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Communication Through Music

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When music casts is magical spell on us, it can impact our feelings, make us have fun, trigger memories, and it can facilitate language development. The power of music is well-documented and well understood by those who have experienced it.   In my experience as a speech language pathologist, I have seen the positive impacts of music in all aspects of my career. From infancy to elderly, music is powerful.  I have further proof of this having been privileged to work in one of the S June Smith Center of Excentia’s preschool classrooms. We have the great honor of working with Certified Music Therapist, Katie Eshelman, over the past few years.  And because of the obvious benefits of music, I implement it in my therapy and coaching with families daily.  Below I will share a few ideas for how music can be used to support communication development.   1. Fun: One reason why music works for learning, is because it’s fun. There are affordable resources available such as youtube.com or Pandora Radio.  You can have fun with your child by watching videos on youtube.com or listening to music together. This removes you from the demand of teaching your child, and enables you to create fun, silly, dancing, sound-making memories with your little one… who will most likely learn to request or remember parts of the song because they will have so much fun doing the activity with you. Pandora Stations to create for children: Raffi, Toddler, Family Road Trip. Youtube videos to watch together: Laurie Berkner Band, The Wiggles, Barney songs, movie clips from a favorite movie (I have watched the Frozen song video for “Let it Go” with many families!), or any band or song your child seems to like.   2. Repetition: Repetition facilitates learning, and repetition is much more fun in the context of song! Use song to repeat ideas and build vocabulary. Sing the same sound or word repeatedly to the tune of a familiar song. (i.e. To the Tune of B-I-N-G-O sing- “Sarah puts her jacket on, she puts her jacket on, jacket on on on, jacket on on on, jacket on on on and now her jacket’s on!”) Sing repetitive songs (Old McDonald, 5 Little Monkeys Jumping on the Bed, etc). Make a song up using 1 or 2 words to whatever tune you want!   3. Gestures: Pairing movements with song/sound can often help facilitate sounds more easily, make the use of sounds more fun, and increase the child’s attention to the words/sounds. Use of gestures is also helpful for children already using or learning sign language. Singing songs that incorporate gestures is a great way to develop these skills. Songs that are easily paired with gestures include: Twinkle Twinkle Little Star, Itsy Bitsy Spider, Head Shoulders Knees Toes, Wheels on the Bus.   4. During routines: Singing about what we are doing throughout the day makes learning the narratives and vocabulary of our routines more exciting. Any routine can be made into a song. Bed time, bath time, waking up, potty, washing hands, etc. (Again, use words to the tune of a familiar song, or make a song up!)   5. Sentence Completion: You can help your child increase their independent ability to produce words and sounds by using a “sentence completion” approach with repetitive songs.  The steps for using this approach are as follows: Sing a familiar and enjoyable song with your little one enough times that you become confident that they have learned it. Continue to sing the song with them, but begin to implement an occasional pause at a familiar part that you know your child likes. (I.e. “The Itsy Bitsy Spider went up the water spout, down came the rain and washed the spider __pause___”) Look at the child with an expectant, excited face… and wait. If they do not respond, you can model the correct word “OUT” with over emphasis and exaggeration. And try again. Eventually, your child may learn to complete the sentence on their own!   Hopefully, you will find some of these ideas helpful and maybe even find that you will also have fun in the process of using music to help children with communication development!

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Routines are Learning Opportunities

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My kids haven’t been infants or toddlers for more years than I would care to mention, but my memory of those times would be that those days were anything but “routine.” I think that most families with young kids feel like the only thing routine about their day is “unpredictability.” For most people, a routine is doing the same thing, at the same time and in the same way each day. When trying to use routines as a learning opportunity for kids I find that parents or caregivers often respond that they don’t have a routine.   What does it mean to teach children during daily routines? We think of routines as the parts of your day that have a start and a finish.  This changes our thinking from a schedule to events. I would like to note that for most people schedules seem to imply structure.  While young children thrive on structure and predictability this article is focusing on how to use your daily routines to enhance your child’s learning.   Figuring out your Routine All families are different however we all generally share routines that involve eating, playing, bathing and bedtime.  These routines are great learning opportunities for any child.  For example, when your child is learning to walk, you might carry her to the highchair for breakfast or you could use that opportunity and help her walk to the highchair instead.   Ideas for using Routines as Learning Opportunities First, consider these questions: Think about the daily routines of your family. What skills are you child working to master?  Where are they in their development? What are your priorities as a parent? Consider your own needs. For example, my son was not a morning child.  On the days that I needed to get him to daycare, getting out the door on time was my only goal.  It probably took him longer to learn to dress himself than it took his friends but I was confident that he would learn it one day. In the morning I just didn’t have the time to make it a priority for him to practice that skill. On the other hand, he was a late talker so it was a priority to bring communication strategies into our daily lives. Take the high priority skills your child is learning and your daily routine to see how many opportunities you can give your child for mastering a skill. Practice, Practice, Practice – young children love repetition!   Using Routine Based Learning for kids with unique developmental needs Back in the day (as my grown-up children say), as a young occupational therapist, I would meet the family of a child in the waiting room of a specialized clinic, take the child away for “my” therapy, and return them to their parents at the end of 30 minutes with instructions for “their” home therapy program. Thank goodness we have evolved to understand that parents are the most important and most consistent teacher that children will have.  We have also recognized that children learn best when the task is relevant to their interests and needs.  Out of this research, we have what we call Routines-based Intervention. This process is more natural and creates a much more comfortable and enjoyable experience for your child. Those 30 minutes of therapy that I was able to give a child made little impact on his/her development compared to the number of minutes a child can practice each week with caregivers who have learned to enrich their routines with the learning opportunities that are so important to young children. My role as a therapist has changed from working in a one-to-one situation with the child to being a mentor and coach to the family.  I believe that with my background in development and the family’s knowledge of their child, their activities, and their priorities, we become a powerful team that can problem-solve and invent unique ways to help young children master new skills.

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Making a SPLASH

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You peer through the window to catch a glimpse of this story hour you’ve heard about, called SPLASH (Sound Play Language Awareness Story Hour.) But where is the book? No one is reading. You see a group of eight parents and their children being led by a woman to march in place, hop up and down, and rock and roll side to side. Finally the woman says it is time to stop, and sit down (while also using the sign language for ‘stop’ and ‘sit’.) As her bottom hits the floor, she pairs a sound effect - “boom!” Once seated on the floor, she dramatically claims she’s hot; fanning herself as she lets out an exaggerated sigh, expressing “whew!” as she feigns wiping her forehead, and putting her hair up in a ponytail. This is a story hour?   Well, this is one segment of the Sound Play Language Awareness Story Hour. The parents in the class have already participated in a parent orientation to learn about the “methods to the madness.” The story hour format is designed to coach parents/caregivers how to use routine childhood experiences to support communication development. There are teachable moments in the simple, ordinary events of every day. While the situation described above might look like silly dramatics, strategies are purposefully woven into each moment:   1. Movement to help toddlers get their bodies ready to listen 2. Sign language 3. Pairing actions with sounds 4. Gesture language 5. Modeling early speech sounds   SPLASH classes are open and meaningful for children of all ability levels between the ages of two and three, yet many of the children who attend SPLASH are nonverbal or minimally verbal. When you are two years old, and “supposed to be talking,” big people spend a lot of time trying to make you talk, asking you to say things. In SPLASH, there is no pressure to imitate. Nothing we do in the class is about trying to make children talk. Rather, we are drawing them in, providing models of achievable speech and language targets in disguised ways. For example, when the woman is hot and lets out a big sigh, it is simply exhaling, and the children try it too. A loud exhale can be a starting point for the ‘h’ sound. Children who are already talking, delight in joining and imitating. They are wonderful models for their peers.   A former SPLASH parent summed up her experience this way: “The brilliance behind the program is that no child is pressured in any capacity to speak. Instead, they are led to speak, on their own accord in a fun and predictable way. This is accomplished by pairing words with actions, reading stories repetitively yet with different twists each week, and having the children experience textures, sounds and movements. The environment is fun, playful and nurturing.”   If there is a two year old in your life, take the plunge – join us at SPLASH!   Upcoming Sessions: 2019 Spring Session: Wednesdays, 9:30-10:30am March 27 - May 1 and May 15 - 29   Space is limited! Please call Excentia’s S. June Smith Center at 717-299-4829 ext. 7 to register. Learn more here.

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Loose Parts

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When exploring TimberNook of Lancaster County at Climber’s Run, a number of random items might catch your eye...a wood pallet by the creek, a spool in the grass, sheer curtains hanging from a branch, a rain gutter leaning against a tree, and baskets of odds and ends. These items, with nature as their backdrop, begin exciting the imagination almost effortlessly - but why? What’s the thinking behind including these items in the woods? The answer is that what might appear to be “random” items are actually materials for inspiring a child’s creative play, called “loose parts."   The concept of loose parts came from the British architect, Simon Nicholson, in 1971 to describe “open-ended materials that can be used and manipulated in many ways.” For example, one of our favorite loose parts at TimberNook of Lancaster County will be tree cookies. Tree cookies are small, thin, round tree branch cuttings that may be used as plates to serve friends a pretend meal, stepping stones to an enchanted forest, a delicious doughnut, or a fence for exotic animals. Loose parts spark a child’s imagination and play.   Maybe this is why a young child sometimes finds the gift box of a toy more fun than the toy itself. The box is just more “loose” and without the constraints implied by the toy’s design and function. This type of flexible, limitless imagination play is what we encourage at TimberNook of Lancaster County, and loose parts are a key part of it.   Want to read more on loose parts? Loose Parts 2: Inspiring Play with Infants and Toddlers (Loose Parts Series) Paperback – July 12, 2016 by Lisa Daly (Author), Miriam Beloglovsky (Author) https://extension.psu.edu/programs/betterkidcare/early-care/tip-pages/all/loose-parts-what-does-this-mean http://www.communityplaythings.com/resources/articles/2015/loose-parts  

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What it Means to be the LPN for Excentia

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What it Means to be the LPN for Excentia In February of 2014, I joined Excentia as the only nurse. My background was varied, working with physicians for most of my career, skilled nursing facilities, dialysis, staff & training development, and dialysis education with patients and their families. My career as a nurse has now entered the 43rd year and I am still learning and growing as a nurse. Being new to working in ID/IDD I didn’t know what to expect or what challenges that I would be facing. How can I improve the health and well-being of the individuals that Excentia serves? Much to my surprise, the experience I had already attained prepared me on many levels for this position but it has given me the opportunity to expand my knowledge. What I find that is key to my position has been educating the staff, providing processes/protocols that involve the standard of care (i.e. hydration, dysphagia, infection control). Education gives the staff the skills, confidence and the knowledge to provide excellent care to those we serve. Talking to the individuals that may suffer from chronic, debilitating diseases on how to take care of themselves and to provide support should they struggle with lifestyle changes. Another key role is being a medical advocate for the individuals we serve. Unfortunately, my peers in the medical profession have limited experience and knowledge about working with the ID/IDD population. Decision making is a major problem for many medical providers, due to individual’s inability to understand informed consent when a medical procedure or immunization is recommended. This truly has been my greatest challenge. This delays the care that our individuals need and deserve. Lastly, but most importantly to me, is spending time with the individuals we serve. The simple act of holding someone’s hand when they are upset or scared, being the shoulder to those that are struggling with physical ailments is gratifying to me. Many years ago I was assigned a hospice case. This person was 90 yrs old and dying from cancer. She was in severe pain which was managed by morphine. When I finished giving her a bath and re-positioning her, I began to brush her hair. She looked at me and said “I love having my hair brushed, it feels so good”. So I kept brushing until she fell into a deep sleep. That day I had done my job, but I came home feeling so satisfied and thankful that I had given this lady real comfort. That is what my goal is everyday. I want to give of myself to provide support, comfort and real caring to the staff and individuals that Excentia serves. I feel extraordinarily blessed to have been hired by Excentia to care for such an awesome group of people! I love what I do and the people I serve as the agency nurse!

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What does Excentia do to enrich the lives of its individuals?

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Excentia reaches out to individuals with ASDs Empowering people with development needs, Excentia is a growing nonprofit organization with a great reputation, a respected human services presence in the Lancaster, PA. Excentia offers services to individuals with physical and intellectual disabilities, and more recently, our support services recognize Autism Spectrum Disorders (ASDs) as covered under Excentia’s umbrella of care. According to the NIMH, ASDs encompass individual difficulties in communicating with others, seeing things from another's perspective (theory of mind), and making sense of information in his or her environment. Residential Services and the Autism Support Program This Autism Support Program operates within Excentia’s Residential Services, which provides housing options, community accommodations, and support resources for its clients. Direct Support Staff and Community Inclusion Specialists, for instance, are employed within Residential Services to facilitate their client’s individual-driven growth. We help the individuals reach their own goals, and we perform the groundwork that is a day-to-day living assistance. Simple acts of service foster an individual’s independence and inclusion within the larger community. My role in the Autism Program Direct Support Staff and Community Inclusion Specialists within the Autism Support Program offer a unique set of skills and services to their clients. We must do more than merely “show up” when scheduled because we as competent staff must be aware of our individual’s particular social, emotional, and sensory needs and challenges. I remember that my clients with ASD possess a sometimes-profound understanding of their own needs and limitations. The individual’s “problem” is that a piece is apparently missing when he or she engages a challenging-to-them task, like cooking a good meal or interacting positively with peers. My job is to provide that missing piece, which can be called “presence”. “Presence” Having presence with an individual helps motivate the person with an ASD to achieve his or her own level of success and independence. Within the Autism Support Program, my clients represent a range of capabilities and diverse degrees of independence and performance. Presence with an individual means being alert to his or her particular level of functioning in a given area. This social-emotional quality is a supportive force that is felt by the client who is often not able to verbalize his or her own need for appropriate help. My presence enables me to step in or back off. To assist the individual or to refrain from assisting. It is all about what the person needs presently to perform the task at hand. I am ready to help and respond in respect with my client’s needs. Working with an individual with an ASD One of my clients is responsible for tasks like wiping surfaces, reordering his belongings, and vacuuming floors, since his apartment is comprised of four rooms which all need cleaning and organization. So during one particular session, I scrubbed bathroom surfaces alongside him. I am no cleanliness expert, but this instance required my hands-on effort, and with a curious yet concerned demeanor, he watched my cleaning progress. Thus, our joint attention, my several verbal prompts, and his conversation about my point of view, cleared a vista into my personal mental state and as well as my own expectations. My presence in this instance incited a teaching moment that reinforced my client’s theory of mind (understanding the world from another's perspective) and, of course, we bolstered his cleaning habit. Commitment to “presence” Excentia is able to support its support staff who in turn support their individuals. The management and direct support staff of this organization really want to see the growth of their clients! Indeed, one of the company’s values is commitment, a virtue that highlights the dedication that is needed to see the most profound and lasting personal growth of individuals with or without ASDs. I can see this commitment expressed in my own presence with clients on the autism spectrum, and I have seen other staff show consistency, attentiveness, and follow-through with their own clients, too. Let us persevere and mature as committed support staff! Our individuals are ready to engage, and we should be, too. by Sean Jesiolowski, Community Inclusion Specialist / Direct Support Staff

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Jack is running!

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This is a letter from one of our families, we hope that parents and who are in the earliest stages will take comfort in reading about Jack and his family.   Our son, Jack, graduated from your birth to three program through S. June Smith last October. We are writing today to let you know that our family is forever grateful.   Jack was born with spina bifida and had multiple surgeries within his first few months. He began receiving physical and occupational therapy when he was just 6 weeks old, and we eventually added speech therapy to his routine.   The team that worked with Jack the longest was Jeane’ Bowerman, PT, Erica Wentzel, OT, and Robin Williams Harnish, SLP.   We equate this team to the Dream Team! They worked together to create appropriate goals for Jack, always keeping in mind his strengths. Upon learning that Jack was diagnosed with spina bifida, we were given a grim prognosis regarding mobility - one doctor believed he would never walk. Imagine our surprise when he was able to move his legs shortly after birth. When Jeane’ began working with him at 8 months, he was just learning to sit. With her help, he was able to sit up, stand, crawl on his hands and knees, cruise, and can now walk independently throughout our home. She had new ideas every week. And thank goodness she was able to bring so many pieces of equipment; a seat, a standing bench, a ride on toy, a gait trainer, a wheelchair, a walker, and a pair of lofstrand crutches. We could have never purchased everything we needed to help Jack make these huge mobility gains. And Jeane’ forged ahead every week. When he needed surgery, we figured out a way to still push him. Jack picked the week his sister was born to begin walking. We insisted Jeane’ come and help us refine this new skill!   Erica, who had worked with Jack the longest, had the most wonderful relationship with Jack. In fact, in the three weeks after therapy has ended, he had asked for her twice. Erica provided our family with a wealth of knowledge. She helped with feeding, seating, toileting, sensory experiences, and our favorite, trips to Costco. Erica was able to problem solve EVERY question we posed (and we posed a lot of questions). Her positive feedback about the difficult situations we faced, was most appreciated. Robin was the last therapist to be added to Team Jack! In fact, we were so pleased with our progress, that we enrolled Jack in your SPLASH program for 2 sessions. Too bad he aged out because he had a fantastic time playing with the other children and developing a foundation for speech. Robin helped us with many techniques to help Jack speak. We added to our word wall in our kitchen on a regular basis to try to get Jack exposed to as many words as possible. He was one tough cookie, but Robin never gave up. If we weren’t working outside, she found a toy from our collection that would motivate Jack.   We are happy to report that Jack has made significant gains over this past year. He began attending our neighborhood preschool in September! This has been a major step for independence for Jack. His time at school is the longest he has spent away from our family, and we are all thrilled. If you had told us one year ago that this transition to preschool would have been this smooth, we never would have believed you. Jack is so eager to go to school that he gets dropped off in the car line “running” to get inside. He has been making so much progress with his mobility, that his current therapist believes he will no longer need to use his lofstrand crutches at school. This is incredible. She also has a new goal for Jack. Running. Honestly, we almost asked her to remove this goal, but he is just so ready.   All of these accomplishments, would not have been possible without the early intervention that Jack received through Excentia. We believe strongly that his success is due to the pushing and endurance of YOUR team members. Thank you for hiring and retaining the best therapists. We were honored to share our son Jack with them and consider them in the highest regard. With thanks, Matthew and Amy Link

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Speech Therapy

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Pediatric Speech Therapy One parent shared her joy the day her child said, "Now people can understand me when I talk!" Imagine our joy here at the S. June Smith Center, knowing we had a role to play in that child's success. We are happy to announce that we are now offering private speech and language therapy services to our community.  In addition to participating in Early Intervention (Birth-K), the S. June Smith Center is responding to the needs of our community by offering Speech Therapy for children under the age of 8.  This program is located at our Prince Street office (across from Clipper Stadium).  Onsite parking, a secure building and a staff of highly trained speech therapists makes this the ideal choice for young children. Intervention is provided for a variety of disorders, including speech disorders, and receptive and expressive language disorders. Many of our staff members have interest and expertise in areas such as apraxia and suspected childhood apraxia of speech. Parents and caregivers are invited to play an active role during the process. Their input is used to develop goals that will be functional for the child. Ongoing family education is provided, as well as activities that can be used in the home. Most therapy sessions are one-on-one, allowing for focused and intensive session. Our experienced staff of therapists continue to receive education, allowing them to provide the highest standards of care.  You can check out their information in the Early Childhood section of our website www.ourexcentia.org    

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