Questions to Ask Before My Clinical Fellowship Year

Photo of student getting ready for their Clinical Fellowship Year

Starting your Clinical Fellowship year is exciting—but it can also feel overwhelming. Before you jump in, take a little time to reflect. Asking yourself the right questions now can help you find the best fit and start your career with confidence.

1. Who will my clients be?

Do you see yourself in pediatrics (schools, outpatient, hospital?) or working with adult patients (in the hospital, SNF, outpatient, or specializing?),? What areas draw you in? Articulation, AAC, literacy, language, or feeding? You don’t have to have it all figured out—but having a general direction helps.

2. What work environment fits me best?

Think about where you thrive! Do you prefer a fast-paced clinic , scheduling yourself in a school environment, or in home with your patients? Do you want to work closely with other professionals everyday or have more independence?

3. What kind of support do I need?

Your CF supervisor plays a huge role in your experience. Ask yourself: Do I want hands-on guidance? Frequent feedback? A team I can easily turn to with questions? An experienced mentor?

4. What do I want to learn this year?

Your CF isn’t just about completing hours—it’s about growing your skills. What do you want to feel confident in by the end of the year?

5. What are my non-negotiables?

Consider what matters most to you. Ask about caseload size (both appointments and number of patients/students whose cases you must manage), work-life balance, mentorship, or pay structure (W2 vs 1099). Knowing your priorities will help you make the right decision.

You can also ask about benefits! Some benefits make a big difference today like PTO, paid holidays (are they taken out of your PTO?), medical coverage, and more. Other will shape your future in a big way, like the retirement plan options.

6. How will I take care of myself?

This year can be demanding. Think about how you’ll manage stress, stay organized, and maintain balance so you can show up as your best self.

Your CF year is just the beginning. Taking time to reflect now can set you up for a more meaningful, supported, and successful start in the field. And if you can, find a mentor who will guide you through these sometimes-challenging questions.

Continue Reading

June 17, 2022

What Is the TheraSuit Method and How Does It Help Children Build Motor Skills?

History of TheraSuit

Richard and Izabela Koscielny are physical therapists, who have a daughter diagnosed with cerebral palsy and tried out suit therapy with her. After significant improvements with the suit, they modified and created their own suit specialized for therapeutic benefits, called TheraSuit™.

How Does TheraSuit Work?

  • TheraSuit worn over a prolonged time will correct proprioception and accelerate progress with functional strengthening
  • Skills practiced become more fluent when TheraSuit is worn
  • TheraSuit facilitates the development of new gross and fine motor skills faster than typical therapy approaches

Benefits Seen with TheraSuit

  • Retraining the central nervous system
  • Restores ontogenetic development
  • Provides external stabilization
  • Normalizes muscle tone
  • Aligns the body to as close to “normal” as possible
  • Provides dynamic correction
  • Normalizes gait patterns
  • Provides tactile stimulation
  • Influences the vestibular system
  • Improves balance
  • Improves coordination
  • Supports weak muscles
  • Decreases uncontrolled movements in ataxia and athetosis
  • Improves body and spatial awareness
  • Provides resistance to muscles to further enhance strengthening
  • Improves speech production and fluency through head control and trunk support
  • Promotes gross and fine motor development
  • Helps decrease contractures
  • Helps improve hip alignment through vertical loading
image

Patient Populations

  • Most major neurological diseases/diagnoses:
    • Autism
    • Down Syndrome
    • Cerebral Palsy
    • Cerebral Vascular Acciden
    • Traumatic Brain Injury
    • Spinal Cord Injury
  • Posture/alignment asymmetries
image

Intensive Physical Therapy Schedule

  • Intensive physical therapy is meant to be done 3 hours/day, for 5 days/week for 3-5 weeks
  • Recommended to complete 3-4 intensive bouts of therapy throughout the year
  • Breaks between the bouts have been shown to be more beneficial for the patient vs continuously pushing for months on end
  • Recommended to complete HEP 1-hour/day to compliment exercises done in intensive, allowing the patient to not only maintain, but improve their functional abilities
  • The schedule of 4  weeks was created specifically in order to change the neuro-pathways, and allow for increased improvements

In General

  • Week 1 works on correct muscle activation and beginning to complete basic concentric exercises
  • Week 2 works on solidifying concentric movements and working into eccentric movements
  • Week 3 solidifies the eccentric movements and introduces isometric holds
  • Week 4 focuses all on isometric holds, working into more complex exercises, as well as creating POC and HEP for time off between bouts of intensive

Work to decrease primitive reflexes and general movements that are present → goal-directed movements → selective effective strategies → refining skills → maintaining through practice

December 8, 2023

Unlocking the Power of Play: 5 Beneficial Toys for Children Aged 0-10 Years

‘Tis the season of shopping! During all the hustle and bustle, MetroEHS wanted to offer a few tips for how to shop smart for your little superhero! At MetroEHS, we know that play is a crucial aspect of a child’s development. This means choosing the right toys can significantly impact a child’s cognitive, physical, social, and emotional growth. During this season of giving, we thought we could explore five suggestions for beneficial toys that cater to the developmental needs of children, as well as share our Amazon Shopping Idea list that was created by some of our amazing and knowledgeable MetroEHS therapists.

Sensory Toys and Building Blocks for Littles (0-2 years):

In the early stages of life, infants rely heavily on their senses to understand the world and face-to-face time during play time is paramount. Through engaging directly with beloved caregivers and family members by singing simple songs, reading nursery rhymes, and playing silly fingerplays like peekaboo, little ones learn to enjoy level appropriate toys as well as time with caregivers.

Sensory toys with high contrast patterns are the most engaging selection for children aged 0-2 years. This includes toys with different textures and sounds and toys that allow for simple problem solving.  Aim for easy to grasp toys that target multiple senses for the sensorimotor stage of play in order to promote motor skill development and learning.  Ensure toys are free from small parts that could pose a choking hazard. Be sure to engage with your child by narrating what they are feeling and doing with the toy with simple language (e.g., “Big ball!” if playing with a ball). soft, cold, bumpy, hard, etc.).

Children are natural builders and playing with building blocks can enhance their motor skills, spatial awareness, and creativity. Choose colorful blocks that are easy for small hands to manipulate. Building activities also promote problem-solving, social skills, and cognitive development as children experiment with different arrangements and structures. Engage with your child by verbalizing and encouraging them to “put on”, “knock down”, “kick over”, “put in”, “take out”, or use narration of colors and counting to practice those ever-important verbal skills. Make playtime learning time!

-Pretend Play for Toddlers (2-4 years): Preschoolers love to pretend and role play. Toys that simulate real life tasks (cooking, tools, costumes) are great for cognition and development of the imagination. They also foster independence, social and emotional skills, overall language, and critical thinking.

-Games for Early School-Aged Kids (4-6 years): Board games tailored for young children offer a fun way to introduce early learning concepts such as counting, color recognition, and basic literacy. Games like “Memory” or “Chutes and Ladders” encourage social interaction, turn-taking, and strategic thinking. Games like “Sneaky Squirrel” and “Twister” can foster fine and gross motor skills. Ensure the games are age-appropriate and encourage cooperative play, fostering important social skills.

-STEM Toys for School-Aged Children (6-10 years): As children progress through the school years, STEM (science, technology, engineering, and math) toys can play a vital role in developing critical thinking and problem-solving skills. Look for age-appropriate science kits, robotics, or construction sets that engage children in hands-on learning experiences. These toys not only make learning fun but also prepare children for the challenges of a technology-driven future. Consider games like Headbandz, which can allow your child an opportunity to practice vocabulary skills. Card games are a great time to play with your child in which your child can think strategically, for instance Uno, Phase 10, and Old Maid, can be fun for early school age children.

-Art and Craft Supplies for Creative Expression (All Ages): Foster your child’s creativity with art and craft supplies. From coloring books and crayons for younger children to more advanced crafting materials for older kids, these activities help enhance fine motor skills, self-expression, and imaginative thinking. Consider providing a designated space for art projects, allowing children to explore their creativity in a supportive environment.

Choosing the right toys for children aged 0-10 years involves considering their developmental stage and providing opportunities for growth through play. Soft, sensory toys, building blocks, educational board games, STEM toys, and art supplies can all contribute to a well-rounded and enriching playtime experience. By selecting toys that align with a child’s developmental needs, parents and caregivers can actively support their journey of learning and discovery. Parents are a child’s first play partner. The importance of a parent engaging in play with their child cannot be minimized! Enjoy this special time with your child and make playtime beneficial for both of you.

Experienced MetroEHS Clinicians pulled together a great shopping list which includes some of the toys discussed in this blog. You can find that list here.

https://www.amazon.com/hz/wishlist/ls/2GKR4U81VUFCE?ref_=wl_share

April 22, 2024

Empowering Communication for Children with Autism: A Look at Therapy Interventions

In a recent airing of Live in the D, sponsored by MetroEHS Pediatric Therapy, the spotlight was on Autism Awareness Month, shedding light on how children on the autism spectrum can benefit from life-changing therapy. MetroEHS, a pediatric neighborhood therapy company with multiple locations across Metro Detroit, including expanding services, is dedicated to enhancing the quality of life for children with various therapy needs, including autism.

Deanna Coker, a board-certified behavioral analyst, and Kris Krajewski, a speech therapist with MetroEHS, joined the show to discuss how therapy can significantly impact children’s communication skills.

Understanding Communication Challenges in Autism

Deanna explained that autism, as a developmental disability, often presents challenges in social interaction and communication. Unlike typically developing children who learn language by observing and imitating, children with autism struggle to find meaningful ways to communicate, despite their desire to do so.

The Role of Speech Therapy

Kris emphasized that speech therapy is essential for children with autism, given that communication difficulties are a hallmark characteristic of the condition. Speech therapists, like those at MetroEHS, work to identify barriers to communication and introduce alternative methods for expressing thoughts and needs.

Speech Therapy Interventions

Kris introduced an innovative tool called the AAC device (Alternative and Augmentative Communication), essentially an iPad loaded with specialized software designed exclusively for communication purposes. This device enables children to select words and icons to express themselves, giving them a voice and autonomy in their interactions.

Empowering Communication Through Tools

Deanna highlighted another communication aid, the PECS book (Picture Exchange Communication System), a low-tech solution that uses pictures to help children convey wants, needs, and preferences. By selecting and exchanging pictures, children can effectively communicate with caregivers, enhancing their independence and self-expression.

The conversation between Deanna, Kris, and the show’s host highlighted the importance of therapy in empowering children with autism to communicate effectively. Through innovative interventions and specialized tools, such as AAC devices and PECS books, children can overcome communication barriers and actively engage with the world around them.

For families seeking therapy services for their children, MetroEHS offers comprehensive support, including ABA, speech, occupational, feeding, and physical therapies. With multiple locations across Metro Detroit and additional centers on the way, MetroEHS aims to make therapy accessible and impactful for families in need.