What Is Pediatric DMI Therapy and How Does It Support Motor Development?

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.

As April and Autism Awareness Month have come to a close, we’re highlighting the incredible work of MetroEHS Pediatric Therapy in Metro Detroit. With multiple locations and more on the way, MetroEHS is dedicated to helping families with children on the autism spectrum and those needing specialized therapy. Today, we’re focusing on a universal challenge for parents: potty training.

Joining us are Deanna Coker, a board-certified behavioral therapist analyst, and Kelly Johns, the director of physical therapy at MetroEHS. They share valuable insights on potty training, addressing common issues and providing practical solutions.

Recognizing Readiness for Potty Training

Kelly Johns emphasizes that recognizing when your child is ready for potty training is crucial. Key signs include:

- Extended Bladder Control: Holding their bladder overnight or for several consecutive hours.

- Interest in the Potty: Playing with their diaper, showing curiosity about the toilet, or performing a "potty dance."

- Communication: Telling you they need to go or showing signs they’re aware of their bodily functions.

Addressing Potty Training Challenges

Sometimes, despite a parent’s best efforts, potty training can hit a snag. Deanna Coker points out that issues such as regression, frequent nighttime accidents, or persistent constipation might indicate underlying problems like pelvic floor complications.

Assisting with Physiological Challenges

To support children struggling with potty training, Kelly recommends several strategies:

- Blowing Bubbles: This helps relax the pelvic floor. Encourage your child to blow bubbles while sitting on the toilet or during playtime.

- Using a Squatty Potty: This stool ensures a proper 90-degree angle, aiding in effective bowel movements.

- Belly Breathing: Teach your child to focus on their belly rising and falling, which can help with relaxation and control.

Effective Potty Training Methods

Deanna shares essential potty training tips:

1. Ditch the Diapers: Transition your child to underwear to help them feel the wetness of accidents.
2. Stay Hydrated: Encourage your child to drink plenty of fluids to ensure they need to use the bathroom regularly.
3. Set a Schedule: Take your child to the potty every 20 minutes initially, allowing them to sit for a few minutes each time.
4. Positive Reinforcement: Use rewards like a sticker chart to celebrate successes. This visual progress tracker can be highly motivating for children.

Deanna shares a personal anecdote about using a princess-themed sticker chart for her daughter, highlighting how such simple tools can make the process enjoyable and rewarding for children.

MetroEHS Pediatric Therapy provides comprehensive support for various therapy needs, including ABA, speech, occupational, feeding, and physical therapies. With their expanding network of locations, they are readily accessible to families across Metro Detroit.

For more information or to find the nearest MetroEHS location, visit http://metroehs.com

**Thank you, Deanna and Kelly, for sharing your expertise and practical advice.** Potty training can be a daunting task, but with these tips, parents can navigate this essential milestone more effectively.

Speech, Occupational and ABA Therapy provided in the comfort of your home via Teletherapy!

Teletherapy

MetroEHS Pediatric Therapy proudly offers excellent therapy to our clients, and service them in a way that suits their individual needs. Speech, Occupational and ABA Therapy provided in the comfort of your own home via Teletherapy! Teletherapy, or telepractice, uses a HIPPA compliant and secure video platform, similar to Skype, to connect a client to a specially trained Speech-Language Pathologist or Occupational Therapist for live, individual treatment sessions. This virtual therapy is an excellent option for families all over Michigan who home-school, have busy schedules, or anyone who otherwise have a difficult time coming into the clinic. Contact us if you think Teletherapy would be a good fit for your family!

In addition to individual families, MetroEHS also offers Teletherapy to schools in Michigan to keep IEP’s in compliance. Please visit our Staffing Page to explore more.

Frequently Asked Questions

1. Will my insurance cover Teletherapy?
   Most insurances cover Teletherapy, including many BCBS plans. Community Mental Health is not currently covering Teletherapy in the Metro Detroit counties, but this could change in the future.
2. How old does my child have to be to participate?
   Any age! If a child is young or active, the therapy session will be geared towards “parent training”. The therapist will provide materials and coach the parents to implement the goals and provide feedback.
3. Do kids find it boring?
   No! Our Teletherapy website offers a variety of picture cards and we always incorporate games to keep clients engaged. Kids also love having the attention of their parent and the person on the other side of the screen. It’s all about them!
4. What do I need to use Teletherapy?
   You will need internet connection, a computer or tablet with a camera, microphone, and speakers. Headsets are not required.
5. How will I access the platform?
   Your therapist will send you an email and you will make a free account. When it is time for your session, you will receive another email with a link to the session, you will put in your password, and you will be connected with your live therapist.
6. What if I live outside of Michigan?
   Due to state licensing requirements, we are only able to provide therapy to residents of Michigan.