3 Basic Wellness Tips for Every Family with Special Needs Children

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arizona sports programs

by Linda Thunn, PT, DPT, DMG CRS Physical Therapist

Life with a special needs child or adult can be a complex, scary and amazing journey full of ups and downs, triumphs and disappointments that affect the whole family. A good thing to remember is to think about the long-term outcome of a goal rather than just the immediate outcome. You may want your child to walk or talk, but that may not be possible. Therefore consider what can be done to support them in their effort to be independent and find joy in their life.

Caring for a child with or without special needs is a marathon, not a sprint. You won’t always do the right thing, but with good intentions, you will be on the right path. Below are three basic tips to improve wellness for the whole family.

 

1. Breathe

We know we need to eat right and exercise, but when you have a special needs child, you may not have the time to do the “right” things for yourself. Incorporating easy wellness activities into your daily life can make all the difference. The act of deep breathing with intention can decrease your cortisol levels, thereby decreasing stress levels. Deep breathing for a few breathes 3 to 5 times a day takes practice to become a habit and be effective.

Try it right now. Sit down in a chair with your feet flat on the floor. Slowly breathe in through your nose, counting to five (using your fingers to count will slow your breath). Hold your breath for two seconds and exhale through your mouth to the count of five. The goal is to have your midsection expand during the inhale breath and soften during the exhale breath, with your shoulders remaining still. Repeat this exercise three times. As you continue this practice, you can add repeated positive thoughts while you breathe. As you improve, you will be able to incorporate this practice when walking, standing and exercising.

 

2. Play

Please take your pediatric therapist’s advice and include their recommendations into typical activities of daily living. Whether you are working on sitting or walking with your child, you are promoting their independence. Ultimately, the goal of all therapies is to promote progression to a less dependent adulthood. Please do not forget to play. Simple, repetitive activities that are common during functional play build pre-literacy, motor and thinking skills. Whatever your age or skill level, everyone likes to participate if they are having fun. Arizona has a variety of resources for various skill levels, including adaptive parks and sports. Also family-based physical activity increases the health and wellness of your family unit.

 

3. Community Resources

If you have access to the internet, search for community resources in your area by using terms such as “adaptive recreation” or “adapted technology,” and tailor the search to your child’s age-based needs. Participate in the special programs that your child’s school offers, and if your child is going to the Special Olympics games, go with them or volunteer at an event. Other good resources are the support personnel in your child’s life, such as case workers, medical providers and therapists.

 

3 Tips for Interacting with Someone on the Spectrum

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by Tre’Shawn Rizo, DMG team member

3 Tips for Interacting with Someone on the Spectrum

Contents:

An insider’s guide on making friends and merging worlds

In the ninth grade, I was fortunate enough to meet my best friend, Daniel, in biology class. At the time I didn’t know he was, as he likes to put it, “different.” It was later in the day that he let me and a few others know about his autism. But that didn’t matter to me. From the moment I first noticed Daniel, I knew he was a guy I wanted to get to know. You see, earlier that day in biology, our teacher used the expression “pull yourself up by your own bootstraps.” I didn’t think anything of it, but Daniel quickly raised his hand and said, “Hey Mr. McWilliams, that’s physically impossible to do. So, I’m confused by your statement.” Watching my teacher get red in the face and fumble over how to respond was priceless. During lunch that day, I decided to find Daniel and sit next to him. And after an awkward introduction and eleven years, I’m quite pleased to still call him my best friend.
Over these past eleven years of having an autistic best friend and in honor of Autism Awareness Month, I want to share my top three tips for interacting with someone who has autism. But first, let’s start with some definitions, just so we are all on the same page.

Autism: A neurological disorder characterized by repetitive behavior, difficulties communicating and problems establishing and maintaining relationships

Autism Awareness: A movement about spreading awareness and acceptance of people on the autism spectrum

Neurotypical: A person who doesn’t display atypical thought patterns or behaviors

Stimming: Self-soothing, repetitive body movements which autistic people may do in response to over-stimulation or emotional stress. Common ‘stims’ are rocking back-and-forth motions, hand flapping and arm and leg rubbing.

Now that that’s out of the way, we as neurotypicals have a way of being weird or awkward when it comes to interacting with someone who falls outside the norm. However, they are people just like we are. The only difference is they think differently. So here are three tips that will help you develop friendships with people on the spectrum.

Tip 1: Be Kind.

It should go without saying, and this tip applies no matter who you are talking with- be be kind and respectful. A little kindness and respect can go a long way. People with autism are often bullied, teased or talked down to. Do not assume their mental capacity is based off their condition. The two do not always go hand in hand. So do not talk down to or baby them.

Tip 2: Be Patient.

When talking, people with autism may experience an eruption of emotions and misunderstandings. As a result, when processing social cues, they might miss something and accidentally say something that may be taken as naive, mean or offensive, which can tend to hinder the formation and maintenance of lasting relationships. But this situation can be avoided by helping to bridge the gap of misunderstandings. Keep in mind that without the physical and emotional cues to guide their responses like neurotypicals do, they are left with just the words. This gap sometimes can make an experience awkward.

To get a sense of what it’s like, try closing your eyes the next time somebody is talking to you. It’ll give you an idea of how much you are missing out on. It is said that more than half of all communication is nonverbal. If you’re the neurotypical in the conversation, it’s your job to make sure you are clear in your meaning. If you feel offended by what they may have said, instead of showing your offense through your facial expressions, kindly verbalize that they have offended you. You will get an apology a lot faster than making a face at them that they may not pick up on or understand.

Tip 3: Pay Attention.

Pay attention to their body movements for signs of stimming, which happens when they are experiencing an excess of emotion or sensory stimuli. It isn’t always bad, and it isn’t always good; it just is. Many people with autism have free floating anxiety even when they are happy, and stimming helps keep that under control. If you see that they are moving around more than usual, ask if they need anything. Most of the time, they will tell you what they need, and the tiniest gestures go the furthest.

I know that these tips won’t make the stigma surrounding people on the spectrum go away in a day, but it’s a start. Kindness, patience and paying attention are a good start to making new friends and merging our worlds together.

Dental Care for Children with Special Needs

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By Lyn Hughes, BSDH, RDHAP

 

Imagine you are a child experiencing a dental appointment for the first time. Now imagine that you are a child with special needs, unable to communicate with those around you and experiencing this for the first time.

Caring for the dental needs of those with complex histories can prove challenging. Knowing how to treat patients with complex histories begins with knowing how to best help the patient feel comfortable and safe in the dental environment. To say this takes practice and patience by the provider is an understatement. Depending on the physical condition and intellectual level of the individual, the appointment can usually be modified and tailored to help facilitate as pleasant and successful a visit as possible.

Advances in wheelchairs have afforded patients the ability to stay in the chair rather than transferring to a dental chair. Many patients have sensitivities to the light or the feel of the gloves, are not comfortable with a provider wearing a mask, do not like the texture of the dental toothpaste or don’t care for someone invading their personal space. These items are only a short list of many issues facing some patients.

With a calm caring voice, many fears can be soothed.

Asking the patient or caregiver for help to avoid triggers that insight fear is key. Knowing as much as possible about any conditions that exist prior to the appointment is very helpful when treating any patient, but especially those who have challenges communicating. For example, a patient with visual impairment may become startled at the sound of some dental equipment if they are not given a warning that such noise is about to happen.

Not every appointment is going to be successful. In my experience, patients have good days and bad days just like we all do.

I recall a patient who was nonverbal and very fearful of any medical or dental facilities. He came in with his mother and all we were able to do on the first day was sit in the chair. I considered it a successful day. The next appointment, two weeks later, he sat in the chair, and I looked in his mouth. This process continued until I gained his trust and was able to complete his dental cleaning. It didn’t happen overnight, but that wasn’t the goal. Winning his trust and making him feel safe was my goal.

We must always remember that our goal as care providers is to offer the best care possible for our patients- no matter what. It is rewarding to win over the trust of a patient, and getting a hug when it’s over is the BEST!

If you have a child with special needs, ask your pediatrician or primary care provider for names of local dental offices that specialize in oral healthcare for patients with special needs. Arizona also has community resources available to help you find the support you need for dental and other services for special needs individuals, including:

Raising Special Kids
The Arc of Arizona
Southwest Institute for Families and Children
Arizona Department of Economic Security

 

Engaging Children with Spina Bifida for Increased Mobility

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By Linda Thunn, DPT, physical therapist

CRS partners with SBAAZ to encourage best mobility in young patients

SCOOOT provides an early experience of independence for kids with mobility challenges. It frees them to explore their home, play, chase and race friends and siblings without any help. Expert clinicians, designers and engineers worked hard to create a device that will help kids discover new skills as well as new pals. The potential for physical and cognitive development was a key factor in every element of the design.

Spina Bifida Association of Arizona Inc. (SBAAZ), an organization committed to enhancing the lives of those affected by spina bifida in Arizona, was awarded a grant from the PayPal Gives Corporate Advised Fund at Silicon Valley Community Foundation. The grant was recommended by PayPal’s employee-volunteer led Chandler, AZ GIVE Team.

The SCOOOT program idea was presented to the SBAAZ by CRS’s Myelomeningocele Planning Clinic Lead Physician Pamela S. Murphy, MD, FAAP. The program was coordinated by Sharri Runnels, executive director of the SBAAZ, along with SBAAZ board member Linda Thunn, PT, DPT who is also the Myelomeningocele Planning Clinic physical therapist at CRS.

The CRS Myelomeningocele Planning Clinic occurs every Friday, and they see approximately seven patients for all day clinic, visiting up to 13 different providers, having blood work drawn, and if necessary they will get casted for their orthotics and/or have X-rays. SBAAZ provides lunch and signs people up for their medical alert bracelets. Free Arts of AZ is there for the kids to create projects at lunch time.

The SCOOOT program involves readiness assessments, equipment placement, activities and progress checks that will empower ‘toddlers’ to keep pace with their siblings and peers as they establish a sense of mastery over their world. The mobility device, resembling a toy more than a piece of medical equipment, allows children to reach items from the floor, ambulate, and enter/exit the seat safely at will.

“CRS is a great partnership for SBAAZ as we are able to share resources with clients and assess needs over lunch with families that are served by the fantastic care team brought together by District Medical Group,” stated Runnels, “SBAAZ is very grateful for the relationship with DMG and wanted to share the first SCOOOT placement with their staff as they pour so much into the kiddos!”

Spina bifida (Myelomeningocele) is a birth defect in which the spinal canal and the backbone don’t close before the baby is born. This type of birth defect is also called a neural tube defect.

The SCOOOT Earliest Mobility Program kicked off was on Friday, November 10, 2017 with placements being made at the CRS Myelomeningocele Planning Clinic.

Children’s Rehabilitative Services (CRS) Physical Therapy Department Spotlight

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By Linda Thunn, DPT, physical therapist

The Children’s Rehabilitative Services (CRS) pediatric physical therapists provide support and services for children (birth to 21 years) with developmental disabilities, and their families. They aim to develop, restore and improve mobility to improve quality of life.

Pediatric physical therapy benefits children and their families/caregivers by promoting activity and participation in everyday routines, increasing functional independence, improving strength and endurance, facilitating motor development and mobility, and easing the challenges of daily caregiving. Because patient’s are allowed to ”opt in” for services past the age of 21, there are several physical therapists qualified to treat individuals over the age of 21 as well.

Besides treating children one-on-one in the rehab clinic our providers also work in CRS’s Multidisciplinary clinics such as:

• Amputee Clinic
• Cerebral Palsy Orthopedic Clinic
• Cystic Fibrosis Care Center
• Myelomeningocele Planning Clinic
• Spasticity Planning and Follow-up Clinic

Our providers also perform equipment evaluations. They trial each child to determine what works best for them. Those evaluations are done on:

• Adaptive Seating
• Adaptive Car Seats (onsite at NuMotion)
• Forearm Crutches
• Gait Trainers
• Standers
• Walkers
• Wheelchairs (onsite at NuMotion)

A Spotlight on DMG Pediatrics

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By Prabodh Hemmady, MD | Eileen Maddix | Jeanine Pittman

Pediatrics Overview

DMG pediatrics is multifaceted, responsible for patient care in many locations. At Maricopa Integrated Health System (MIHS), there is a robust ambulatory clinic at the Comprehensive Health Center (CHC) where both general pediatric and subspecialty patients are seen.

In partnership with the Ambulatory Care division of DMG, pediatrics staffs primary care physicians at some of the MIHS Family Health Centers (Maryvale, South Central and Mesa). With the implementation of Proposition 480 (“Care Reimagined”), we are hoping to grow pediatric ambulatory care at MIHS. The Pediatric Emergency Department (ED) and inpatient care units at Maricopa Medical Center are also great resources for Phoenix and the surrounding communities.

The Pediatric ED is open 24/7/365 and is staffed by Pediatric ED trained physicians. The inpatient units consist of a neonatal intensive care unit (NICU), pediatric intensive care unit (PICU) and acute care unit. We also care for non-ICU newborns who stay with their mothers on the post-partum unit until discharged home.

Pediatric Subspecialties

Subspecialties at the MIHS CHC include the following fields:

Adolescent Medicine
Neurology
Endocrinology
Gastroenterology
Cardiology
Infectious Disease
Nephrology
Genetics
Pulmonology

Pediatric Residency Program and Medical School Affiliations

DMG pediatrics is a strong partner with Phoenix Children’s Hospital (PCH) and MIHS in training resident physicians, and for many years it has been known as the PCH/MMC Pediatric Residency Program.

There are 32 categorical pediatric positions per year and well over 100 pediatric residents who rotate through MIHS when the medicine-pediatric residents and the pediatric/pediatric neurology residents are added. The pediatric residency program receives well over 1000 applications and interviews over 275 people for the 32 pediatric spots each year. The residents come from all over the country and bring with them a variety of backgrounds.

The department is also very active in educating medical students from the University of Arizona College of Medicine and Midwestern College of Osteopathic Medicine. We also teach medical students from the Mayo School of Medicine and are excited about the relationship developing with Creighton Medical School.

Learn More About DMG Pediatrics

Would you like to know more about DMG’s Department of Pediatrics? The website is available in Spanish as well as English to better serve our patient population, giving them full access to the great information about us!