Welcome to our Blog Community!


 We want to welcome you to our new blog which we hope will become your blog!

Do you often have clinical questions/problems that you would love to share with others? We hope you will use this blog to glean opinions from other respected therapists, and to learn more about current relevant issues that you face daily.

This is an exciting venture for us, as we move forward in this fast paced, exciting digital world. We want to engage you, our community of physical therapists, occupational therapists, speech language pathologists and special educators and become the go-to place to share your ideas, challenges, solutions, and to learn therapy tips from others.

We will regularly be posting topics that are current and relevant such as:

Clinical challenges and solutions, therapy nuggets from our distinguished faculty, therapy tips from colleagues, professional development and CEU issues, as well as clinical research updates. 

We invite you to share your ideas with us, post a clinical challenge you are currently facing, or share a great therapy tip with your colleagues.  

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23 Responses to Welcome to our Blog Community!

  1. Amy says:

    Excellent to see a blog here through ERI…anyway to share info is a good thing 🙂

  2. Nancy D Carpenter says:

    This is such a great idea!

  3. Kat says:

    I currently have a client with Rett Syndrome and this is my first case in my career to treat the child. She presents with very high functioning skills, she is able to transition from the floor to stand via bear stance, she can walk over uneven surfaces with out falling over, she can gallop and increase her walking speed without falling. She has a #3 DAFO on one foot and a #4 DAFO on the other. Cognitively she does not follow verbal commands and requires hand over hand assist to stay on task. This child is 10 years old and the previous therapy place was seeing her on a weekly basis. I reached to them to ask their recommendations and opinion on realistic goals and if she requires continued therapy on a weekly basis. The therapist philosophy was to treat this child on a weekly basis due to her progressive neurological decline and that if she saw the child, that the child would not regress. I treat what I see, I also work in an outpatient clinic which insurances drives to see improvements. Is skilled services required at this time with her current presentation?

  4. Jennifer Hughes says:

    I am a new pediatric occupational therapist and I can’t wait to hear some suggestions. A fellow physical therapist and I have been struggling with a patient: 16 month old female, Dx with Down’s syndrome. I have been seeing this pt. for around 5 months. The physical therapist and I whom are working with this little one feel as if we have hit a wall for about the last month. The patient was making excellent progress, including independence with sitting balance and improvement with functional transitions. The patient now begins to cry the second she leaves her Mother’s arms. We have tried having the mother observe unseen through a one way mirror, using the mother as a distracter, and even utilizing Mom for much of the handling. The other therapist and I have begun testing a variety of sensory strategies along with private rooms, large treatment gym, natural lighting, low lighting, music, etc. We have backed off with handling and tried moving off of the floor to platform swings, swiss ball, & even mother’s lap to no avail. The patient immediately closes her eyes, throws herself into extension, begins to cry, and is unable to be calmed by Mom or therapist. The patient has been cleared by her MD for GI, cardiac, and any other factors we could think of. Mom and Dad report the Pt does not demonstrate any difficulties at home. Any suggestions would be greatly appreciated!

    Tip for OT’s working on feeding:
    I recently attended a conference on Autism and an amazing OT & DO, Paula Aquilla was one of the presenters. She shared many techniques she has tried, but one that has really worked for me is a feeding game. You begin by making a die with words such as lick, kiss, smell, touch, look, etc. We have a pile of cards with pictures of foods we are exploring that day; we used the PEC images with the word underneath. We take turns rolling the die and picking a card from the top of the pile. We both follow the directions on the die matched with our card and we maintain a very non threatening environment. This patient has begun trying food at home. I have my fingers crossed but so far this has worked for us!

  5. lorraine says:

    Hello from NH! Nice to meet everyone.

  6. theresa swift says:

    Clinical Challenge: Home Care OT treating 60 y.o. male w/GBS (diagnosed 1 year ago), who has almost no sensory or motor function in bilat hands. Had restricted extension in wrists/hands/fingers premorbidly (i.e. couldn’t do push ups). Has IDDM, but no other restrictions. Trying to apply NDT concept of promoting return through weight bearing on BUE, but very difficult to position his hands appropriately. He is able to maintain stance with min A and has return in proximal BUE. What successful strategies has anyone tried with these patients that they’d care to share?

  7. Rick Evans says:

    I am in an acute setting for a large university hospital in the midwest. Currently our management staff prefers we rotate on an average of 4 month schedule around the hospital, with all Level 1 Trauma areas such as Cardiac, Neuro, Ortho/trauma, Oncology, Renal, Transplan, Burn, and ICU. Are there any other hospitals out there that work in a similar function? I have been looking at other area hospitals and they seem to keep their therapists in areas of preference rather than a rotation that allows little room for specialization. Thanks for your input.

  8. Linda Veale says:

    I am an experienced OT (37 years) working in Early Childhood Intervention working in the home. Our program really wants us to use what is in the home and in the child’s natural environment. I have a 23 month old child who is in Spanish speaking family (so I work through an interpreter). He is extremely shy (fearful of all change)and will not interact with me at all. The way I treat is giving the mother ideas and then she tries them with him. The interpreter is an ECI Early Intervention Specialist who can also interact with the child and get him to do some of the things I suggest. He did not walk until 19 months. He never tolerated tummy time and even after he crawled he would not get on the floor to look for a toy under the bed, etc. He is an over responsive sensory avoider, extremely posturally insecure, moderate hearing loss, balance and motor planning are very poor. We have made lots of improvements and he will now get on the floor and look for a toy that rolls under furniture, get on a jumping horse and bounce, sit on a donut gym ball and play with toys, runs in the house but not the yard or playground, climbs on and off furniture, allows Mom and Dad to bounce him on their knees as long as it is not too aggressive and kicks a ball. I have left a few things in the home to work with (Rody Jumping Horse and Donut Ball). I am needing some new ideas in the challenging case.

  9. Rachel says:

    Looking forward to sharing ideas!

  10. Beth says:

    I have a client right now that I am having trouble teaching how to chew. He was on stage 2 baby foods at 14 months old when I first started working with him. He is now eating mashed table foods, but often needs pudding or appleasuce on the spoon with the foods to tolerate. His mother has done the Therapressure Protocol with him in the past and we saw great improvements with tolerating touching foods, diaper changes, etc. I have asked his mother to start the Therapressure Protocol again. Now that we are gradually making his food chunkier, we have noticed that he does not chew. I gave his mom a NUK brush and gave her suggestions on working on tongue lateralization to improve oral motor skills. He will briefly hold something between his front teeth, but he pushes the chewy tube forward with his tongue when I place it on his back molars. I have his mother inserting the spoon to the sides of his mouth so the food is placed on his molars and she said she thinks he chewed one time over the past week. Any tips or suggestions would be appreciated! Thanks!

  11. Can’t wait to share and learn!

  12. Jen Corbeil says:

    We are a multidisciplinary pediatric practice and are looking to start doing some case studies. Our last student did some research and came up with a protocol and I was surprised at how involved it was and overwhelmed with the time commitment.

    We have quite a few students so that is one way we were going to trial our first case study but I was wondering if anyone else is doing formal case studies specifically in a busy outpatient setting.

    Thanks so much
    Jen PT
    Mainely Kidz

  13. Jaclyn says:

    Clinical Challenge Question:
    Client with Feeding Difficulties:
    I am seeing a child who is now 15 months of age. She was born at 36 weeks gestation, with very low birth weight and a very weak suck – was never able to breast feed successfully. After transitioning from hospital to home, mom found that only one orthodontic nuk nipple would work for feeding her 50/50 mix of breast milk and formula. The child was very sensitive to different bottle nipples, many of which would make her gag and vomit. Since 1 month of age, the child has been vomiting almost daily (previously was after every feed). She was diagnosed with reflux (GERD) and put on medication (Prevacid), which was recently discontinued due to doctor’s belief that the reflux has improved now. The child was able to take in enough with the frequent liquid feeds, and she is still currently an age-appropriate weight. Mom has been trying several strategies and for over a few months to transition her to accepting anything solid (started with trying pablum, which child could not accept without having a gag and/or vomit response). Mom has applied all recommended sensory strategies (z-vibe introduction and exercises, tactile exploration, sensory play, introducing new smells/tastes in graded steps, and use of wilbarger oral protocol, etc.). The problem now is that the child’s transitioning to solid foods and thickened liquids is ongoing, but slow. As well, the child has been vomiting daily since 1 month of age. Now, when the child coughs too much, gets too upset, or has something stuck in her mouth that she can’t get out with her tongue, she uses vomiting as a default strategy for getting anything uncomfortable out of her system. The mom would like to know if there are any strategies/tools or approaches that can be used to 1) stop the vomiting from occurring once she can see early signs of that response in the child (i.e. if the reflux is just starting, the mom can sometimes stop it if she distracts child by putting her feet in water — she would like more strategies like this); and 2) prevent the child from developing a voluntary behavioural issue with vomiting, as she matures.
    Any advice, recommendations, feedback from other health professionals familiar with these issues would be greatly appreciated!!!!! Thanks 🙂

  14. Diane says:

    I saw a program on the use of Yoga for therapy in June in Phoenix. I thought I saved it but can’t find it. Is it sponsored by ERI? Please e-mail me or call me at 866-567-7330 and let me know. Diane B

  15. I am working with a baby that is 8 months old. She presents with orthopedic deformities of the left hand and foot. She also has a torticollis on the left side. She has some mild tightness throuought the left side. I am writing concerning the torticollis. I have been working with her since she is 3 months old. She is not responding to the standard therapies for torticollis including massage, stretch, positioning, and kinesio taping. (We also have an appointment with an eye DR. to rule out the possiblity of this coming from the visual system) We are currently using a Tott collar and I am hopeful that we will see success. I am interested in knowing if there are any practitioners that have had children that required surgical intervention for a torticollis and if so how did they make that determination and what was the procedure like.

  16. kristen hall says:

    I am a pediatric nurse practitioner that works in a NICU but ironically my own daughter, an x 35 weeker, struggles with severe oral aversion. I knew the day I brought her home from the hospital she was special and “different.” I couldn’t pinpoint at the time what was wrong and never imagined the journey we have travelled thus far. At 18 months old she was diagnosed with sensory processing disorder and failure to thrive and enrolled her in the early intervention program. She was much delayed in her gross motor skills and not walking until 19 mos. Fast forwarding to age three, she was diagnosed with Celiacs disease and we thought that was the answer to her failure to thrive and her sensory issues. A year later she didn’t grow in height and only gained a pound weighing a mere 26lbs. After a long agonizing 3 month decision with the GI team we placed a gtube. All this time her family, doctors, and therapists seemed to miss her oral aversion focusing on her delayed grossed motor skills. So today at age 5 she maybe orally eats a select few foods and relies on gtube feeds to keep her alive. Everyday is a struggle to get her to eat and “just take one bite”. What are your experiences with these children in their teen and adult years? What percentage out grow this problem? What have you found to be the most successful treatments? Thanks for all your help.

  17. One difficult area is getting older kids with Down Syndrome or on the Autistic spectrum (4-5years olds) to cooperate with higher level activities. Some of these kids are either not well structured at home and combined with short attention spans, I find them difficult to guide in physical therapy.

  18. Inger.Brueckner says:

    I think this may be a good option for solving some problems with difficult patients. I have a question to toss out to eveyone:
    I sometimes have difficulty calming down symptoms in my vestibular patients. I can usually manage in the clinic, but I would like to give the patient more ideas on what to do at home. I am thinking more of the vertigo-migraine patient during one of their spells at home. I have a few tools that I give patients, but any more ideas, or tips that help would be greatly appriciated!
    Thanks,
    Inger

  19. Nere says:

    I feel this is a great way to increased the ability to have resources available to clinicians. One of the things I would like to be available is hands on continuing education workshops!

  20. Hilda L says:

    Hi everyone, This is a great idea, and welcome to shared and learn. I am interested in PTA’s CEUS-workshops…!

  21. Jessica says:

    I’m interested in any splinting/positioning techniques for infants in nicu with low tone on primarily lower extremities;
    Anyone have any ideas?

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