“The wonderful staff at CTC helped us see the miracle in each and every step that Abby has taken. They've helped us to celebrate the fact that each of those tiny, individual miracles make it possible for the next miracle to happen. And the next one, and the next one, and the next one.”
-Beth, mom of Abby
Abby Mclean is a 9 year old force to be reckoned with. She boxes with her older brother, Owen. She swims and practices tae kwon do, where she was recently awarded a “pink belt” created especially for her. And in her group workout sessions at CTC’s fitness center, she tackles the elliptical machine and the treadmill like an old pro.
As her mother, Beth, watches her daughter work out, she smiles. “It is pretty amazing to see her doing all this stuff,” she says. “As the parent of a child with developmental delays, it is sometimes difficult to see the progress your child is making. It's easy to become focused on waiting for a miracle – that recurring dream that she’ll wake up one morning speaking full sentences and doing backflips! But the wonderful staff at CTC has helped us see the miracle in each and every step that Abby has taken. They've helped us celebrate the fact that each of those tiny, individual miracles make it possible for the next miracle to happen. And the next one, and the next one, and the next one.”
At the age of 8 weeks, Abby was in need of a few miracles. She was diagnosed with Prader-Willi syndrome, a genetic abnormality that resulted in multiple developmental delays in speech and motor skills, moderate hypotonia (low muscle tone) and difficulty feeding as an infant. Abby was referred to Children's Therapy Center right out of the NICU.
“We started with feeding therapy,” Beth recalls, “which helped her progress from being fed through a tube to eating independently.” From there, Abby began working with speech therapists. She went from being completely silent, to using sign language, to making understandable speech.
Abby received occupational and physical therapy as well. “With a typical child, you take for granted that they will learn to turn their head, roll over, sit up, crawl, and walk. For children like Abby, all that had to be intentionally taught,” Beth says. It was important that Abby learn to become active, too. “Not only do Prader-Willi children deal with low muscle tone, but their metabolism is super slow and they always feel hungry. Weight gain is a real concern for them.”
Even as she got older, Abby continued to love the days when she got to play with one of her “friends” at CTC. “When children are little, it’s easier to get them involved in therapy but as they get older, it becomes more challenging to impart that desire to work and learn. The variety of techniques and toys the staff has at the center makes it possible to motivate any kid to work on and achieve their developmental goals.” Games using painting, swinging, water, and even flashcards were exciting for Abby. “The children just see their therapy as playtime. Meanwhile, the results are amazing!”
Back in the fitness center, Abby has moved on from her warm-ups on the elliptical and treadmill and is ready to demonstrate a jump rope routine to her group. She has been working hard and long to develop this skill, both at CTC and in school. Boys and girls all approximately Abby’s age sit in a semicircle around her, watching attentively as she grabs the jump rope handles and flips the rope above her head. After a few false starts – and a few frustrated grimaces – she hits her stride.
“I’m gonna do 20,” she announces, and the group counts down together for her, erupting in a cheer when she hits her goal. But Abby keeps going. “Four more!” she says. “Four more!”
In the photo above: Abby with her therapist, Lindsay. Abby began to defy expectations the moment her parents watched her pull herself up upright and start walking the week after she turned 2. “Prader-Willi kids don’t crawl because they have such weak arm strength,” says her mom. “We were told that she might not walk until she was 3 or 4. But one thing I have learned about her – when she decides to do something, she does it. She is a redhead, after all!”
Anthony is a rambunctious 4 year old boy – and his mother, Nikita, sounds proud to be able to describe him that way. “The first question after his birth was, ‘Would he survive?’” she says. “The second was, ‘What will his quality of life be like?’ Doctors didn’t know and couldn’t predict.”
Anthony was born prematurely at 27 weeks old and weighed just 1 lb 9 oz. He’d suffered a brain hemorrhage (a grade 4 on a scale of 1-4) and although doctors knew he’d be delayed as a result, they could not say to what extent. They did know he had cerebral palsy affecting his left side.
The uncertainty grew for Nikita and her family. “Not knowing [what is happening or what to expect] is the hardest thing,” she says. She began comparing his progress to that of other children, which left her more worried and anxious. “By his first birthday, Anthony was still not walking and doctors were saying he may never walk. I wasn’t sure what to believe he could do.”
One day, Nikita reached a turning point. She started thinking in other ways. “Now I ask myself, ‘What’s the best that HE can do?’” As a result, she is experiencing the excitement of seeing small miracles happen all the time. “We don’t take ANYTHING for granted because when we left the hospital with him, we didn’t know what was possible.”
When Anthony started receiving occupational therapy at Children's Therapy Center, his therapist, Lindsay, helped Nikita and her family set goals for Anthony. “At first, I didn’t even know where to start,” Nikita says. “Then out of the blue, I just started signing with him and he surprised me by picking that up quickly! That’s when I started raising my sights.”
One of Anthony’s goals became using his left hand, which, as a result of his cerebral palsy, was often at his side and curled into a fist. “Prior to therapy, Anthony was not using his left hand at all,” Nikita says, watching as her son delivers a perfectly executed left-handed high-five to his therapist. He continues to practice by carrying a box of blocks with both hands across the room – that is, until he gets a four-year old’s twinkle in his eye and allows the box to come crashing down. He giggles.
“Oh, no!” Lindsay says. “Now you have to pick up all the blocks!”
“You’re killing me, Lindsay!” Anthony says, delighted to have an opportunity to use his favorite new phrase. He begins picking up the blocks as requested and dropping them one by one back into the box. Since practicing grasping and releasing is another skill Anthony is working on, the scattered blocks have served another purpose.
Nikita’s family helps Anthony work on using his left hand more frequently at home, too. “It’s a daily expectation, not just one that happens weekly at therapy. Most kids learn how to drink from a cup starting with two hands and moving to one. We had to start Anthony the other way around and encourage him to use both hands!” Working with Lindsay has helped Nikita understand how reinforce at home what he learns in therapy.
“Luckily, Anthony loves learning,” says Nikita. “He just started pre-school and picks things up quickly, including Spanish and Japanese. He can count to 100 and loves to read! He has an entire collection of books. He loves puzzles, the iPad, and all things Elmo.”
Nikita reflects on her son’s progress. “Some milestones are tangible,” she says, using his left hand as an example. “There is a huge difference between this –“ Nikita opens her hand wide, “ – and this,” she says, closing her hand into a tight fist. “But his attitude has also changed over time. At first he was resistant but now he’s enjoying therapy. He knows he can do it!”
Want to help more children like Anthony maximize their potential? Please donate today!
“We are a family of four, with one child who receives services at Children's Therapy Center. Liam has Trisomy 21 (Down syndrome) and he’s been receiving services since he was 3 weeks old. We have been seen by physical therapists, speech therapists, and orthotists at CTC. We have also attended the Tuesday class play group and Movin’ and Groovin’.
We received Liam's diagnosis at birth and were not given too much information about his diagnosis, what type of care he would need, or where to start. I reached out to CTC and was told they’d be glad to have someone come out and evaluate Liam to see what services he may need and to assist us in any way. In stepped his Early Intervention therapist, Linda, our lifeline!
Linda was so encouraging of how well our son was doing. I had friends who would tell me he was amazing, but they are my friends – what else would they say? Linda wasn't going to tell me what she thought I wanted to hear, though. She was going to be honest. I needed to have someone in our lives who really understood the excitement of the little things that our son was accomplishing.
I feel that Liam would have eventually reached the milestones he has hit today even without CTC. But without CTC, I would not have known how to best help my son or feel so supported in a time when I felt so lost. I am so thankful for the connections, encouragement, friendships, and support that I have received. This mom would be in a much different state emotionally, personally and mentally if it were not for our therapy team.
CTC has made a huge impact on our lives. Not only have they helped Liam be the best he can and help us know how to help him they have encouraged us throughout our journey. I have learned how strong I am. I have learned how to be an advocate for my son. And I have learned that there are some amazing people in this world who are capable of loving and supporting my child and my family as much as I do.”
-Liam's mom, Ashly
No mother is ever fully prepared to receive a diagnosis of cerebral palsy for her child. For Ariel Robison, the news was especially hard to take. Recently married, she was stationed in Hawaii with her husband who was on active duty in the military, and she had no family and few close friends to depend on. “It was traumatic,” she says, her usually animated expression darkening. “I still need to remind myself to focus on what’s happening now and on how far he has come.”
And indeed, her son has come far. At the age of 8 months, Luke suffered a brain injury that left him hospitalized. Doctors’ predictions were grave. “They were certain he would never fully recover and that he’d require assistance his whole life.” He was put on both a tracheostomy and a feeding tube. Ariel and her husband could do nothing but wait.
Luke progressed, however, and was soon moved to a ventilator and then put on oxygen. Once he was eating normally, he was assigned to a rehabilitation facility to receive physical, occupational and speech therapy as well as participate in group activities with other children. “He lived [at the facility] 24/7 but they made all the parents go home at night,” Ariel recalls. “It was really, really tough to leave him, but they did that for us. They knew we needed the rest and the sleep.”
The family was transferred in December 2011 to Joint Base Lewis-McChord (JBLM) in Tacoma, a facility known for their ability to serve military families who have children with special needs. Ariel accompanied Luke on a medical transport plane while her husband remained behind to complete his assignments before joining them. It was a scary time for Ariel. “We lived at Children's Hospital” for several weeks, she said, before finally being released to her new house at JBLM. Luke was given a nurse who cared for him at home seven hours a day until he was able to breathe on his own. “And that,” says Ariel with a laugh, “was the first 16 months of his life!”
Children's Therapy Center in Tacoma was their next stop for outpatient therapy. “It has been unbelievable,” says Ariel. “Luke still has motor issues, especially difficulty swallowing. He has lots of interest in food but needs to learn how to eat, so we’re working on that now. He’s still on a feeding tube for hydration and takes a canned formula at night.” He also continues to receive occupational and physical therapy.
Ariel bounces her one year old daughter, Ryanne, on her lap as she watches her son work with his therapist. She beams. “I sometimes can’t believe this is my son, doing all these things,” she says. “In fact, we got an MRI a few weeks ago and the doctor was comparing it to the first one he received right after his injury – and it was like the brain damage never even happened. The MRI was totally different. It was so obvious from looking at it that I didn’t even need an explanation!”
The family plans to retire from military life shortly and settle in Texas, closer to family. Ariel is cautiously optimistic. “I’m a little worried about leaving all the support we’ve had from Children's Therapy Center and Children's Hospital, but he doesn’t require as much help as he did. And I know we will all be just fine.” Still, she has learned to surround herself with support. “I’m part of three online support groups,” she says. “It’s really helpful to be able to get ideas and feedback from other parents going through the same thing. I love it when adults who have gone through similar experiences themselves weigh in because they can describe things that kids can’t." Support and faith have pulled her through, she says. “Look where we are today. His doctors thought he would just lay there for the rest of his life. He has certainly proved them wrong!”
Elena and four other moms share their emotional experiences raising children with special needs.
“When our son Carter was born, we were stunned that he was diagnosed immediately with Down syndrome. I was 29 at the time, and it almost felt as if we had a baby, and at the same time lost a baby.
At the hospital, we were given a packet of information and told to look on the internet for more information. Our pediatrician told us that he would likely need physical and speech therapy. We felt overwhelmed and wondered if there was anybody that could just give us some answers and information to help us now? That’s when we found Children’s Therapy Center and their early intervention program.
When we walked in the door, it felt as if we were walking into a place where we belonged. We were accepted and we knew that these therapists were there for us. They understood, they knew what to do, and they wanted to help. Our team of therapists, including Linda and Christina, became like coaches, supporting us in all areas, making sure that we were doing everything that we could do.
The wonderful thing about Children’s Therapy Center is that it’s full of people just like Linda and Christina! These are people who care about you and will do the best job they can for your child. We never expected to come to CTC, nor did we expect to need physical therapy, speech therapy or aquatic therapy. But they were there for us and for many, many families in our area. It is comforting to know that Children’s Therapy Center will be there to support us with Carter every step of the way for years to come."
- Eric and Alison Tharaldson
Zachery was born with the diagnosis of Myelomeningocele (Spina Bifida). This is a birth defect in which the backbone and spinal canal do not close before birth. In Zachery's case, it caused partial paralysis and a lack of sensation in his legs as well as a build-up of fluid inside the skull (hydrocephalus). At two months of age, Zachery started physical therapy at home.
"I don't feel that Zach would have reached his current status without the early intervention services he received," says his mom, Korie. "While his therapists focused on Zach, it was a family experience through and through. Having a child with special needs is a very emotional experience, a roller coaster ride. His therapists provided us with tools to assist our child in our own home. They taught us how to work with him on stretching and strengthening exercises, and other activities that fit into our daily routines.They included Zach's big sister, Zoey, by having her show Zach what they wanted him to do. It made her feel so much a part of the care team for our son."
By the age of three, Zachery was walking independently with his walker, talking up a storm, and bragging about the fish he caught with his grandfather. Not only was he achieving milestones that were uncertain two years earlier, his family had grown in confidence as his greatest believer and advocate.
Today, “Zachery continues to be one of the hardest working kids I know!” says his therapist. “He has focused on using his crutches for walking and now almost exclusively uses them at home, school, and in the community. He participates in adaptive baseball, basketball, and track and field, and loves camping and fishing. Zach and his family are a fabulous example of how CTC celebrates what is and commits to what can be!”
"Our therapists helped keep us grounded when we were feeling down," Korie says. "Most importantly, they celebrated the highs that a parent with a typically-developing child might just not understand. I knew we were part of a team working towards the goals that we were setting and keeping us all on the same page. It also kept us as parents from limiting the goals we set for our son or setting unrealistic goals and having our hopes crushed. This is a very caring group of people who have touched our lives in a way that cannot be described in words."
I love working at Children's Therapy Center because of the flexibility and support that allows me to be a mom and a professional. No matter what's on my mind about treatment strategies, new research, evaluation tools, or unfamiliar developmental disorders, there is a colleague here who is knowledgeable and more than willing to take the time to discuss my questions or concerns.
Christina Terbovic, SLP
CTC is more than a place of business. It is like a family for those of us fortunate enough to work here and especially for the families we serve. We value learning, teamwork, collaboration. We encourage and support staff to pursue their passions and interests so that each employee represents this center of excellence well.
I enjoy working alongside smart and caring people who share my expectations for the highest quality in the services we provide for every family. We care about the family first; the child's delay, diagnosis, or need for therapy second. We meet families at a time in their lives when they may have been told what is wrong with their child. And then we have the rewarding mission of supporting the family in learning about the possibilities -- not so much about what their child cannot do, but what they have the potential to do. Ultimately, it is about what we can do to empower every family.
Linda Thompson, PT
I love working for an organization that is willing to grow, change, adapt, and respond to best meet the needs of the community as well as the employees. It is rare to find a company that is so dedicated to supporting and utilizing the strengths of its individuals, allowing us to continually improve all that we do. From documentation to parent education, from treatment strategies to teaching workshops, the whole is greater than the sum of its parts.
Joli LaBissoniere, OT
I love to work here because I have the autonomy to do what is best for families. My treatment is not limited by "higher ups" who set rigid rules based on the financial bottom line. Instead, we encourage one another to think outside of the box and go above and beyond to make things happen for families. When a family puts their trust in us and invites us to be a part of their lives, I want to do all I can to help them reach their goals. I really feel I can do that here.
M'Liss Buckles, OT
I recently returned to Seattle after visiting family back home...happily, returning to work felt like just as much of a home coming. I love that I found a second family and am surrounded by people who care so deeply for me and perhaps more importantly for the work that we do.
The flexibility is amazing. Vacations are not only tolerated, but greatly encouraged. When you are sick, people sincerely want you to go home and get well guilt-free. It’s a luxury I can’t help but brag about!
Erica Phelps, OT
I started work here at CTC right out of graduate school as a new speech therapist, and I felt supported and constantly encouraged as I learned my style and developed my skill set. Now, after years of employment here, I continue to feel surrounded by a creative, supportive, inspiring family of therapists and co-workers. I am so very grateful to work in an organization that celebrates teaming and supports and values its team members.
Lauren Kipp, SLP
In my position, I am able to greet all the families that pass thru our doors on a weekly basis. I see children's hard work pay off! It's amazing to see a child who could not speak a few months ago, or a child that could not walk, come to the front desk in their walker or wheelchair to ask me to call their therapist to 'come play.' It is the little triumphs that keep me smiling and loving what I do every day.
On a sunny morning in Burien, a little girl with strawberry blonde hair and a huge grin zips through the front door of Children's Therapy Center with just the touch of a finger on her wheelchair switch. In just a few short months, Charlee has virtually mastered the chair, which at 370 pounds weighs nearly ten times what she does. “She’s the youngest child I’ve worked with in a motorized chair,” says her physical therapist Sara. Exactly how young is Charlee? Not even three years old.
Charlee was born in Ketchikan, Alaska, with respiratory failure, broken bones, and other as-yet undiagnosed conditions. After 12 hours in the hospital in Ketchikan, Charlee was airlifted to Seattle Children's with her father, Joel. Her mother, Ashlee, spent a mere 30 seconds with her newborn daughter before she left.
Once the family was reunited in Seattle, reality hit. “People like us in the military are pretty open to adapting, but this was like putting our life in a paper bag and shaking it,” she says. “We were thrown into this world of drastic special needs. We’ve had to do so much learning – the terminology, the doctors, how to use the medical and home care equipment. When to go to the doctor, and when to stay home. Learning her unique signs and symptoms. It’s been a lot.”
Charlee was enrolled in Early Intervention at Children's Therapy Center where she has received physical and feeding therapy. She also attends a weekly playgroup at CTC with other children. “That’s her favorite – she talks a ton there. I call her ‘Queen of Playgroup’ because she answers any and all questions, even from across the room. It’s nice that she has control over something in her life.”
Charlee’s undiagnosed condition – which could be neurological or muscular – doesn’t bother her mother. “My husband would prefer to know, but I don’t,” she says. “The way I see it, the moment you’re diagnosed you’re in a box. Charlee doesn’t have a box. We never get told what she ‘can’t do.’”
Ashlee smiles as she watches Charlee maneuver her chair over to a colorful bulletin board that has caught her eye. “That chair could take down an entire fence!” she says. “And that’s a 2-year old driving it!” She allows Charlee to drive most of the time but keeps close tabs on her. “We practice everywhere – Costco, the mall, Ikea. The only thing that we sometimes have trouble with is tight aisles in stores.”
Sara attributes Charlee’s navigational ability in part to her natural smarts but also to the efforts of her parents. “They are truly remarkable people,” says Sara. “They are so invested in her and in helping her achieve!”
Charlee’s “purple chair,” as her mother refers to it, cost more than both her and her husband’s vehicles combined. “She can’t use any old chair because she requires so much support,” Ashlee says. “We have to take it with us everywhere. I never realized what a shortage of disabled parking spaces there is!” Retrofitting their family van with a wheelchair lift proved incredibly frustrating. “There was so much specificity involved. And we found that many lift companies don’t even take insurance.”
Ashlee is grateful for the insurance her family has from the military. “I have no idea how we’d afford it without that,” she says. “I don’t know how anyone does.” She plans to donate the chair when Charlee outgrows as a way to help other families.
Ashlee wants to continue therapy at CTC for Charlee even after she ages out of the Early Intervention program, particularly feeding therapy and aquatic therapy. “It’s amazing to watch her move when she’s weightless. Her arms and shoulders are weak so the movement in the water helps strengthen them.”
“Charlee has made so much progress here. It’s been wonderful to have people to talk to at CTC who are immersed in the world of special needs,” Ashlee says. “It makes our lives easier.”
Colton's mom shares how Early Intervention services at CTC helped her as much as they did her son.
"Colton was the kid everyone looked at in public. At 24 months, he still couldn't speak. Colton would yell, scream, hit, kick, and bite his message across. He hated the smell of strong foods – they made him gag or vomit. He hated anything on his hands and would scream until we wiped them, but he hated the wet wipes as well and would scream even more. Good luck getting anything off his face without a wrestling match! His face was off limits: no wiping, no touching, not even a kiss goodnight.
Colton was constantly on the move. Jumping here and there, crashing into things. We had him evaluated for Autism Spectrum Disorder but that was ruled out. We knew he had a speech delay and a sensory processing disorder. I was an exhausted mom. I was a frustrated mom. It's hard to admit, but I was also a mom who was embarrassed by his behavior. One of the biggest blessings of Children's Therapy Center Early Intervention program was having someone explain why our son was acting like this and giving us the encouragement and knowledge to support him.
I was surprised when his first therapist was a special education teacher, considering he had been referred for speech. But Stephanie was exactly what Colton needed. He couldn't practice speech until we helped him regulate himself. She taught us how to parent him with love and logic. She taught him sign language (“more,” “all done,” “help,” and “please”) so that he could request his needs. She gave us PECS (Picture Exchange Communication System) so that meals, snacks, and activities were no longer a guessing game ending in fights and tears. She saw his body and knew a SPIO® would help him gain control. She was right! He was like a different kid with it on. Stephanie saw that music helped him learn and calm himself, and she utilized it. She led a play group where he flourished and was motivated by his peers. Within 6 months, Colton went from speaking 4 to 60 words. He began tolerating wiping. The first person my son ever blew a kiss to was Stephanie. I think that's a bold expression of the amazing staff that CTC employs.
Colton’s speech therapist, Alyssa, had participated in his playgroup and I think this familiarity made a huge difference. Her enthusiasm really drew Colton in. Alyssa was great at taking Stephanie's observations and utilizing games and songs to get him to enunciate. She showed us how to break words apart, target sounds, and practice repetition in positive ways.
Colton also received occupational therapy with Marge. Marge really took the time to understand Colton. She observed his reactions and the environmental input and explained all of this to me in a way I could understand. She helped us see how his lack of speech was causing his aggressive behavior. Marge helped us make daily struggles (teeth brushing, hair washing, eating, bedtime) into tolerable and fun routines. She also noticed his weak muscles (hypotonia) and how they negatively impacted the simplest tasks. She taught us how to help him gain strength utilizing household items and games.
I was extremely nervous knowing that Colton would be leaving Early Intervention. All of his therapists and teachers were unconditionally supportive. They worked with me to review notes, prep for the evaluations, and calm any fears I had. With their help, we were able to get Colton the support he needs for the future via developmental preschool.
Colton doesn't need to yell, scream, hit, kick, or bite to get his messages across anymore. He can use one of the 120 words he now has in his vocabulary. Colton can play with clay or paint with his sisters and wipe his hands calmly. Colton is still on the move but he is not crashing into things. He has much better control over his body and his emotions. Every night now, I can tuck him in and give him a kiss – something that would never have been possible without Early Intervention and his teacher and therapists at CTC."
“Our therapists are so much more than just therapists. Whatever else is going on in our lives, I can always count on them. They are our constant.”
Megan Carter tears up a little when she talks about the therapists, teachers, and Family Resources Coordinators who’ve been a part of her family’s life for so many years. “The amount of family support we get here is incredible,” she says. ”I feel so lucky we live here and have this kind of access.”
It’s easy to support a family so dedicated to being involved in their child’s therapy. “Megan does such a nice job connecting with us,” says Kim, her daughter Ellie’s physical therapist. “She brings us into their [family] world and helps us understand what’s going on and how we can help. She makes us feel like partners with her family.”
Family partnerships are everything at Children's Therapy Center. Megan and her husband, Andy, are the parents of two children, both born prematurely.
Spencer (below, right), who began receiving occupational and speech-language therapy at CTC at the age of 10 months, was diagnosed shortly before his fifth birthday with ADHD and Asperger’s. “Spencer’s therapists have helped us advocate for services at school, which has been huge,” Megan says. “And therapy has improved his ability to get through daily life more easily.”
The tips Megan picks up during therapy sessions are ones she and Andy practice regularly with their son. “Sometimes, when he’s really wound up, we use the analogy of an engine to remind him to calm down. We’ll say, ‘Your engine is running really high right now, so it’s time to take a break.’ The great thing is that now, he recognizes it himself and will say to us ‘My engine is too high, I need a rest.’”
Their daughter Ellie (above) was born at 24 weeks weighing less than one pound. At 2 months, she was still only the size of a 20-oz soda bottle. “She was in the NICU (neonatal intensive care unit) for 125 days,” recalls Megan. Ellie started receiving Early Intervention services immediately after her discharge. She was extremely delayed. “Essentially, she was a newborn at 4 ½ months old.”
Although she has yet to receive a formal diagnosis, Ellie has already faced significant challenges. Her joints dislocate easily. She has epilepsy. She is dependent on a feeding tube and has lung disease, so she is accompanied by a medical stroller that holds her IV fluids and oxygen tank. And when she needs to walk long distances, she uses a walker. Still, she is making tremendous progress.
“Never once have I heard anyone at CTC say my kids can’t do something,” Megan says. “They find workarounds. They believe.”
Ellie receives coordinated occupational, physical and speech-language therapy at CTC. “The way her therapists collaborate is amazing,” Megan says. “They all talk with each other and develop a plan, and change their approach when needed. They know how to accommodate medical needs. I have no doubt that Ellie wouldn’t be as far along as she is without them.”
Your support helps us provide services to children like Ellie and Spencer!
Spencer and Ellie
Three and a half year old Onora concentrates carefully as she transforms her grilled cheese sandwich into a caboose with the help of a sandwich cutter. “It’s a train!” she announces, as she takes a big bite. “And it’s delicious!”
For many children, chowing down on a grilled cheese sandwich is almost second nature. But for children like Onora, who spent the first few years of her life receiving nourishment from a feeding tube, it’s a hard-won achievement.
Eating is one of the most difficult tasks to complete – more difficult than walking or talking – and it is a vital function for survival and development. Feeding Matters estimates that there are over one million children under age five nationwide with severe feeding disorders that disrupt many aspects of life including growth, cognitive development, physical strength, behavior, and nutritional status.
Children develop feeding issues, or oral aversions, for a variety of reasons and with varying degrees of severity. In Onora’s case, a defect in her abdominal wall caused her internal organs to grow in a sac on the exterior of her body. The condition is known as omphalocele. Yet as challenging as it was to treat, Onora’s mother, Kristen, said the toughest part was yet to come since Onora’s condition resulted in diminished lung capacity and severe reflux. Feeding without a tube was simply impossible. “I didn’t anticipate that gastrointestinal and feeding issues would be the biggest part of our journey so far,” Kristen says.
Seattle Children's, where Onora was treated, recommended that she receive feeding and occupational therapy from Children's Therapy Center. In anticipation of eventually weaning her off the feeding tube, Kristen worked with Onora’s occupational therapist, Joli, to try to preempt a food aversion. “We knew [an aversion] would probably come up, but we wanted to do what we could to lessen the severity,” she explains. “We dipped her pacifier and favorite toys in applesauce or baby food to get her to try it. Even just putting food on the table in front of her, and having her accept that it was there, was a big deal!”
Kristen says that one of the biggest challenges so far has been to avoid feeling discouraged. “You often feel like it’s always two steps forward, and then one really big step back,” she explains. “One day, you’re thrilled because you’ve found something that works and you say to yourself, ‘YES!’ And then the next day it doesn’t work anymore and you’re back to square one.”
For that reason she’s especially grateful for CTC. “We’re forever indebted to Joli,” she says. “She helps us keep perspective, and when we’re really feeling down she reminds us to look at the other wins we’ve experienced along the way.” They team up to revisit goals often and “we usually find something that we can get excited about,” says Kristen. “It’s also always helpful to be able to reflect over the journey in writing and talk through it. I can ask Joli anything!”
Today, Onora samples not only grilled cheese sandwiches but also Thai food, bacon, spicy burritos, and scallops. “Graham and I always expose her to what we’re eating and give her options to try,” Kristen says. “That said, her feeding journey is still atypical and may always be that way to some extent. But it’s funny – so many parents worry about their child eating junk food, whereas I’m just thrilled my child is eating anything at all!”
Being able to enjoy snack time with her peers at school was a big turning point for Onora, Kristen says. "She wasn't eating much by mouth prior to starting school, so we weren't sure what to expect. We put no pressure on her. We knew this was just a social activity to enjoy with peers. But she sat at the table with the rest of the kids and did it. I love that she can participate with her friends in something as social as eating!”
As Onora gets older, Kristen realizes she’ll need to allow her daughter more independence. “I have to partner with her now,” she says, “and let her make choices about what she wants to eat and when. That doesn’t mean I don’t prompt her or make suggestions, though. And I’m a mom. I always worry whether she’s eating enough!”
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Five year old Kelan was born prematurely. “We knew he’d have some challenges,” says his mom, Becky. “We just didn’t know what they’d be. Our doctors told us to just keep an eye on milestones.”
For a while, things seemed normal enough. Becky and her husband, Darren, enrolled Kelan in day care. They began noticing changes in his behavior starting at the age of about 12 months.
“He started distancing himself from groups of children, and often we’d find him under big play cushions because he needed to feel some compression for comfort,” Becky says. “He didn’t want to come out. Once, he removed the sink from a toy kitchen set and climbed inside. The confined space made him feel more comfortable. But we didn’t know his behavior was especially unusual – he was our first child! Our pediatrician, who sent her own child to CTC, recommended that we give CTC a call.”
Kelan was eventually diagnosed with Sensory Processing Disorder and ADHD. The techniques and strategies Becky learned in therapy to help her son have proven invaluable.
“I’ve learned how to communicate effectively with Kelan, and that’s been huge” she says. “For example, behavior is often an issue for kids with ADHD. ‘Time outs’ don’t work for Kelan. Instead, he gets five stars a day and one is removed – or added back in – based on his behavior. His goal is to end up with at least one star by bedtime. The system works very well for him…and for me!”
Becky and Darren have also learned how useful tools like fidget toys, sensory bins (containers filled with items such as dried beans or rice that help children become accustomed to sensation) and a SPIO® vest can be when he’s not at the center for therapy. “We’re at CTC a couple times a week for occupational therapy and gymnastics, but in order for therapy to really be effective we have to practice at home. His therapists have taught us how to do that.”
Becky has also enrolled Kelan in social skills classes and aquatic therapy at CTC. “We love being able to try different options for therapy at CTC. The social skills classes have been really useful in helping Kelan communicate better with other kids who may shy away from him because his behavior can be all over the place sometimes.”
Becky’s goal is for Kelan to be able to recognize when he’s having trouble and learn how to regulate himself. “We’ve learned a lot in two years [in therapy] and it feels great! It’s not just therapy sessions – it’s the result of all the therapists working together as a team, and our family feels like part of that team.”
When five year old Alex arrives at Children's Therapy Center for his weekly speech-language and feeding therapy session, he can hardly contain his excitement. Dashing through the front door, he makes a beeline for the cubbies against the wall and stashes his coat, shoes and hat in an empty slot.
“Good job, Alex!” says Erin, his therapist. She turns to his mother, Maria. “He has worked hard to learn that routine and now it’s coming to him naturally.”
Diagnosed with Autism Spectrum Disorder (ASD), Alex received both occupational and speech-language therapy through Early Intervention, a program specifically designed for children age birth to three. However like many children with ASD, his symptoms didn’t simply disappear after his third birthday.
“Our pediatrician recommended that he continue to receive therapy,” says Maria. “He gave us a list of places to call but most were too far away and hard to get to by bus – we don’t have a car. Children's Therapy Center is in our neighborhood. We can walk here, which is so helpful!”
Alex leads the way to the feeding room, where today Erin will work on helping Alex accept new and different foods into his diet. Like many children with ASD, Alex has very specific likes and dislikes when it comes to food. The list of welcomed food includes yogurt, bananas, Oreo cookies, rice, Mexican pasta, soup, Mexican bread, and Lay’s potato chips. He has recently tried apples and – at least for now – finds them acceptable, although Maria acknowledges that might change with no warning.
Erin arranges several small dishes of snacks on the table including orange slices, carrots, crackers and applesauce. Alex becomes agitated at the sight of the carrots, a food to which he has a strong aversion. However, instead of jumping up from his seat and racing off, Alex reaches for his picture communication book, a red notebook filled with pictures that his mother made for him. He opens the book, rapidly searching for a picture of a carrot. He jabs at the picture, shaking his head.
“No carrots today, Alex?” Erin asks, tilting her head to try to make eye contact with him.
Alex refuses the eye contact but continues shaking his head forcefully. “Can you show me ‘no’ Alex?” Erin asks. “Show me the picture for ‘no.’” Alex scans the page and then flips to another one, where he identifies the picture he’s seeking. “Good, Alex!” Erin says. “You said ‘no carrots’ so we’re not going to have any carrots today!” She gently moves the dish of carrots off to the side and Alex’s anxiety subsides.
“Alex is learning how to communicate vocally as well as through pictures, which can help him manage his emotions,” Erin explains. “Without a reliable, effective way to communicate he can’t explain his needs. When a child can’t do that, it’s incredibly frustrating for them. They end up having to express themselves in other less effective and potentially damaging ways such as running away or hiding.”
Maria says that she and her husband made the decision that she should quit her job in order to stay home with Alex. “I wanted to,” she says. “The more time I spend with him, the more he improves. Unless we practice [what we’re learning in therapy] with him constantly, what’s the point of taking him to therapy? Alex and I are learning together.”
Her son’s achievements delight Maria. “Alex loves coming here,” she says. “It’s fun for him. When you make things fun for a child, they learn more. He thinks therapy is all about play time!” Her biggest goals for Alex are to continue working on communication, potty training and the transition to a full day of school. Alex is currently on the waiting list at CTC to receive occupational therapy in addition to speech-language therapy.
Very little gets past this curious, perceptive little boy. Spying a UPS driver coming through the lobby door to deliver a package at the front desk, Alex calls out, “Hola!” Then he adds sternly, “No diapers!” His mother laughs. “I buy his diapers in bulk and have them delivered by UPS to the house,” she explains. “He is not a fan of diapers. Maybe that will motivate him for potty training!”
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When Erin Aleman was pregnant with her first child a few years ago, neither she nor her husband Rob had any indication there was anything wrong. “Not a single sign,” says Erin. “And as new parents, we were completely unprepared for what we were facing.”
Their son, Rhys, has microcephaly and schizencephaly, a rare birth defect that causes abnormal clefts in the brain. “He may also have cerebral palsy,” says Erin, “but we’re still in the process of getting diagnosed.” She tears up. “This is hard to go through,” she admits. “There have been a lot of highs and lows, and lots of uncertainty.”
Rhys’s condition turned their lives inside out. “We had to reorganize our lives so we could care for him,” Erin says. “Rob works nights and I work from home. We’d planned to move out of our condo after he was born but we’ve had to stay put.” She feels fortunate, however, to have options that many families don’t. “If you’re a single parent, or have few financial options, it would be devastating.”
There are other more personal challenges as well. “‘You have dreams for your child, and over time you figure out that you need to adjust them,” says Rob. “It’s hard to make sense of it all – to be a good dad and be a good husband.”
It helps that Rhys is, in Erin’s words, “an absolute dream. He’s such a cheerful and easygoing baby!” And both Erin and Rob are adamant that Early Intervention services have made the journey much more manageable. “Being able to have his therapists come to our home and have us participate in the sessions has been so helpful,” Rob says. “We see what they’re doing and we learn from them. We’d be in the dark without them.”
“Rhys is lucky to have Erin and Rob as parents,” says his physical therapist, Sarah. “They are dedicated to his success. A lot of the progress he has made is because they work with him and play with him on a daily basis, always following through with our suggestions.”
Rhys has achieved significant milestones in his two-and-a-half years. “One of our biggest goals for Rhys was to help him learn some independence,” says Erin. “He can army-crawl now, so he can get from the living room to the bedroom without having to roll his way along!” He’s also progressed from using a gait trainer to using a walker and orthotics. His physical therapist, Sarah, is working with him on making the transition from getting out of a chair. “Right now, when he’s done eating, he lets himself fall out of the chair to get down. It’s the only way he knows how to do it.” Meanwhile, his speech language and occupational therapists, Marisol and Lani, are helping him learn to eat without choking on his food.
“Rhys works through hard activities with determination and a little bit of sly avoidance,” says Lani. “He loves to use his charming smile to let me know when I am expecting a lot from him, but with encouragement and a little bit of silly, he is willing to try!”
He’s also learning how to sign – and eventually say – “help.”
“I can tell when he needs help,” says Erin. “Rhys almost has his own language. It’s a combination of sounds, movements, signs, and a few words. I know what he’s trying to communicate, but I want others to know and I want him to communicate to them himself.” Erin and Rob also hope he can learn to walk on his own and gain better use of his weak left arm and hand.
However, Rhys turns three in June, an age at which Early Intervention services are replaced with school-based special education. “It’s not going to be the same,” says Erin. “Therapy will be more academically focused. Parents don’t have the same level of involvement – we don’t attend school with him. We’ll have no way of knowing what’s going on, and certainly not to the extent we know now. He’s made so much progress with us being part of his therapy, reinforcing what he’s learning day after day.” She hopes to enroll Rhys in Children's Therapy Center’s center-based program for children over the age of 3. “I know that might be tough, because there’s a waiting list for kids over 3 and limits that our insurance imposes. But we’re going to try.”
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