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Let the Children Play

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As a pediatric occupational therapist with many years of learning in both formal and informal ways about early child development, I have developed some personal “guiding rules:" A child’s relationship to his/her mommy/daddy/loving adult is primary. Our role with an infant is to nurture and protect. Easy. The not-so-easy role is the gradual changes that should occur during childhood where parents step back and allow the child to learn from their own experiences. Allowing a child to take a risk; difficult. A child’s relationship to “Mother Nature” is a key component of development. For babies, this refers to gravity. As a society we have “over-containered” babies: infant seats, strollers, swings. Babies need to move and maximize the time they are playing on the floor. Children, too, need to move. Run. Climb. Roll down a hill. The evidence is in and it indicates that these activities promote far more than physical development. The architecture of the brain is established by our early experiences. We are sensory beings. Information gets into the brain by the sensory systems. Some of these are not widely recognized by everyone such as the proprioceptive system (information from our muscles and joints) and the vestibular system (information about movement and how we relate to gravity). They are vital components of our development. Play IS a child’s occupation. As an occupational therapist, I have frequently been asked how occupation relates to children. Play is the answer. Not all play is created equally. We must choose those opportunities that allow children to develop critical thinking and problem-solving skills while having fun. We want to stimulate their imagination and creativity. Knowing the above, it will not be surprising that I was very excited to learn about TimberNook. It knows, understands and supports my “guiding rules." Tagged as the Ultimate Sensory Experience, TimberNook is both a philosophy and curriculum. Set in the outdoors, Mother Nature is used as a “third teacher” to provide an environment where children can have authentic play experiences. With multiple options for programming, TimberNook can serve toddlers from 18 months-4 years (Tiny Ones) in a parent-child setting, and 4-7 year olds (Little Wild Ones) and 7-12 year olds (Wild Ones) in a child-and-staff setting. Excentia is excited to announce that we are now a TimberNook provider and will be doing programming in 2019! We are working in partnership with the Lancaster County Conservancy to use Climbers Run Nature Preserve as our site. This unique location will have an area specifically planned to facilitate “play the TimberNook way” as well as the existing trails, meadows, a stream, and forested areas. Head over to our TimberNook Facebook page and click the ‘Like’ button to stay informed as we roll out the plans for next year. We will also start posting more detailed articles about subjects that support the philosophy of TimberNook of Lancaster County!

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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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Give back to the S. June Smith Center

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Tis the season to give back! Every year when Christmas time rolls around I always find small ways to give back to my community. One year my family participated in an “adopt a family” for for the holidays where we got a wishlist from the family and headed out to stores like walmart and target for items. Another common way to give back to schools. Many times people donate books to kids at bookstores which is so easy when you are checking out. This year though I’m asking that you think about Excentia’s S. June Smith Center when you decide who you want to give back to, big or small.   If you aren’t already familiar with Excentia’s S. June Smith Center we provide Early childhood and early intervention services to help children, from birth to five, who are experiencing developmental delays or disabilities. While we don’t believe that growth and development occurs on a strict timetable, we do strive to provide our parents and caregivers with a proactive approach to ensure that their children are put on a healthy path of development. We have a collaborative approach and we work with the individuals involved in a child’s life that could enhance a child’s development, such as the family, caregivers, teachers, other support providers and members of the community.   One way for you to give back is to use Amazon Smile. Amazon Smile is a service that Amazon offers where you can link up your Amazon account with Excentia’s S. June Smith Center and .05% of every purchase you make is donated directly. So if you are already buying christmas presents or your monthly order of toilet paper for your house you are giving back without having to put any effort forward. I have provided directions below on how to link up your accounts below.   Choose SJSC as your charitable organization: Sign into www.smile.amazon.com on your desktop or mobile phone browser. From your desktop, go to Your Account from the navigation at the top of any page, then select the option to Change your Charity.  Or, from your mobile browser, select Change your Charity from the options at the bottom of the page. Select S. June Smith Center a Service of Excentia and get to shopping!   You can also follow the link below to a wishlist that the teachers at the preschools have added items that are in high demand for their classrooms. I have an example of the types of items on the list to the left.   https://www.amazon.com/gp/registry/wishlist/1HHSRY6OLNHXI/ref=cm_sw_su_w Another way to give back is to hop in your car and head out to a few stores for gift cards. Susan Oberholtzer, Preschool Special Education Teacher and Associate Director of Preschool Services at Excentia was kind enough to suggest a few items that you can donate directly to a preschool. Those items being Gift Cards! In particular gift cards to Target, AC Moore and/or Michaels are great because a lot of classroom materials are purchased throughout the year at these three stores. She also suggests iTunes gift cards because they are “used to add educational apps for the children to use during guided centers in the classroom as well as to add circle time songs.”   Get in the give back spirit and help keep the classrooms at Excentia’s S. June Smith Center stocked and running by donating today!   ALAM, Lexis

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Katee loves working for Excentia.

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Swoosh! The door swings shut behind me, and I am whisked into the hustle and bustle of work. It’s an overcast day outside, and my mood seems to match the weather. As I plop my items onto my desk in an office of four people, I sit down with a sigh. It’s only 8 AM, and I already feel exhausted with the amount of work that beckons me. The noise both inside and outside of my office prickles at my nerves, and I glance at my calendar to see the list of tasks that must be done. I slowly and meticulously check items off my list: check email, check my mailbox upstairs and downstairs, visit the different group rooms in hopes that my “hello” will brighten their day. Seeing that all is well, I shyly tuck away my superhero cape, knowing that, for now, all is well.   When I share with people where I work and for whom I provide support, I receive a mixed bag of looks and responses. You do WHAT? You have to do what? That’s crazy. You should be sainted for all you do. It takes a special person to do something like that. I understand where they’re coming from, but I so wish that I could prove the population at large wrong about the group with whom I have the pleasure of working.   There’s a song in the famous musical “South Pacific” that says that one “[has] to be taught to fear.” Growing up, I didn’t have any opportunities to interact with or learn about those with disabilities. One summer in high school, I had an chance to serve at a camp geared specifically for those with special needs. That weeklong experience sparked a desire to continue the fun and kindness and social justice for these people. One degree in special education and five years in education later, I found myself at a crossroads. I was faced with the questions What happens to people living with disabilities after they completed their education? Why aren’t there more integral opportunities for people with disabilities to truly participate in their community? Searching for these answers, I found and began working for residential and day programs.     For the past two and half years, I have served Excentia’s Adult Day Service. I started out as a direct support professional (room worker) and currently serve as a program specialist. I’m not going to lie: the days are sometimes long, loud, and overwhelming. We face many challenges that include short staffing, drama, deadlines, paperwork, being hit, etc. People see these things, and they don’t see or remember the smiles, hugs, and skill development that occur as well. When the going gets tough, I am sent these little reminders as gems. They reinforce the idea and feeling that these are people, like anyone else. When working with people, there will be both good and bad days.   People tell me all the time that I have a “gift” or “have a heart of gold” for working with the population I do. I don’t see it as such. The populations I work with have taught me how to be kind, how to love, how to be patient, how to be creative, and how to find joy. I thought I was going to teach forever, but I ended up being the one who is learning. Anyone can do what I can do. You just have to have the courage to try and to listen when there are no words to be said. As Allison Krause says, “You say it best when you say nothing at all.”   To learn more about Katee's first job at Excentia, check out the video below! https://www.ourexcentia.org/careers/

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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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Ryan's TRAIL to employment

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Ryan began his journey to Independent Living in September of 2017. While learning the skills needed to live independently at home, an important part of this skill set is finding employment and maintaining that employment to sustain him self financially. Ryan entered the TRAIL Program in the middle of his OVR assessment. He had already participated in one assessment and was waiting for the second to be scheduled.  Due to the timeline of the TRAIL program and after waiting six months, all along playing phone tag with his OVR counselor, finding Ryan employment was becoming more urgent and important to his success. Liz and I started brainstorming about possible employment opportunities for Ryan circumventing OVR. We spoke with Ryan on several occasions discovering his likes/dislikes, where he saw him self employed and what tasks he saw him self performing. Through this process, we decided some form of construction or landscaping work would be his ideal.  When these ideas were brought up to Ryan he responded positively and was excited at the possibilities. I thought about the contacts and resources I had and first called my Aunt who owns Beaver Creek Farm Cabins on March 10th, 2017. This property requires significant outside upkeep. She liked the idea and was very receptive; however, this idea would not work due to unforeseen obstacles. I then contacted my cousin who is partners in an Arborist/landscaping business; Weaveson Arborist. At first he gave me the names of others in the field that focus specifically on landscaping due to not knowing if he had any part-time positions open. However, he called me back a few days later explaining that he had discussed this with his partner and they would welcome the help part-time performing odd tasks and general assistance. He asked that Ryan email him his resume. Ryan emailed his resume the evening of April 7th, 2017. An interview was scheduled for Tuesday April 11th. He prepared for the interview through role playing interviews and filling out an employment application. Liz and I accompanied Ryan to the interview. Ryan held his own with minimal prompting from us during the interview. Ryan was offered the job and he accepted the part-time position. Additionally, Ryan would be receiving transportation to and from work by his employer. Liz assisted him in filling out the W-4 paperwork. His first day of work was April 18th, 2017. Ryan enjoyed preparing for work by purchasing specific boots and attire required for his position, as well as an extra large lunch bag. Ryan’s job supports were provided by his employer, he would be working 1:1 with certain co-workers. Ryan has had a few obstacles while employed; however, his employer has adapted Ryan’s tasks to his skill level and has addressed concerns as they have come into play. Only one time has his employer contacted Liz or I with a concern. It was brought to our attention that Ryan had been calling off work multiple times a week. We brought this concern to Ryan’s supports coordinator and had a meeting with him to discuss what was causing these call-offs. Ryan has improved his attendance since. Ryan has benefited in multiple ways; both professionally and personally through employment. He has formed friendships and other natural supports while working there and has been included in many activities such as camping at Knoebles, going out to eat, and attending his boss’s wedding reception. We have seen Ryan’s self-confidence increase. Ryan continues to build on his skills, grow and sustain Independent Living.

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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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