FOCUS Therapy evaluations

Why FOCUS Asks Parents to Stay in the Waiting Room During Evals, Sessions

FOCUS Therapy in Fort Myers conducts a range of in-depth evaluations for children who have been referred for speech, occupational, physical, or ABA therapies as well as ADOS testing. During our evaluations and therapy sessions, we rarely allow families to directly participate – but we have evidence-based reasons for our position.

During evaluations, we want to ensure every child receives an assessment that is as accurate as possible because that is what is going to allow us to:

  • Determine whether the child needs therapy.
  • Calculate the frequency/level of therapy that might be recommended.
  • Make a strong case to the relevant insurer(s) about the medical necessity of the therapy.

Parents, when present in the room during FOCUS evaluations, can unwittingly stand in the way of those goals. Why? Mainly because children rely on their caregivers when things get tough – to help them, to comfort them, to make it better. When a child is struggling in a certain area, such as communication or independence with self-care skills, our clinicians need to independently observe the particulars.

Parent input is a key aspect of our evaluations, but we need to see for ourselves, too. Jennifer Voltz-Ronco, MS-CCC/SLP and FOCUS Therapy Owner/Founder, explained that when a child is accompanied by a parent during the direct observation portion of the assessment, parents often interfere without intending to do so or even realizing it.FOCUS Therapy

“For example, in speech evaluations, parents might talk to the child or give clues to help their child ‘get the right answer’,” Voltz-Ronco explained. “We might ask the child to point to an object out of an array of 3-4 items by saying, ‘Show me the cup.’ Standardized testing requires that we be very specific in how we present these items – and with the requirement that we wait. And while we wait, we’re looking to see how long it takes them to process the directive and what they do. Will they look at us to see if we’re looking at the object? Will they point to it or make a face if they’re unsure? They might associate a cup to mealtime and instead point to a cookie. If the child looks to our face to get a clue, that would indicate social awareness and joint attention – key pre-linguistic communication skills. If there is a delay in their response, there may be an auditory processing issue. If they grab the first thing in reach, they may have impulsivity issues. Watching a child while they’re thinking tells us so much. But parents in the room might think the evaluator presumes the child doesn’t know the answer, so they interject. They say to the child, ‘You know what a cup is, like the blue sippie cup you have at home.’ Unfortunately, what that does is give the child numerous opportunities to hear the word, ‘cup,’ and in many standardized tests, we aren’t allowed to repeat the word or give a description or synonym. So with that, we lose the opportunity to see what we needed to see, and must in turn score the response incorrectly – which impacts the overall results.”

She went on to explain that often the key responses FOCUS therapists are looking for aren’t necessarily what an untrained observer may presume.

What’s more, some children can become what we call “prompt dependent.” That means the child looks to the parent to prompt them (to take an action, answer a question, etc.) – even if they don’t necessarily need the prompt. Many of our team members are parents ourselves, so we wholeheartedly understand how difficult it is to wait for your child to “do it themselves.” It is actually instinctual to intervene when we see or sense our child needs help. But during these evaluations, this intervention – however slight – can actually prove more of a hindrance when what we’re seeking are accurate results.

We DO Want Parents Involved in Their Child’s Therapy Journey

Although it is important for parents to remain outside the room during evaluations, this does not mean we lack transparency or that we don’t want parents involved at all in the therapy process. In fact, we get the best results from therapy when parents are fully engaged!

But we discourage direct engagement during the evaluation process and therapy sessions because we want to ensure our findings are accurate and that your child gets the true level of support they need.

While we want parents to be involved in consultation, goal-setting, education, and carryover, we strongly advise parents against sitting in during therapy sessions for the following reasons:

FOCUS Therapy child development

Boost Child Development While Playing in Nature

As the weather cools in Southwest Florida, it’s the perfect time to get outside and play with your child! It’s not just about enjoying the day and making some memories (though these are worth it in itself). Our speech, occupational, physical, and ABA therapists know that spending time outdoors is great way to boost child development.

Being in nature has been proven to boost kids’ academic achievement, physical health, mental health, and overall well-being. One analysis of hundreds of studies on the subject found that nature boosts learning in eight distinct ways. Those include:

  • Improves attention.
  • Relieves stress.
  • Boosts self-discipline.
  • Increases physical activity and fitness.
  • Promotes self-motivation.
  • Increases enjoyment.
  • Improves engagement.

As pediatric therapists dedicated to helping disabilities and delays make strides, we have found that nature provides a calmer, quieter, and safer setting for learning. It can also help with:

  • Motor skills
  • Communication
  • Social-emotional skills
  • Speech and language skills
  • Executive function
  • Sensory integration
  • Relaxation and emotional regulation

Spending time outdoors creates opportunity for more creative, exploratory forms of play – and play is how children learn best!

FOCUS Therapy

Join FOCUS Therapy for FOCUS POCUS Trunk-or-Treat!

FOCUS Therapy in Fort Myers is hosting its first ever FOCUS POCUS Trunk-or-Treat event of socially-distanced Halloween fun for all our patients & families!

We’re welcoming everyone to dress up, bring a treat bag and join us for games, candy, prizes and more!

Our Southwest Florida speech, occupational, physical and ABA therapists are committed to providing enriching experiences for our young patients while encouraging the kind of inclusion we want to see at all events. That’s why we’re opening our FOCUS POCUS Trunk-or-Treat fun to our patients as well as their siblings and family.

From 6 p.m. to 7:30 p.m. on Thursday, Oct. 29th, FOCUS Therapy staffers and therapists will park their decorated vehicles a full vehicle-length apart in the parking lot outside our clinic, 4997 Royal Gulf Circle, Fort Myers, FL 33996. Parents will be encouraged to park to the west end of the office plaza, and we’ll have a carefully directed flow of trunk-or-treaters, with only one family allowed in front of a vehicle at a time.

FOCUS Therapy Fort Myers
One family per trunk: Map of foot traffic flow for safe social distancing at FOCUS POCUS Trunk-or-Treat.

“Halloween and trick-or-treat are such special events that kids look forward to all year long,” said FOCUS Therapy owner/founder Jennifer Voltz-Ronco. “We know a lot of families this year may be wary of the traditional door-to-door trick-or-treating, but we don’t want anyone to miss out on the fun. It’s also great for our kiddos with disabilities and delays who could use some practice before venturing out door-to-door over the weekend.”

Some of our therapists will have fun, engaging activities and games at their “trunk stop” for children to play and engage, while still remaining socially-distanced.

“For many of our patients, traditional trick-or-treat can be tough anyway, whether because of sensory issues, language deficits or physical challenges,” Voltz-Ronco explained. “Trunk-or-treat events in general have sort of always been the perfect opportunity to allow for both tradition and accessibility. And now this year, as families with children of all abilities in our community are expressing concern about safe trick-or-treating, our team is excited to be involved in making that happen for them.”

For more information, contact FOCUS Therapy at (239) 313-5049 or e-mail Jennifer.Voltz@FOCUSFlorida.com. 

Fort Myers pediatric physical therapists

FOCUS Fort Myers Pediatric Physical Therapists Dedicated to Top Quality Treatment of Sports Injuries

"It's not whether you get knocked down, it's whether you get up." -Vince Lombardi, late American football coach and executive in the National Football League (NFL)

Our Fort Myers pediatric physical therapists know how important sports are to children's development, physical fitness and mental health. That's why we are committed to providing they highest quality care for children who have suffered sports injuries. We understand that while they may get knocked down, it's essential not just to their recovery but their overall well-being that they get back up - and the sooner, the better.

The U.S. Centers for Disease Control and Prevention estimates that more than 2.6 million children are treated in hospital emergency departments annually for sports and recreation-related injuries. Recently, one of those was 14-year-old Jett, a local baseball and basketball player in Fort Myers. He suffered a knee injury during one of his practices that sidelined him completely. Emergency department doctors referred him to physical therapy. But his mother, who just happens to be FOCUS Therapy's owner and founder, wasn't going to take him to just any Fort Myers pediatric physical therapists.

"I knew that a physical therapist who mostly sees adults wouldn't necessarily be attuned to the unique needs of a developing athlete," said Jennifer Voltz-Ronco. "But our physical therapists at FOCUS would."

As a speech-language pathologist, Voltz-Ronco knows a thing or two about providing therapy to kids. So when the need arose for physical therapy for her own son, she trusted the team she put in place.

Pediatric Physical Therapist Julie O'Conner virtually oversaw Jett's evaluation and first session with Physical Therapist Assistant Tabitha Baxter. Voltz-Ronco said the experience - as a patient parent rather than provider - was invaluable. She noted that it was great to see how a physical therapist could work well virtually with an assistant (and noted that not every session with physical therapist assistants must be monitored). She watched how, as a caring, professional team, they worked so well together to provide Jett with the best care.

"We treat all of our patients like family, but experiencing this not just as the owner, but also as a parent was so insightful," she said. "It made me even more confident that I hired the most knowledgeable, loving, super-amazing people."

Dr. O'Conner, who has five years of experience treating children, explained that the goal with treating pediatric sports injuries is not to get an athlete simply to the strength and endurance of their typical peers. She wants them to be at their peak level of performance.

"I want him to get to the point again that he can pivot quickly, change direction and bear as much weight as he did before the training," O'Conner said. "So that this doesn't happen again, and he can get back to playing the sports he loves."

FOCUS offers pediatric physical therapy in Fort Myers and throughout Southwest Florida. Call (239) 313.5049 or Contact Us online.

Additional Resources:

Sports Safety, Key Prevention Tips, U.S. Centers for Disease Control and Prevention

More Blog Entries:

Fort Myers Physical Therapy Tips & Tricks to Prevent & Reduce Toe-Walking, June 8, 2020, Fort Myers Pediatric Physical Therapists Blog

occupational therapy

Therapy Isn’t a Quick-Fix – Why You Should Still Follow Our Course Until Successful

Parents of children disabilities can quickly find themselves immersed in a dizzying world of various doctors, therapies, medications and treatment. The thought of their child spending several days a week – for years – in speech, occupational, physical and ABA therapies is frankly overwhelming. So we do understand the temptation of quick-fix, non-medical services that promise to “get your child talking” or “catch your child up” with just a month or so of intensive programming.

Call them hype or scams – but they don’t work.

In fact, some do more harm than good. They waste precious time and valuable resources – which can be especially damaging when you’re encouraged to interrupt or leave the routine of traditional, physician-recommended therapies.

“Parents of children with special needs will go to the ends of the Earth to get their child the additional help they need,” said Jennifer Voltz-Ronco, owner and founder of FOCUS Therapy in Fort Myers. What we don’t want to see is parents being taken advantage of. In fact, we care so much about these kids that we will even help parents investigate other treatment options and share information about and with other medical providers if that’s the direction parents want to go. But it pains us to see parents blindly signing up for ‘treatment’ from centers that make big promises, but objectively just don’t compare to what we’re offering in terms of quality and effectiveness.”

Fort Myers physical therapy

Identifying, Treating Pediatric Vestibular Dysfunction Involves Occupational, Physical Therapy Collaboration

Once upon a time, vestibular dysfunction in children was thought to be exceptionally rare. Our occupational and physical therapists know, however, that pediatric vestibular disorders, which affect as many as 35 percent of adults, are increasingly being identified earlier than ever. Symptoms include chronic dizziness and imbalance. In children, vestibular system disorders can also cause problems in early development, impacting:

  • Ability to maintain an upright position when sitting;
  • Delays in crawling and walking;
  • Difficulty with steady vision when moving the head (for example when copying words or letters at a chalkboard when seated at a desk);
  • Diminished balance and motor function.

Long-term, this can have significant and painful social, educational and economic impacts for kids. Professionals on our FOCUS Fort Myers occupational and physical therapy teams are committed to identifying and addressing these issues early on, promoting the highest possible level of relief and function and ultimately mitigating the worst adverse impacts.

What is the Vestibular System and How Do I Know if My Child’s is Dysfunctional?

Fort Myers Physical Therapy Builds Strength After Teen Knee Surgery

Popularity of youth sports has exploded in recent years, and that’s great news for public health. However, it has also meant an uptick in child sports injuries – especially knee injuries like ACL tears. FOCUS Fort Myers physical therapy can help your teen  get back on their feet – and hopefully back to their sport – often with a few months of treatment.

The Cleveland Clinic reports it’s not just boys but girls too who are suffering sports injuries, as their participation rates have spiked. The hospital reports male and female injury rates are about the same these days, with 40 percent of all child injuries requiring emergency department treatment now being sports-related, amounting to roughly 4.4 million annually.

Our FOCUS Fort Myers physical therapists know sometimes  child sports injuries are worsened when coaches or teammates trivialize them, urging the youth to just play through the pain and stay tough.

pediatric physical therapy

Pediatric Physical Therapists Say Swapping Seats Can Boost Grades

Could improving grades and classroom behavior be as simple as changing a child’s chair? That’s what a number of physical therapy researchers have concluded in recent years.

As pediatric physical therapists, we help children improve fine and gross motor skills using “playtime” designed to strengthen or stretch certain muscle groups, manage pain or work on balance. Many of our FOCUS patients have conditions like down syndrome, cerebral palsy or spinal injuries where this type of intervention is obvious. However, we’re increasingly seeing a number who have conditions (co-occurring or singular) like autism and attention deficient hyperactivity disorder (ADHD).

Children with all these conditions are often very bright (sometimes exceptionally so) but may struggle with how to behave appropriately in a classroom setting, especially when required (like every other student) to sit still for long periods, denied opportunities to retreat from overstimulation or outlets to meet their sensory needs. These elements are just as important for them to achieve success in the classroom as any amount of studying.

Pediatric physical therapists have studied this particular issue, and have discovered that for many children with ADHD, dynamic seating can offer important benefits that can help improve classroom behavior and academic outcomes.

pediatric physical therapy

Pediatric Physical Therapy Can Help With Chronic Constipation

Chronic constipation is a crappy problem – one common among all children, but especially prevalent among children special needs. Pediatric physical therapy at FOCUS Fort Myers may help, using exercises to strengthen pelvic muscles and improve posture.

We know this can be an uncomfortable issue to discuss, but if it’s causing your child pain and difficulty on a regular basis, it’s one that requires attention because it’s essential to good health. The Journal of Pediatrics reports constipation among children with autism is associated with increased emergency department visits and inpatient admissions. Depending on the underlying cause, pediatric physical therapy may help alleviate the problem. Occupational therapists, ABA therapists and even speech therapists can also collaborate on solutions.

Constipation involves either the inability to pass stool or problems that make it not as easy or frequent as one would like.

One analysis published in the journal Gastroenterology examined more than 50 school-age children suffering from functional constipation, all of whom were receiving the “standard” treatment for chronic constipation, which included potty training, education and laxatives. Half were randomly chosen to also receive pediatric physical therapy. Six months later, more than 90 percent of the children who got physical therapy no longer suffered from constipation, compared to about 60 percent of those who didn’t get physical therapy.

Physical therapy

Physical Therapy Targets Gross Motor Delays That Spur Other Problems

A child who struggles to explore their environment on the same level of their peers due to a gross motor delay may struggle on other fronts too, including cognitive development and behavioral challenges.

Recently, the journal Physical Therapy published a study determining that gross motor delays were associated with problem daytime behaviors and quality of life issues for children with autism spectrum disorder. Researchers examined cross-sectional, retrospective data of more than 3,200 children between the ages of 2 and 6 diagnosed with ASD. They found that children who struggled more with gross motor skills had more daytime problem behaviors. So when the goal is targeting problem behaviors for children with ASD, researchers concluded it’s important not to overlook the possible need for physical therapy.

Children with a wide range of conditions and diagnoses may have gross motor delays, which are those skills involving the large muscles of the arms, legs and torso. Gross motor skill delays might become apparent when a child is learning to crawl, sit, walk, run, throw a ball or balance. All kids reach developmental milestones at varying increments, but those who are far behind can benefit from physical therapy to help them catch up.

Gross motor skill delays can be linked to any number of conditions – or may exist independently of anything else. Untreated, these delays can impact your child’s ability to reach their full potential.