Edna Elisabeth Nyang

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Family Education Support through a Growing Partnership

2015-12-15 Olivia's Place Comments Off , , , , , , ,

The Neurology Department of Beijing Children’s Hospital (BJCH) is one of the leading pediatric neurology departments in our country, which has been existed for more than forty years. This department has complete professional disciplines with advanced technical skills. They have accumulated rich clinical experience in both common and rare diseases of pediatric neurology. The outpatient service is filled with patients of varying difficult cases. In 2013, there were more 110,000 outpatient visits to the department. . This Department is responsible for training and teaching doctors of pediatrics for Capital Medical University and the Inpatient Department of Beijing Pediatric Hospital. To provide parents with more knowledge and improve the communication and exchange of information between BJCH and LIH Olivia’s Place, we decide to carry out joint training for parents.

LIH Olivia’s Place specializes in children’s development, behavior, and rehabilitation for children and adolescents ages birth to 18 years of age. The Beijing clinic offers an international multi-disciplinary team (developmental behavioral pediatricians, pediatric neurology, pediatric rehabilitation physicians, clinical and educational psychologists, and an therapy team composed of physical therapists, occupational therapists, speech-language therapists, and behavioral therapists.

In order to give full play to the respective advantages of both BJCH and LIH Olivia’s Place and provide the highest quality medical services for children and parents, we established a team of experts to organize public scientific knowledge training, take advantage of technical experts, create a platform to provide parents with training and knowledge about their child’s diagnosis, how to support their child’s independence and education, and other aspects of growth and development. This training model allows for organic interaction between medical intervention and family education support for children.

BJCH Partnership 1In 2015, the partnership successfully implemented three training activities. The first was a physical therapy presentation in March by Dr. Lisa Kenyon（PT, associated professor, Grand Valley State University, who provided case-based teaching with three children. The second was for parents of children with autism spectrum disorder (ASD) in April; the presenter was Edna Elisabeth Nyang（CCC-SLP, Speech- Language Pathologist, LIH Olivia’s Place）, Finally, Dr. Mease (Developmental-Behavioral Pediatrician, LIH Olivia’s Place) presented additional information for parents of children with ASD in June. The initial three training events were very successful, with both doctors and parents speaking highly of their experience.

In 20016, LIH Olivia’s Place and the Neurology Department of BJCH are planning to continue this partnership to empower parents through training. The training plan for the first six months of 2016 includes 21 training sessions, with topics covering autism spectrum disorder (ASD), attention deficit/hyperactivity disorder (ADHD), and cerebral palsy.

To learn more about this program or to obtain information on the training schedule and registration, please contact Yangshaoun at yangshaoyun@lih-invest.com.


Activities to Develop Your Child’s Social Skills

2015-12-15 Olivia's Place Comments Off , ,
by Edna Elisabeth Nyang, Speech-Language Pathologist, Speech-Language Lead Bejing

by Edna Elisabeth Nyang, Speech-Language Pathologist, Speech-Language Lead Bejing

Children experience many new and unfamiliar situations. Sometimes these situations can also seem new and unfamiliar to their parents! This is especially true for expatriate children who are living with their parents outside of their home culture. It may also be true for children who are attending a school that is different in curriculum, language, or expectations than the schools their parents attended, or where caregivers from several generations are supporting a child. For children (like their parents), depending on their personality, this can feel exciting and even overwhelming at times. Sometimes, as a caregiver, we may have the urge to establish an oasis at home in hopes of making our children feel more comfortable. Unfortunately, this can have the opposite effect and create a situation where the child has little exposure to others outside of their family. It’s important for all children to learn the verbal and non-verbal rules needed to participate in interactions with their peers.

Even though these rules may vary widely across various cultures, the intentions and goals of each interaction are relatively the same. Social interaction is something that we should participate in daily. Whenever your child is in a group of two or more people, it is important to see how well he or she can follow unwritten rules of social communication. For example, is he able to make eye contact to acknowledge a person or to make a request? Can he make a request by using a gesture or words? Is she able to start and maintain a conversation? Can she discuss a variety of topics? Is she able to recognize basic emotions in others? Can she change her response based on how someone else feels? If he is having trouble, do you (or others) jump in to communicate on his behalf or is he allowed to figure it out on his own? While most of us can make the correct decision in various social situations without giving it much thought, these interactions can be extremely difficult for those who have difficulty with social cues.

Here are a couple activities that you can try with your child at home to help increase their awareness of non-verbal cues and build on their skills:

  • Eye Spy is a good activity if you would like your child to work on locating and referencing items in your immediate environment. Have your child take turns describing and searching for items in the room. Start by reminding students that eyes are like pointers that show what someone is thinking about. Choose something in the room to look at, and tell them they have to guess what you’re thinking of. In the beginning, choose items that are close by, then work up to things that are farther away. Tell students that this is why we look at others when we’re talking or listening to them–it shows them that we are thinking about them. For those who may need extra assistance, you can use a small pen light or flashlight to help them find the objects or you can give them a “hint” by cutting out a “thought bubble” and glue it to a popsicle stick. Use a small piece of tape to attach a clue about the item you’re thinking about (I use small squares of colored paper to show the child what color the object is).

 

  • Use books to help your child learn about and understand idioms. One book that I recommend is In a Pickle and Other Funny Idioms by Marvin Terban. It gives a funny literal illustration and provides background history on each phrase. Once your child learns a few idioms, have them create a mini performance and act out the meaning of each one.

 

  • Board games are great activities to encourage turntaking among peers. I like playing Chutes and Ladders for younger children and Operation or Headbandz for the older kids.

 

  • Action games are a great way to engage children to have them give directions for others. Simon Says is great for younger children and Mother May I can hold the attention of older kids.

 

  • Emotional Charades is a great game for kids who have difficulty recognizing basic emotions in others. Instead of using movie titles or animals or other typical words, use emotions. Take turns picking a slip of paper and then acting out the word written on it or have the child draw a picture and describe it.

 

  • Storytelling is a great way to have a child work on turn taking and expanding their sentences by using their imagination. You can use photo cards to help your child decide what should be in the story. By adding pencil and paper, the child can draw small scenes to remember what is happening in the story and use the drawings to retell the story.

 

If you find that your child is having difficulty participating in these activities or if they present with a few of the following signs, you may want to consider consulting with a speech language pathologist:  difficulty following directions that are not paired with visuals (pictures, objects), limited or no eye contact, doesn’t understand jokes or idioms, never initiates conversation with others, only wants to talk about him or herself, and/or doesn’t like to play with others.

 


Important Things to Know about Feeding Therapy

2015-07-15 Olivia's Place Comments Off , ,
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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