Child Therapy

Lumiere Children’s Therapy: Breathing Difficulties in Children

Examine your breathing for a minute. Are you breathing through your nose or mouth? Is your mouth open or closed? Is your tongue on the bottom or roof of your mouth? Optimal breathing should be effortless and quiet through the nostrils with the tongue suctioned to the roof of the mouth behind the front teeth and the lips should be gently closed. Nasal breathing positively affects swallowing patterns, chewing, speaking, voicing and body posture. If nasal breathing is compromised for any reason, orofacial myofunctional disorders and/or airway function disorders may arise. This article focuses on descriptions of airway function disorders, including pediatric obstructive sleep apnea, and treatment options.

Airway Function Disorders (AFD)

AFD occur when the airway function is obstructed at any level of the airway, affecting a range of human functions. Sleep disorder breathing such as pediatric obstructive sleep apnea, is a collapse at any level of the upper airway resulting in abnormal breathing during sleep. Pediatric sleep apnea will be discussed further in this article. Sleep disordered breathing is initially impacted by daytime breathing specifically in children who mouth breath.

Signs of mouth breathing include the following:

  • Open lips

  • Low or forward tongue posture

  • Short upper lip

  • Forward head posture (protruding from neck)

  • Frequently dry lips

  • Misaligned teeth requiring orthodontics

  • Dry mouth

  • Hyponasal speech (speech that sounds nasal like they have a cold)

  • Drooling

  • Nasal congestion or constant runny nose

Impact of AFD

Airway function disorders may impact a variety of functions in a child’s life. It may interfere with language development, learning and academics, memory, attention, socialization, and self-regulation. Children with AFD may exhibit primary behavior characteristics of excessive fidgeting, hyperactivity, decreased attention and emotional outburst.


AFD may also impact a child’s speech and swallow function. Some children with AFD present with an interdentalized (tongue between teeth) on the following sounds /s, z, t, d, n, l/ as those sounds are produced with tongue elevation.  Children may also experience abnormal swallowing patterns such as tongue-thrust swallows or impaired chewing.

Risk factors of AFD

The following is a list of risk factors associated with AFD:

  • Enlarged tonsils and/or adenoids

  • Mouth breathing

  • Nasal abnormalities such as a deviated septum (Deviated septum is when the thin wall between nasal passages is displaced causing one nasal passage to be smaller)

  • Frequent nasal congestion or allergies

  • Chronic rhinitis: set of symptoms including running nose, itchy nose, post-nasal drip, congestion, and sneezing that persist for months to a year

  • Higher Body Mass Index

  • Gastroesophageal reflux disease (GERD): when stomach acid flows back up irritating the lining of the esophagus

  • Low muscle tone

  • Craniofacial syndromes or growth alteration

  • Prematurity

  • Traumatic birth

  • Gender (Males are two times more likely to have SBD)

  • Ethnicity (African Americans are at a higher risk)

Pediatric Obstructive Sleep Apnea (OSA)

Reflect on your quality of sleep the past few nights. Did you sleep soundly through the night without any disturbances and wake up rejuvenated, or did you toss and turn all night feeling distracted and lethargic in the morning? The quality and effectiveness of a good night’s sleep impacts your mood and productivity the following day. The same holds true for children; if a child experiences disturbances throughout the night, they may demonstrate difficulties in behavior and attention during the school day. Studies have suggested that as many as 25% of children diagnosed with attention-deficit hyperactivity disorder may have symptoms of obstructive sleep apnea.

What is OSA?

OSA is an airway function disorder that is observed during sleep. OSA is when a person has repeated episodes of partial or complete upper-airway obstruction during sleep

How prevalent is OSA in children?

Studies have shown that up to 5% of children are diagnosed with OSA, with a correction between pediatric obesity and OSA.

What are the symptoms of OSA?

The most prevalent symptom of OSA is snoring. Although some children may only demonstrate habitual snoring which consists of vibration of airway tissue with no airway obstruction, studies have found a ratio between 3:1 and 5:1 between symptomatic habitual snoring and obstructive sleep apnea (OSA).

Other symptoms include the following:

  • Agitated sleep

  • Nightmares

  • Mouth breathing or open mouth posture

  • Bedwetting

  • Pauses in breathing or gasping for air during sleep

  • Audible breathing

  • Grinding teeth

  • Sweating

Treatment for Airway Disorders

  1. The first step to treatment of airway disorders is to determine the function of the nasal airway. Determining structural or physiological barriers to nasal breathing is necessary to determine plan of care. An evaluation by an allergist and otolaryngologist (ENT) is necessary to determine if medications such as antihistamines, allergy medicine or surgery is required to be able to safely breath out of the mouth.

  2. Elimination of non-nutritive sucking is important for adequate growth and formation of dental structures. Non-nutritive sucking (e.g. pacifier, finger, and object sucking) is a risk factor for future dental occlusion abnormalities. Orofacial myofunctional therapist can provide strategies to eliminate the use of nonnutritive sucking.

  3. Establishing adequate oral rest posture would be the next step of therapy. Orofacial myofunctional therapy focuses on retraining the muscles to stabilize a normal rest posture between the tongue, lips, teeth and jaw. Orofacial myofunctional therapy uses oral tactile stimulation and resistance activities to help disassociate the tongue from the jaw, improve lip closure and strengthen tongue elevation.

  4. Once the resting posture has been achieved, orthodontics may be recommended for dental stability if the child presents with a malocclusion of crossbite, overjet, or underbite; this might include braces, retainer, or rapid palatal expansion depending on the occlusion.

Pediatric Obstructive Sleep Apnea Treatment

In cases of pediatric sleep apnea, the first treatment step is typically the removal of the adenoids and tonsils. As reported by American Sleep Apnea Association, the removal of the adenoids and tonsils results in complete elimination of pediatric OSA symptoms in 70-90% of uncomplicated cases. As previously mentioned, a dental evaluation should be performed to check for hard palate development to accommodate the child's tongue. If necessary a rapid palatal expander (a non-invasive fixed and/or removable dental device) can be worn for six months to one year, to expand the transverse diameter of the hard palate.The next treatment option to consider is positive airway pressure, or PAP, which is typically used as a palliative treatment for adults with sleep apnea. A PAP machine blows pressurized air into the child’s mouth to counteract the closing of the throat during sleep. The amount of pressure is determined through an overnight sleep study.

If you feel your child exhibits any of the symptoms listed above for an airway function disorder, speak with your primary care physician for adequate referrals to airway specialists. At Lumiere Children’s Therapy, our speech-language pathologist can treat speech sound disorders, swallowing disorders, and oral motor deficits associated with AFD.

Lumiere Blog Signature.png


Archambault, N. (n.d.). Healthy Breathing, 'Round the Clock. Retrieved from

Capdevila, O. S., Kheirandish-Gozal, L., Dayyat, E., & Gozal, D. (2008). Pediatric obstructive sleep apnea: complications, management, and long-term outcomes. Proceedings of the American Thoracic Society, 5(2), 274-82.

Children's Sleep Apnea. (2017, February 13). Retrieved from

Deviated septum. (2018, March 03). Retrieved from

Gastroesophageal reflux disease (GERD). (2018, March 09). Retrieved from

Hayes, K. (n.d.). Coping With Chronic Rhinitis. Retrieved from

Orofacial Myofunctional Disorders: Treatment. (n.d.). Retrieved from§ion=Treatment

Positive Airway Pressure Therapy for Sleep Apnea. (2017, February 03). Retrieved from

Lumiere Children’s Therapy: Holiday Toys for All Ages

It’s the most wonderful time of the year! Finding the perfect gifts for your young ones that are both fun and encourage developmental skills may seem impossible, but Lumiere Children’s Therapy is here to help!

Early Development

Throughout their early years, children develop cognitive, language and motor skills that drive their development for later years. Toys should be challenging but engaging for children at this age. Limit the amount of toys that do all the work for them, such as light-up, musical or spinning toys; instead, focus on toys that require attention and fine & gross motor skills. Here are a few examples:

Cause & effect

Cause and effect toys help children understand the concept that one action can create a reciprocating action. Understanding cause and effect is the baseline for effective communication skills. Children will understand that if they use a facial expression, gesture or vocalization, they will get something in return. Cause and effect toys also encourage the development of fine motor skills by manipulating the toy for something to happen. It also requires strong trunk control to hold oneself up while interacting with the toy.

Fine motor

Fine motor skills are necessary for eating, dressing and writing in later years. The first grasp to develop around six months of age, is the pincher grasp, which requires using the fingertips and thumb to lift smaller objects. As the fine motor skills increase, children will learn how to perfect the pincher grasp, use hands to hold bigger objects, manipulate objects by placing or retrieving from containers and play with smaller toys.  For a full description of fine motor development click here.


Animal sounds and names can promote language in small children. Often times, babies’ first few words are either an animal name or sound. Animal sounds are usually the first consonants to develop such as /n/ in “nah”, /m/ in “moo”, /w/ in “woof”, /m/ “meow”, and /t/ in “tweet”.

Imaginary Play

Imaginary play encompasses social, cognitive and language skills to emulate another person. Imaginary play skills usually develop between 18-24 months by imitating talking on the phone, driving a car or unlocking a door with a key.  By four years old, imaginary play will incorporate elaborate story plots with a variety of characters, settings, problems and resolutions.

The Arts


Music aids in all areas of child development as well as preparing for school, including  intellectual, social and emotional, and language skills. Music can serve as a calming or self-regulating tool, aide in communication, and positively affect a child’s mood. Interacting with your child while playing music serves as an intimate bonding experience. Dancing along and using hand gestures (such as the “Itsy Bitsy Spider”) can improve fine and gross motor skills as well! Read our Music Magic post for more ways to incorporate music into your daily routine.

Blowing instruments:

Hand instruments:


Art is just as important to development and school readiness as music. Dexterity skills are developed while creating art by learning how to grip a writing utensil, manipulate scissors and glue paper together. For younger children, art can also serve as a platform for language development and identification of colors, shapes and actions.

Board Games

For older children (4+), board games can serve as a way to indirectly teach educational concepts in an engaging manner. Board games can target letter, shap, and color recognition.  It also encourages social and cognitive skills such as attention, sportsmanship, turn-taking and listening.




Following directions/listening games:

The most important aspect of gift giving is interacting and playing with your children, nieces/nephews and grandchildren! Children learn best from adult models and they will cherish your time spent together more than any toy. Take time away from the busy holiday schedules to enjoy time with your family.

Happy Holidays!

From the Lumiere Children’s Team.


Children and Music: Benefits of Music in Child Development. (n.d.). Retrieved from

ExpectEditors, W. T. (2014, October 20). Pretend Play. Retrieved from

Lynch, G. H. (2012, May 25). The Importance of Art in Child Development. Retrieved from

Staff, S. Z. (2015, April 28). Teaching baby animal names, sounds, and habits builds important skills. Retrieved from

Lumiere Children’s Therapy: Swallowing Difficulties in Children

Swallowing is a complicated process that is both voluntary and involuntary. Many people take swallowing for granted since it becomes second nature to most. Observe the complexity of a swallow by paying close attention to the many stages involved when taking a bite of food or sip of water. For some children, eating and swallowing can cause numerous difficulties leading to poor growth, failure to gain weight and inadequate nutrition. The medical term for swallow difficulty is called Dysphagia.

There are three types of Dysphagia: oral, oropharyngeal and esophageal. For the purpose of this article, we will focus on oral and oropharyngeal dysphagia as speech therapists can diagnose and treat these types.

Stages of a Swallow

There are four stages to an efficient swallow: oral preparation, oral stage, pharyngeal, and esophageal. Dysphagia can occur in one or more of the four phases of a swallow, possibly leading to food or liquid entering the airway causing aspiration.

  • Oral Preparation: In this stage, the teeth chew the food as saliva adds moisture in order to create a cohesive ball or bolus.

    • Signs/symptoms of difficulty in this stage:

      • Child has trouble chewing a variety of textured food that should be age-appropriate

      • Liquid or food spills out of the mouth while eating

      • Excessive amounts of drooling during meals or between meals

      • Takes over 30 minutes to finish a meal

      • Over-stuffing their mouth with food or only allowing small amounts of food into mouth

  • Oral Stage: In this stage, the person voluntarily pushes the food to the back of the mouth by the tongue in preparation to swallow food.

    • Signs/symptoms of difficulty in this stage:

      • Child holds food in the mouth for a long time before swallowing

      • Requires multiple swallows on one piece of food

      • Some food remains in mouth after swallowing

  • Pharyngeal Stage: The food passes through the throat into the esophagus. During this stage, the windpipe or airway is protected by a flap called the epiglottis so food does not enter the lungs.

    • Signs/symptoms of difficulty in this stage:

      • Breathing difficulty during meals as noticed by skin color change, changes in heart rate, or increased breathing

      • Coughing and choking during or after meals

      • Spitting up, vomiting or gagging during meals

      • After or during meals, the child talks with a raspy or wet sounding voice

      • Frequent congestion in chest after meals

  • Esophageal stage: Food travels from the esophagus into the stomach during this stage.

    • Signs/symptoms of difficulty:

      • Frequent constipation

      • Complaints of stomach pain

      • Sensation of food coming back up the pipe

      • Excess vomiting after meals

Signs and symptoms of swallowing problems may be difficult to notice if a child does not express complaints.  Other signs to watch for during meals may include the following:

  • Crying during mealtimes because the child does not want to eat

  • Refusal of food and/or certain textures

  • Distracting behaviors such as excess talking, frequently getting up, or negative behaviors

  • Long meal times due to slow eating or refusal of meals

  • Facial grimacing during mealtime for older children and arching of the back for infants

  • For infants, decreased responsiveness such as blank stares during feedings

  • Food or liquid coming out of nose during or after feedings


There are two other types of feeding/swallowing disorders related to the oral preparatory stage: oral and sensory aversion.

Oral aversion is usually a self-defense mechanism that kids use to avoid foods that they know they cannot process due to lack of skills. Chewing and swallowing can be a very complicated process requiring adequate jaw strength, tongue elevation and lateralization and rhythmic chewing and coordination. For children that lack strength and/or coordination in one of these areas, swallowing can be complicated and even dangerous. To assess if your child may have oral motor difficulties, take a bite of a food, such as a cookie, and count the amount of chews it takes you before swallowing. Observe your child eating the same type of cookie and count the amount of chews it takes him or her, while observing the jaw movements. Adequate jaw movements should be a circular/diagonal motion, not simply up and down as in a munching pattern.

Sensory aversion is usually a symptom of a  sensory-processing disorder. Sensory aversions may appear as hypo-sensitivity (lack of sensory awareness) or hyper-sensitivity (excessive sensory awareness). If the child is hyposensitive, the child lacks awareness of the food impacting his/her ability to manipulate the food before swallowing. Symptoms may appear as over-stuffing the mouth, leftover food in the mouth and excess drooling. If the child is hypersensitive, symptoms may include vomiting, gagging, spitting up food or refusing behaviors at dinner.

Consequences of a swallowing disorder

Difficulty with swallowing may cause an array of complications if not properly treated. These complications may include, but are not limited to, the following:

  • Malnutrition: Malnutrition is when the body is not receiving enough nutrients and vitamins through the consumption of food needed to keep tissues and organs working properly. Malnutrition may occur due to undernourishment or overnourishment. Undernutrition is when the child is not receiving essential nutrients due to lack of food consumption. Overnutrition occurs when the child consumes an abundance of food but lacks the necessary vitamins in those foods. Overnutrition may also involve lack of exercise, excessive eating, and/or taking too many vitamin supplements.

    • Signs of malnutrition:

      • Pale and dry skin complexion

      • Easily bruises

      • Thin hair or hair loss

      • Gums that bleed easily

      • Swollen or cracked tongue

      • Sensitivity to light

      • Rashes or changes in skin pigmentation

    • Treatment for malnutrition: Pediatricians will recommend speech therapy as well as working closely with a dietician to increase oral intake of nutritious food.  If malnutrition continues, treatment may involve inserting a thin tube through the nose that carefully enters the stomach or small intestine. If long-term tube feeding is recommended, a tube may be placed directly into the stomach or small intestine through an incision in the abdomen.

  • Dehydration: Dehydration is when children lose an excessive amount of water and salts without replacing the fluids through diet.

    • Signs of dehydration:

      • Limited tears when crying

      • Decreased need to go to the bathroom

      • Irritability

      • Eyes that have a sunken look

      • Dry or sticky mouth

      • Dizziness or lethargic tendencies

    • Treatment for dehydration: Treatment varies based on the severity of dehydration. For mild cases, children will be advised to drink plenty of fluids (preferably water) and rest in a cool room. For more severe cases, children may be required to drink oral rehydration solution (ORS) which is a combination of sugar and salts that rehydrate the body. If a child refuses liquids, alternative feedings such as tube feeding may be required.

  • Aspiration pneumonia: When food, saliva or stomach acid enters your lungs, it is called pulmonary aspiration. Healthy lungs are able to clear foreign bacteria, but if the lungs are unable to clear the food or liquid, pneumonia may occur.

    • Symptoms of aspiration pneumonia:

      • Shortness of breath

      • Bad breath

      • Excessive coughing, and sometimes coughing up blood or phlegm

      • Chest pain or wheezing

      • Excessive sweating

      • Fever

    • Treatment of aspiration pneumonia: Treatment usually involves antibiotics and supportive care for breathing such as oxygen, steroids or breathing machine.

  • Ongoing need for a feeding tube. As mentioned before, a feeding tube may be deemed necessary if your child is unable to consume enough nutrition through the mouth. There are four types of feeding tubes: nasogastric tubes, nasoduodenal tubes, nasojejunal tubes and gastric or gastrostomy tubes. (Our next blog will focus on the types of feeding tubes and provide more information.)

  • Inadequate weight gain: Attending regular pediatrician check-ups can ensure your child is growing at a healthy rate.

Treatment for Swallowing Disorders

Treatment depends on the child’s age, health conditions, physical and cognitive abilities, and most importantly, specific feeding and swallowing concerns. Feeding therapy is a a team approach consisting of the child, speech therapist, dietician, occupational therapist, pediatrician and family members. The main goals of therapy are to support adequate nutrition and hydration, minimize complication risk and maximize the child and family’s quality of life.

If you feel your child may have difficulty with any stage of the swallow process, express concerns with your pediatrician immediately. Lumiere Children’s Therapy can provide feeding therapy to help your child reach their highest potential for adequate nutrition and quality of life. Contact us here.


Children's Hospital. “Dysphagia.” Children's Hospital of Philadelphia, The Children's Hospital of Philadelphia, 24 Aug. 2014,

“Dehydration.” Edited by Patricia Solo-Josephson, KidsHealth, The Nemours Foundation, June 2017,

“Pediatric Dysphagia: Causes.” Averican Speech-Language-Hearing Association, ASHA,§ion=Causes.

Lowsky, MS, CCC-SLP, Debra C. “Food Refusal - Is It Oral Motor or Sensory Related?” ARK Therapeutic, 10 Nov. 2014,

“Malnutrition.” Is There Really Any Benefit to Multivitamins?,,Malnutrition.
“Tube Types.” Feeding Tube Awareness Foundation,

Child Therapy: School Therapy

The beginning of the school year may seem overwhelming for parents, with navigating bus schedules, after-school activities, and new classroom expectations. To make the beginning of the year a little less hectic, we answered all your questions about the IEP process as well as  taking a look at speech therapy services in the school.

What is an IEP?

An IEP, Individualized Education Program, is a legal document for each child in public school who qualifies for special educational services. The IEP documentation process is a team approach consisting of caregivers, classroom teacher, special education teacher, and specialized therapists (speech therapist, occupational therapist, vision therapist, psychologist, etc). The IEP outlines the appropriate and necessary special educational services available to your child to help them become most successful in the classroom.


What is included in an IEP?

The Individuals with Disabilities Education Act (IDEA) is a federal law requiring specific information in the IEP, but does not mandate a specific format. Therefore, each IEP may look different depending on the involved professionals and school district. The main purpose of the IEP is to outline the necessary support and services provided to your child inside and outside classroom instruction. It includes the type, amount, and frequency of services. An IEP will include the following information:


  • Current performance level. The IEP will outline your child’s strengths and weaknesses academically, socially and behaviorally. If appropriate, it will include an analysis on language and speech development, sensory needs, fine motor development and gross motor development. Standardized assessments will be explained with scores and severity level. Each member of the IEP team will communicate specific information about their area of expertise such as progression with current goals, strengths and weaknesses, and type of support provided.


  • Measurable goals. The second piece of information included in an IEP is the goals. Goals are created based on your child’s current needs. Goals are specific, measurable, attainable, realistic and timely. Progress on goals should be observed and documented throughout the year by the attending professional. During annual IEP meetings, goals will be modified, upgraded, and downgraded based on your child’s progress.


  • Appropriate services. The final piece of information included in an IEP is the action plan, such as recommended services, start date, location (in classroom or out of classroom), and professionals involved. Services may include extended testing time, reading intervention, speech therapy 1x/week, qualification for a communication device, and so on. The type, frequency, and implementation of services will be specific to your child’s needs.


What should you expect in an IEP meeting?


IEP meetings occur annually to discuss progress, concerns, and make necessary updates. If necessary, IEP meetings can occur more than once a year to discuss changes or modifications to the current plan. Prior to the annual meeting, team members will re-evaluate skills through standardized and/or non-standardized assessments, observe behaviors and participation in the classroom and analyze data collected on goals.

The new IEP is written with updated goals and services. The annual IEP meeting will be scheduled in advance to ensure each member of the team is present. During the meeting, each team professional will communicate progress and modifications of current goals and services. After each member of the team has discussed their area of specialty, caregivers will be able to discuss current concerns observed at home. In preparation of the meeting, write down noticeable areas of improvement and weaknesses to discuss during the meeting.

The meeting may seem overwhelming with excess amounts of educational jargon, so being prepared with specific questions or concerns will ensure you have all your questions answered. If you feel rushed during the initial or annual meeting, feel free to ask for a copy of the IEP to review at home before signing off on the current plan. Once you are comfortable with the current plan for services, your signature will allow for the IEP to become effective.


Speech Therapy in School


In order to determine eligibility for speech therapy services through the school, the speech therapist must obey the federal regulations of the Individuals with Disabilities Education Act (IDEA).  Eligibility is determined through a multi-step process including observation, teacher reports, screening, standardized assessments, work samples, and parent reports.

The speech-language pathologist will determine if there is a language or speech disorder. In order for the child to receive services in school, the disability must be adversely affecting educational performance. The following can be used to determine adverse academic impact: teacher’s reports, work samples, grade and therapist’s observations in the classroom. Due to caseload capacities, mild speech and language disorders may not qualify for services in the school. If you are concerned with your child’s speech and language development but your child does not qualify for services in the school, you may obtain services through a private practice.

If your child qualifies for speech therapy services, it is important to establish a good rapport with the speech-language pathologist. Parent involvement is crucial for carryover of skills into the home environment. Below are questions to ask your speech therapist in the beginning of each school year.


5 Questions to ask your speech therapist:


1. What will be the type of service?


There are two types of service methods: push-in or pull-out. Push-in is providing speech services in the classroom. The speech therapist collaborates with the teachers and classroom staff. This method allows the speech therapist to target social interactions within the classroom setting. Therapy in the classroom is most beneficial for children demonstrating difficulty with participation in the classroom. It is a great way to work on social skills, reading comprehension, or other language goals that may be impacting one’s academic success. Benefits include peer models, not missing instructional time, collaboration between classroom staff, and addressing specific academic concerns. Disadvantages include classroom distraction and limited one-on-one instruction.

Pull-out method performs speech therapy in the designated speech room. Services may be conducted in a group or individual setting. Pull-out method is recommended for children with articulation goals or specific language concerns. Advantages of pull-out allows specific instruction and intervention in a small group setting. The lesson can be child-specific and independent from the classroom curriculum of that day. The disadvantages of pull-out is that the child is taken away from peer models and may be pulled out during classroom instruction.


2. What will be the group size?


Group size varies depending on grade, speech goals and time of day. Most school groups fluctuate between three to five students in a group.


3. How will be the groups be divided?


Groups can be divided in a variety of ways: grade level, type of speech therapy (articulation, language, social), or ability level. Knowing how the group is divided is important to make sure your child is receiving the adequate amount of personalized instruction.


4. What will the weekly schedule be?


Each school speech therapist creates their weekly schedule differently. It is important to know how often and the amount of time your child will be receiving services. Will it be once a week for 20-30 minutes or three times a week for 15 minute increments.


5. What are the goals of therapy?


This is the most important question to ask your speech therapist. The speech therapist will have long term goals for the length of the IEP, as well as short term goals she/he will be targeting during sessions. Ask the therapist what goals to work on at home to facilitate carryover into the home environment.


For more information on speech therapy services outside school, contact Lumiere Children’s Therapy at 312.242.1665 or

Lumiere Blog Signature.png






School Services Frequently Asked Questions. (n.d.). Retrieved from

School-Based Service Delivery in Speech-Language Pathology. (n.d.). Retrieved August 14, 2018, from

Baumel, J. (n.d.). What is an IEP? Retrieved August 14, 2018, from



Child therapy: Autism and Feeding Problems

While many children have picky food preferences, children with autism spectrum disorder (ASD) often have ritualistic or restrictive behaviors negatively affecting their food repertoire. Severe selectivity with food may lead to nutritional deficiencies and malnutrition. Below are answers to frequently asked questions regarding feeding disorders. 

What causes food selectivity?

      Many children with ASD have limited food inventories due to oral motor deficits, sensory problems, and/or other medical complications. Children who prefer puree, soft food, and/or dissolvable foods such as Cheetos may have an underlying oral motor deficit. The child may prefer softer foods because they have not fully developed the oral motor skills to adequately chew and swallow foods. Speech language pathologists are able to evaluate for oral motor deficits, and provide appropriate therapy to increase oral motor abilities for eating and swallowing. 

      Sensory problems may limit a child’s food choices based on color or texture. A child may avoid finger foods because they refuse to touch certain types of foods. Slippery or slimy foods may create a problem for children with sensory intolerance. One characteristic of children with ASD is rigidity. If a child approves of one brand of cereal, they become fixated on that brand and may refuse the generic brand. Occupational and speech therapist can target sensory tolerance of new textures and colors, as well as help expand a child’s brand and food options. 

      In some cases, limited food preferences may be caused from other medical complications including gastrointestinal (GI) issues such as reflux and abdominal pain. Certain foods may be avoided because the child experiences pain or discomfort while consuming these foods. Children with ASD, both verbal and nonverbal, may have difficulty conveying the discomfort to parents and caregivers.  

What is the difference between a feeding disorder and picky eater? 

      Feeding disorders typically involve extreme aversion or selectivity to food tastes and/or textures. Below is a chart to distinguish the difference between picky eaters and feeding disorders based on food groups, selectivity, resistance, effect on daily life, and response to motivation. 

Screen Shot 2018-05-01 at 9.59.33 AM.png

My child has a feeding disorder, what is next?

            Feeding therapy involves a comprehensive team consisting of, but not limited to, a speech therapist, occupational therapist, pediatrician, GI specialists, and nutritionist. Physicians and specialists can determine underlying medical conditions contributing to food intolerance, and provide the necessary medical treatment. Nutritionists ensure the child is receiving sufficient nutrition during each stage of treatment. Lastly, speech and occupational therapists address the oral motor, sensory, and behavior problems affecting the child’s food preference. Speech therapist are trained to provide individual treatment to increase the amount of food tolerable by the child. 

Contact Lumiere Children’s Therapyfor a full feeding evaluation. For strategies to incorporate during mealtime read our article here.





Nath, Sowmya. “Feeding Problems in Children with Autism.” Interactive Autism Network, 11 Feb. 2014,

“TREATMENT OF FEEDING DISORDERS IN ASD.” Interactive Autism Network, 15 June 2010,

“When Does Autism-Related Picky Eating Cross the Line into a Feeding Disorder?” Autism Speaks, 25 July 2012,

Child Therapy: Autism and Sensory Integration🗣️

Imagine walking into your grocery store for your weekly shopping. The bright glow of florescent lights, the loud noises from people and shopping carts, and the strong smells coming from multiple food groups may not bother you, but for children with Autism it may be an overwhelming experience. Children with Autism frequently experience difficulty with sensory integration.

Sensory integration is the interpretation of sensory stimulation by the brain. Sensory integration dysfunction is a neurological disorder that affects processing information from the five senses: vision, auditory, touch, smell, and taste. Due to the disorganization of the senses in the brain, varying problems in development and behavior may arise. Sensory processing disorder may affect one or more senses.

            Sensory integration dysfunction often co-occurs with Autism. Individuals may seek or avoid certain sensory situations. Children who crave sensory input may excessively touch objects, crash into furniture, and/or fixate on objects with lights and textures. Children who avoid sensory input may cover one’s ears, avoid personal touch, and/or experience discomfort with certain clothes. Sensory problems may be underlying reasons for behaviors such as rocking, spinning, and hand flapping.

Occupational therapists provide sensory integration to children in order to regulate and activate senses. Therapy activities are focused on arousing a child’s alertness by targeting appropriate sensory regulation. Below are a few of our favorite products targeting sensory regulation.

Sensory-seeking products:

1.     Weighted blanket: A weighted blanket can provide the tactile sensation a child is craving. A weighted blanket can be used at night to improve sleep as well!

2.     Weighted compression vest: Similar to a weighted blanket, a compression vest provides tactile stimulation throughout the day. Compression vests may be worn under clothing during stressful activities to provide comfort and ease for a child.

3.     Therapy ball: Rolling on a therapy ball can provide tactile as well as vestibular sensation.

4.     Fidget pencil toppers: These toppers are great for school! They fit on the top of a pencil, and act as a fidget for children requiring constant tactile sensation and movement.

5.     Resistance Tunnel: The resistance tunnel encourages heavy work while integrating sensory integration. Try to roll the therapy ball through the tunnel for extra heavy work!


            For sensory avoiders, auditory sensation may cause frustration and uneasiness. Noise Reducing Earmuffs are a great product to own for loud situations that may be overwhelming for your child, such as flying, sports games, or grocery stores.


Check in next week for another post about children with Autism in honor of Autism Awareness month!


Lumiere Children's Therapy Team🖐️



Ford-Lanza, Alescia. “The 10 Best Sensory Products for Children with Autism.” Harkla, Harkla, 19 Apr. 2017,


Hatch-Rasmussen, Cindy. “Sensory Integration .” Autism Research Institute,


Child Therapy: Traveling Tips

Spring break for many people is a time to relax and rewind on a beautiful beach or lively city, but for children with Autism it may be associated with broken routines and sensory overload. Flying with children with Autism can present many challenges from the airport security, moving sidewalks, tight spaces, and loud noises. Below are some tips to make your travel experience as comfortable as possible for you and your family:

1.     Wings for Autism:

Wings for Autism is a program that provides a “rehearsal” airport experience for individuals with autism spectrum disorders and individuals with intellectual developmental disabilities. Families are able to practice going through airport security and boarding an airplane with first time flyers. It is a great way to help your child become familiar with the process without the added stressors of making a flight in time. For more information, visit The Arc to see when they are visiting your city!

2.    Rehearsal at home.

Recreate the airport experience at home by packing bags, role-playing security, and setting up chairs in the living room as an airplane. The more familiar your child is with the new routine, the more comfortable they will feel.

3.    Apps.

Off We Go: Going on a Plane is an interactive app that takes a child through the steps of flying with realistic airport noises.

4.    Explore the airport.

A few days leading up to your trip, take a visit to your airport with your child. Let them experience the lobby of the airport, watch the planes take off, and listen to the noises associated with traveling.

5.    Read books about flying

My First Airplane Ride, Maisy Goes on a Plane: A Maisy First Experiences Book, and Richard Scarry’s A Day at the Airport are all great books to introduce the experience of flying.

6.    TSA Cares:

72 hours prior to traveling contact Transportation Security Administration’s hot line, TSA cares, for priority check-in and boarding for travelers with disabilities. For more information, click here.

7.    Pack the essentials.

Pack a carry-on with all the essentials to make your child most comfortable. Noise-canceling headphones, snacks, empty water bottle, books, and electronics may all come in handy.

8.    Taste of Home.

Don’t forget your child’s favorite stuffed animal or blanket from home. Dress your child in their favorite, most comfortable outfit.

9.    New toy.

Surprise your child with a new toy or movie to open when they get on the plane. This will serve as a motivator for your child through airport security and provide them with a distraction on the plane ride.

10.  Take breaks.

Allow enough time to take breaks throughout the process. Find a quiet corner for your child to decompress after a stressful activity such as airport security.





“7 Tips for Flying with an Autistic Child | Travel with a Special Needs Child.” MiniTime,

Harris, Meg. “Top 10 Tips for Flying With Special Needs Children.” The Huffington Post,, 9 July 2014,

“National Initiatives.” The Arc | Wings for Autism®,

Child Therapy: Story Telling

Narrative skills allow us to understand and express information. We tell stories everyday by introducing ourselves, retelling memories, providing directions, reporting news, describing an event, and persuading others. Good storytellers are able to capture an audience with a compelling and fascinating story. Children experience storytelling first hand through caregivers, teachers, movies, books, etc. Children learn to determine the plot, characters, climax, and conclusion by listening to stories. Eventually, children will develop the skills to retell stories in a cohesive and sequential manner.



If a child demonstrates difficulty with reading comprehension in school, they may experience poor narrative skills as well. The child may have trouble detecting key parts of the story such as the main idea and character development. Problems with verbal narrative skills may include poor topic maintenance, deletion of important details, and poor sentence structure. Below are tips to incorporate at home to increase story telling. Continue to share memories, read books, and create playful stories with your children!


Improving Story Telling:

·      Bedtime stories: Creating a consistent routine of nightly story time instills the importance of reading and story telling at a young age.

·      Narrate routines: Verbalize the steps to everyday activities in front of your children. For example, at bath time narrate, “First I turn on the hot water, then add the soap, and finally step into the bathtub”. Once children learn sequencing, they will be able to provide verbal directions or steps.

·      Imaginary play: Play pretend with your child by creating a story line with dolls, figurines, or dress-up. Create a clear plot with characters, conflict and resolution.

·      Ask “wh” questions. Ask specific questions that start with who, what, where, or when instead of black and white questions requiring only a yes or no response. While reading a book, ask “wh” questions throughout to encourage reading comprehension and expressive language.

·      Summarize shows and movies: After watching a TV show or movie, ask your child to explain what happened. Guide your child’s response by asking about the characters, scene, conflict, and resolutions.  

·      Reminisce about the past. Children love to hear stories about themselves. Tell funny stories about them as a child, or reminisce together about fun family activities or vacations.


Story games to encourage storytelling:

·      Rory’s Story Cubes: Roll 9 cubes to generate 9 random images and create a story beginning with “Once upon a time...” by incorporating all 9 image elements. 

·      eeBoo Create and Tell Me A Story Cards:  These cards incorporate elements of a fairy tale into beautifully designed cards. Play the game as a group by taking turns adding to the story. The cards inspire story telling, language elements, and imagination.  

·      Tell Tale Card Game: Consists of 120 illustrations of characters, settings, objects, and emotions for endless imaginary possibilities. 

·      Good Dog, Carl: A Classic Board Book: This wordless picture book provides children with an opportunity to create their own story line.


Lumiere Therapy Team🖐️



“Storytelling: Why Narrative Skills Are Essential to Communication.” Integrated Children's Therapy, 1 Mar. 2018,

Child Therapy: Importance of Hydration💦

You have heard it over and over again to drink more water, but what about your children? Children are at a higher risk of dehydration than adults because of their smaller size. Children also have difficulty identifying thirst. Our bodies are made up of approximately 70% water. Water has many body functions such as regulating body’s temperature, digesting food, and removing toxins from the body.

What is dehydration?

Aqua Mechanical

Aqua Mechanical

            Dehydration occurs when the body is not receiving enough water, or losing fluids too quickly. Dehydration is usually due to an illness and/or fluid loss from diarrhea or vomiting. Dehydration may also be due to decreased fluid intake. Water is eliminated from the body through sweat, breathing, and urination. Due to the active lifestyle of most children, they are more susceptible to losing excessive amounts of fluid during the day. It is important to encourage adequate water intake during meals and playtime. Children older than 8 year old require 6-8 glasses of water, and children under 8 years old need 4-6 glasses of water per day.

Signs of dehydration in children:

  • Sunken eyes
  • Reduced bathroom breaks
  • Dry lips or mouth
  • Irritability
  • Fatigue
  • Constipation
  • Poor concentration
  • Headaches
  • No tears when crying

Tips to increase water intake: 

  • Add a slice of lemon or lime to flavor the water.
  • Keep infused water pitchers in the fridge for accessibility. Some favorites include raspberry-mint, lemon-cucumber, blueberry-lime, and strawberry-basil.
  • Freeze berries into ice cube trays for flavored ice-cubes.
  • Use crazy straws to make water glasses more fun.
  • Have your child pick out a water bottle of their choice. ContigoPura kikiManna Moda, or Polar Bottle are all great options.
  • Be a role model by frequently drinking water around your children.
  • Make a water chart. Every time your child drinks 1 glass of water, they can put a sticker on the chart.
  • Limit Juice, soda, and energy drinks to special occasions only.


“Children & Hydration.” Healthy Kids,

“Dehydration.” About Kids Health

Gladwell, Megan. “4 Reasons Your Kids Should Drink Water.” FamilyShare – Discover How to Improve Your

Family Life and More,

Jr., Robert Ferry. “Dehydration in Children: Symptoms, Signs & Reaction.” EMedicineHealth, 21 Nov. 2017,

“Water.” Healthy Kids,

Child Therapy: Valentine’s Day❤️

Mateus Lunardi Dutra

Mateus Lunardi Dutra

Valentine’s Day is a not about the candy, cards, teddy bears, nor flowers. It is a day to spread love and happiness. It is a day to tell the people close to you how much you appreciate and love them. Below are some cute and simple ways to communicate how much you love your children.

Valentine’s Day

Express your love for your children through these small but meaningful gestures.

  • Send a notecard with a sweet message in their lunch or backpack.
  • Write a short “I love you” on the bathroom mirror with lipstick to brighten their morning.
  • Decorate the bedroom door with heart-shaped notes with messages of things you love about your child.
  • Spend the morning browsing through old baby books and picture albums. Your children will love looking at their baby pictures.
  • Make new Valentine’s Day traditions as family. Some fun activities include making heart-shaped pancakes, baking cookies, getting a sweet treat after school, playing a game or seeing a movie.
  • Give back to others as a family. Create valentines to bring to a neighbor, nursing home, or children’s hospital. Volunteer at a local soup kitchen or donate to a charity.

The other 364 days of the year

Valentine’s Day is a great reminder to express love to others, but showing gratitude and love should be a daily practice. Show your children how much you care for them through time and attention, nutrition, and teaching.

  • Your time is the most valuable gift you can give your children. Put away the phone, to-do list, and work deadlines to make a daily commitment of uninterrupted engagement. Read stories, play a board game, and/or engage in a meaningful conversation. Each day the length of time and activity may differ, but your children will appreciate the undivided attention.
  • Nutrition. Give your children the gift of a healthy life by providing nutritious and well-balanced meals. Although your children may not realize the importance of a healthy lifestyle, they will thank you in the long run. Finding a balance between nutritious meals and special treats is important for young children. Too much sugar can cause irritation, fatigue, and mood swings affecting your child’s cognition and attention.
  • Valentine’s day is an excellent opportunity to discuss what it means to love. Love is an abstract concept that may be hard for children to fully understand, but give examples on how your family members express love to one another. Love and gratitude go hand in hand. Make a list of the most important people in your lives and what they mean to your family.
  • Most importantly, tell them you love them every day.

We love and appreciate our Lumiere Children’s family! Wishing you all a happy Valentine’s Day!



Sheff, Jean. “4 Ways to Show Your Kids You Love Them.” Westchester Family , 28 June 2017,

Lindsay. “12 Ways to Make Your Child Feel Loved on Valentine’s Day (& Every Day).” The Family Room, 8 Feb. 2017,

Child Therapy: Holiday Parties🎉


Holiday season can be overwhelming for anyone, but it is especially hard on children. Anticipation for the magic of Christmas begins at Thanksgiving and continues for many weeks. Throughout the many holiday traditions, family gatherings, and celebrations, children are expected to be happy and excited all season long. These gatherings can be even harder for children with special needs, shy temperaments, or young children. Learn how to make this special season relaxing and inviting for you and your family.

1. Do your homework

Observe your child in social situations leading up to the holidays. There may be certain times of the day your child is more outgoing and playful compared to others. Determine the people your child is most comfortable around, whether it be close family members, grandma and grandpa, or kids their age. Identify the environments your child prefers. Some children have difficulty with excess stimulation like lights and music. Determine if your child can adjust to new environments easily or prefers to stay at home. Knowing when and where your child feels most comfortable will help to plan out your holiday excursions.

2. Set Boundaries

Kids can experience stress during the holiday season with constant exposure to new places and people. Setting healthy boundaries around the holidays is important to decrease the chaos and stress of the season. Maybe skip the town’s tree lighting ceremony if it is too late or cold. Politely turn down the ornament exchange if you already committed to a party earlier in the day. If declining an invitation is not an option, consider hiring a babysitter for the night to give your kids a break.

3. Keep Schedules Consistent

Children thrive on stable schedules but the holidays are notorious for inconsistent bed times, excess food, and traveling. Try to keep sleep schedules relatively consistent during this time. Losing 10 minutes of sleep a night can add up quickly for toddlers resulting in more temper tantrums, illness, or stress. If traveling for the holidays, communicate in advance about naptime and bedtime. Bring along pajamas for the car rides to encourage sleep.  Keeping a regular mealtime is important as well. Most adults tend to indulge around the holidays resulting in one to two big meals a day. Children cannot adjust as easily to fluctuating mealtimes so keep healthy food readily available for young ones.

4. Prepare in advance

Give your child notice about what to expect from holiday parties. Show pictures of the people attending the party and explain the relationship. Describe what the party will entail (gift opening, cookie baking, tree decorating, etc). Have your child pick out their favorite toy to bring to the party to share. Discuss the house rules and expectations ahead of time with your older children.

5. At the party

Bring along a bag with your child’s favorite toy, blanket, snacks, and pajamas to change into. Designate a corner or area in the house as a quiet space for your child to retreat to. If they feel overwhelmed, they can read a book or play with a familiar toy in the corner to decompress.  If your child is slow to warm up at a party, play with your child at first. Invite another child or adult into the play to help ease the transition.

6. Adjust your expectations

Be realistic with your expectations for your children over the holidays. Kids need downtime and relaxing just as much as adults. Praise your child for good behavior, and listen to your children when they are upset. Tantrums are not necessarily a negative behavior, they are a way for children to express when they feel stressed. Hold your child close and comfort them at times of distress.

Most importantly, have fun! Enjoy this magical season with your loved ones!



Marchenko, Gillian. “5 Tips to Help Children with Special Needs Feel Comfortable at Your Holiday Party.” Chicago Parent, 15 Dec. 2014,

Lerner , Claire, and Rebecca Parlakian . “Children with Shy or Slow to Warm Up Temperaments.” ZERO TO THREE, 18 Feb. 2016,

Team, The Understood. “11 Tips to Help Kids With ADHD Manage the Holidays.”,

Child Therapy: Chicago Holiday List🎁

Toys are great tools to facilitate fine motor, gross motor, and speech development, but experiences spent as a family create memories of a lifetime! Instead of buying a toy from our 2017 toy list, give the gift of time by participating in a family-friendly holiday activities!

Personal Creations
Personal Creations

Outdoor Activities:

1. Illumination: Tree Lights at the Morton Arboretum

Nov.17- Jan. 1

  • The Morton Arboretum decorates 50 acres of trees with colorful light displays.
  • The lights create a majestic light show to the tunes of familiar Christmas songs!

    2. ZooLights

Nov. 24- Jan. 7

  • Zoolights at Lincoln Park Zoo is free event for all ages!
  • Watch the musical light shows, sip on some hot chocolate, and participate in holiday-season activities including carousel rides, live ice-sculpture carving, and free crafts!

    3. Holiday Magic

Dec. 26-31

  • Bring the whole family to Brookfield Zoo for the annual Holiday Magic light festival!
  • Enjoy nightly music and entertainment, Twinkling LED lights, train displays caroling with the animals, and so much more!

Indoor Activities:

1, Christmas Around the World and Holidays of Light

Nov. 16- Jan. 7

  • Explore rich holiday traditions from around the world at the Museum of Science and Industry.
  • Admire the four-story grand Christmas tree, and enjoy live holiday performances on the weekends.

    2, Elf the Musical

November 22- January 7

  • “Buddy the Elf, What’s your favorite color?”. Both kids and parents will be laughing along to the Christmas comedy, Elf the Musical, at Paramount Theater.

    3. Twas the Night Before Christmas

November 12- December 31st

  • Enjoy the classic Christmas play, Twas the Night Before Christmas at the Broadway Playhouse in Water Tower Place.

Holiday Home Activities:

1. Cookie Baking. Each member of the family can pick their favorite recipe for a family bake off!

2. Christmas Movie Night: Enjoy a cozy night on the couch with popcorn in hand. Watch some of the Christmas classics including the Polar Express, Elf, and Home Alone. The list goes on and on.

3. Ginger Bread House: A house made of frosting and candy? Sounds like a child’s dream! This kit provides everything you need to make your own ginger bread house.

4. Ornament painting: Decorate your Christmas tree this year with your children’s beautiful creations!

5. Snow painting: Add food dye to water bottles to make beautiful, colorful artwork in the snow!

Make time this busy holiday season to spend with your loved ones. Your children will remember the days spent together more than the toys they received. Happy Holidays!



“Chicago Tree Lighting and Light Fests.” Chicago Kids, 9 Nov. 2017,

Child Therapy: Toy List 2017

Scurrying to finish all your Christmas shopping in time? Fear not, Lumiere Children’s 2017 Christmas List is here! Purchase gifts that will help your child develop the necessary language, fine motor, and gross motor skills.

Shannon McGee
Shannon McGee

The Nice List of Toys

            The toys that made the nice list this year are geared towards language, fine motor, and gross motor development. These toys are divided into age-appropriate groups as well as the specific developmental milestones addressed.  The affiliated links are provided for easy access!

Younger children (7 & below):

Language Development: Toys that focus on identifying objects, corresponding sounds of objects or animals, imaginary play, theory of mind and cooperative play.

• Toy cars

• Pretend play: toy kitchen, doctor kit, and cash register:

• Toy animals:

• Little People Farm

• Little People Zoo


• Fine motor development: Focuses on manipulating small objects, hand-eye coordination, and handwriting development.

• Shape Sorting Cube

• Magnetic Doodle Drawing Board

• Tool kit

Gross motor development: Focuses on Heavy lifting, balance, and proprioceptive skills.

• Toy Vacuum

• Floor scooter

• Little Tikes Toy car

Older children  (7 & up):

Language development: Addresses deductive reasoning, cognitive aspects of language, and expressive and receptive language.

• Headbandz

• Guess Who

• Clue or Battleship

Fine motor: Targets hand grip, hand-eye coordination, and fine movements.

• Table tennis

• Legos

• Sew kit

Gross motor development: Focuses on balance, proprioceptive skills, right/left identification, and crossing midline.

• Balance beam

• Standing scooter

• Twister

The Naughty List of Toys

            Toys that fall under the ‘naughty’ category this year include electronics and restrictive movement toys. Although electronics may seem like an appropriate and engaging gift for most children, it often inhibits fine motor development and appropriate social interactions. Restrictive movement toys inhibit the development of gross motor skills such as rolling, sitting, and walking. Common restrictive toys include Bumbo seat, power wheel ride-ons, and exersaucer.


Happy shopping! Happy Holidays from the Lumiere Children’s Team!





“The 'WRONG' Toys for Holding Your Child Back and the 'RIGHT' Toys for Building Your Child's Brain.” Integrated Learning Strategies, 1 Dec. 2016,

Child Therapy: Giving Thanks🦃

Between meal prep, holiday decorating, house cleaning, and out of town guests, the true meaning of Thanksgiving may be forgotten. Thanksgiving is a time to reflect on the positives in life: roof over your head, food on the table, good health, and most importantly, your family. Thanksgiving is a great opportunity to model gratitude for your children, but it is important to carry over gratefulness into your weekly routines.


Expressing Gratitude on Thanksgiving

  • Donation. Donate toys, coats, and baby items to Children’s Home + Aid for their Holiday Gift Guide. Explain how some children are less fortunate and cannot afford new toys and clothes around the Holidays. Once your children understand the meaning behind the shopping, they will enjoy picking out new toys and clothes for another child!
  • The Thankfulness Jar: Create your family thankfulness jar by adding pictures, stickers, or ribbons to a glass or plastic jar. Have each family member contribute to the jar by adding what he or she is most thankful for this year on a little piece of paper. At Thanksgiving dinner, have your kids take turns reading the notes. Make it a game by seeing how many people wrote similar notes!
  • Thank you cards. Encourage your children to write a thank you card to all the people in their life they are thankful for. Cards may be given to grandparents, teachers, friends, coaches, therapists, etc.
  • Volunteer:Little Brothers of Chicago provides support to the elders in Chicago. They offer multiple volunteer opportunities over the Holidays including Thanksgiving. Some volunteer roles include setting up for Thanksgiving meal, serving food, driving elders to one of the party locations, holiday home visits, home-delivered meals, and holiday party cook.

Encourage thankfulness not only during the Holidays:

  • Model gratitude by showing appreciation for the little things in life. Talk about the beautiful weather, sharing time together at dinner, or playing in the backyard. Children imitate adults often, so make it positive!
  • Give your children responsibilities around the house. Even if it takes double the time to complete a chore, your children will learn how much effort chores require. They will appreciate everything you do for them with nothing in return.
  • Incorporate ‘high and low’ into dinner routine. During each dinner, go around the table and mention the best and worst part of the day.
  • Reduce the amount of stuff accumulating in your home. Gifts should be reserved for special occasions. Resist the urge to give in every time they want something. Children will have more appreciate for their things if it was given to them on a special occasion or for a specific purpose.
  • If your children get an allowance, have them contribute to buying a new toy or treat. This is a great way to teach the importance of working and saving for desired items.
  • Give back to the community. If your children are old enough, urge them to help out a neighbor with a household chore or yard work. Volunteer as a family at a soup kitchen or nursing home.
  • Thank you cards. As mentioned above, handwritten cards are important to teach children the importance of saying thanks.

Children learn more from what you do than what you teach. Show gratitude and give thanks often at home. Children will learn to find happiness for the important aspects of life more so than the materialistic. Happy Thanksgiving to you and your family from Lumiere Children’s Therapy.



Latvala, Charlotte. “Teaching Children to Be Grateful.” Parents ,

Reiser, Andrea. “11 Tips for Instilling True Gratitude in Your Kids.” The Huffington Post,, 5 Feb. 2014,

Child Therapy: Bullying and Stuttering

         Bullying is a problem for many school-aged children, and often times the target is a child who differs from their peers in some way. Unfortunately, incidences of teasing and bullying are significantly high for children who stutter. Any form of teasing can cause damage to a child, so parents often feel angry, helpless, and concerned for their child. As much as a parent would love to march right up to the bully himself, teaching children how to appropriately handle bullying situations will prepare them for any future encounters.

Lance Neilson
Lance Neilson

          Many children may feel ashamed or embarrassed to admit they are being teased. Children who stutter may also avoid confiding in their teacher because they are embarrassed they may stutter while explaining the situation. Avoiding school or social functions by making excuses, grades dropping, losing or gaining weight, depression or irritability are all common signs of bullying. If you notice any of these signs, talk to your child first.

Next, address the bullying head on. Educate your child on appropriate ways to interact with a bully without resorting to their poor behavior. Role-playing is an effective way to prepare your child for situations in a safe and comfortable environment. Role-playing may include rehearsing what to say to the bully, approaching a teacher or principle, or walking away from a negative situation. Rehearsing prewritten lines may help a child who stutters feel at ease when the moment arrives. For examples of role-playing, visit the International Stuttering Association website.  As a parent, you may feel responsible to address the situation as well.  Avoid addressing the situation with the bully’s parents; instead, reach out to the principle of the school. The principle and teacher will be able to observe the children interacting and handle the situation appropriately. A discussion with the speech-language pathologist (SLP) in the school may be beneficial as well. The SLP can address the situation with your child, and practice the role-playing at school. The SLP may also chose to talk to his/her class as a whole about stuttering and how to best react to a child stuttering. Always ask the child for permission before sending the SLP to the classroom.

            Make your child feel important and loved at home. Plan a day filled with their favorite activities, or spend a few hours one-on-one with them to make them feel special. Bullying and teasing can be detrimental to a child’s self-esteem. Reach out to Lumiere Children’s Therapy to talk to our family counselor about bullying.



Lew, Gail Wilson. “What Parents Can Do For Your Child When He Is Being Teased for Stuttering.” Parents Main Page, International Stuttering Association,

Child Therapy: Fall activities



With Halloween only a week away, get in the spirit with some Halloween-themed crafts and activities. We compiled our top 10 crafts and activities targeting gross and fine motor, sensory, music, and speech!

  • Pumpkin seeds count: Pumpkin seeds, ice tray, and tweezers are all you need for this fine motor and counting activity. On the bottom of an empty ice tray label the numbers 1-10. Have your child add the amount of pumpkin seeds to each hole using a pair of tweezers.
  • Spider races: Ready, set, go! See which spider can cross the finish line first by blowing through a straw to move the plastic spider. This oral motor activity encourages lip closure and breath support.
  • Pumpkin pie play dough: Not only is this play dough fun, but it smells amazing too! Let your children participate in making the play dough by following directions to measure, pour, and stir. Model cooking language and vocabulary throughout activity. Once the play dough is cooled, roll out the dough and use cookie cutters as a fine motor exercise!
  • Pumpkin Apple Stamp: Create cute pumpkins by stamping half of an apple with orange paint onto the paper! Add a stem with green paint and a face with black marker! This fine motor activity is fun and engaging for all ages!
  • Letter writing with spiders: Practice alphabet writing by tracing letters with plastic spiders or pumpkin seeds. After tracing a prewritten letter, have your child create their own letters or spell their name with spiders or pumpkin seeds.
  • Googly Eye Sensory bag: Simple, spooky, and slimy sensory bag! With only three ingredients necessary, this is a go-to activity. Sensory bags allow children to explore and learn while engaging in their senses.
  • Apple Pie in a cup: Delicious kid-friendly apple pie recipe! Write out the directions or a picture for each step on a piece of paper. Teach your children how to read and follow directions to make this treat. They will love smashing the graham crackers and topping with whipped cream!
  • Spider web walking: Practice balancing skills by following a spider web made of painters tape on the floor from start to finish. Incorporate language goals by sprinkling Halloween objects around the web, and having your child label each object as they pass!
  • Spider Speech Sounds: We can’t have a spider web without a spider! Outline the legs and body of a spider on a piece of black construction paper. Your child will cut out the parts and glue them together; add googly eyes to create an adorable spider! In white crayon write their target speech words on each leg and encourage your child to name each leg before gluing.
  • Corn Shakers: Simply add popping corn to a screw-top bottle or jar for an instant musical instrument! Play a few Halloween songs and have your child shake along to the beat. Use a variety of containers (empty spice jar, toothpick jar, mason jar, water bottle, baby food jar) and compare the sounds made from different containers.

Share your spookiest pictures and best Halloween crafts on our Facebook page!



Editor. “Corn Shakers Music Activity.” Pre-K Pages, 11 Oct. 2017,

“Montessori Activity Trays.” AlenaSani,

“Spectacular Spider Activities for Kids.” Early Learning Ideas, 7 Oct. 2017,

“Spider Web Walking Halloween Game.” No Time For Flash Cards, 9 Oct. 2017,

Child Therapy: Feeding and Fine Motor Development

When your child starts to feed himself, he is tapping into his fine motor skills.  Every time he smashes bananas all over his face or spoons his favorite veggies into his mouth, he's actually cementing muscle strength and coordination into his memory. The emergence of self-feeding facilitates improvements of fine motor skills needed for writing, cutting with scissors, etc. Fine motor ability is also the foundation for independent self-feeding. Below is a normal developing timeline outlining the fine motor development related to self-feeding.

Mark Doliner
Mark Doliner

3-4 Months

• Fine motor/oral motor: Hands are starting to rest on the bottle during feeding.

• Food intake: Breast milk and/or formula. At 4 months, puree or baby cereal may be introduced if approved by your pediatrician.

5-6 months

• Fine motor/oral motor: Your child should be independently holding the bottle with both hands. With the introduction of purees, co-feeding develops. Co-feeding is the positive interaction between the caregiver and child during mealtimes.

• Food intake: Continue with breast milk and/or formula, as puree, cereals, and possibly lumpy solids are introduced into the diet.

6-9 months

• Fine motor/ oral motor: Pincher grasp (index finger and thumb) emerges allowing children to begin to finger feed. Posture is more upright allowing for independent sitting during mealtimes. Vertical chewing pattern (munching) emerges.

• Food intake: Provide more finger foods to encourage self-feeding such as pieces of cereal, teething crackers, or pieces of cooked pasta. Continue with breast milk and/or formula.

9-12 months

• Fine motor/ oral motor: Your child will begin to purposefully reach for a spoon and attempt to spoon-feed. Pincher grasp becomes more refined. With the help of a caregiver, your child will be able to drink out of a cup. Munching pattern matures into rotary chew.

• Food intake: Increase solid intake in diet including bite-sized fruit, cooked vegetables, and cheeses. Begin introducing thicker combination foods such as mac and cheese, casseroles, etc.

12-18 months

• Fine motor/ oral motor: Child can grasps spoon with both hands for self-feeding. Drinks from cup with both hands placed.

• Food intake: At 12 months, the switch from breast milk/formula to whole milk occurs. Continue with soft solids including vegetables, fruits, and meats.

18-24 months

• Fine motor/ oral motor: Independently self-feeds and chews a variety of textures. Grasps spoon with whole hand.

• Food intake: At this age, your child should be eating the family meals.

24- 36 months

• Fine motor/oral motor: Drinks from a cup with only one hand, and uses a fork and spoon.

            If you feel your child is significantly behind in fine motor development, an Occupational therapist can help! If your child is having difficulty with chewing and/or food acceptance, a speech therapist can best meet your child’s needs. Contact Lumiere Children’s therapy for a consolation with one of our occupational or speech therapists.



Mattingly, Rhonda. “Typical Feeding Development.” 26 Sept. 2017, Louisville, University of Louisville .

McCarthy , Jessica L. “Feeding Infants and Toddlers.” Mosaic Childhood Project, Inc.

Child Therapy: Tips for Transitions

Tom Reynolds
Tom Reynolds

Starting your day might be as simple as a wave goodbye, or as difficult as a tantrum. Transitions can be challenging for many children, whether it may be going to the doctors, leaving a birthday party, or washing hands for dinner.

Keep some of these tips and strategies in your toolbox when a transition issue occurs in your daily routine:

Smooth Transition Tips

• Fair warning. Allowing at least 5 minutes before an activity ends. This prepares your child for a quick transition. Make it visible by using a timer on your phone or Ipad so your child can easily determine how much time is left. If appropriate, keep a timer going for the entire activity and refer to the clock periodically giving verbal reminders, “we are halfway done”, “10 more minutes”, “Time to clean up in 2 minutes”

• Concrete number. If a timer is not available or needed, use backwards counting as a reminder. For example, “Five more pushes on the swing, 5-4-3-2-1 all done”. Stick to the number you decided on to reinforce consistency even if your child asks for the inevitable “one more"

• Special signal. Determine a shared signal to indicate when an activity is over. Examples include turning off the lights, singing the clean up song, or signing ‘all done’

• Visual schedule. A visual schedule is a great tool for your child to visualize the finished activities, and prepare them for the future activities. If the day includes some non-preferred activities, add in a few preferred activities (snack break, 5 minute screen time, play outside, etc) so your child has something to work towards. Choicework is a great resource to create a visual schedule on the iPad.

• Transition toy. Bringing along a familiar toy or object can help children remain calm and feel safe during a period of change.

• Waiting game. Transitions can become even harder if there is a waiting period involved. Come up with some fun waiting games (I spy and Simon Says) during stressful moments. Games may also be used to distract during transitions, for example racing to the car, counting your steps, or singing a familiar song as you are walking.

• Social stories. Transitions are difficult because they involve change from a familiar activity to something new. Talk through new situations with a visual storyboard. If making a storyboard seems daunting, practice acting out the situation ahead of time!

• Transition words. Children need to learn concepts such as first, then, next, later, and now before they can understand the words used during transitions. Use the words in less stressful situations such as playing, “First you throw the ball, then I catch the ball”. Once they understand the words during play, these words will become easier to comprehend during transitions.

            It may take a few trials and errors before finding the best strategy for your family. Be sure to allot enough time during transitions in case of possible setbacks. It is important to keep a consistent schedule. Once your child becomes familiar with the weekly routine, transitions will start to become second nature.



Heffron, Claire. “10 Calming Techniques and Transition Strategies for Kids.” The Inspired Treehouse, 20 Sept. 2017,

Oakley , Bec. “18 Tips To Make Transitions Easier.” Snagglebox,

Child therapy: What is ABA therapy?

Lumiere Children’s therapy now offers Applied Behavior Analysis (ABA) therapy services as part of its comprehensive programming.  ABA is an evidence-based therapy that uses motivation and interests unique to each child in order to teach new skills across all domains. ABA therapy focuses on positive reinforcement to encourage beneficial behaviors and reduce ones that may be harmful or interfere with new learning. ABA is most successful when all parents and caregivers are educated and informed on the components and techniques of ABA therapy for their child.


What does ABA therapy involve?

ABA therapy focuses on individualized intervention based on the learner’s motivators, skills, needs, interest, and family/caregiver situation. Therefore sessions will look different from person to person, but each approach will consist of common components: discrete trail teaching, programming for generalization to natural environment, reinforcement, prompting and fading strategies, and outcome-based decision making.

• Discrete trail teaching: Discrete trail teaching involves taking a task and breaking it down into smaller parts in order to teach and reinforce a behavior. Breaking a task into steps allows for recognition of underlying skill deficits that need to be addressed in order to successfully complete the given task.

• Programming for generalization: Sessions will initially occur in a calm, isolated environment to eliminate all distractions or barriers in order to facilitate new learning. Once the skill is learned in a quiet, structured environment, the child will practice the new skills across all daily environments. The new skill is considered mastered once a child is able to successfully generalize the skill across all environments.

• Reinforcement: ABA focuses on the principle of positive reinforcement to encourage new learning. Therapist will take a reinforcer assessment to determine the child’s preferred activities and items. Multiple reinforcer assessments will be completed throughout the program to continue to implement appropriate and desired motivators.

• Prompting and fading strategies: As new skills are introduced, therapist and caregivers provide multiple cues and prompts to help a child be successful. As the child continues to show progress in learning a skill, prompts will begin to decrease until the child can independently demonstrate understanding.

• Outcome-based decision-making: ABA relies on objective information from concrete data to guide therapy session goals. Therapy goals will emphasize appropriate skills needed to be successful in a variety of areas including communication, sociability, self-care, play and leisure, motor development and academic skills. The intervention involves ongoing objective measurement throughout sessions, which is frequently analyzed to determine progress and adjust procedures and goals as needed.

For more information on ABA therapy and to register for our program, visit  Lumiere Children’s therapy website here. Our knowledgeable ABA therapist will put your child and family’s needs first to ensure progress and successful outcomes!



What is ABA therapy? . (n.d.). Retrieved August 24, 2017, from

Applied Behavior Analysis (ABA). (2012, July 24). Retrieved August 24, 2017, from

Child Therapy: Healthy Eating

             It may come as no surprise that childhood obesity numbers continue to increase. Between TV commercials and online ads, kids are presented with unhealthy foods daily. Childhood obesity affects 12.7 million children and adolescents in the United States. Obesity in childhood may lead to high blood pressure and high cholesterol, risk of diabetes, breathing problems, joint problems, and/or liver problems down the road.  Childhood obesity may also have a negative effect on your child’s mental and emotional well being, possibly leading to anxiety and depression.

Most children have little control over the food they are fed at home, daycare, and school. It is the parent and caregivers’ responsibility to educate and model healthy eating for children.  Read more about tips to implement at home to encourage healthy eating!

U.S. Department of Agriculture
U.S. Department of Agriculture

At-home tips:

• Buy more real food. We all love the convenience of cereal, cookies, chips, and granola bars, but processed food provides little to no nutritional value and are high in calories and sugar. Opt for natural foods such as fruits, vegetables, and meats. Create your own on-the-go snacks including apples and peanut butter, carrots and hummus, or peppers and guacamole.

• Limit sweetened beverages. Instead of fruit juice, soda, and energy drinks, keep a pitcher of water with fresh fruit in the fridge. Other tasty options include flavored sparkling water such as LaCroix or blending milk with bananas or berries for a delicious smoothie!

• Limit Fast food trips to special occasions only. If it is unreasonable to cut back on eating out, make good choices at restaurants such as swapping out French fries for fruits or vegetables. Instead of ordering the macaroni and cheese off the kid’s menu, chose a lighter choice such as chicken and vegetables. Be aware that the portion sizes at restaurants are sometimes double what one should eat. Box up half your child’s dinner to save for dinner the next night.

• Eat meals together. Make dinner a family event by preparing and eating the meal together. Share stories during dinnertime instead of watching TV or playing on the tablet. Eating together can decrease mindless eating.

• No more clean plate club. Allow children to determine when they are full, instead of encouraging finishing the entire plate. Save the leftovers for later if your child becomes hungry again.

• Don’t become a short order cook. Instead of cooking a separate dinner for your kids, make one dinner for all. Create a balanced meal with whole-grain, fruit or vegetable, and a protein. Serve the dishes family style so kids can pick and chose what they want to eat. Kids tend to mimic their parents, so set a good example by eating a little of each dish!

• Get active! Limit TV, computer, and tablet time to 1-2 hours a day and spend the rest of the day playing with your children outdoor riding bikes or swimming at the pool. Click here for outdoor activities

Allow treats. Banning certain types of food will only make your child want to eat them more. A child can still eat healthy and enjoy some cake and ice cream once in while. Balance is key.

            Make eating fun by cooking new recipes together, exploring local farmer markets, and having your child pick out their favorite fruits and vegetables! If you are concerned about your child’s weight, contact your pediatrician today.



"Childhood Obesity Facts." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 10 Apr. 2017. Web. 18 July 2017.

"Healthy Food for Kids." Help Guide. N.p., n.d. Web. 19 July 2017.

Julie Burns. "15 Ways to Get Your Kids to Eat Better." Parents. Parents, 11 May 2017. Web. 19 July 2017.

Mayo Clinic Staff. "Childhood Obesity." Mayo Clinic. Mayo Foundation for Medical Education and Research, 17 Nov. 2016. Web. 18 July 2017.