Olivia’s Place

Clinician Profile: Pengsi Shen, BCBA

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Pengsi Shen, BCBA, Behavior Analyst

Pengsi Shen, BCBA, Behavior Analyst

Pengsi Shen is a Behavior Analyst with our Behavior and Learning Support team at Beijing LIH Olivia’s Place. She holds a Master of Arts degree in Applied Behavior Analysis from Teachers College, Columbia University (US). She has worked with preschoolers with disabilities in self-contained classrooms, assessing students, selecting evidence-based programs, and implementing intervention and behavioral plans. She has also worked with early elementary students with or without disabilities in inclusive classroom settings, providing interventions for students who lack certain developmental/social skills using scientific protocols, providing group and class-wide instruction, and implementing both individual and class-wide positive behavior plans to facilitate learning and love for learning. Pengsi works with children in both Mandarin and English.

 

How long have you been in China?

I was born here, raised here, and received most of my education here too. I left China three years ago to earn a master’s degree in New York, and came back again to China in July 2015.

 

Why did you choose to work at LIH Olivia’s Place?

I love to work with kids with special needs, and want to learn more about different professionals that also work with the same population.  I would also like to keep up to a te with the latest research and practice from well-trained foreign therapists, but still be able to work with local children. LIH Olivia’s Place is a place where therapists (from all over the world) of all disciplines work closely together for the same goal: help each kid (regardless of their nationality) to reach their full potential.

 

Why did you choose your field?

The truth is by accident! I had never heard about applied behavioral analysis (ABA) before and had little experience working with kids with autism spectrum disorders (ASD) since there are no ABA degree programs in China yet and most children here with ASD have been excluded from general educational classrooms. However it is the best decision I’ve made so far in my life.

 

What are some of the most rewarding experiences you have had in your chosen profession?

(1) When a child starts looking into my eyes, with affection. It is really hard to get many of the children I work with to make eye contact.

(2) When all of sudden a child runs to me, gives me a hug, and runs away.

(3) When parents tell me that my suggestions have worked so well with their child.

 

What’s your favorite thing about living in China and working at LIH Olivia’s Place?

I can talk to my family without lag time and visit them more often.  I am so excited for this coming Chinese New Year in February, since it will be my first New Year with family after three years.  I love to talk to different therapists at LIH Olivia’s Place, and get to work with children with a variety of needs.

 

What would you like to be doing in 5 years time?

I would still be working with kids with special needs, and working with parents and teachers too. In 5 years, hopefully people will be better educated and can embrace kids of all kinds, acknowledge them, and love them unconditionally through our joint efforts.  Also I hope for a flexible work schedule to enjoy life with my family.

 


Caring for Children with Autism Parent Lecture Program

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IMG_2825The second “Caring for Autistic Children -Health Lectures for Parents of Children of Autism” was successfully held at Beijing Chiildren’s Hospital, Capital Medical University, on 28th June 2015. The lecture was jointly organized by Beijing Children Hospital Group, The Department of Neurology at Capital Medical University, the Department of Psychiatry and Clinical Psychology at Capital Medical University, Beijing Developmental and Behavioral Pediatric Association,Beijing Association of Rehabilitation Medicine, and LIH Olivia’s Place.

 

IMG_2801Dr. Fang Fang, the Director of the Department of Neurology at Beijing Children’s Hospital, and well-known pediatric neurologist, presided. Dr. Mease, Developmental and Behavioral Pediatrician and LIH Olivia’s Place Medical Director, gave the keynote lecture, Rearing and Accompanying Autistic Children: The Behavioral Problems of Children with Autism Spectrum Disorders. Holding a model of the brain model in his hand, he explained autism spectrum disorders to over forty parents from across the country in simple language. Moreover, he helped them to understand and to be receptive of autism. Dr. Mease presented some behavioral problems in detail, such as sleeping, potty training, ritualistic behavior, obsession or compulsive behaviors, anxiety, depression, hyperactivity-attention deficit, and self-injurious and assaultive behavior. He started with the appearance and assessment of problems through case studies, then attentively guided the parents IMG_2812through the process of drawing solutions. His lecture provided parents with feasible measures to cope with their children’s behaviors, helping to alleviate their anxiety

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Dr. Zhang Jishui, from Beijing Children’s Hospital, gave a speech called The Brain Cognitive Function Intervention of Autism. Dr. .Zhang has abundant clinical experience and has been engaged in autism treatment for a long time. Many parents attending the event came from other provinces to hear him speak.

 

 

From Left to Right: Susan Zhu, LIH Olivia's Place, Professor Fang, Beijing Children's Hospital, Dr. Alan, Mease, LIH Olivia's Place, and Dr. Zhang Jishui, Beijing Children's Hospital

From Left to Right: Susan Zhu, LIH Olivia’s Place, Professor Fang, Beijing Children’s Hospital, Dr. Alan, Mease, LIH Olivia’s Place, and Dr. Zhang Jishui, Beijing Children’s Hospital

After 3 hours of lectures, lots of parents still wanted to ask questions. One after another, they told Dr. Fang Fang, the director, that they hoped the event could be carried out again. It’s the long-cherished wish of parents to see their children reach their maximum potential. This health lecture aimed at helping parents to understand and accept autism objectively, to cope with present problems, and to be prepared for future challenges.


Leading Pediatrician Presents on Autism at Beijing’s BoAi Hospital

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Dr. Eldon Schulz presents at BoAi Hospital in Beijing.

Dr. Eldon Schulz presents at BoAi Hospital in Beijing.

On 30 September 2015, LIH Oliva’s Place hosted Dr. Eldon Schulz, Director of Pediatrics and Rehabilitation Medicine, College of Medicine University of Arkansas Medical Sciences (UAMS), at Beijing Boai hospital for academic exchange with doctors and therapists of pediatric rehabilitation. Dr. Schulz gave a presentation titled Autism Spectrum Disorder: An Update.

 

At his presentation, Dr. Schulz compared the current version of the American Psychiatry Association’s Diagnostic and Statistical Manual (DSM-5) with the previous version with respect to autism diagnosis. Some of the things that Dr. Schulz noted for attendees are that in the DSM-5, there is a category called Autism Spectrum Disorders. Pervasive Developmental Disorders and Asperger’s are no longer separate diagnostic options. He also indicated that the DSM-5 has included sensory processing differences in the diagnostic criteria. Symptoms together must limit and impair everyday functioning and must be present in early childhood (the previous version required that symptoms be recognized prior to the age of 3 years). Autism spectrum disorders may be designated as with or without: language impairment, intellectual disability, and/or known medical or genetic condition.

 

Dr. Eldon Schulz with BoAi staff and Dr. Alan Mease, Medical Director, Beijing LIH Olivia's Place, and Susan Zhu, LIH Olivia's Place

Dr. Eldon Schulz with BoAi staff and Dr. Alan Mease, Medical Director, Beijing LIH Olivia’s Place, and Susan Zhu, LIH Olivia’s Place

Dr. Schultz mentioned the US Center for Disease Control’s (CDC) Autism Surveillance This program has collected data from 11 sites around the United States since 2000. Results have found that boys are diagnosed five times more often with autism spectrum disorders in the US.  The program has also found statistically significant differences among racial/ethnic groups in the US.

 

Dr. Schultz shared possible reasons for increasing prevalence of autism spectrum disorders,  “red flags,” and best practices for diagnosis. Dr. Schulz recommended the following web-based resources to participants:

 

 

US Center for Disease Control (CDC): Learn the Signs. Act Early.

National Autism Center (US)

Autism Speaks

First Signs ASD Video Glossary

Arkansas Autism Resource & Outreach Center (AAROC)

 

 


A Day in the Life: Shanghai’s Early Intervention Program

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September 2015 saw the opening of an Early Intervention Program at LIH Olivia’s Place Shanghai. The program is aimed at pre-school children with additional needs. The children attend class five mornings a week and are developing their classroom readiness skills. Amongst other things they learn to listen and respond, share, take turns, and problem solve. Our team of LIH Olivia’s Place therapists supports the program and the children participate in group therapy for an hour each morning.EI 2

As I’m riding the elevator up to my classroom, my tummy feels funny. Maybe I’d rather just stay at home today? But as soon as the doors open on the 19th Floor I see Olivia’s Place and a smile plasters across my face: I’m at school!

I quickly change shoes, say goodbye to my family and run in to see my teacher and friends. What are we going to do today?

My teacher has laid out fun activities for us on the table, and so I start there. She says these activities are to help me practice the skills I’m learning in my therapies, but in any case they’re super fun. Then I move on to the puzzle shelf- some of the puzzles are a bit tricky for me still but I have my favorites. There are other games, books, and role-play activities, and I decide to try on some dress-up clothes.

At 9 o’clock we sit down on the mat for our Morning Circle time. We sing Hello, read a book, and look at our visual schedule for the day. I like sticking my activities choices to the Velcro board… and I love it even more being able to say “All Done” when we’re finished! After reading a book and joining in for a song we’re ready for snack (Yum!), and then it’s our group therapy session. It’s really fun to do my therapy with my friends, and we learn from and encourage each other. We do physical therapy, occupational therapy, and speech therapy several times throughout the week. It just seems like playing to me, but the grown-ups say I’m learning so many new skills!

Gosh I’m tired after therapy. We have some quiet reading time and sometimes a bit of a swing to calm down. Then it’s back to work: I’m learning to work independently, and I’m so proud of myself!

Now it’s lunch time and I help to set the table. I love showing my friends how I can eat by myself: I’m a big kid now after all! Sometimes I spill a bit of food and it gets a bit messy, but my teachers don’t mind, they say its all part of learning.

After lunch it’s time to go home, and I greet my parents with a tired but happy smile. The door of our room says ‘Early Intervention Program’: those are big words, but I think it means ‘Big Kid School’… I’m so proud of myself!


Beijing LIH Olivia’s Place Pediatric Clinic Holds First Open House

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On 19 September 2015 Beijing LIH Olivia’s Place Pediatric Clinic held its first Open House. Families, teachers, doctors, and other Chinese and foreign community members attended the event. Nelson Chow, LIH Olivia’s Place CEO, and his wife Quynh, daughter Olivia (the namesake of our company) and their son Peyton came from Shanghai for the event. The event included clinic tours, opportunities to meet our therapists and doctors, and games for children led by Occupational Therapist Eva Ma.

 

Nelson and our Beijing clinic General Manager, Jacqueline Chen, spoke briefly about our vision and mission, our new clinic and our current strategic direction. Our team was excited to spend an afternoon showing our patients and the community our large, family-friendly facility which will serve a large variety of pediatric development needs for children in Beijing and beyond.

The Open House was one of several events celebrating our merger with LIH this summer. In addition to therapy and psychology services, Beijing LIH Olivia’s Place now also offers Developmental and Behavioral Pediatrics,Learning Support, and Behavioral therapy (ABA).  Over the next three years we will open four additional clinics and a specialized children’s hospital in various locations throughout China.

 

The new clinic in Beijing, located at 13 Jiu Xian Qiao Road, is the first free-standing developmental and behavioral pediatrics clinic in China. LIH Olivia’s Place’s mission is to bring high quality specialized pediatrics and pediatric therapy to China. With 45 international therapists, we now have the largest team of international therapists of any organization in China.


International Cooperation Makes a Difference for the Smallest Babies

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Lis Ringrose, Physiotherapist, Chief Therapy Officer, LIH Olivia's Place

Lis Ringrose, Physiotherapist, Chief Therapy Officer, LIH Olivia’s Place

Xinhua staff practice new  skills.

Xinhua staff practice new skills.

One of the longstanding mission areas of Olivia’s Place has been to impact therapy throughout China and it is an area that is close to my heart. Earlier in the summer I was privileged to be part of a team leading a professional development course at XinHua Hospital. The course was jointly led with Pacific University, Oregon, US and focused on care for babies born prematurely. We were able to provide the course for free through a grant secured by the university.

The course was divided into two parts. The first was online study with articles and teaching materials to be read and assignments to complete. This lasted for four weeks with an hour online discussion with the U.S.-based professors each week. The second part was a three day workshop. The university professors flew over for this. I helped with translation, cultural adaptation, and coaching during the practical elements of the workshop. It was so encouraging to watch the skills and confidence of the participating therapists grow as they first practiced on dolls and then older babies and finally the very small premature babies on the NICU. Having therapists work on NICUs in China is more or less unheard of and everyone had the sense that we were all part of something new and exciting for the therapy professions as well as for the children and parents. When we asked when they planned to use their newly learned skills, ‘tomorrow’ was the answer. As far as we know, they will be the first service of this kind in China.

The course was considered a success by those who both taught and learnt on it. ELR XinhuaA second is already planned for this fall focusing on another skill area. It can also be provided with no charge due to the grant. We already hope that these two courses may be the beginning of something bigger and even more therapists can continue developing their skills in the future.


Deepening Partnership with Changning Special Education Guiding Center

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Staff prepare for an LIH Olivia's Place professional workshop at Changning Special Education Center

Staff prepare for an LIH Olivia’s Place professional workshop at Changning Special Education Center

Over the last school year, Olivia’s Place completed a training project about autism spectrum disorder (ASD) in cooperation with Shanghai Changning Special Education Guiding Center, a public organization which provides opportunities for career development for local educators who work with children with special needs. The trainings attracted many local school teachers and medical practitioners. Participants came from all over the city and neighboring provinces. The program content included childhood development, theory-based knowledge, and the sharing of clinical experience. Therapists from Olivia’s Place in each field of practice have made contributions to the project through interactive, inspiring, and practical presentations for all attendees:

 

  • Anna Pascual, Occupational Therapist Lead, introduced occupational therapy for children with learning difficulties.
  • Zili Wang, Physiotherapist, introduced how children with ASD benefit from physical therapy.
  • Jamie Fanelli, Learning and Behavioral Support Lead, introduced strategies and supports for academic success for children with ASD.
  • Yi Lien, Speech-Language Therapist, introduced speech-language assessment and treatment for children with ASD.

 

In addition to the multi-disciplinary ASD project, Olivia’s Place and Changning Center started a new series of trainings in the area of communication disorders. This project targeted applying clinical skills for different types of communication disorders in the school setting, including evaluation methods and comparison of different therapy approaches. These speech and language training projects were conducted by Angela Gong and Yi Lien. Both therapists have worked with Changning Center since 2013. The specific topics addressed included:

 

  • Heidi Gao and Jamie Fanelli, Learning and Behavior Support Specialist, field questions.

    Heidi Gao and Jamie Fanelli, Learning and Behavior Support Specialist, field questions.

    Children with autism spectrum disorder

  • Children with oral motor disorders/delays
  • Children with social and pragmatic impairment
  • Children with articulation and phonological disorders
  • Children with stuttering
  • Children with hearing loss

 

So far, we have received many greetings and positive feedback from the attendees of these projects. As a new school year comes, we cannot wait for new outreach and more collaboration with our partner organizations!


We are now LIH Olivia’s Place: A New Partnership Committed to Your Family and The Children of China

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Dear Friends,

We are delighted to announce that Olivia’s Place and Eliott’s Corner have merged with one of China’s leading start-ups in the field of rehabilitation medicine, LIH ChangHe. When we founded Olivia’s Place in 2010 and Eliott’s Corner in 2011, we set a clear mission for our organization: To help the children of China maximize their potential through access to high-quality pediatric therapy.  We have made progress but as we’ve reached each milestone, it became evident that we needed to think more broadly and systemically about rehabilitative and developmental services for children in China. In short we realized we needed to be able to provide medical services to have the impact we were aiming for in our mission, which is true multidisciplinary services. This led us to envision a new “minimum platform” of several medical clinics and one specialized pediatric hospital as the minimum infrastructure we need to provide a comprehensive service platform to the families we serve, to train current and future clinicians, to work with universities and medical facilities to effect change in the rehabilitation and therapy fields, and to alter the landscape of opportunities for children with special needs.

亲爱的朋友们,
我们非常高兴地宣布大蕴之家和胡宝小屋与 中国康复医学领域新兴的领军企业—北京长和系国际医疗投资管理有限公司合并!我们于2010年成立大蕴之家,2011年成立胡宝小屋。为该机构确立了明确的使命:通过提供高质量的儿童康复治疗,让中国的孩子们最大程度发挥其潜能。我们已经取得了一些进展,但是仍需要提供给广大的中国儿童全面系统的康复与发育行为诊疗服务。总之,我们意识到如果我们要达到我们真正的多学科团队使命,我们必须取得提供医疗服务的资格。在我们的发展初期,我们需要建立一个“基本的平台”,包括最低需要的基础设置,几所发育行为诊所和一所专门为了特殊儿童服务的医院。同时,我们需要建立一个全面的服务平台,更系统的帮助需要特殊服务的家庭,这个平台应该能够承载培训我们现在和未来的临床人员的任务,我们会与中国医科大学和医疗机构合作,让这个平台能够为康复医学和康复治疗行业培养人才,为这个领域的进步做出贡献,为更多的中国特殊需求儿童提供更加专业的服务。

We realized that we would need a partner to help us with this, and we were incredibly fortunate to find LIH ChangHe.  Prior to founding LIH in 2013, Dr. ChangSen Sun spent more than 20 years in the pharmaceutical industry, founding and leading one of China’s largest pharmaceutical companies, CITIC Pharmaceuticals, which later became Shanghai Pharmaceuticals and grew to 20 billion RMB in annual revenue. Following this success, he set his sights on making a positive impact in the development of healthcare services in China and the significant value to Chinese society that this could bring. He saw that rehabilitation medicine was the area in which China could benefit the most from development and founded LIH with the mission to bring high quality, international rehabilitation medicine and therapy to China.

我们清楚的认识到为了完成目标需要一个合作伙伴来与我们共同努力,我们非常幸运的遇到了北京长和系国际医疗投资管理有限公司(LIH)。2013年LIH成立之前,孙长森博士用了20余年的时间领导并建立了中国一家年销售近200亿元大型医药药公司(中信医药)。成功之后,他将目光投向了将会对中国医疗服务行业起到积极影响的康复产业,发起并建立了LIH。在他看来康复医学服务在中国有巨大的发展潜力,发展康复医疗业务将为社会带来巨大的价值,长和将国际高水平的康复医学与康复治疗带到中国定为自己的使命。

Our new partnership, LIH Olivia’s Place, will bring new clinics with services tailored to children to several major cities in China, offering world-class developmental and behavioral pediatrics and pediatric therapy.  Joining the team is Children’s Specialized Hospital, which is considered the leading provider of pediatric rehabilitation and developmental and behavioral pediatrics for children in the United States. With a 120-year history, CSH will provide a depth of institutional knowledge and medical and therapy resources that will enrich our ability to provide high-quality, efficient, and affordable care.

大蕴之家与长和医疗合并后,我们建设的第一个项目—北京长和大蕴儿童之家已经诞生,她将会以全新的诊所模式,为孩子们提供世界一流的发育行为儿科和儿科治疗服务,我们近期还会很快在几个城市建立这样的诊疗机构。我们儿科康复和行为发育领域的诊疗服务获得了美国最大的儿童康复专科医院CSH的全力支持,CSH是美国最佳儿童医院之一,她有着120年历史,CSH为我们提供最新的管理模式和医疗信息资源,为我们更好的提供高质量服务、高效率的运作提供更实用的医疗服务提供帮助。

I’m honored to serve now as one of the founders of LIH as well as the  President and CEO of our new combined organization and will continue in my role as the General Manager for the Shanghai clinic. Joining me will be the same clinical and administrative managers as before. Jacqueline Chen, mother to Eliott and our Beijing clinic co-founder, will be serving as the General Manager of our new Beijing LIH Olivia’s Place Pediatric Clinic, which is just opening on Jiuxianqiao Road. Elisabeth Ringrose, who has been with Olivia’s Place since the week we opened (over 5 years ago), will be serving as the Chief Therapy Officer for the combined organization.

我很荣幸能够成为LIH合作创始人之一,担任新组织的总裁兼首席执行官,并且将继续担任上海诊所总经理。我们北京诊所的创始人之一杰奎琳陈(胡宝的母亲)将成为我们北京长和大蕴儿科诊所的总经理,该诊所坐落在酒仙桥路并将于开业。伊丽莎白-里恩罗斯——她在五年前大蕴之家开业的时候就加入了我们的团队,她将就任诊所的首席治疗官。

At each of our locations, we remain committed to leading with our most important resource – our clinicians. This means ensuring that our team is highly qualified, diverse, and family and patient focused and that each staff member is committed to learning and teaching and fully engaged in our mission. Our current clinical team is excited about the next steps toward our vision and has been a stable and guiding force in planning services that meet or exceed international standards in each of their fields.

在所有的地方,我们都秉承最初的理念不变,临床人员是我们诊所最重要的资源。我们必须保证团队是高质量、多学科、交叉的。家庭和患者是我们的最重要的服务对象。为了更好的完成我们的使命,团队中的每个成员都会参与到学习和培训中,都将为实现我们的目标—实现或达到国际服务标准而在他们的专业领域里努力奋斗。

In Beijing, we are now adding specialized pediatric medical services in our new clinic, Beijing LIH Olivia’s Place Pediatric Clinic. We are proud to welcome Dr. Alan Mease as our Medical Director in Beijing. Dr. Mease is an American board-certified pediatrician with more than 40 years of experience, and was Beijing United Family Hospital’s first CMO (Chief Medical Officer) and their head of pediatrics for many years. He is a proven leader in the development of medical services in China

.现在,我们合并后的新诊所——北京长和大蕴儿科诊所的开业仪式正在启动中,新的诊所将会增加特殊儿科医疗服务。我们很高兴能够邀请到艾伦密斯博士成为我们的医疗总监。密斯博士是美国认证的儿科医生,拥有超过40年临床经验,担任北京和睦家医院的首席医疗官以及领导者多年。他是在中国医疗服务发展的领导者之一。

We invite you to visit our new clinic in Beijing and hope that you will join us in celebrating our next steps as we grow!

我们邀请您来北京参观我们的新诊所,感谢大家能见证我们每一步的成长!

Sincerely,

Nelson Chow 周良荪
President and CEO 首席执行官
Father to Olivia 大蕴的爸爸
LIH Olivia’s Place 长和大蕴


Building a Framework for China’s Therapists

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Authored by April Gamble, Physical Therapist, Beijing, pictured here at the WCPT Congress 2015 in Singapore.

Authored by April Gamble, Physical Therapist, Beijing, pictured here at the WCPT Congress 2015 in Singapore.

I had the opportunity to represent Olivia’s Place at the World Confederation of Physical Therapy (WCPT) Congress 2015 in Singapore. The WCPT serves as an international voice of physical therapy and seeks to move the physical therapy profession forward around the globe. It was thrilling to engage with therapists at the Congress from all over the world. There was such an immense air of excitement that only occurs when you bring people together for development within a shared passion. The WCPT Congress was also an excellent opportunity to share via a presentation, our recent efforts in the development of a Knowledge, Skills, and Abilities (KSA) Framework in the field of pediatric physical therapy.

The KSA Framework we have recently developed is made up of multiple documents to guide both locally trained and newly graduated physical therapists through a process of learning and developing their professional skills. We developed the KSA Framework based on current research, existing frameworks, and an extensive knowledge of China’s culture, training system, and educational needs. It will be used to support our mission of improving the standard of care in rehabilitation throughout China.

Lis Ringrose, Clinical Director and Physical Therapist, and April Gamble, Physical Therapist at Olivia’s Place, with the assistance and guidance of  Lisa Kenyon, Associate Professor of Doctor of Physical Therapy Program at Grand Valley State University, Michigan (US), to ensure the content and approach are in keeping with international standards.

We are currently working on completing a KSA framework for pediatric occupational therapy and pediatric speech and language pathology. As well as using the frameworks internally with locally trained Chinese staff and newly graduated international staff, we are also making it available to individuals and organizations across China because we believe that the frameworks have the potential to facilitate improved care, which will positively influence the children and families of China.


Important Things to Know about Feeding Therapy

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Authored by Edna Elisabeth Nyang, Lead Speech-Language Pathologist, Beijing

Authored by Edna Elisabeth Nyang, Lead Speech-Language Pathologist, Beijing

Many families know to consult with a speech pathologist if their child is delayed with their articulation or language skills, but they do not know who to turn to if their child has trouble tolerating certain food textures. As a result, some of these symptoms remain untreated and turn into a more serious issue. According to the Kennedy Krieger Institute, approximately 50% of children experience a form of feeding difficulty, of which 10% develop a severe feeding disorder. If a child has difficulty eating properly, this can result in weight loss for a developing child. For all families, regardless of the issue, the main goal for children who present with feeding difficulties is for them to eat a variety of foods with their family in a fun, nurturing environment.

 

You should consider seeking out a speech pathologist, if your child is experiencing a couple of the following symptoms: coughing and/or choking during or after swallowing, crying during mealtimes;, decreased responsiveness during feeding, dehydration, difficulty chewing foods that are texturally appropriate for age (may spit out partially chewed food), difficulty managing saliva, disengagement cues, (e.g., facial grimacing, finger splaying, or head turning away from food source), frequent congestion after meals, frequent respiratory illnesses, gagging, loss of food/liquid from the mouth when eating, noisy or wet vocal quality noted during and after feeding, extremely long feeding times, refusing foods of certain textures or types, taking only small volumes or over-packing the mouth, and vomiting (more than typical “spit up” for infants).

If you have concerns about your child and their feeding habits, I would like for you to consider the following:

  1. All therapy starts with an evaluation.

Typically conducted by a speech language pathologist or occupational therapist who specializes in feeding and swallowing difficulties in children, this evaluation can be done in the clinic and generally consists of replicating a mealtime that is similar to one that your child experiences at home. It should it be noted that prior to the evaluation, you may be asked to complete a questionnaire and/or keep a “food journal” over a period of time to provide the therapist with more information.

2. The therapy should focus on the whole child and not only the symptoms.

It’s extremely rare for a child to have a feeding or swallowing difficulty due to one issue.  For example, some children with cerebral palsy present with low tone and have difficulty eating and chewing tougher textures because it hurts. As a result, they may start to eat less or not at all. A pediatrician may prescribe medication to stop the pain, but the learned behavior is still there and needs to be addressed.

  1. Family dynamics and culture should be incorporated into the therapy.

Feeding your child is cultural and emotional as it’s about creating a bond with your child and your culture.  When feeding becomes challenging, it’s stressful and it impacts the entire family on a daily basis and potentially socially as the family may be less likely to socialize during mealtimes. It is extremely important for the therapist to recognize what is culturally important to you and incorporate those objectives into the therapy program.

  1. It will take time.

First, eating is a developmental process. When a child has difficulty eating, it means they have stalled in the midst of learning a new skill.  Regardless of their age, the therapist will begin to teach the step by step process wherever they are having trouble (e.g., chewing) as a means to reaching the long term goal of eating with less restrictions. Therapists also have the advantage of charting every detail of progress and going days without seeing your child. On the other hand, when you are immersed in trying to feed your child multiple meals a day, it’s not always easy to see progress. Your therapist will give you small goals to work on every session and together, we will celebrate every single accomplishment!

  1. Every child will have their own journey

You may meet other parents who describe different techniques and strategies that your therapist uses with their child. It’s important to keep in mind that every child is different and that each approach will be tailored toward your child.


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