language and Hearing Convention (ASHA) this week, along with Jennifer McGlothlin, author of Helping your Child With Extreme Picky Eating.  There are extensive references that accompany their presentation and support our work with responsive feeding and creating a healthy relationship with food for new and fragile eaters.  We thought others might find these references to be helpful as well. If you are interested in learning more about our intensive tube weaning program check out our previous post here. Stay tuned for more information about Heidi’s presentation at ASHA!

ASHA 2016 References

For more information about Jennifer’s book check out this website!

November 10, 2016

Feeding Tube to Family Table: How does that work?

Did you ever wonder why feeding therapy doesn’t look anything like the meals you hope to have?  We did too!  At Spectrum Pediatrics, we believe that tube-fed kids need to learn to eat in the same safe way that other kids learn to eat, utilizing the same principles of healthy eating that are good for everyone.

Meet Jennifer Berry and Heidi Liefer Moreland, as they introduce the philosophy behind the Spectrum Pediatrics Tube Weaning Program.  Watch as they explain how a healthy relationship with food that is shared by the whole family leads to freedom from tube-feeding, enjoyment at mealtimes, and lifelong healthy eating habits.

Want to learn more about the people who work with the children in the tube weaning program? Click here to meet Jennifer, the owner of Spectrum Pediatrics, and here to meet Heidi, the clinical coordinator of the tube weaning program. See our Tube Weaning Program featured in the New York Times here.


November 1, 2016

Toe-Walking: Should You Be Concerned?

By: Colleen Donley, PT, DPT
  • New walkers often experiment with toe-walking, but it should not persist.
  • Toe-walking is not an early indicator of autism.
  • Toe-walking can become a long and vicious cycle if not addressed early.

Toe-walking refers to instances where a child is walking without their heel in contact with the ground. This includes walking on the balls of the feet or tip-toes. There are many different reasons a child may toe-walk, which may be an indicator of an underlying diagnosis, but there are also times where we see children walk on their toes for no reason. Sometimes children outgrow toe-walking on their own, but some require skilled intervention to address the problem from worsening.

Most pediatricians and baby books address toe-walking when a little one is beginning to cruise and take their first steps. I often see new walkers experiment with being on their toes and this goes away in time. Young toddlers go up on their toes for a host of different reasons, most often just to experiment with new positions and movement. Being up on their toes helps a toddler to have a more stable arch in their developing foot. Since they are experimenting with walking and do not feel secure, they are often moving quickly with a push toy or “falling” into a parent. Walking at an increased speed imposes more instability on the child and they want to feel stable at the foot/ankle. The American Academy of Pediatrics recommends that toe-walking should not persist beyond 2 years of age. Personally, I feel toe-walking is a problem before 2-years if the child never comes down to flat feet and toe-walks consistently.

As autism has become a more widely discussed syndrome, many people have begun to associate toe-walking with autism. It is true that some children who have autism do walk on their toes for a variety of reasons. Toe-walking has not been linked to autism and is not an early indicator of autism. However, toe-walking can be an early indicator of cerebral palsy or muscular dystrophy in the presence of other symptoms.

The biggest concern with toe-walking when it is not related to an underlying diagnosis, like cerebral palsy or muscular dystrophy, is that it turns into a very vicious cycle that is tough to break. When a child is up on their toes, their calf muscle and Achilles tendon are in a shortened position. If they stay on their toes consistently then the muscle and heel cord are never put on slack and, as a result, tighten up. So now we have a child with a tight calf muscle and heel cord who cannot get their heel down even if they wanted to. Alternatively, the muscles in the front of the shin are in a constant lengthened position and become weak over time due to not being used.

At Spectrum Pediatrics, we like to address toe-walking with a simple stretching and strengthening program while making it fun for the kiddo. No child will enjoy sitting still and letting me stretch their heel cords because most adults wouldn’t either. Spectrum uses a creative approach to put children in a stretched position and encouraging strengthening those-now-weak muscle during play and functional activities.

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October 5, 2016

Trick of the Trade from Colleen Donley, PT, DPT

Push, Pull, Carry

These are 3 of my favorite words to teach parents with kids who have low muscle tone. By adding weight to simple chores or playtime activities, we provide our kiddos with more input to help with position sense and muscle activation. This is especially helpful when talking about a kid with low muscle tone.

For younger kiddos: I like to let little ones play around with full diaper boxes or pretend the laundry basket is a zoo train full of their stuffed animals. They might enjoy building a fort or tower with all the throw pillows, which would require them to pull them off the sofa and carry them over to the pile. Jumping into the tower is just the added bonus!

For older kids: Try adding weight to their normal chores or routines. It may seem simple that a kid would pick up the stack of books and take it back to the shelf, but it also has amazing benefits. I also like to encourage parents to have their kids help carry groceries in from the car. As we head into fall, it will be the perfect opportunity to have your child help rake up all the leaves, pick up a pile and put in the wheelbarrow or bag, and push the wheelbarrow/pull the bag out to the curb.

Can you think of any other playtime games or household chores that might involve push, pull, or carry?