How do I Know if My Child has a Feeding Disorder?

Pediatric Dynamic Movement Intervention (DMI) therapy is a specialized treatment aimed at improving the gross motor skills, movement control, and overall functional mobility of children with developmental delays.  DMI therapy is designed to promote and enhance the natural ability of children to develop motor skills through structured, targeted interventions.

What is Dynamic Movement Intervention (DMI)?

Dynamic Movement Intervention (DMI) is a cutting-edge therapeutic approach focusing on improving strength, coordination, balance, and motor planning in children with developmental delays. DMI therapy is based on neuroplasticity principles—the brain’s ability to reorganize itself by forming new neural connections. This means that with consistent and well-targeted interventions, children with motor impairments could make significant gains in motor function.

Without disruption or intervention, unhealthy habits (the types of learned patterns of movement a child relies on rather than reflexive movements) become engrained in the child’s behavior repertoire. Neuroplasticity is defined as the ability of the brain to form and reorganize synaptic connections, especially in response to learning, experience, or following an injury. Neuroplasticity is at its height in young children. Without novelty and challenge, well-established habits always dominate. Due to this natural neuroplasticity, it is often better to start children young with any kind of therapeutic care.

The primary theory behind DMI is the use of the body's automatic postural responses.  In DMI therapy, we place the child in a position where gravity provides information requiring a response. We then wait for the child to complete the movement, with gradually less assistance over time.

Who Needs DMI Therapy?

DMI is beneficial for children with and without a specific diagnosis. However, those with specific diagnoses include, but are not limited to:

Cerebral Palsy: Children with cerebral palsy often struggle with motor control, muscle tone, and balance, all of which can be targeted by DMI therapy.

Developmental Delays: Children experiencing delays in reaching motor milestones (such as crawling, walking, or standing) may benefit from DMI’s movement-based approach.

Genetic Disorders: Certain genetic conditions that affect motor development, such as Down syndrome or muscular dystrophy, may be candidates for DMI.

Spina Bifida: This congenital condition affecting the spinal cord can cause motor deficits, and DMI can be useful in strengthening movement capabilities.

Brain Injuries: Traumatic or acquired brain injuries in children that result in impaired motor functions can be addressed through DMI therapy.

Other symptoms of a child who could benefit from DMI include:

• Difficulty with postural control (e.g., sitting, standing, or balancing)
• Delayed or atypical motor development (not crawling or walking at the expected age)
• Limited muscle tone or spasticity
• Challenges in coordination and movement precision
• Fatigue or weakness during movement activities

This is not an exhaustive list. There are many other conditions that may benefit from Dynamic Movement Intervention. DMI therapy is typically recommended for children who have developmental motor disorders or neuromuscular challenges that affect their ability to move, balance, or coordinate their body movements.

Identifying the Need for DMI

The need for DMI therapy is typically identified by healthcare professionals such as neurologists, rehabilitation specialists or physical therapists, often after a comprehensive evaluation of the child’s motor function. Parents may also notice signs that their child is not reaching developmental motor milestones and seek medical advice.

Any physical therapy diagnosis can result in the use of DMI, and this is often very useful for children under 1 to help with head control, children under 2 to help with standing, walking, and posture control, and children 5 and under with more involved diagnoses. Early identification and intervention are extremely beneficial in maximizing the effectiveness of DMI therapy and improving the child’s functional outcomes.

Teletherapy, also called tele-practice or tele-speech, has become more popular during the uncertain circumstances and stay at home orders of COVID-19. Teletherapy can bring a sense of familiarity in uncertain times, as your child can have a weekly live speech therapy visit with a consistent speech language pathologist (SLP). A relationship is built, and the therapist and child share smiles and laughter in between working on their goals. With teletherapy, children can continue to receive continuity of care even as they stay safe at home! But does this foreign method of attending speech therapy really work?

Research is largely in agreement: Teletherapy is a very effective way of teaching kids speech and language!

With teletherapy, speech therapy is provided via a video chat platform that is secure. MetroEHS’s online platform includes fun games, a box for clients to watch applicable videos and talk through worksheets or read stories, screen share, practice cards, and, of course,  a live-streaming video SLP guiding them through all of it. All of these features engage most children, including those on the Autism Spectrum. This 1:1 teletherapy has been proven effective: according to a review of 7 studies of school-aged children, “telehealth is a promising method for treating children” (1). Another study looking specifically at children with ASD stated, “All [14] studies reported high levels of programme acceptability and parent satisfaction with the telehealth component of the intervention” (2). And another states, “Emerging research in telepractice treatment for ASD clients already shows success in both direct and indirect interactions” (3).

If a child is too young or difficult to engage, the SLP may opt for a parent training approach. The parent will receive a list of supplies to gather from around the house, and the SLP will teach the parent how to target the child’s goals. The parent is encouraged to ask questions, and the SLP coaches as the parent engages their child and completes their goals. This has also been proven effective for children learning language! Evidence suggests, “that parent-mediated intervention training delivered remotely can improve parents’ knowledge in [autism spectrum disorder] ASD, parent intervention fidelity, and subsequently improve the social behavior and communication skills of their children with ASD (4).

Feeding Therapy can be provided with a similar model. The SLP guides the caregiver during the session, and talks through strategies and techniques for children accepting the food, chewing, and swallowing. Providing feeding therapy online can be beneficial because the SLP can see where the child typically sits, the types of eating utensils that are used, and overall family dynamic- all of which play a major role in carryover of skills to the home environment. What better way to support generalization to home, than having therapy in the home! Feeding Teletherapy, too, is an excellent and effective substitute to in-person therapy, according to research (5)!

As you can see, teletherapy is a powerful alternative to in-person therapy, especially during situations when receiving in-person therapy is difficult or impossible for families. If you would like more information about teletherapy, to enroll your child, or a free “Teletherapy Tour” to see our platform, please contact MetroEHS today!

Resources

1. 2017. Wales, D., Skinner, L., et al. The Efficacy of Telehealth-Delivered Speech and Language Intervention for Primary School-Age Children: A Systematic Review. International Journal of Telerehabilitation, 9(1), 55-70.
2. 2018. Sutherland, R., Trembath, D., et al. Telehealth and Autism: A Systematic Search and Review of the Literature. International Journal of Speech-Language Pathology, 20(3), 324-336.
3. 2015, April 28. Cornish, Nate. Social Mediating: Using Telepractice for Clients With Autism. ASHAwire.
4. 2017. Parsons, D., Cordier, R., et al. Parent-Mediated Intervention Training Delivered Remotely for Children With Autism Spectrum Disorder Living Outside of Urban Areas: Systematic Review. Journal of Medical Internet Research, 19(8), e198.
5. 2008. Clawson, Seldon, Lacks, Deaton, Hall, Bach. Complex pediatric feeding disorders: using teleconferencing technology to improve access to a treatment program. Pediatric Nursing, 34(3): 213-6.

Are you concerned about your child’s toe walking habits? Toe walking, a common concern for parents, can sometimes be associated with autism spectrum disorder (ASD). Understanding the connection between toe walking and autism is crucial for early intervention and support.

What is Toe Walking?

Toe walking refers to a walking pattern where a person walks on their toes or the balls of their feet without their heels touching the ground. While occasional toe walking in toddlers is common, persistent toe walking beyond the age of two may indicate an underlying issue.

The Connection with Autism

Toe walking is often observed in children with autism spectrum disorder (ASD). While not all toe walkers have autism, studies suggest that many children with ASD exhibit toe walking behavior. Children with Autism often have higher sensory seeking behaviors, and being up on their toes gives them deep sensory input through their feet and in their contracted calf muscles. This connection can lead to more targeted interventions and support from therapists and parents.

How Can a MetroEHS Physical Therapist Help?

Physical therapy plays a crucial role in addressing toe walking in children, especially those with autism. A skilled physical therapist can:

• ‍Assess the Underlying Causes: A physical therapist will conduct a comprehensive evaluation to identify any underlying factors contributing to toe walking, such as muscle tightness, sensory issues, muscle weakness, or lack of range of motion.‍
• Develop Individualized Treatment Plans: Based on the assessment, the physical therapist will create a personalized treatment plan tailored to your child’s needs. This plan may include stretching exercises, strengthening activities, balance training, or different sensory inputs.‍
• Educate and Empower Families: MetroEHS Physical Therapists work closely with families to educate them about toe walking and provide strategies for home exercises and activities to support their child’s progress.

Toe-walking can impact your child long-term if left untreated:

Toe walking will impact your child’s overall body positioning, posture, and muscles. With toe walking, because of these impacts, it will also change the load of the body’s joints and likely cause chronic pain as the individual ages. It is common for toe walkers to lose range of motion in their ankles, preventing them from being able to reach their heels to the ground and causing their Achilles tendon to shorten. In more severe cases, if the Achilles tendon shortens too much, the only way to regain that length is with a surgical lengthening.

Take the First Step Towards Support

If you’re concerned about your child’s toe walking or suspect they may have autism, early intervention is key. Schedule an evaluation with a qualified physical therapist who specializes in pediatric care. Together, we can help your child take confident steps towards improved mobility and independence.