April 2009


so I went out with single women this weekend and we talked about the Oprah show where two 14 year olds stated they were ready to have sex…

As you can imagine, there were many different opinions and some who preferred to stay quiet…

The questions Dr. Laura was asking the teens were amazing… I definitely thought it was a good way to talk about sex…

I don’t know that I would go as far as to buy condoms for my son… but I would give him the money and maybe even take him to a store once and show him where he could buy them… Although, in this day in age kids probably know where to get them…

I definitely agreed that the kids should be empowered by having all the information without encouraging them to have sex.

Sex has been such taboo for so long… I think it would help to talk about sex in as a positive expression of oneself… It’s another way to express ourselves to our loved one…

It might help to talk about sex as a normal and healthy action. It is a gift we give to others with whom we feel we want to share it.

Teenage girls need to understand that they have not committed a sin just because they gave in to temptation… They should be taught to feel it is ok for them to explore their bodies with or without someone…

We need to educate our girls about how to decide when they are ready to explore their bodies with someone else and how to choose the right person to share their bodies with…

Just like we need to teach our teenage boys to be respectful of teenage girls…

It shouldn’t be okay for the teenage boys to score and taboo for the teenage girls to score…

There is definitely an unbalance among the boys and girls… which is the same as the unbalance seen between men and women…

Give everyone options and the whole story, good and bad, about having sex. I think it will help us out in the long run…

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Well…

we’ve been discussing taking a vacation in November… We’ve planned to take a mini vacation in July… if possible…

The key is we both have work in Puerto Rico and plan to try to coincide our trips in order to get a family vacation out of our time…

So if we do this… we are thinking of taking a mini honeymoon in November…

Where should we go? We love the beach…

We’ve been looking at Roatan

Any other ideas out there?

This is the best article I’ve read on the Mommy wars…

http://www.time.com/time/nation/article/0,8599,1193793,00.htm

So true… ๐Ÿ™‚

โ€œMom always tells me to celebrate everyone’s uniqueness. I like the way that sounds.โ€ -Hilary Duff

This has really been bothering me and I thought I would blog about it today…

It seems that a mom poured her heart out to other moms (whom she doesn’t know) through a website and these moms lashed out at her…

They pointed the finger stating that she should be at home with her son in order to solve all their problems. Some were nice about it and some were out right mean.

Some said things like do you really have to work? Maybe you just need to stay home instead of placing your child in daycare…

I found these messages so inappropriate and mean… just so cruel… I mean if the parent does stay home with the child, the problems aren’t going to go away.

I asked myself… how ignorant can a mom be? these moms were just plain ignorant…

they replied and judged her without taking into consideration their knowledge about children with special needs or developmental delays/disorders/ or even the fact that this mom was just so anxious and so out of her element…

I mean these moms didn’t even think for a moment that this mom could be at her wits end… if she wasn’t depressed… they sure pushed her over the edge…

Did these moms even think to put themselves in her shoes? Nobody is the perfect parent and just because your child is considered “normal” doesn’t mean you are doing it right…

If and when the child goes to school, the problems will return and may have escalated or even be more apparent since schools are so strict and rigid. Schools are very demanding in all areas of development… academics, socially, emotionally, etc…

Working mothers do not cause developmental delays, disorders, or differences…

The one thing Stay at home moms never seem to figure out is that the more you hover over your child the less independent they are…

Stay at home moms aren’t always in the know regarding redflags in development… and guess what… your pediatrician isn’t either…

If they are… they don’t spend enough time with them to figure it out and if they aren’t then they don’t know what questions to ask the parents or how to probe the parents to get a better picture of the child’s development…

Development is not just about growth in their bodies and muscles and brains… but it also includes the subjective areas of social-emotional behaviors, speech and language skills and/or communicative behaviors, and of course adaptive behavior…

These subjective behaviors are behaviors that involve analysis and observation… they are not just seen in an xray…

So when your children are always around you and you are always adapting their environment to them… Redflags in development may not be apparent to you… OR… you just might find it normal for your child…

Many moms, regardless if they are working or stay at home, don’t know or understand what redflags to look for to catch developmental delays, disorders, etc before they send their children to school…

So it’s the teachers or the outside people who begin to ask questions and have doubts about the child’s development…

and let me tell you it is not easy to approach any parent and say “I have some concerns with your child’s behavior… I would like to recommend you to explore the idea of having your child evaluated…”

That is one of the hardest things to tell a parent and it’s incredibly stressful because of the uncertainty of how the parent will react…

You are trying to help someone and their family but you are also breaking someone’s heart… and making them feel incompetent…. without even wanting to…

This is where my doubt comes in about supportive moms… I think the only supportive moms you may find are those that have been through some difficult times with their children…

and even then, are they going to judge you about what steps you decide to take for your child’s intervention???

I don’t see other moms as supportive… I see them as critical… as judgmental… as inconsiderate… as uncompassionate… and always looking for one thing to use to put you down as a mother…

Do you cook? do you go to the gym? do you work? how do you discipline? do you follow the standard pediatrician recommendations for feeding, sleep training…. who’s your pediatrician? how do you dress your child? you name it…

It’s like moms are vultures and their waiting and watching and when you least expect it they are going to throw a knife at your heart and make you feel guilty for the decisions you’ve made as a parent with the greatest intentions you can possibly have for the well-being of your children…

Every parent does the best they can in the situation they are in at that moment in time…

That does not mean that parents don’t make mistakes…

That means that parents have strengths and they have weaknesses in their skills for raising their children and many factors play into how you as a parent will react at that moment when your child needs you the most…

I would only spill my guts to moms who are considered safe… and only, you, as a mom can determine if that parent is a safe and supportive person to have as an advocate for you…

So if you feel defensive when you are talking to another mom, that’s not a safe and supportive advocate for YOU!

Don’t forget… many people, friends, neighbors,etc will turn on you in the event of a crisis…

It’s all about people. It’s about networking and being nice to people and not burning any bridges. Your book is going to impress, but in the end it is people that are going to hire you. -Mike Davidson

How do SLPs and other therapists determine the amount of therapy a child needs to significantly improve his skills?

Well… it should involve lots of analysis and thinking outside the box to tailor each treatment plan to your patient.

However, most SLPs will recommend the standard 2x/week for anywhere between 30-60 minutes… most of the time 30-45 minutes is what’s given…

Many Doctors like to prescribe this also… even if they have not evaluated the patient in terms of communication… That is mind boggling…

I believe that less is more…

Therapy can be anywhere from 1x/mo to 2x-3x per week depending on the patient…

I rarely see a patient more than 1x/wk and generally see my patients 2x/mo… They all receive a home exercise program which is expected to be implemented into daily routines…

See… I like to empower my parents and caregivers… I feel like you see greater improvement and more parent satisfaction with less is more.

Here’s what I look at:

age, type of delay/disorder, severity of delay/disorder, delay vs disorder, patient motivation, family support, prognosis, environmental factors, behavioral factors, concurrent diagnoses, maturity level, cognitive functioning levels, etc…

(Must take graduate level diagnosis/treatment courses to get more valuable information about treatment plans)

Lots of things to consider when recommending therapy… Less is more in order to empower families… because the more therapy you give the more your families depend on you…

In essence, you are encouraging dependence rather than independence with more therapy, better outcomes…

Ultimately, therapies are given to increase their skills in communication and obtain the highest level of independence the patient can attain (prognosis). So less is more…

Having said that… Family support is a valuable tool to supplement therapy services…

See… I can see my patients every single day for an hour… but if the families are not following through with strategies and home exercise programs… little change will be noted…

Here are some things to think about:

If you see your patients every day for an hour:

1. How much change will you see from 1 day to the next?
2. Will your recommendations change from 1 day to the next?
3. Are you empowering your families or are you fostering dependence?
4. Is the patient receiving enough time to process and assimilate strategies learned?
5. Have you given the families and your patients enough time to implement and practice?
6. Are you incorporating parent education and prevention in your therapies? (important for families who are still growing)

Now ask yourself the same questions regarding the standard 2x/wk 30-45 minutes…

Now… Some patients may need the standard 2x/wk 30-45 minutes… but most do not… especially the younger ones…

Try it… 2x/mo 45 min to hour… include direct tx time and indirect tx time via the parent

Again… relying heavily on parent follow through is key…

if you want to see significant changes in your patient’s communications… your families must follow through with strategies…

Here’s an example:

If your patient goes to the doctor and the doctor prescribes antibiotics. (This is considered the MD’s recommendation and strategy). The patient does not take the antibiotics as prescribed and comes back to the doctor 1 week later and then continues to come back everyday with the same complaints…

Who is doing their job? Who is not doing their job? What can the doctor do to improve the patient’s health, if the patient is not following through with the strategies?

Nothing… A doctor is no miracle worker… and if you don’t get the surgery or take the medication or do your exercise and eat a balanced diet as prescribed by the doctor… you will die…

because ultimately their job is to maintain your health in order for you to live as long as possible through recommendations…

So if the patient doesn’t take the medication then the doctor can’t help them… This is why the phrase “against medical advise” exists.

Well… Our job as SLPs is to facilitate communication for our patients… but we are not miracle workers… if our families do not follow through with our prescribed recommendations and/or strategies… an increase in frequency will not cure the problem…

Here’s another tidbit… make sure that the patient and their family understands that you are using the phrase “against therapist advise” or “limited family follow through” or “against therapist recommendations”… Use it outloud and in your paperwork…

document, document, document… ๐Ÿ™‚

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