Therapy Resources

Are mornings a fight in your house because your child WILL NOT put on weather-appropriate clothing, or has a meltdown because of the way his/her clothing feels or fits?

Here are some ideas to try:

• Buy tagless clothing or cut the tags out.
• Try seamless socks and underwear, or turn socks inside out.
• Avoid socks with patterns, as these have knots and threads on the inside.
• Find the right fit. Some people are bothered by clothing that is too tight and some are bother by clothing that is too loose and moves around on their body too much.
• Find the right fabric. Some people prefer super soft or light clothing while others prefer thicker materials.
• Provide choices when dressing for the day to allow your child to participate in the selection process.
• Provide a quick massage prior to or after putting on challenging clothing items (Example: Foot massage after putting socks on).

If your child continues to have clothing sensitivity difficulties, he or she would likely benefit from an occupational therapy evaluation to further address his/her sensory processing needs.

Call us for details: In Sioux Falls, 605-444-9700. In Rapid City, 605-791-7400.

To learn more about what occupational therapy services.

All children develop differently, and a boost here and there can make things go more smoothly! Pediatric therapists from LifeScape have pooled together their top tips to help kids master some important developmental skills.

Balance Bikes: These bikes without pedals allow children from a young age to master balance and steering, and make the transition into pedaling a bicycle much easier. Our favorite is Strider® (they are made in Rapid City!) www.striderbikes.com

Fat Wheels: For those children (and adults) who need more support to ride a bicycle, but don’t need an adapted trike. Fat Wheels are large training wheels that can fit any bike from 16” to 27”. This is a cost effective way of adapting a typical bicycle for those who just need help with balance. www.fatwheels.com

Rocket Laces: These laces are stiffer, but look exactly the same as regular shoe laces. They are sturdy yet flexible to allow novice shoe-tiers to be more successful and less frustrated with floppy laces.

Hickies No-Tie Laces: For kids or adults that are unable to tie shoes, try Hickies no-tie laces. They look cool and come in a variety of styles and colors. Find them locally at Scheels and Menards. https://www.hickies.com/

Chewies: Are you tired of chewed collars, shirt sleeves and gnawed pencils? Our occupational therapists recommend pencil topper chewies that are clear, and therefore less distracting to peers. My own 5 year-old prefers his robot or shark tooth chew necklaces, and the girls love the bracelets! www.funandfunction.com

Handwriting Without Tears®: A developmental approach that teaches correct formation and establishes good writing habits from the start! HWT (www.hwtears.com) has an excellent pre-writing curriculum. It’s so much easier to develop the right habits early than to fix or break them later. Bonus – their website has a ton of free tools for parents!

Pool Noodles: These inexpensive fun toys can be used for all sorts of things! When cut lengthwise, use under baby’s chest to elevate them during tummy time, cushion sharp edges or corners, provide extra support in a highchair, or use as a positioning device (instead of a rolled up towel). They can even be used to cover trampoline springs!

Pictures to communicate: Try this for children struggling to say the name of things they want on a regular basis. Take a picture of the item – milk, water, toys, bath, diapers, favorite snacks, etc. - print them and affix to a magnet and put on the fridge (or somewhere accessible to the child). Have your child choose the item he wants and give it to you in exchange for the real item (while you model saying the word). It will decrease frustration for you both, and actually will encourage expressive speech!

Looking for ways to work on balance control with your child? These activities will challenge your child’s static and dynamic balance, in turn helping them to maintain appropriate control of their body during stationary and movement activities. Improved balance will help your child become more independent with daily functional activities and will progress their ability to complete age appropriate gross motor skills.

1. Standing with one foot on a small bench or weighted ball. As a great way to work towards standing on one foot, have your child stand with one foot on the ground and one foot on a small bench or stool. Have your child try holding the position for 10 seconds. If this skill becomes easy, progress the activity by playing a game; such as playing catch with a ball or tapping a balloon back and forth with a partner. You can also challenge your child by replacing the small bench with a weighted ball.
2. Standing on 1 foot. Once your child has mastered standing with one foot on a small bench, have them try standing on one foot. Make sure they practice standing on both legs. You can make this activity more fun by making it into a game; such as a contest for who can balance the longest on each leg, having your child pop bubbles while standing on one leg and or having them try to reach in several directions to tap targets on the wall while standing on one foot. You can also make this activity more challenging by having your child put their hands on their hips and or having them close their eyes while balancing on one foot.
3. Walking forward on a line or balance beam. Walking forward on a line works on your child’s dynamic walking balance. To encourage walking forward in a narrow stance, you can place a long piece of tape on the floor and encourage your child to try walking forward on the line. To progress this activity, have your child try walking forward on a straight curb and or using a slightly raised balance beam. You can also make this activity more challenging by having your child walk with their hands on their hips, walking heel-to-toe, and or walking sideways or backwards.
4. Walking forward on a zig-zag line or figure 8 line. If your child has mastered walking forward on a straight line, try having them walk forward on a zig-zag or figure 8 line. You can also make this activity more challenging by having them walk on their toes or heels and or trying to walk backwards or sideways.
5. Standing with one foot in front of the other. Another balance activity to challenge your child includes having your child try standing with one foot in front of the other on a line. Have them start off with their feet slightly spread apart and progress towards having them stand with their feet heel-to-toe. You can make this activity more challenging by having them stand with their hands on their hips and or with their eyes closed.
6. Standing on a soft surface such as a pillow or balance mat. Another simple way to work on balance with your child, is having them stand on an uneven or soft surface such as a pillow or soft mat. You can make this activity more challenging by incorporating a game while standing on the pillow such as playing catch, doing a board game on a high surface, and or having them close their eyes.
7. Stepping over small objects or barriers. One fun way to work on standing on one foot is stepping over small objects or barriers. Try making a small obstacle course in your living room or outside using whatever objects you have available at the time. Start off using small (1-2”) objects such as pool noodles or pillows and progress to higher objects as your child’s balance improves.
8. Sitting on a therapy ball. Try having your child sit on a therapy ball. You may need to help them at first by giving them support at their hips or legs. To make the activity more challenging, try having your child lift one leg up off the ground and or playing catch with a small ball while they are sitting on the therapy ball.
9. Standing on a balance board. A balance board is a flat board made of wood or plastic with a rounded or curved bottom. Try having your child stand with their feet spread apart on the board. As they progress, have them try rocking side-to-side or forwards and backwards while standing on the balance board.
10. Hopping forward on 1 foot. For an increased balance challenge, have your child try hopping in place and/or forward on one foot. You can make this activity more challenging by having them try to hop forward multiple times in a row, hopping back and forth over a line, and or hopping backwards and sideways.

Call us for details: In Sioux Falls, (605) 444-9700. In Rapid City, (605) 791-7400.

To learn more about what physical therapy services.

A consistent complaint from people who don't use verbal communication (and of their families) is that people tend not to speak directly to them. The conversation is often directed to the person’s family or caregivers instead. Here are some tips for including people who don't use verbal language in conversations, and to make it clear that their input and opinions matter.

Introduce yourself to the individual first, and then to other family members.

Ask the person’s caregivers/companions how the person usually communicates, as well as their level of involvement in decision-making.

Establish how the individual indicates “yes” and “no.” Ideas of some simple methods for yes/no responses are looking up for “yes” and down for “no,” blinking eyes once for “yes” and twice for “no,” using a tight fist for “yes” and an open hand for “no,” or pointing to/looking at “yes” or “no” picture cards or written words.

Ask the person if it’s okay to ask their family members questions about them. Even if they don’t respond, it will show respect for their opinions.

Even if the conversation is mainly directed toward the caregivers, involve the individual by providing eye contact to them and using their name.

Try to be patient, no matter how rushed you are. Remember that, for people who communicate with modes other than speech, conversations may take longer than usual. Wait time may be needed for the person to use a communication system to respond.

Don’t pretend to understand a response if you haven’t. Ask the person to repeat/rephrase, or ask a family member to interpret.

Get down to the individual’s level and talk to them face-to-face, using eye contact.

Allow extra processing time.

Offer choices using objects, flashcards, or picture icons.

For more information about increasing communication skills for people who don’t use spoken language, contact us: In Sioux Falls, (605) 444-9700. In Rapid City, (605) 791-7400.

Or to learn more about what speech-language pathology services.

Infant torticollis diagnoses are on the rise and early detection is critical for effective treatment. Torticollis is any abnormal posture of the head and/or neck caused by neck tightness and weakness that often can develop during pregnancy. The first sign of torticollis that parents usually notice is that their baby prefers to look to one side. In addition, a head tilt (ear to shoulder) may also be observed. These may be very subtle and usually require the skills of a pediatric physical therapy to determine if your baby has torticollis.

The earlier the treatment for torticollis is initiated, the quicker it may be resolved. If the physical therapist determines that your baby has torticollis, he/she may recommend treatment and will educate you on various exercises, stretches, and repositioning techniques. A family’s active involvement in consistently completing the homes exercise program prescribed by the physical therapy is a key component to the resolution of torticollis.

In the meantime, there are things you can do before you schedule your appointment:

• TUMMY TIME! Tummy time, while baby is awake, can be started immediately and there is no limit to the amount of time a baby can spend on his or her tummy.
• If you notice your baby has a preference to only look one direction, reposition to promote looking the opposite way
• Limit use of “containers” such as care seats, Rock-n-plays, swings, etc. Unless a baby is required to remain upright after eating or during sleep due to such things as reflux, all positioning devices should be limited because of their tendency to promote poor posturing of the head and neck and decreasing the child’s ability move their head in all directions. This can result in worsening of any neck muscle tightness that may be present, as well as significant head shape changes. Time spent playing on the floor is the best position for your baby to move through his or her full motion and promote developmental strengthening, as well as explore and interact with their environment.

If you feel your child may have torticollis, seek out a physical therapist that specializes in pediatrics, and in particular, torticollis evaluation and treatment. It is important that they are assessed, as every child presents differently and will have a unique treatment plan that includes stretching, but also strengthening exercises to the opposite side. Again, early identification is essential to resolving neck tightness and weakness, allowing your baby to move, discover, and explore his or her environment for optimal development!

Call us for details: In Sioux Falls, (605) 444-9700. In Rapid City, (605) 791-7400.

To learn more about what physical therapy services.

For various reasons, more babies today have misshapen heads. Greater use of infant “containers” like bouncy seats, swings and car seats, plus the successful “Back to Sleep” program to address Sudden Infant Death Syndrome, have all added up to babies spending more hours on their backs. The result is that babies’ soft skulls may develop a flat spot, which is referred to as plagiocephaly. Parent education for re-positioning and tummy time are important. The best defense for plagiocephaly is prevention!

Statistics relate that infants with plagiocephaly may also have torticollis, which is tightness and weakness of the neck muscles. Because of this, babies may rest with their heads in the same position, creating an area of flatness of the skull. For infants with torticollis or plagiocephaly, assessments by a physical therapist and cranial remolding helmet practitioner are recommended. Torticollis and plagiocephaly treatments are both very time sensitive. Because torticollis affects head shape, this treatment can and should start as soon as possible before the muscle becomes less responsive to treatment. Even after a baby has developed a flat spot, conservative therapeutic efforts may help the head shape to “round out” on its own.

For cranial remolding with a custom-fabricated helmet, length of treatment usually corresponds to the age the child begins treatment. Early referrals offer the best chance of prevention. If you think your child may have neck tightness or you are concerned with head shape, visit with your doctor and call LifeScape Rehabilitation Center in Sioux Falls at 444-9700 or LifeScape in Rapid City at 791-7400.

Measurement guidelines are used to help define your baby’s status and needs, and parent education is always provided. Click here for details on cranial remolding services. Check out LifeScapeSD.org for more information about all our services.

To learn more about what cranial remolding services.

Outdoor play can be one of the most rewarding and developmentally beneficial activities for a child to engage in. On the flip side, however, it can also be one of the most challenging activities and experiences for to child to partake in if they have any kind of sensory processing difficulties or sensory defensiveness. Here are a few sensory based activities and ideas to allow a child to explore and learn about their different sensory systems and how they affect their bodies:

1. Water tables are a great option! Even something as simple as water in a bucket allows a child to learn about interoception (wet vs. dry; warm vs cold). By adding color, rocks, bubbles, toys, etc a child can learn to be comfortable around water which then will begin to transfer to acceptance of bath times, etc.
2. Sand play is also a great option. While some kids may not feel comfortable getting dirty in a sandbox, having sand in a small bucket for them to play with and explore is a great option. This can provide the chance for some great imaginative play, as well as a chance to work on tolerating messy hands, and learning about tactile exploration.
3. Swinging can also be another activity that some children can’t get enough of while others would prefer to stay far away. Swinging can help to regulate a child with the use of vestibular and proprioceptive input. Some children love to swing in fast circles, some love linear or back and forth motion, while others love slow long circles. Whichever your child prefers, working into trial of all different methods can help them to better understand aspects of their body!
4. Any kind of jumping, skipping, hopping, ball kicking/catching, and moving that you can do is beneficial! Not only does it help with the overall health of a child, it also helps a child to develop improved bilateral coordination and kinesthesia (body awareness) skills. What this means is that a child is learning about how to move all the parts of their bodies together at once, which can be a big challenge for our kids that struggle with praxis (movement) deficits!
5. Playing iSpy, naming games, or searching for words that are out in the community can address many aspects of development. The most obvious is letter recognition and identification. What is not as apparent, is all of the visual motor skills that these activities can address. These visual based activities work on visual tracking, appropriate eye movement, visual discrimination (identifying things in a messy background), and overall visual processing. These are all important developmental skills that also have an impact on school performance.

Children typically begin moving around on their own between 9 and 12 months of age. This movement is essential for children to develop visual and cognitive skills through exploring on their own and to promote social development and independence. Independent movement can be a major obstacle for children with motor, cognitive and visual difficulties. These difficulties do not need to keep children from having these same experiences. Using the proper supports and technology, children of all levels of skill can move and explore on their own with appropriate help and supervision.

Some examples of technology for this purpose include:

• Seating or other supports that help children balance and use their motor skills more effectively
• Specially adapted ride on toys
• Gait trainers and other assistive walking devices
• Light-weight easy to maneuver wheelchairs
• Power wheelchairs with joysticks or other controls to help kids explore on their own

Call us for details: In Sioux Falls, (605) 444-9700. In Rapid City, (605) 971-7400.

To learn more about what occupational therapy and mobility services.

“Sit up straight!” That’s something you may have heard you mother or grandmother say. They probably thought sitting or standing up straight made you look better than slouching. Chances are they didn’t know it, but they were onto something much more important. This is especially true for people who have difficulty with fine motor tasks and attention.

The position of the pelvis in sitting can affect numerous body functions in typically developing children and adults. The effect can be even more significant for people who have fine motor, coordination or attention concerns.

The ideal position of the pelvis in sitting is a position of neutral to somewhat anterior tilt, meaning straight above the hips or slightly leaning over the hips. Think of this in terms of the activities you perform in various positions. When you are relaxing on the couch watching TV, most people are sitting with a posterior pelvic tilt. They may even put their feet up which moves the pelvis even farther in a posterior direction. Now consider sitting at a table eating soup or playing a game like Jenga. Without thinking you will likely move your pelvis into a position of neutral to slightly anterior tilt. The reason is you have placed greater demands on your fine motor skills and this position of your pelvis creates stability through your body for better control of your arms, hands and fingers. Your body (and brain) instinctively knows this position is an active position; a position from which you are engaging in something more demanding. As a result, your brain responds by making you more alert and giving you improved concentration.

The reverse is also true. When relaxing on the couch with a posterior position of the pelvis you are more likely doze off during a slow part of the show you are watching. There are several ways to help achieve this position of the pelvis. They include thing like sitting on an exercise ball or a downward sloping wedge or even sitting on the edge of a chair or sitting on a chair backwards. Keep in mind this is an active position and may be difficult to maintain for long periods of time. Used when demands are high however, this position can help to enhance performance and attention.

Call us for details: In Sioux Falls, (605) 444-9700. In Rapid City, (605) 791-7400.

To learn more about what occupational therapy and mobility services.

Do you know why crawling is important?

• Crawling is important for strengthening of the arm/shoulder, core, hip muscles
• Crawling is important for hand-eye coordination
• Crawling is important to help your left and right sides of your brain work together
• Crawling is important to develop reciprocal coordination, which means your body can coordinate left and right sides moving in an alternating pattern
• Crawling is important to for developing appropriate flexibility and mobility in your spine and rib cage
• Crawling is important for children to gain the ability to move independently and explore their environment

Some tips for encouraging crawling:

• Children gain strength and learn skills necessary for crawling while playing on their tummy. Try to include supervised tummy time multiple times per day, every day in your child’s routine from an early age
• Give your child a safe, supervised place to explore his/her environment
• Place toys in which your child is interested a few feet in front of him/or to encourage crawling to the toys
• Avoid baby walkers and minimize time spent in equipment such as exer-saucers, baby seats, and baby carriers

Call us for details: In Sioux Falls, (605) 444-9700. In Rapid City, (605) 791-7400.

To learn more about what outpatient therapy services.

Babies’ brains are hardwired to learn language and communication. The process of learning language happens earlier than you would expect. A study published in 2013 found that infants as young as 7 hours old were able to tell the difference between the vowel sounds of their mother’s language and those of a different language. This suggests that newborns can learn and remember basic sounds of their language from their mother during the last 10 weeks of pregnancy.

The development of early language skills helps build a foundation for future success in reading, learning, and social interaction. In fact, the vocabulary built by age five will predict a child’s future educational success and outcomes for when they are 30 years old!

Poor language skills can affect reading performance. This is because language knowledge provides the foundation of the vocabulary and grammar that’s necessary for understanding what you read. Use of correct speech sounds is also important for literacy because you must be able to recognize how specific letters are connected to specific sounds in order to decode words. Literacy outcomes directly affect educational achievement and future career opportunities.

If your baby is showing signs of developmental delay or if your toddler is a late talker, simply adopting a wait-and-see attitude could prove to be a mistake. Language delays and reading difficulties may be the window to diagnosing underlying learning problems. Here are some red flags for language delays:

• A family history of language or learning disorder
• Diagnosis of developmental delay, congenital anomaly (such as cleft palate), or traumatic injury
• History of multiple ear infections. A child cannot produce language if he/she cannot hear well
• “Quiet baby.” Baby makes few or no sounds between 6-10 months, no babbling.
• The child does not produce a “first word” between 12-15 months
• The child produces only a few words by 24 months
• The child does not produce two-word phrases by 2.5 years

A child’s communication environment influences language development. The number of books available to the child and the frequency of visits to the library are important predictors of the child’s expressive vocabulary at two years. Speech-language therapy can help if you question your child’s language development, and early intervention is most effective. In the meantime, chat away with your child. That conversation will flow between the two of you before you know it!

Call LifeScape for information on speech therapy for your child. In Sioux Falls: (605) 444-9700. In Rapid City: (605) 794-7100.

If you have a child with any kind of medical diagnosis or learning challenge, you’ve likely been introduced to the complexity of services. Knowing what’s considered a school-based service and what is a private service is confusing in itself. There are similarities and differences between the two. Here’s a brief rundown of each.

Schools serve the purpose of educating children. Sometimes, in order to benefit from education, it will be determined that the child needs additional services, such as special education, speech therapy, occupational therapy, physical therapy, or some form of behavior intervention. These additional services are meant to help the child meet the educational goals in their Individualized Education Plan (IEP), or to allow the child to better participate in the classroom. The school goals often benefit the child outside of the classroom, but the school environment is of primary concern. When the services are determined necessary, they are provided and funded by the school.

Private, or medical-based therapy, addresses goals not identified by the school as necessary for learning. Under this model, a physician makes a referral based on a diagnosis, concern, or observed delay. This might be speech therapy, occupational therapy, physical therapy, psychology/counseling, or applied behavior analysis. After the referral, the need for treatment services is determined by an evaluation based on testing and observations that takes the home, school, and community settings into account. If treatment services are deemed necessary, insurance often covers all or part of the costs.

It’s common to receive both school and private services. For example, a young child recently diagnosed with autism may attend preschool and receive special education services that target early learning skills. He or she may also get speech therapy to improve communication skills, and have a behavior intervention plan to decrease behavior that interferes with learning—such as dropping to the floor during transitions. The same child may also benefit from private services such as speech therapy to increase communication skills at home, or applied behavior analysis to address such things as toilet training, safety skills, or hitting/biting a sibling.

A comprehensive plan with both school and private therapies can help your child reach their highest potential. If you have a concern about your child’s development, talk to your pediatrician or school, or call an Intake Specialist at LifeScapeWe’re here to help.

In Sioux Falls: (605) 444-9700. In Rapid City: (605) 794-7100.

Does your child have difficulty falling asleep, staying asleep, or possibly both? Bedtime can be difficult for a variety of reasons – biological, environmental, and/or behavioral. Sleep is important for effective development and learning, with 11-14 hours recommended for toddlers, and 8-10 hours for children and teens. The following are some suggestions to support sleeping success:

• Set and follow consistent sleep and wake times. This will support the body’s natural circadian rhythms.

• Create and participate in a bedtime routine each night. It can be a few minutes up to several minutes used to prepare your child physically and mentally for bedtime.

• Reduce screen time, preferably up to an hour before bedtime.

• Encourage physical activity throughout the day to expend energy.

• Make sure the environment is dark and quiet.

• Products to assist with sleep:
  • Weighted blankets
  • Compression sheets
  • Noise machine
  • Black out curtains

You may also wish to consult with a physician to determine if medications to promote sleep are warranted.

Call us for more details: In Sioux Falls, (605) 444-9700. In Rapid City, (605) 791-7400.

Almost everyone recognizes that there are 5 senses, but did you know that there are actually 8? Most will be able to list sight, touch, smell, hearing, and taste, but there are also proprioceptive, vestibular, and interoceptive senses. Proprioception gathers information about the muscles and joints, the vestibular system gathers information about the body’s position and movement in space, and interoception gathers information about the internal organs and physiological states of the body. Interoception helps us to recognize when we feel ill, hungry, the need to use the restroom, hydration, and many others. Individuals with sensory processing disorder or autism spectrum disorder often experience difficulties with their sense of interoception, but others even without diagnoses can have difficulty with this system. Signs that someone may have impacted interoception may include:

• Inability to recognize when he or she is hungry or full
• Trouble with potty training, incontinence, or constipation
• Abnormal responses to pain, stress, or emotions.
• Difficulty reporting illness or symptoms such as headaches, nausea, fever, etc.

Altered interoception may result in difficulties with emotional regulation, toileting, nutrition, self-awareness, and overall health.

If you feel that your child has difficulty with interoceptive awareness or any other concerns listed above, please call us for more details: In Sioux Falls, (605) 444-9700. In Rapid City, (605) 791-7400.