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Pediatric Services

2011: Year in Review

Kim Becker, Director of Pediatric Services

Pediatric Services Continue to Develop Programs

Heartspring’s 2011 fiscal year proved to be a time to further develop and refocus Pediatric Services and Hearing Center.

While there has been an increase in the number of patients diagnosed with autism through private insurance, we continued to expand the number of services provided under the state of Kansas, with an addition of a State of Kansas Autism Rider. The program reimburses families with children diagnosed with an autism spectrum disorder (ASD) for Applied Behavior Analysis (ABA) services and speech, occupational and physical therapies. The program joins the Autism Demonstration Project and State of Kansas Autism Waiver as aids to families of the growing number of children diagnosed with autism.

We have also refocused our services for the Hearing Center. We want to effectively serve more children, and in order to better provide those services, the Hearing Center now only accepts pediatric care patients and children through the ages of 21. Our Donor Hearing Aid Program has become the Children’s Hearing Assistance Program (CHAP).

Additionally, our online KidCheck program continued to assist a variety of families, pulling in individuals from as far away as Nigeria. Heartspring Pediatric Services is looking forward to further expanding relationships with other organizations, both locally and worldwide.

Elizabeth learns to use visuals to communicate as the group observes

Learning in Groups

The group method began when four children came to Heartspring at the same time with the same needs. The twin boys and two girls all have Autism Spectrum Disorders (ASD) and similar skills. They meet for two hours each week to participate in group activities. Parents are always encouraged to observe and participate.

Children with autism often have difficulty processing sensory information, which often leads to the inability to communicate their needs. In a group setting, there are more opportunities for sensory overload, which may not happen in individual settings.

Thus, a sensory diet is developed to help the child process sensory input. The diet may include movement, proprioceptive input (sensation from joints, muscles and connective tissues that lead to body awareness), auditory input, visual input, and oral input. In a group setting, the therapist can implement appropriate components to help the child better adapt to the activity. For example, during circle time, the children shake hands with their neighbors with assistance (tactile) and wave (visual), while listening to music (auditory). This may be too much stimulation for one of the twins, so the therapist places an air cushion beneath him. The subtle movement on the air cushion helps calm him by regulating his sensory system. Another child, on the other hand, may need more calming, which can be provided by a weighted compression vest.

Group activity has provided many benefits for the children. It allows for communication opportunities that do not exist in one-on-one settings. They can adapt the skills they learned in individual therapy. Snack time and craft time, for example, provide great opportunities for the children to request food and materials. Some of the children can request and comment verbally when prompted, while others communicate by pointing to pictures. Language expansion occurs when helping the children verbalize or point to longer sentences after they use a one-word expression.

Receptive language skills are also practiced during group time. The children practice following directions. Prompts begin as a learning tool and are faded out as soon as possible. Visuals, such as recipes with pictures, are paired with verbal directions whenever possible to maximize comprehension. Stories during group time facilitate opportunities for listening and answering comprehension questions. Each week, a theme is used throughout the entire session to provide opportunities for learning seasonal vocabulary in a variety of different contexts.

Following a visual schedule is also an important element of group. Through consistent practice, the children have learned how to independently go to their schedule, check to see what is next, and then go to that area of the room. This is an important skill for children with autism, as they need extra help to organize time and space in their environment.

The group therapy sessions prepare the kids for future school settings. While they learn necessary skills, they also form friendships. During an individual therapy session, one of the girls continued to ask for her group mates. She wondered where her newfound friends were.

Financial Assistance

Last year, Heartspring gave almost $240,000 in financial assistance to local families. Because of generous donations, 146 children received more than 3,000 therapy sessions. Insurance doesn’t always cover the therapy that children need, and the costs can be overwhelming to families. We believe all children deserve the chance to succeed.

Individual Success: Malachi

I evaluated Malachi in July 2010 at barely a year old. He could sit by himself, but if he turned his head to look at a toy or lifted his arm toward a toy, he fell over. He had no protective responses, so with each loss of balance he fell flat. He was able to roll all over the place, but otherwise, had very limited mobility. He had significant weakness throughout his core, trunk, neck and extremities.

Shortly after his evaluation, he received a medical diagnosis of Duchenne Muscular Dystrophy (DMD). This is rare, because most kids with DMD aren’t diagnosed until they are four or five years old. Needless to say, I was unsure about his prognosis, and what was going to be realistic as far as his mobility and gross motor skills.

Less than a year later, Malachi has blown away my expectations. He is not only able to sit by himself and catch himself if he loses his balance, but he is also able to transition into sitting independently. Yet, the thing I have been most proud of has been his recent ability to crawl on his hands and knees. He was army crawling for quite a while, but then one day, the hands and knees just clicked. He is also able to pull himself to stand at a stable surface. We have also started working on walking on the treadmill and walking with a walker. He is a smart, determined little guy and he has come a long way!