The Jason Miller Better Health Podcast

Have your kids been doing virtual school or going in person? My children are getting ready to head back to school in person from virtual. It's been since March that they've been in school. Like you I was concerned about the possible drawbacks to such a long "lock down." How would their social skills be impacted? I've put together this episode to help you as you start bringing your kids out of lock down. As always, I welcome your comments and messages!

One question that I am frequently asked by parents of children with whom I work, is how they as parents should handle the questions and advice that they are often given from members of their own family. Normally, I would write this article to help the parents of children who have some sort of developmental delay, whether it be autism, downs syndrome, global development delay or sensory processing disorder. However today, I want to talk to another group of you; the aunts, uncles, and especially the grandparents of children with special needs. Whether a child is born with a disability or disorder, or whether it develops later in life, the child's special needs are likely to affect the entire family. Grandparents are no exception. Grandparents can and should play a vital role in providing support for their adult children, often helping care for their grandchild. However, moving through this very sensitive area can be challenging. Therefore, my article today will focus on giving you a few tips on how to support your adult child while at the same time, making your time spent with your special needs grandchild more rewarding So how do you help? We'll talk about that in this episode!

It looks like some form of school will be through virtual and remote learning. This has placed a lot of parents, myself included, in the position of having to sort of "home school" our kids. It's definitely going to be a challenge, but I put together a quick episode on how you can get through it a little easier!

I get asked all the time about Sensory Processing Disorders. Parents often want to know if I think their child has one. I always recommend that if you have a concern, then you should seek out an Occupational Therapist who specializes in sensory processing disorders. But if you are unsure whether or not to start that process, I have made a quick episode for you on some of the more common signs of a sensory processing disorder. As always, reach out to me directly if you need help!

I talk a lot about how a child's screen time affects their development. But have you though about how YOUR screen time affects your kids? In this episode I explain some of the effects your digital usage has on your children and what you can do about it!

It's July, and that means, the beginning of school is (hopefully) around the corner. If you're like my wife and myself, you are desperately praying that schools open this fall! If it's time for your child to enter kindergarten for the first time, this may be a day that you've been looking forward to. Or, for some of you, the thought of your child entering kindergarten might bring some anxiety. It's kindergarten! And it's the first step in a long series of educational milestones. However, as excited as you and your child might be, it's perfectly normal to question if your child is ready for this big step. Today's kindergarten classroom looks very different from the one you and I remember. How can we as parents know if our little one is ready? Most districts have a cut- off date for kindergarten enrollment. When they reach a certain age, they must enroll. There is a little bit of wiggle room that allows you to wait to enroll until the following year. But, how do you know whether or not to hold them back? As parents, we're often not the best judge of readiness, simply because we can be plagued by anxieties. We might worry that they'll get lost in the crowd, not have any friends, get picked on by others, or not be able to keep up with instruction! Keep in mind, there are some basic guidelines to help you determine if your child is ready. You need to consider your child's age and maturity. Most of us think the magic number is the age of 5 for starting kindergarten. Most children enroll at the age of 5, but just because your child is the right age, doesn't mean they are automatically ready for school. In this episode we look at a list of signs that can help you determine whether or not your child is ready for kindergarten.

If we want to raise our children to be compassionate people who can contribute to society as responsible citizens, then we need to find ways to talk to our children about some of the thornier issues that we struggle with in this country. First of all, let me explain who I am. I am a white male trying to raise children in today's world. I can't possibly begin to understand what it must be like to be a black male trying to raise children in today's world. I know that I don't have to have the same conversations with my own children that a black man must have with his children, and I can't even begin to understand what those conversations must be like. Demonstrations, sparked by the killing of George Floyd, have left many parents, myself included, trying to figure out how to talk to their children about the resulting protests and the events that led up to them. But how exactly do you do that? In this episode, I'll talk about some of the best ways for you to talk to your kids about racism and provide some valuable resource to help.

Special education services and distance learning. Does it work? The Covid-19 Crisis has closed schools and rehabilitation clinics. But that hasn't stopped the need for services such as speech therapy, occupational therapy and physical therapy. Many schools and clinics have made the pivot to online therapy, or telehealth, in order to continue providing various therapies. But does it work? Is online therapy as effective as in person therapy? Can it be beneficial at all? Personally, I have made the switch to online therapy for about 90% of the children on my caseload, and so my answer to whether or not online therapy is effective is “yes” Some of the children I am working with, have actually made more progress working with me online, than when they were physically coming into the clinic for face to face therapy. However, as with anything in life, online therapy has both positives and negatives. Therefore, let's explore both, to help you decide whether or not it is a good fit for your child. What's Good About Online Therapy? First of all, online therapy is better than no therapy at all. I normally would not use phrase “it's better than nothing” but in truth, during a pandemic when there are no other options, it is. Secondly, online therapy offers children face to face interaction with someone who is specifically there for them. Online therapists, just like therapists whom you would see face to face, are preparing lessons designed specifically for you child. Online therapy, provides your child with an opportunity to speak, converse with another person, ask questions and simply interact with someone outside of the family which is especially, if not more so, important during this time of social isolation. In addition, online therapy provides children, especially special needs children, with the stability and consistency that they need in order to thrive. With daily routines changing overnight, seeing the same therapist face to face, even if by computer, keeps the children in a routine and helps them adjust to this “new normal” we are living in. Therapists, like classroom teachers, most often become a big presence in children's lives and in many cases, they become as close as a family member. It is important to note that many aspects of therapy, speech or occupational, are easily transferable to the “online therapy” format. In this day and age, most children are very well versed in anything involving electronics, so the majority of them will have very little trouble adapting to online therapy. What seems difficult to us as adults, is often very easily learned by children. Something that pleasantly surprised me, was that some of my most severe patients have adapted to online therapy easily, and actually seem to be enjoying it quite a bit. And lastly, online therapy eases a parent's workload just a little. You get to stay home! You don't have to get your child dressed and remember to leave the house with plenty of time to make it to your appointment. It takes seconds to “log on”, making it easier to keep appointments. In addition, you don't have to worry about keeping brothers and sisters occupied in the waiting room while your child is in his or her session. Don't forget, during this time, routines are what children (and even parents) are longing for the most. Having regular online therapy sessions will provide your child with some of the routine they are so desperately craving.

With school out for the summer, and social distancing the new norm, the lack of socialization for children could impact them later on. Social interaction is critical to a child's development and the skills they learn and develop will follow them through the rest of their life. Whether this time of social separation will have a lasting impact on their development, will likely depend on how long social distancing lasts. This is new territory for all of us, and the effects it will have on children remain to be seen. What we do know, is that we still have options to help our children socialize, even while confined to their homes. While many in-person interactions are currently out of the question, we still have ways through which we can connect with others. This is where technology becomes important. If you have been following me for a while, you know that I am fairly outspoken about reducing the amount of time children spend in front of screens. My opinion on that has not changed. Spending too much time browsing social media and even educational apps, has been shown, by research, to be harmful to a child's development. However, this does not apply when your phone or tablet is used for meaningful communication. Platforms such as Zoom, Facetime, and Skype and others are perfectly acceptable, especially during this time of social distance. Although many special needs children struggle in social situations, peer and family support can make for a more positive experience even as we socially distance. Having a conversation and interacting with someone via the internet has been shown to work particularly well with children on the autism spectrum. I conduct online therapy through zoom and am having good results with many of the special needs children whom I work with. Therefore, if you are looking for a way to provide some social interaction for your child, get them off of social media and video games, and instead, connect them with a friend or family member through Zoom, Facetime, Google Hangouts, Discord or simply pick up the phone and make an old fashioned phone call!

So, school has been canceled and your kids are stuck at home complaining about being bored. Due to the shutdown resulting from rising covid19 cases, there aren't many places to go, and you can't really visit anyone. Therefore, it seems that the only thing to keep children busy is to let them watch tv or browse YouTube. Right? Wrong. Being cooped up inside is hard. But you don't have to result to letting your kids watch endless rounds of tv, play hours of Xbox, and constantly scroll through YouTube. Too much of that screen time in one day can actually be harmful to a child's development. There are plenty of things that can be done around the house, at no cost, that are not only safe, but can encourage a child's development. So, today I want to talk about an old favorite from my childhood. How many of you remember building a fort when you were young? Do you remember how much fun it was? Most children build at least one fort over the course of their childhood, while a large number of parents has wished that they hadn't given their child the idea to build a fort. Building forts automatically has children dragging every blanket and dining room chair in the house into the living room, often taking up most of the floor space. Most likely your children have built one before, and if they haven't, I strongly encourage you to motivate them to get started on one.

Most child development experts believe “the earlier the better” when it comes to detecting developmental delays in children. However, social distancing due to COVID-19, has made early detection increasingly difficult. Social distancing is keeping children away from teachers and various other childcare providers, many of whom can be critical sources for early identification of delays. These professionals are often vital in connecting parents to other services in the community, such as occupational and speech therapy. With preschools, public schools, and day cares closed, those children who might need screening for developmental delays may be missed. With children at home during the pandemic, it is even more important for parents to educate themselves on their child's developmental expectations. So how is this accomplished? Online screening is slowly becoming an essential strategy to try and meet some of these needs. With early intervention, there's no time to waste. The earlier a child development expert can identify a problem, the better. How does online screening work? While there might be slight differences between therapists' approaches, most therapists walk parents and caregivers through a series of tasks and ask various questions about their child. Part of the screening my require children to perform a certain skill, such as stacking blocks, drawing shapes, and even pronouncing certain words. In some cases, the therapist may need to simply observe the child talking or playing. This may seem a little confusing to parents, which is why it is essential that therapists communicate their reasons behind the questioning and observing to parents. Each screen can differ according to the child's age. Younger children will have more of a parent response screening, where the questions are directed to the parent. As kids get older, more questions are directed directly at the child. If the screening reveals that there is a potential delay, then further recommendations may be made. This could include full evaluations to a speech-language pathologist, occupational therapist, developmental psychologist or even a physical therapist. The important thing to remember is that these resources are out there. If you have a concern about your child's development, then act now. The earlier the better! If you have any questions, feel free to reach out to me. I would be more than happy to help!

I wanted to share a letter to you that a mother of a nonverbal 3-year-old wrote to me. “Hi Jason. My son has been in speech therapy for a while and is beginning to use words. He babbles quite a bit and some of the words he uses are difficult to understand. This is all new to us and we are excited. However, I'm surprised that his speech therapist doesn't use sign language in therapy. I have heard that sign language encourages speech development and I figured she'd want to use it. At least teach him a new way to communicate. What are your thoughts on this? Do you use sign language in your therapy?” So, I did respond to this mom, but I'll tell you what I said. First of all, it's impossible for me to know the reasoning behind someone else's treatment. A good therapist has a reason behind whatever course of treatment they are taking and should always explain it to you. If you don't know why a therapist is doing this or that, you need to ask. Now, as to what I think about sign language in therapy. I don't use it that much primarily because I haven't had many kids on my caseload who would benefit from it. If that's the only way a child can communicate, you bet I'd use it. However, most of the time I have been working on getting the child to verbalize and fortunately have had success at that. I will tell you my frustration with sign language in speech therapy. So many times I have seen a child pointing to an object that they want “juice” for example, indicating that the child wants more juice. The logical thing to do is to give the child the juice. Especially if they are pointing at it. It's right there and they've singled it out. They are communicating very clearly what they want. I think it's a disservice for a parent or a therapist to withhold that very specifically requested item because they didn't sign “more” or “please.” I'm not a big fan of “more “and “please.” Those could mean anything and when not taught properly, it's used for everything. I've seen so many kids that want something, frantically signing “more.” But because “more” is the primary word taught, I or the parent no longer know if they want more juice, Cherrios, snacks, music, tv, fun, etc. So I have always found that part to be useless. However, it can be useful with concrete signs. But remember, the goal is to help your child communicate, not learn sign language. Whatever functional form of communication that they choose should be rewarded.

I want to share with you my one of New Years resolutions. I have a few which include getting better organized, getting in shape, spend less time working. But I wanted to share with you one and I hope you'll join me in it. And that is less screen time. There has been a lot of research released recently about the amount of screen time that teenagers, kids and young children get each day and it's staggering. What's troubling is some of the damage that can be done to a child's learning abilities and overall development if he or she spends to much time in front of a screen. But what is this doing to adults? No one really talks about it and I haven't read any research on it. However, I can't force my kids to limit the amount of screen time they get and not limit my own. I'm not going to tell my kids that they can't have a smart phone and then spend hours thumbing through Facebook and Instagram. I'm not going to tell my kids to shut the TV off and then spend hours watching nonsense shows after they go to bed. So, I've made this resolution to cut my time drastically. And I'm starting with my phone. I've decided to use my phone for work only. No more thumbing through anything on my phone just to relieve boredom. Also, I'm not going to use my cell phone while I'm with my wife and kids. A while back I shared a picture of my son and me. He's cuddled up next to me and I am staring at my phone. Completely disengaged. Unfortunately, I'm sure that situation has been repeated since that picture. But no more. I hope you'll join me. I have found my phone to be a bit addicting. So, I'm starting slow. My phone for work and not around my kids. I'd love it if you would try this to. I'll keep you posted, and I hope you will keep me posted!

I want to share with you my one of New Years resolutions. I have a few which include getting better organized, getting in shape, spend less time working. But I wanted to share with you one and I hope you'll join me in it. And that is less screen time. There has been a lot of research released recently about the amount of screen time that teenagers, kids and young children get each day and it's staggering. What's troubling is some of the damage that can be done to a child's learning abilities and overall development if he or she spends to much time in front of a screen. But what is this doing to adults? No one really talks about it and I haven't read any research on it. However, I can't force my kids to limit the amount of screen time they get and not limit my own. I'm not going to tell my kids that they can't have a smart phone and then spend hours thumbing through Facebook and Instagram. I'm not going to tell my kids to shut the TV off and then spend hours watching nonsense shows after they go to bed. So, I've made this resolution to cut my time drastically. And I'm starting with my phone. I've decided to use my phone for work only. No more thumbing through anything on my phone just to relieve boredom. Also- I'm not going to use my cell phone while I'm with my wife and kids. A while back I shared a picture of my son and me. He's cuddled up next to me and I am staring at my phone. Completely disengaged. Unfortunately, I'm sure that situation has been repeated since that picture. But no more. I hope you'll join me. I have found my phone to be a bit addicting. So, I'm starting slow. My phone for work and not around my kids. I'd love it if you would try this to. I'll keep you posted, and I hope you will keep me posted!

I want to talk to you about one of the three main areas of development that we look at here at the clinic and that fine motor development. Fine motor development is important because the ability to use the smaller muscles in the hand allows children to perform self-care task without our help. Some of these tasks are brushing the teeth, eating and feeding themselves, writing neatly and dressing. Problems doing the Some of these tend to be indicative of fine motor weakness. But the good news is that there are some many very easy ways that you can help develop your child's fine motor skills. Number one is puzzles. Do a puzzle together with your child and encourage them as a guide the pieces to the right place. Another is a board game. Any game that involves rolling the dice is helpful. It takes more control than you realize to roll and have the dice land on the board correctly. If you have any other questions always feel free to reach out to us and our website is www.jasonmillerhealth.com

If your child struggles with messy handwriting, then you as a parent might have more than sloppy handwriting to worry about. Kids who struggle with handwriting tend to worry more about the legibility of their words and forming letters rather than forming ideas and getting them on to paper. It's the formulation of ideas and properly expressing those ideas that's important. With Technology in schools becoming so prevalent, it's easy to let good handwriting fall off of the educational radar. However, good handwriting is still very important. If you have a child who struggles with their handwriting, I encourage you to seek help from an occupational therapist quickly.

Today, I want to talk to you about Echolalia. Many kids on the Autism spectrum, and sometimes children who are not on the spectrum, present this. While you may not have heard the name Echolalia, you have likely encountered it, especially if you have regular involvement with a developmentally delayed child or a child with special needs. Echolalia is a term that is used when a child repeats what you say without there being any function or purpose to it. A parent of a child who is speech delayed may be very excited to hear their child repeating words back to them. However, parents of these children often become discouraged when they realize that their child doesn't understand what they are saying, and doesn't appear to know the meaning of the words being spoken. It often starts with parents labeling various objects such as animals or vehicles. For example, a parent will say “cow” and the child will say “cow” right back. The parent notices that when he or she names any object, the child will say it right back. Sometimes, the child may pick up phrases and say them. “Here we go! or “Time to eat” and use them constantly, however, often without any type of purpose. It's then that parents realize, that their child doesn't really understand the meaning of the phrases they are saying. There are various approaches with which speech therapists address Echolalia, and the advice they give to parents often varies. Some say to extinguish it because it's not purposeful speech. Some will encourage it because it is “speech”, and the words were learned in an appropriate context. I try to do a little of both. I find that the process is easier this way, although quite a bit of patience is required. In order to address Echolalia and progress it into to meaningful speech, you will need two different pictures of the same object. For example, two different drawings of a cow. In addition, I use music and video for kids who like music. I like using the classic “Old MacDonald Had a Farm.” I have a book and a video of the song. I begin with the song. I let the song play until we get to “cow.” I stop it and point to the cow and say “cow.” A child with echolalia will typically look at it and say “cow”, repeating what they just heard me say. Next, I take an Old MacDonald book, and turn to the page that has the picture of the cow. All I do, is simply point to the picture of the cow. I don't say the word “cow” because then the child would just be repeating it. The goal is to get the child to verbally label the other picture of the cow his or herself. I'm not afraid of silence, so I wait. If the child doesn't say anything, I go back to the original picture of a cow and say “cow” again. Then, I return to the book and point and wait. Waiting is the key! I give it about 10 seconds before I tell them the word. The goal is to link the word not just with the object, but with various forms of the object. Try this at home. However, don't spend ages waiting for the child to say the desired word. Cue it and move on. Do it as long as they show interest, using several different animals. You want it to be enjoyable! Don't turn it into therapy! Don't be surprised or discouraged if your child doesn't get it the first time. Time and consistency are needed for this approach to work. Once the child does get it, you're onto something and you've got more work to do! I hope this helps. Remember each child is different and this strategy might not work for every child. My goal was to share a strategy with you, that works well for me, as I work with many different types of children to correct this problem. If you have any questions for me I encourage you to reach out to me. Thanks!

This is a clip from an interview I did from a radio show. The question spurred me to address it more fully in a video/podcast

Recently, I received an e-mail from a mother in which she included a picture of her son's bedroom door. On his door, her son had posted a hand written sign saying, "I hate you mom." She explained that her son has some developmental delays, and because of those delays, his behavior can be off at times, causing reactions such as his posting such an emotionally charged sign on his bedroom door. I felt awful for her because, as a parent of 3 myself, I know how gut wrenching it can be to hear your child utter the words "I hate you". I remember having an argument with my son when he was approximately 5 years old, over picking up his toys. I remember gettin on eye level with him and telling him to "pick that up". He, of course, refused and instead stomped off. About 10 minutes later, he came back with a folded piece of paper which he handed to me. I opened it up, to see "Daddy" written in large letters. Then he had taken a red marker and put an large "X" over the word "Daddy". I was stunned that he would have, what I felt to be, such a strong reaction to my asking him to pic up his toys. But I remember this moment so well, because I feel that this was the moment that my kids started saying "I hate you" when things weren't going their way. Of course, we correct that type of behavior at our house by reminding our children that "hate" is a very strong word that needs to he used very carefully, but it still stings. The son of the woman who sent me the picture is considerably older than my five year old, and in addition he has developmental issues that make getting through daily life a challenge for him as well as his mother. I would imagine that it is much harder to hear the words "I hate you" from an older child, especially when you have to devote so much attention to him and her to work through the developmental delays. However, parents should always keep in mind that hearing the words "I hate you" from a child, should be interpreted as a statedment of extreme frustration from that child. Nothing more. That statement in no way reflects your child's feelings about you. Most kids don't have the vocabulary to express their feelings aside from using the words "love" or "hate". Before you take to personally the "I hate you" statement, reflect on other conversations that you have had with your children. Most likely, you'll realize that they always talk about either "loving" or "hating" things or situations. Very few children will respond with statements such as "this was a very unpleasant experience" or, "I didn't like it when you did that." It is our job as parents to help them learn to better express themselves. Brainstorm other words with your children that might express what they're feeling in a better way. Talk to them about how strong the meaning of words like "love" and "hate" can be. Often children don't realize that words can have lasting effects. So, next time you are presented with that dreaded phrase, take a moment, let your child calm down, and then go and help your child find a better way to express his or her feelings.

Last week, I discussed the importance of being informed about what is happening in your child's treatment room. I decided to address this particular question, since I have received multiple e-mails and facebook messages, asking for advice in this area. However, there is a second question I often get asked by parents. “How does my child progress, if I am never given anything to reinforce at home.” If you are asking this question, then you are the type of parent I love to work with! It shows that you are taking a lead in your child's development, and no amount of therapy can trump that. So give yourself a pat on the back. Job well done! What should you be doing at home? This is a very simple question, but it has a very complex answer. I can't speak for every therapist, just for myself. So, here is an example of how I work with parents of children, whom I treat in my clinic. I don't often give a lot of “homework”. Depending on the child's developmental level, the way I reach a goal is often through a very intricate process. Repetition and consistency are paramount! I can control the way I, myself, deliver a cue to a child, but I can't control yours. It is so essential that that cue to be given the same way every time. Then, once the child has reached a certain level of mastery of a skill, the consistency of giving the same exact cue isn't needed anymore. In fact, it can be harmful. I don't want a child to be able to respond to a question only when it is presented by me, the therapist, in a certain way. I often tell the parents that I don't need their child to learn how to communicate with a 42-year-old man. They have to learn how to communicate with mom and dad, brother and sister, friends, and grandparents. Another reason I don't like to give a lot of “homework” is that the skill the child and I are working on is often extremely difficult and frustrating for the child. It's strenuous for them to speak, and even though I try to make it as much ‘fun' as I can, it is still work. Because of the difficulties of learning something new, often children rebel and fight back, or they shut down. When those resulting behaviors are directed at me during therapy, I have the training and endurance to work through those behaviors with the child. However, I don't want the parents to have to battle with their children on a daily basis merely to reinforce a skill we are working on. I tend to tell the parents to let me be the “bad guy”, so that they can focus on just being mom or dad. I don't want any of the children I see in therapy to feel as if every time they want to talk to their parents, they will have to work. I'm very protective of that parent-child relationship! Parents should be able to talk to their children as parents, not as therapists. Parents should always be the safe place for children to come and communicate in whatever way they feel the most comfortable! This is why knowing what is happening in therapy is so important. You definitely need to reinforce what is done in therapy in your home! Play the games your child played in therapy. When speaking with your child, use words that emphasize the sounds your child was working on with his or her therapist. But keep in mind that you do not need to “teach” a skill. The “cueing” and “teaching” should be done by your child's therapist, in order to avoid confusion.

I have received many responses regarding my last post about whether or not you, as the parent, should be in the therapy room with your child. Many of you emailed me asking two questions. The first question many of you asked was "how do I know what is happening in therapy, if I'm not able to watch?" And the second question many of you asked was "if I'm not observing my child's therapy session, then how will I know what to do to reinforce therapy at home?" Let's talk about the first question. How do you know what is happening in your child's therapy session? Your child's therapist should be giving you regular updates. He or she should have a scheduled time set aside to sit down and discuss with you what skills they have been working on during each session. Your therapist should also explain how they have been working on those identified skills, and share with you what progress your child has made. My biggest frustration when I supervising a new therapist or therapist in training, is when they inadequately explain what they are working on during their therapy sessions. Having a therapist say “we blew bubbles, played with blocks and colored" is simply not providing adequate information for the parent. Explaining therapy sessions in that way, makes it sound as if anyone can provide therapy, and a professional is not needed. What the therapist should have said was “we blew bubbles to try to get your child to make his mouth move to form the /f/ sound. In addition, we alternated stacking blocks in order to emphasize the importance of taking turns. Taking turns is essential for effective communication. And lastly, we colored pictures for the picture book we are creating in which we are featuring the /f/ sound that we have been working on." This way of explaining therapy is not complex ore hugely involved, but it shows that goals were set and the activities used to reach those goals had a clear purpose. If your child's therapist is not providing you with this type of information after your therapy sessions, ask questions! Having your child tell you what he or she did in therapy, does not give you enough information to provide adequate reinforcement at home. You need to know the goals that have been set for your child, and the reasons for using the chosen activities. Next week I'll discuss what you should be working on with your child at home and why you may not be hearing what you think you should.

When I evaluate a child for the first time, one of the first questions parents ask me is if they should attend the therapy session as well. Parents often find themselves awkwardly standing in the waiting room, uncertain if they should go with their child, wondering if they're allowed to go with their child, or if they should just wait in the waiting room while the child attends his or her therapy session. As a therapist, this is what I tell parents. For the first visit, parents should absolutely attend the therapy session! For all of the following visits, that decision needs to be made on a case by case basis. During the first therapy session the therapist will perform an evaluation of the child, and for this evaluation, parents need to be present. The purpose of the evaluation is to gather as much information about the child as possible, and much of that information has to come from the parents. Therapists need to know what behaviors you are seing or not seeing at home. Of course, therapists are also watching and talking to your child and most likely also administering some type of standardized assessment, but personally, I have never found the initial meeting with the child to be a good indicator of what his or her abilities are. It tends to be overwhelming for children to be in a new room, meeting a new person who is asking them questions, many of which they aren't really sure how to answer. Therefore, the most useful information from comes from the parent. The second question is whether or not you should attend the following treatment sessions. That entirely depends on your child. Some children do better by themselves, some do better with mom or dad in the room. Some children are so dependent on the presence of a parent, that they don't know how to function or communicate without them present. In that case, the therapists goal will most likely be to have the child directly communicate with the therapist without going through the parent first. At a certain age, it is no longer appropriate for a child to cling to his or her parent, constantly seeking confirmation from mom or dad before answering. The goal of communicating independently, will most likely not be reached, if the parent remains im the treatment room during therapy. However, I'm also not in favor of taking a child from his or her parent in the waiting room, and spending the next 3 or 4 therapy sessions listening to him or her scream and cry. It's not good for the child or the parent, and frankly, not good for me. Separation from the parent has to occur gradually. I often have mom or dad come to the therapy room to attend the session, but during that session, the child and I will leave the room for brief periods of time. We'll go to the swing room before returning to the therapy room to "check" on mom or dad. Then we might go to the play room for a while, before again, returning to the therapy room to check on mom or dad again. Eventually, mom sits out in the hallway, moving further away each session . But there certainly does not have to be a permanent removal from the therapy room. So my answer to the posed question is plain and simple. It is your child! If you prefer to attend therapy sessions with your child, you certainly can. However, think very carefully about whether your presence during therapy is helping or hindering your child's progress. But more importantly, please don't be offended if a therapist suggests that you leave the room. The therapists are trying to meet goals, some of which might be easier to meet without parental interference.

I wanted to share an email with you, that I received from a parent a few days ago. In this e-mail, the parent talks about her son who is on the autism spectrum. He is verbal and communicates very well but, by her own admission, he can be quite challenging in terms of his behavior. The reason she decided to contact me, was because she is concerned that her son's speech therapist doesn't like him. She said the therapist tends to be short and irritable with him and always appears frustrated, sometimes even coming across as "cold". As a parent, she is unsure how to handle this particular situation. On the one hand, she wants a warm and nurturing environment for her child, but on the other hand, she realizes that his therapist is a professional who knows how to achieve the goals they are trying to achieve. I have a feeling that there are many other parents out there who have come across a teacher or therapist who appears to dislike their child. As a therapist myself, it saddens me that any parent would have to feel that way, especially if those feelings are pertaining to a professional who is supposed to be helping their child reach his or her full potential. I believe, parents need to consider two things. One, therapist are human and just like everyone else, they can get annoyed. Bad behavior is bad behavior, whether it's coming from a normally developing child or a special needs child. Those same behaviors that drive you crazy as a parent, can drive therapists crazy as well. I can recall several instances where I have become annoyed with a child's behavior, especially if that behavior is getting in the way of his or her progress. And in rare instances, I have had to work with a child who caused me to stop and take a deep breath before I went to get him or her from the waiting room. Having said that, I need to stress that I have never ever disliked a child, and the odds are, that your child's therapist doesn't dislike your child either. Therapists have the difficult job of trying to get a child to achieve something that is very difficult for that child to do. They are constantly having to try new approaches to therapy, evaluating and adjusting what works and what doesn't work. In addition, it is most often done under the watchful eye of your child's health insurance carrier who can deny coverage at anytime, if required progress isn't being made. This means, there is a lot at stake and a lot to be accomplished, in what is often a short amount of time. That being said, therapy should be a positive and fun experience for your child. It isn't school. Your child should be engaged. A skilled therapist should be able to put on a positive face for your child and guides his or her behavior with a patient and affirming voice. There are times when it's perfectly acceptable for a therapist to let a child know that his or her behavior isn't acceptable. However, a true professional will never let a child feel that he or she is not liked as a person. Getting frustrated is acceptable, but reflecting an air of dislike is not! Always keep an open line of communication with your child's therapist. Talk to him or her. If you still feel that the therapist dislikes your child, then you may need to look at making some changes. I hope all of you are building great relationships with your children's therapists, and as a result, are achieving the goals you have set! If you have any questions, please feel free to reach out to me at any time.

Are you trying to improve your child's language development? Are you wanting to speed it up? There is a lot of research out there as to what type of book is best and I've read most of it! I'll share my thoughts in tis episode.

In this episode I discuss my recent completion of our churches sensory friendly vacation bible school. I offer tips to help you implement a program at your church!

If you want to help kids who struggle with sensory issues enjoy vacation bible school, you'll want to keep your groups small. In this episode, I explain what I did to help the kids in my group learn and have fun!

In this episode, I explain how we started our own sensory friendly VBS!

I was talking to a friend of mine yesterday whose two children are borderline special needs children. One of them is on the autism spectrum and one has a sensory processing disorder. This friend was explaining to me some of the behavior problems that her middle child is dealing with and some of the defiance and impulsive activity that he has. As she was illuminating some of the things with which she was dealing, I caught myself attempting to make her feel better. I came back with a response that I knew better than to use. I told her that I have three children and I see mine doing the same things. Even as the words came out of my mouth, I realized that it was not the correct thing to say. One of the most annoying and irritating things for the parent of a child who is on the autism spectrum or who is dealing with a sensory processing disorder to hear is, “well my child does that too. I think that's just normal.” I was frustrated with myself for what I had said, because I always advise others not to compare the behavior of normally developing children with special needs ones. We think that we understand, and yet we really don't understand at all. No two children are the same. Despite what we see on the outside, kids with SPD and autism are not behaving the same way that normally developing ones are. The behavior that you are dealing with in your children who are typically and normally developing is not the same as that of a mother with a child on the spectrum. One of the biggest differences is when we're talking about defiance and tantrums. I, as a parent, am tempted to say that my children behave like that all of the time. When I say “all of the time,” it means at the most once or twice a day. It may seem like “all of the time” to me and I may feel like I have to deal with it “all of the time,” but to the mother of a child on the spectrum or with SPD, it probably is about 400 times a day. The behavior is over and over and over again, to the point of being exhausting. It is very much a different thing with which to deal. So, whenever you are talking to a parent and they are venting or explaining some of their frustrations, it is best not to come back with the response that it's normal and that all children have those problems. While it's true that they all may behave this way some of the time, they don't do it on the scale that a child with sensory processing disorder or autism does. If you have any questions you'd like addressed on this podcast, please reach out to me on my website, www.jasonmillerhealth.com

If you have a child that is constantly on the move and is always seeking physical input, I would like to recommend something to you. You may have heard of this in conjunction with adults and yet never considered it for children. What am I referring to? CrossFit. I have been involved with CrossFit for a long time now and I recently spoke to one of the coaches at a gym near me. She said that she has a couple of autistic children who are participating in weekly workouts, which made me think about children who are sensory seekers and how this would be beneficial to them. For one thing, it's just good movement. The workouts require constant motion. However, CrossFit has 3 movements that I think give a lot of proprioceptive and vestibular stimulation where needed. The first movement is the burpee and that covers the entire body. You start from a standing position and then fall down to the floor in a push up position. From this position, you pull your feet up toward your hands and jump up in an explosive movement to a jumping jack clap. The second one is the box jump. This is simply jumping from the floor onto a box over and over again. The third movement is the slam ball. Young children especially like this. You take a heavy , weighted ball, hold it overhead and then slam it down as hard as you can. There are many other movements in CrossFit that are beneficial to the children, but these are the three moves that I have found to be the most useful to those on the spectrum and those who are sensory seekers. CrossFit is great for children who aren't particularly good at sports, but want to be involved. Although it appears to be an individual activity, CrossFit has a very supportive community that will give a sense of belonging to these children who have a difficult time “fitting in.” CrossFit gyms are everywhere and most of them have a CrossFit program for young ones. Stop by for a visit and get to know this supportive community.

Why do we fight with our kids while we are supposed to be helping them with it? I work with kids all day, but struggle to be patient with my own children when it comes to helping them with their homework. Please listen for some easy to implement tips!

Today I just wanted to share some my thoughts on the paralyzing fear that some parents feel when they suspect that their child might be developmentally delayed. Please listen, I have a feeling you'll feel better about everything!

A parent asks me if the toys she gives her child is a reward or a bribe. Does it matter? It matters quite a bit. You shouldn't have to pay your child to behave. But how do you know which one you are doing? It's all in the timing!

A mother writes to me that her son is having temper tantrums and they are getting worse. Her concern is that he has a sensory processing disorder. In this podcast, I discuss the differences between a sensory meltdown and a temper tantrum. There are things to watch for. However, they may not be that obvious!

Choosing a therapist for your child in any discipline can be difficult. In this podcast, I discuss ways to make this choice easier and more efficient. I also discuss what to do when it's simply not working out and why you need to make a change.

One question I get asked on a daily basis is "what apps do you recommend for speech development?" I'll answer that question and more in today's podcast!