Planes, Trains, and Automobiles: Sensory Edition

Planes, Trains, and Automobiles: Sensory Edition

Everybody looks forward to a family vacation, but the closer you get to the departure date, the more you feel some of the stressors that come along with what should be a relaxing vacation.  Traveling with kids in general can mean a few curve balls being thrown your way, but when you have children with special needs, those curve balls can multiply!  Below are some tips for making your trip run as smoothly as possible so you can enjoy your time away!

  • First, always check to see if the attractions you will be visiting have programs or accommodations for children with special needs.  Some parks and museums offer sensory-friendly events or areas.  Matt’s blog post this week has more details on some of the local attractions and how to find out about special accommodations they offer.  

  • Think about your daily routine – there are likely some things that make your day run smoothly that are such a part of your daily life that it would be very missed if you had to go without it, like specific snacks, a special blanket, or a swing.  Many things are easy to pack so that you don’t have to worry about finding it at your destination.  But you may not be able to pack everything that you use on a daily basis, so get creative and think about how you can replicate some of the things you can’t pack.  For example, a travel hammock could replace a swing and compacts down to a small pouch; a wiggle cushion or inflatable mattress are much smaller than a trampoline but can give similar input.   

  • Use visual schedules or social stories to prepare your child for the upcoming events and to add an element of routine/predictability.  This will reduce stress and prevent meltdowns.


  • If your child is sensitive to sensory input:
    • Use a billed hat, sunglasses, or a sleep mask to reduce visual input.
    • Pack ear plugs or headphones to reduce noise, or to play calming sounds at times.
    • Use a weighted blanket, lap pad, or ankle weights to provide calming deep pressure. 

  • Heavy work activities can help regulate a child's arousal level, concentration, and ability to sit still and attend to a task.
    • While driving or flying, use theraband or exercise bands for heavy work.  Try stretching the band between your arms, or tie it into a loop and stretch between your feet! 
    • Stress balls, putty, pop beads, clothes pins, and other fidgets can make good heavy work activities for fingers and hands. 
    • Chewy snacks (licorice, gum, bagel, beef jerky) and sucking through a straw are great heavy work activities for your mouth!
    • Before boarding the plane or at rest stops, try to work in some heavy work tasks.  Push/pull a suitcase or cooler, carry a backpack, do jumping jacks, pushups, or animal walks.


  • A note about Car Sickness: Car sickness is caused by the discord within the brain’s ability to process movement with visual input. For example, your visual system says you are moving as the landscape passes by; however, your body and the proprioceptive receptors of the brain say you are sitting still. As your sensory receptors cannot find a way to process both sides of the sensory input, your body begins to have a visceral reaction, leading to nausea.  Another example occurs as you are trying to read a book in the car; your eyes are stationary on the book while the fluid in your ear canals are moving as the car goes over bumps and the car accelerates/decelerates; your brain has difficulty in processing if you are moving or if you are stationary as the input it is receiving does not match up.




Author: Krista Flack, MS OTR/L

Pool Safety and Pool Exercises

Pool Safety and Pool Exercises


Now that school is out and it is starting to get hot outside I have been seeing more and more people using the pool. This week we will go over some pool safety tips and some fun games that you and your children can play to help develop gross motor skills.


According to , drowning is the leading cause of unintentional death in children ages 1-4. It is important to follow your local pools rules and regulations that are posted around the pool area. also outlines 6 other tips to help keep you and your children safe at the pool. 1) Always watch children when they are in or near the water, and never leave them unattended. 2) Teach your children how to swim. 3) Teach your children to stay away from drains and to never enter the pool if the drain is lose, broken, or missing the drain cover. 4) Ensure that all pools and spas that you and your family visit have compliant drain covers. 5) Install proper barriers and covers on and around your pool and spa. 6) Know how to perform CPR on both children and adults. These tips and more can be found at


Becca Fitzpatrick is a PT at our Port Royal location and also one of the therapists for Lowcountry Connections. Through Lowcountry Connections, Becca has been providing aquatic therapy to a few patients and below you will find a list of exercises that she uses with her patients and that you can use at home.

  • Holding a kickboard or noodle in front of you and doing flutter or frog kicks and race. This helps strengthen the glute muscles.
  • Playing tag in the shallow end but using just their arms to move. This helps build upper body strength as well as neck strength to keep their head up.
  • Climbing in and out of the pool and have them jump over a target. Slowly increase the distance. The climbing and jumping help to strengthen the upper body, lower body, and core muscles.


Teach your kids how to blow bubbles under water. This will help to teach them to blow out instead of breathing in water when their lips go under the surface. You can also make the exercises harder or easier by adjusting the level of the water. The more submerged they are the more difficult the activity.


-Matthew D’Antonio, PT, DPT

Pediatric Physical Therapist


Speech Activities for Summer

Speech Activities for Summer

 Now that school is out, you might be looking for extra ways to fit in some speech practice!  Summer time means there is extra time to fit in some of those activities that can get neglected when homework and after-school activities fill up the schedule.  It can also mean experiencing new activities and outings that open the door for learning new vocabulary.  Below are just a few ideas for incorporating speech practice into everyday activities this summer!

  • Read a book!  Reading helps build vocabulary and language skills.  Check out the Beaufort County Library Summer Reading Program , where you can earn points and win prizes for reading and attending library events.  Barnes and Noble also has a Summer Reading Triathlon, where you can earn a free book just for signing up!
  • Set up playdates, join a camp, or head to a park to play with same-age children and develop and improve social skills.
  • Plan activities like gardening, baking, or a scavenger hunt to work on following directions and sequencing.  You can also find ways to incorporate new vocabulary and practice describing and categorizing objects.
  • Strengthen those mouth muscles and improve oral awareness by blowing bubbles, drinking sour lemonade, and sucking on popsicles. 
  • Participate in arts and crafts.  From color labeling to following directions, there are craft projects for all levels and interests to practice a variety of skills!
  • Go for a walk, to the zoo, to the children’s museum, or anywhere new to expand vocabulary and describing skills.
  • Check out these great calendars on the following link for quick and simple ideas to practice speech and language skills every day throughout the summer: 

As always, talk to your child’s speech therapist about individualized home exercise programs.  If your child does not receive speech therapy, but you have concerns about his or her speech and language development, talk to your pediatrician about making a referral, or call us to set up a quick and free screening with one of our awesome therapists!

Author: Krista Flack, MS OTR/L

Summer Activities That Help Develop Gross Motor Skills

Summer activities that help develop gross motor skills


Gross motor skills are body movements such as walking, running, jumping, throwing, etc. In order to develop gross motor skills we must be able to coordinate our large muscle groups (arms, legs, and core) to work together. Practice and repetition are the best ways to develop and fine tune gross motor skills. In this week’s blog I am going to give you some fun outdoor activities to help develop your child’s gross motor skills.



  • Jumping forward = Have your child practice jumping forward by placing hula hoops on the ground and having them jump from hoop to hoop
  • Jumping down = Take your child to the park and work on jumping down from surfaces of various heights. Start small and work your way up to higher surfaces
  • Jumping up = Have your child practice jumping up over obstacles with some pool noodles. Place a noodle on the ground and have them jump over it, and add noodles on top to make it harder.


  • Walking balance = Build a balance beam with your child and practice walking different ways such as forward and backward.
  • Single Leg Balance = Have your child practice balancing on 1 foot while doing an activity like a water balloon or egg toss.


  • Agility = Play red light green light outside and have something fun at the finish line like a snack or toy.
  • Endurance = Have you and your child create a track with sidewalk chalk and pretend to be race cars. Make a set number of laps and start running.


These are just several ideas to help with gross motor skill development. Whether you are working on a specific activity or just playing, being outside can help develop lots of different skills. Below are some links with lots of outdoor activities, so get outside and play!


-Matthew D’Antonio, PT, DPT

Pediatric Physical Therapist

Scoliosis Awareness Month Interview with Stacie, DPT, PT

Interview with Stacie Schaidle, DPT, PT about June is Scoliosis Awareness Month


Welcome, Stacie!  Thank you for doing this interview.  First of all, what brought you to Lowcountry Therapy Center?

I wanted to do pediatrics, and after school I liked the location and I started talking to Jessi and liked the company and decided it was a good match for me.

June is Scoliosis Awareness Month, so I wanted to ask you a little bit about scoliosis.  First of all, what is scoliosis?

Scoliosis is a curvature in the spine, the majority of the time it happens in the thoracic lumbar region which is the lower part of the spine, but it can also occur in the upper thoracic and cervical regions.  Typically you’ll see what most people look at straight from behind is a lateral curvature of the spine, but it actually has a rotational component, too, meaning that the vertebrae are twisted, and typically parents don’t recognize that because it’s not as visual as the lateral curvature. 

How does scoliosis affect function in everyday life?

What happens with scoliosis is you get a tightness of the core muscles on one side, leading to weakness on the other side. And so a lot of times, kids will have decreased core strength, which can lead to asymmetrical movement patterns and decreased function on whichever side happens to be weak. And so you’ll see a lot of delays in coordination skills and it also can lead to pain with higher movements with athletes or active kids.

How is scoliosis normally diagnosed?  Do you need x-rays?

Checkups with pediatricians is the most common way it’s diagnosed.  All pediatricians should be doing the forward bend test with kids to check for that.  Some kids get checked in schools, too, but it’s not as typical anymore as it used to be.  Kids get checked during sports physical exams, too.  You do need x-rays to determine if it’s more than a 10 degree curve - you won’t get a diagnosis until its 10 degrees, and the only way to measure the specific degrees is via x-rays.

Can scoliosis be fixed?

It can be corrected to a degree.  Physical therapy wise, we look at managing it.  We cannot necessarily correct that curve. We’re not going to decrease the degrees on the x-rays.  We can manage it to where it’s not going to worsen.  We’re trying to maintain it through strengthening and stretching to keep that curve from progressing.  Bracing is an option, they usually do that at 20-25 degrees and up, depending on your maturity level, as in if your bones are still growing or if you’re done growing. Some studies have shown that bracing can take away about 5 degrees at most, correction-wise. So if you’re at a 25 degree curve, bracing may bring you back to a 20 degree curve. They have shown studies that bracing with physical therapy is the most effective for reducing that curve.  Surgery is an option, typically not until 45 degrees, and they typically want the child to be skeletally mature to do it.  After surgery, there’s more following that needs to be done because they put rods into their back and fuse some of their vertebrae. Once that happens you’ll notice the vertebrae above and below where the rods are placed will get way too much motion so that can lead to more problems down the road with pain or discomfort with positioning. You have to be careful that they build that core strength to prevent that from happening. 

What is the difference between structural and functional scoliosis?

Structural is when there is an actual change in the structure without movement.  When you look at them they’re always going to have that offset.  Functional you’ll only notice come out during movement patterns, so when they bend forward or start to do trunk rotation activities, you’ll notice they have scoliosis, but in standing they’re fine.  Typically it’s due to low tone kids that don’t have core strength to maintain that posture.

Are they treated differently?

Yes, they would be.  Structural is a lot harder to change once it’s already to the point.  Surgery or bracing is often needed.  For functional, we do stretching, strengthening and muscle training (when to activate certain muscles and postural awareness).   We do a lot of stretching initially to start to lengthen the muscles on the shortened side.  And then after you start to see that muscle lengthen you can start strengthening, now that you have them in a more optimal position to try to maintain their posture in better alignment.  A lot of it is core strengthening. 

Why does it need to be addressed early; what long term impact will you see from letting it go unaddressed?

If it’s not addressed early, you will see it continue to progress and worsen until they’re done growing - that curvature can get worse.  So typically once they’re diagnosed with scoliosis they are followed every 6  months or a year depending on their age and if they still have growth plates, and they will keep doing x-rays to make sure it’s not progressing, and do the bracing or surgery if need be.  Once they’re done growing, it comes back to whether or not they are going to have pain because of changes in their movement patterns and asymmetries.

Is there anything else you think is important to share?

Scoliosis is idiopathic, which means they’re not certain on the cause of it.  They have linked some of it to genetics.  So if there is a family history of it, it might be worthwhile to inform your pediatrician and have them monitor it closely.  If an athlete is complaining of back pain, and they’re still growing, it’s always a good option to check that and make sure it isn’t due to scoliosis.

Author: Krista Flack, MS OTR/L

Welcome, Summer!

Welcome, Summer!

Now that school is out, I’m sure many parents are already hearing, “I’m bored!”  Below are some ideas for staying busy this summer, while also working on some important developmental skills:


  • “Sneak” reading into your routine by completing recipes, science experiments, and games that have written instructions.
  • Make your own “play-doh” – there are hundreds of recipes out there, including some that are edible and scented using herbs, spices, Kool-Aid/Jell-O powder, and other ingredients.  Incorporating scents and flavors adds another sensory experience and can have a calming or alerting effect of your child. 
  • Fill balloons with different textures (water, air, beans, rice, beads, sand, marbles, hair gel, etc.) for a great tactile experience.
  • Make calming or visually stimulating sensory bottles.  Mix water and glitter glue, fill with magnetic objects and use a magnet wand from the outside to move them around, or fill with water beads.  Get creative!
  • Play I-Spy!  Gives clues of color, size, shape, or function to compliment your child’s strengths or address the areas you’re working on.
  • Play Pictionary or Hangman using sidewalk chalk or window markers for some variety.
  • Create a scavenger hunt, and get as creative as you want.  Give rhyming clues, or puzzles to solve, or search for things of various colors, shapes, or categories.
  • Work on following directions and other executive functioning skills by playing games like “Mother, May I?,” “Red Light, Green Light,” and “Simon Says.”  Incorporate whatever your child is working on in therapy to your directions.  For example, include jumps, hops, skips, or jumping jacks for gross motor skills, saying words/sounds or answering questions for speech/language skills, or even writing letters or drawing shapes for visual motor integration skills.


Follow us on Pinterest to see more ideas we like!  We’ve pinned posts that have recipes and instructions for tons of different sensory bottles, sensory doughs, and other activities and games. 

Author: Krista Flack, MS OTR/L 


Interview with Sarah Hanson on Dysphagia Awareness Month!

Interview with Sarah Hanson on Dysphagia:


Matt: What brought you to the Bluffton area and to LTC?


Sarah: After I graduated from graduate school at the University of Wisconsin-River Falls, I signed on with a national company and they got me hooked up with a school in Ridgeland. After that I worked with Jessi at a previous location and when she opened LTC she offered me a position and I followed her.  


Matt: So as you know June is dysphagia awareness month. Can you tell us a little bit about what dysphagia is?


Sarah: Dysphagia consists of feeding and swallowing disorders and can include difficulty with any step in the feeding process. There are 4 different phases in the feeding process that can be affected by dysphagia and your speech and language pathologist can help determine which one is affected. The first stage is the oral preparation phase and this is the phase that we see the most affected by dysphagia at Lowcountry Therapy Center. Then there is the oral transit phase which is when the food is moved back through the oral cavity. The third phase is the pharyngeal phase which is the initiation of the swallow and moving the bolus through the pharynx. The final phase is the esophageal phase which is moving the bolus through the esophagus and down into the stomach.


Matt: How can dysphagia affect children?


Sarah: The main effect that dysphagia has on children is that it prevents them from getting the proper nutrition that they need. If they have pain, choking, problem with textures, or manipulating the bolus in their mouth, they are not going to be getting the proper nutrition that they need for proper growth and brain development.


Matt: What are some of the signs of dysphagia that parents should look for at home?


Sarah: Refusal to eat is a huge sign. Coughing, choking, gagging, and throwing up during meals whether it is with liquid or with food are other signs that parents should watch for. Being a picky eater after the parents have tried everything and the child still refuses certain foods or textures could also be a sign of dysphagia.


Matt: Can dysphagia affect a child’s speech development?


Sarah: Absolutely, especially with oral dysphagia. It means that the muscles are not working appropriately, and if they are not working appropriately to eat chances are they might not be working appropriately to talk and can cause problems such as articulation errors. The other way it can significantly affect speech is that if they are not getting the right nutrition then they cannot thrive to their full potential.


Matt: What are the primary goals of feeding therapy?


Sarah: According to The American Speech and Hearing Association (ASHA), the main goal of feeding therapy is to safely support adequate nutrition and hydration. Also to determine optimum feeding methods and techniques that maximizes swallowing safety. There is a big time collaboration with families. The parents are heavily involved in the session to help give them proper training that they would need at home. We also want to develop the most age appropriate eating skills in a normal setting, and to decrease pulmonary complications such as congestion and aspiration. We also want to prevent future feeding issues with positive feeding oral experiences such as learning thru play.


Matt: Can other therapies help with dysphagia?


Sarah: Yes. Often times I like to involve occupational therapy especially if the child is refusing to eat. If the child is refusing to eat it might be due to a texture aversion, and this can lead to dysphagia. If the child is avoiding certain textures then the mouth is not doing what it is supposed to be doing and so we are not developing our chewing skills. If the texture aversion does not go away, then we do not have the muscle and motor plan to chew certain foods. I have also used physical therapy before in my sessions as well. If the child does not have the core stability or if they have poor positioning the child might not eat. I have seen changes in a child’s eating habits with proper positioning and core strength.


Matt: What should a family do if they have concerns that their child might have dysphagia?


Sarah: Absolutely speak with your pediatrician, and they can steer you in the right direction. They can send you to speech therapy or order some tests such as a modified barium swallow study. This is when they take a video x-ray of the swallow to rule out aspiration. Once that is ruled out speech therapy can work on the oral motor component. If there is aspiration then there needs to be a diet change such as different textures or different chewing techniques.


Here are some links to learn more about dysphagia


-Matthew D’Antonio, PT, DPT

Pediatric Physical Therapist

Get Set for Summer!

For many kids, the end of the school year and beginning of summer is an exciting time!  But for children that have difficulty tolerating changes to their routine, it can also be a stressful time.  School provides a structure and routine that is predictable and comfortable, while summer can be full of spontaneity and free time, which can be a difficult thing to adjust to.  For some families, finding a way to add structure and predictability to the day-to-day happenings of summer is a good way to keep everyone calm and happy. 

For some, having a schedule of the day, week, or month is enough to add an element of predictability.  Visual schedules can add more predictability for young children to be able to see what to expect throughout the day or week.  Social stories and verbal scripts can be helpful when preparing for something new or different that may cause anxiety, like a vacation, daytrip, or having family come to visit. 

Summer camps and day programs are a great way to add structure, while providing educational, social, and leisure opportunities.  Below are a few camps and programs that are available in this area this summer:

Camps Specifically for Children with Special Needs:

  • T.E.K. Quest is a half-day camp designed to expose children and parents to different technologies available to help overcome obstacles faced in everyday life.
  • Challenge Camp at Island Rec is designed for children with special needs. Continued development of motor, social and cognitive skills throughout the summer. This camp is integrated into our all day summer camp program.  An All Day camp is also offered through Island Rec.
  • Camp Treasure Chest serves between 25 and 30 children under the age of 21 each summer. It provides those children who cannot fit into any other camp situation a chance to have a camp experience.


Affordable Day Camp Options

Additional Camps in the Area

Author: Krista Flack, MS OTR/L


Speech Therapy vs Dyslexia Therapy with Dana Glaser

Interview with Dana Glaser
Matt: What brought you to LTC?  

Dana: Originally I came to LTC as an alternative to working in the schools. I worked in the schools for 11 years in Wisconsin and then came down here. I ended up taking about a year off due to medical issues and having a hard time lifting kids up and putting them in swings. So I sat down with Jessi and we talked about changing the position and using more of my reading and literacy background.


Matt: What is the difference between speech therapy and dyslexia therapy?


Dana: The biggest difference would be that Lowcountry Dyslexia Center’s goals and objectives are much more focused on phonemic awareness and orthographic awareness, so how letters represent sounds. The lessons are much more focused on developing that along with reading comprehension, reading fluency, and spelling which are not part of typical speech therapy.


Matt: What are some of the myths about dyslexia?


Dana: The biggest myth would be that people with dyslexia read and write backwards. We certainly see that in a lot of kids with dyslexia such as things like the “b” and “d” reversals, but that does not mean that they are going to have dyslexia.


Matt: What are some of the signs of dyslexia?


Dana: Some of the biggest signs to me would be the difficulties at the sound level, being able to play with words, and being able to manipulate rhyming words. It really comes down to difficulties at that sound level, and knowing what letter represents what sound and being able to decode. Decoding is being able to look at a word and putting the sounds together and blending them correctly.


Matt: What does the dyslexia program entail?


Dana: Typically we start with a 2 part evaluation. The first part is a speech and language evaluation and the second part looks at site word reading and nonsense word reading. I also compare listening comprehension to reading comprehension. Once we have recommended therapy, we always include a plan for classroom accommodations whether it is books on tape, give warning if being called on, give copies of notes, etc. Then they come in and we teach them letter names, letter sounds, vowel combinations, etc. The curriculum follows the Orton-Gillingham Approach which is a very direct and structured program.



Matt: How can dyslexia therapy and speech therapy work together?


Dana: Speech and language and reading are twofold. In speech therapy we look at speech fluency, spoken language comprehension, and word meaning. In reading we talk about decoding, spelling, reading fluency, and reading comprehension, so really they are a nice blend. Some patients will also see a speech therapist to really focus on articulation and other spoken language aspects, so that when I see them we can focus on the literacy piece.


Matt: What should a family do if they have concerns that their child might have dyslexia?


Dana: They can look at our website and read about what dyslexia is. The international dyslexia association is an awesome resource with lots of information. Talk to your pediatrician and share your concerns with them. Even if your child is in kindergarten it is not too early to see if the phonological awareness needs to be worked on.  You can contact us and come in and get an evaluation.  If we don’t diagnosis with dyslexia we typically see speech and language impairments or a combination of language and literacy impairments, but no matter what they will leave with some suggestions to help build their skills.


-Matthew D’Antonio, PT, DPT

Pediatric Physical Therapist

Interview with Barbara Helms on School Versus Clinic Based Speech Therapy

Interview with Barbara Helms, M.Ed., CCC-SLP

Author: Krista Flack, MS OTR/L


Krista: What brought you to Lowcountry Therapy Center?

Barbara: I was looking for a change of environment, stability working in one place, not traveling, working with an interdisciplinary team under one roof.

K: Where did you work before this?

B: I started out working in the Beaufort County School District, I worked there for 3 years, then I heard of a greater need in the Hampton County School District so I contracted for a position to work for them and I was ere for 3 years.  I had also done nursing home work, home health briefly, and my internship was in a hospital doing outpatient and I liked it a lot.  I always wanted to get back to that, so I decided to go ahead and go for it.

K: How do you feel like the transition went?  Was there anything that was hard to get used to?

B: Were led to believe in grad school that its really hard to make the change between schools and clinic but I didnt find it hard at all.  In fact, it was pretty seamless moving from one environment to another.

K: What would you say are some of the biggest differences between working in the schools and working in the clinic?  What do you feel like we can provide in the clinic that cant be provided in the school?

B: Your team is different between school and here.  You dont always have OTs and PTs around you all the time, your support system in mainly your teaches, your guidance counselors, the faculty and staff at school.  The one-on-one attention that is available here is not always possible there.  Not to say that it wasnt done, because I definitely had children that I saw one-on-one.   When youre going from Pre-K all the way to high school, you have to serve all those kids in the amount of time you have to be there.  And you always felt really bad when you did miss kids, whether you were out, or they were out, testing; there was always something going on in the schools.  Parents are not there, thats another huge thing.  There are some families you only see once a year for an annual review.  Whereas here, [families are] bringing them.  I like the parental involvement.  I feel like its better for generalized carryover because you can talk to the families face-to-face on a weekly basis as opposed to an annual basis.

K: What would you recommend for parents that have kids getting school services but maybe arent seeing the progress they want?

B: I would tell them that ASHA totally advocates both clinical and school.  The more support you can give your kid, the better off theyre going to be.  Also, the reality in school is that youre seeing two, three, possibly four children in a group at the same time; not that theyre not getting what they need, but that one-on-one is just really so much better.

K: Any other comments or advice for parents?

B: Im glad I got the chance to do both and see both sides, because when a parent does come in and asks me Oh you used to work in the school, let me ask you some questions. Im happy to help as much as I can.  Things change drastically from year-to-year, not only on a county level but state and federal levels, too.  I would definitely encourage parents to go online, do the research.  The South Carolina Department of Education has any information that you could need.  Theres also the Office of Special Education Programs and the United States Department of Education.  I encourage parents to read up on what IDEA is and what a free and appropriate public education (FAPE) entails.  If youre going to be an advocate for your child, its really important that youre on top of it, because youre not there all the time.

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