Proprioception is a medical term that refers to the body’s ability to sense itself. It is the sense that allows us to perceive the location, movement and action of our own body parts and their relation to external objects and forces around us. Our FOCUS physical therapists usually explain it with a simpler term: Body awareness.
Proprioception is what enables us to judge how we move and position our limbs, how much force to use and how best to balance. An example might be one’s ability to kick a ball or walk without looking at your feet, move a spoon to your mouth without looking at it or touch your nose even though your eyes are closed. It’s closely tied to our ability to control our movements, and it’s guided by the body’s receptors (skin, joints, muscles) that connect to the brain via the nervous system. Vision can play a role in proprioception, but it’s not inherently necessary. In fact, some evidence suggests it’s already present in newborns.
Many things can impact proprioception. Drinking alcohol is one example. (That’s why one of the standard field sobriety tests involves testing the ability to touch your nose while you’re standing on a single foot.) Some injuries and certain medical conditions can impact it too. Our physical therapists at FOCUS have treated many kids whose parents and caregivers report them to be “clumsy,” “uncoordinated” or “sensory seeking.” They might report their child is pressing too hard on the paper when writing or unable to apply the right amount of pressure for tasks like brushing their teeth or hair.
Often what these kids are experiencing is proprioceptive dysfunction.
Worrying about your child’s safety is something with which all parents are familiar. If your child is typically-developing, these concerns usually lessen as he or she gets older, becomes more mature and gains better judgment and safety intuition. However, children with autism and other special needs may be delayed in acquiring the skills necessary to navigate unsafe situations – if they are able to acquire them at all. That doesn’t mean there is nothing we can do. There are many ways that parents, caretakers, teachers and public safety officials can work together to create safer environments for children and adults with autism – both for individuals and on a broader scale. It is also something we can work on with our young patients in occupational therapy and ABA therapy at FOCUS.
Safety skills are life skills – and they are important. However, there is no single approach to safety that is going to work for every single child on the autism spectrum – because every person on the spectrum is different. Plus, some safety issues might be present throughout a person’s life, some might build over time, some may fade and others could become more complex. Like any other life skill, safety skills will take time, effort and different approaches to master. That’s why we advise early intervention with therapy and frequent practice.
Out of an abundance of caution for our patients, families and staff in response to the COVID-19 pandemic, FOCUS Therapy of Fort Myers will be closing effective TOMORROW (March 17th) until tentatively March 30th.
We will continue to heed the advice and directives of Florida public health officials, which means it is possible we may open sooner, but it’s also possible the closing will be extended.
We are working to contact each of our families individually and inform them of possible teletherapy options.
Teletherapy is currently covered by the following insurance companies:
We are also offering teletherapy at a reduced rate of $85 for those whose insurance does not cover (it is normally $100).
though we may be able to offer a reduced rate for those whose insurance does not cover this service.
If you have any questions, you can still reach us at email@example.com. You may also reach out to your child’s individual therapists if you have their contact information.
More information about COVID-19 is available from the U.S. Centers for Disease Control and Prevention website.
We hope our FOCUS families continue to stay healthy and well, and that we’ll be seeing you again soon.
Learning to read is not simply about gaining knowledge. Literacy (which is not just reading but writing, speaking and listening too) touches everything we do, from finding our way around to learning new things to staying informed. It’s one of the core ways in which all of us engage, communicate and connect. When a child has reading difficulties, it can result in anxiety, frustration, social isolation and even depression. One longitudinal study of 4,000 students found that kids who don’t read proficiently by third grade are four times more likely than proficient readers to drop out of high school. Pediatric occupational therapists work to support child literacy and help kids who are struggling to learn how to read.
Literacy often begins at or even before birth. Many kids are exposed to books and stories before they even know what to do with them. Sometimes for children with disabilities, it’s tougher because their early years are filled with doctor appointments, day care issues, therapies and other challenges. This is beyond the family’s control, but it unfortunately leaves less opportunity for literacy development.
Our Fort Myers occupational therapists at FOCUS work with many children who have a broad range of challenges that can interfere with learning to read and other aspects of literacy. It could be fine motor skill problems that impact one’s ability to manipulate a book. It could be a visual processing difficulty where the child has trouble tracking pictures or letters in a story. It might be auditory processing difficulty, where a child struggles to process and understand what he hears. They may have attention problems that make it hard to sit long enough in a lap to read a book. It could also be sensory issues like tactile defensiveness that make it arduous to interact with printed materials or writing utensils.
The way we address it in our OT sessions is first to break down these challenges into bite-sized pieces that can be addressed in smaller steps. From there, we turn our attention to finding what interests the child. Then we incorporate activities and tools that will help strengthen their abilities.
At FOCUS Therapy, we’re always looking for creative ways to teach our patients life skills by making speech, occupational, physical and ABA therapy fun and engaging. The new FOCUS Kids Store is yet another example of how FOCUS Therapy is looking outside the box to achieve this.
The brainchild of our Therapist Manager, Lisa Shogren, The FOCUS Kids Store offers an array of toys, games, puzzles, books, bracelets and more.
Patients can “pay” for items of their choice using FOCUS Bucks. FOCUS Bucks are earned by achieving certain therapy goals as well as completing a task from our list of chores. Each chore is tiered by price. Some examples of chores include:
- Refilling snack containers (once weekly – take note of any snacks we’re low on, inform our office staff if we are low so more can be ordered) – $5
- Paper shredding (twice monthly – gather any paper that needs to be shredded from all of the four offices at FOCUS Therapy, shred the paper and change the bag as needed) – $10
- Party Planner (once monthly – pick a theme and choose a day, make decorations and a list of food to be brought, design signs and display them to let everyone know) – $20
- Office closing sign creator (pick from one of the upcoming holidays FOCUS Therapy is closed, create a sign, laminate it, give to the front office staff so they can be hung the week before the holiday). – $1 per sign creation, $0.50 each to hang
FOCUS Families: Let’s talk coronavirus.
Also known as COVID-19, the coronavirus spreads between people who are in close contact (defined as within 6 ft). It can also spread by touching surfaces contaminated with droplets of the virus and then touching one’s face, mouth, nose or eyes.
FOCUS Therapy is taking several measures to address the concerns related to the coronavirus.
All children develop at their own pace and in their own way, each displaying their own strengths. This is as true for speech and language development as it is for anything else. But while the traditional wisdom when it came to late talkers was to simply wait-and-see, medical professionals are increasingly urge parents to have their kids evaluated sooner than later. Our Fort Myers speech therapists encourage the same, knowing that while some kids really are late bloomers, a language problem becomes more difficult to correct the longer you wait.
Sometimes, this message can get a bit muddied when reports of some studies, such as one published by The American Academy of Pediatrics, are reported under headlines such as, “Late Talkers Do Fine as They Grow Up.” This ends up giving many parents a false sense of assurance. That study tended to show little to no lasting behavior or emotional problems associated with late-talking toddlers by age 5. However, it didn’t assess the language outcomes, so it’s a leap to say those kids went on to be “fine.”
Somewhere between 70 percent and 80 percent of toddlers who talk late will outgrow that language delay – but only if it is an expressive language delay (difficulties with verbal and written expression). Those with receptive language delays (understanding what is being said to them) may have a more difficult time. What our speech therapists want parents to bear in mind is that while many toddlers will outgrow a language delay, 20 percent to 30 percent will not – unless they have access to early intervention like speech therapy.
Medical providers are increasingly relying on telehealth services to ensure patients' needs are met - by meeting patients where they are. It's been used by nurses, psychologists and therapists too. FOCUS Fort Myers is now among the first providers in Southwest Florida to offer online speech therapy for kids.
Sometimes called virtual therapy or teletherapy, it's any therapy that can be conducted via technological device (iPad, phone, computer, laptop, etc.). FOCUS began offering online speech therapy services sporadically about 18 months ago. Recently, we established our Teletherapy Department, consisting of two pediatric speech therapists who exclusively operate remotely.
"The same diagnoses and conditions that can be treated in our clinic can be treated effectively via teletherapy," said Haley Ott, FOCUS speech-language pathology assistant and director of the Teletherapy Department.
The process is similar to a Face Time call, except it's through a secure, HIPPA-compliant app.
"It's fairly simple from there," FOCUS SLP and TD department founder and executive director Emmi MacIntyre Ring explained. "We provide our clients with a meeting code, the client enters it into their device, and we pop up on their screen and utilize a variety of online platforms to target their therapy goals. It's an evidence-based and supported administration of therapy services that we've found to be extremely convenient and effective for our clients at FOCUS."
Some local schools contract with companies that strictly offer teletherapy services. However, only a small number of private therapy clinics offer it - for now.
In many regions - including Southwest Florida - the need for speech therapists is greater than the supply. The new Advanced Report on Telehealth and Telemedicine Market Analysis Forecast indicates that by 2026, the global market for all telemedicine is expected to exceed $185 million.
The cost for speech teletherapy is the same as an in-clinic visit, and it's covered in FOCUS' contract with Medicaid. We also extend this service to private pay clients, and are working to expand availability for patients in other insurance networks.
Therapists don't need any special training for telehealth services except for use of the app. If there are parent concerns about how attentive a child will be in online speech therapy, we encourage quiet observation of a session or two in the background. After the first few, though, kids usually make more progress when given space to connect one-on-one with their therapist - even from a distance.
Effectiveness of Teletherapy for Speech
Because telehealth is relatively new in the medical field, researchers are still gathering data and anecdotal evidence that will provide definitive proof of its effectiveness. Still, early impressions are that online speech therapy could be a game-changer for many kids who might otherwise be limited in the early intervention services they could receive.
One study found that kids receiving speech teletherapy outperformed control groups and national benchmarks in expressive and receptive language, social pragmatics and articulation skills.
Research published in the spring 2017 edition of the International Journal of Telerehabilitation concluded: "The evidence presented showed that telehealth is a promising service delivery method for delivering speech and language intervention services to school-age children. This alternative service delivery model has the potential to improve access to SLP services for children living in geographically remote areas, reducing travel time and alleviating the detrimental effects of communication difficulties on education, social participation and employment."
In other words: We KNOW that early speech and language communication skills are a strong indicator of a child's future success. The sooner we can treat speech and language deficits, the better off that child will be long-term. Online speech therapy is a way to extend the same services to kids who might have a difficult time to make it to the office everyday.
"The therapy we're offering isn't different - the mode of delivery is," explained Ott. "Many therapists believe that teletherapy is especially beneficial and a superior method for children in schools because it allows for a FULL session, without having to take time out of a session to transport students. More minutes means more progress."
It's also important to note that while screen time for young kids is generally frowned upon, teletherapy is different. While most television and online games deprive kids of key social interaction, the whole point of speech teletherapy is engaging them.
"Teletherapy is led and directed by a licensed, certified clinician, working specifically on therapy goals in a way that is tactical and motivating for each child and their needs," MacIntyre said.
Parent Feedback on FOCUS Online Speech Therapy Program
Parents come to FOCUS Fort Myers from all over Southwest Florida because we are one of the most trusted providers of speech, occupational, physical and ABA therapy in the region. But teletherapy is still fairly new, so it's understandable parents and even some providers would approach it with healthy skepticism. Ott said the primary concern initially is, "What if my child doesn't pay attention?"
"This is 100 percent understandable, and is a concern of ours as well," Ott said. "However, you can apply this question to your child in most situations - including at school and during in-clinic therapy sessions. In school, your child isn't paying attention ALL the time, and in-person therapy at FOCUS isn't always smooth-sailing either. Most children need frequent breaks in order to attend, and online speech therapy is no different."
Elliot Warford, 8, of Fort Myers, has been a speech teletherapy patient for several months now.
"We love teletherapy so much," his mother Crystal Warford said. "It's a more controlled, one-to-one session, as opposed to in the clinic, where there are sometimes distractions. He loves that Haley incorporates games, and he feels more in control when he gets to choose which games to play. And of course for us, it's convenient to be able to cook dinner while he's in therapy."
Teletherapy may not be an option for every child, but we also know for some kids, it can be every bit as effective as in-person sessions. Sometimes children are more engaged in teletherapy sessions than in-person sessions because they get access to functional screen time.
This service makes a big difference for working parents and families constantly ferrying back-and-forth to other appointments and commitments. It increases access to providers, allows for greater transparency (every session can be recorded) and children enjoy it.
"It's a great way to incorporate education with something they like and aid in increasing their development," Ott said.
Andrea Cappuccilli's daughter has been attending speech therapy, occupational therapy and physical therapy at FOCUS for the past several years. Recently, the 7-year-old started doing some of her FOCUS speech therapy sessions online from home.
"Our primary purpose for speech therapy is to work on voice and breathing exercises so that her respiratory system can get stronger," Cappuccilli explained. "Teletherapy at home gives her a solid chance of improving these skills, while allowing her to avoid exposure to illnesses like the flu or RSV that can easily put her in the hospital for weeks."
And her daughter loves it.
"She knows she's doing therapy, but being on a screen - which kids are already all about - makes it seem cool, and like it's on HER terms."
FOCUS offers pediatric speech therapy and online speech therapy for kids in Fort Myers and throughout Southwest Florida. Call (239) 313.5049 or Contact Us online.
A Pilot Telerehabilitation Program: Delivering Early Intervention Services to Rural Families, Fall 2009, Jana Cason, International Journal of Telerehabilitation
Teenagers and children prone to depression, apathy or behavior problems may benefit significantly from an “electronics fast,” according to a new article published in Psychology Today. At our FOCUS Fort Myers ABA therapy clinic, we have noted that exposure to electronics in children of all ages is an environmental factor many parents overlook when analyzing how to curb certain behavior issues.
For example, if your child is having a difficult time at dinner sitting still, focusing or avoiding meltdowns, handing them a smartphone to occupy them for a few minutes is not an uncommon strategy. It’s often effective too – at least in the short-term. The problem is the adverse impact it has in the long-term.
Firstly, in this situation, the parent is unintentionally reinforcing the undesirable behavior by rewarding the child with a screen – something they probably desperately want. But even if it buys you a few minutes of quiet time (and we don’t doubt that so many parents need that), what it won’t do is help your child get any better at sitting through a meal.
Further, it’s likely to be exacerbating behaviors subsequent to meal time, and the effects can be cumulative.
Happy New Year from all of us at FOCUS Therapy!
To ensure this year goes as smoothly as possible, we’re publishing the 2020 FOCUS Therapy Scheduled Office Closures list in advance.
Typically, our Fort Myers therapy clinic’s schedule mirrors that of the Lee County School District. In other words: If the schools are open, we’re open. If schools are closed, we’re closed. Keep this in mind anytime there are severe weather closures, etc. (particularly during hurricane season!). Obviously, this doesn’t apply to the summer schedule, but where there are deviations, your child’s therapists should alert you in advance. Please don’t hesitate to ask if you have any questions!
Scheduled 2020 FOCUS Therapy Office Closures
- 4/10/20 – Good Friday
- 5/25/20 – Memorial Day
- 9/7/20 – Labor Day
- 11/26-11/27 – Thanksgiving and the Friday after
- 12/21/20-12/25/20 – Christmas Week
- 1/1/21 – New Year’s Day
(Note: We will be open during spring break, March 16-20th and Friday, July 3, 2020.)