Communication has two components: form and function.

Communicative form is the way in which someone communicates.

Below are some common communicative forms:

Non-verbal Forms: eye contact, reaching, pointing, facial expressions, head shakes/nods, body language, sign language, picture exchange, pushing an item away

Verbal Forms: sounds, words, sentences, voice output Written Forms notes/letters, text messages, email

The communicative function is what the communicator is trying to communicate.

Below are some common communicative functions:

Requesting (I want that.) , Refusing (I don’t want that.) , Protesting (I don’t like that.), Labeling (That’s a ____.), Commenting (I see a ____.) , Gathering Information (What is that?), Expression of Feelings (I am happy.), Social Connection (Hi!)

Communication becomes functional and effective when the form meets the desired function. For example, if a child who wants a cookie says, “cookie” and is given a cookie, then the form met the desired function and the communicative exchange was effective. If the child wants a cookie, however, says “cookie” and the caregiver says “Yes! That is a cookie,” then the form did not meet the desired function. In that example, the caregiver perceived that the function was to label the cookie when the function was actually to request a cookie.

For children with speech and language deficits, communication can often be a source of great frustration. For some children, communication is challenging because an articulation disorder makes their verbal speech difficult to understand. Other children may not have the ability for verbal speech and therefore have to rely on only gestures, body language and/or the ability of those around them to figure out their often very subtle communicative forms. Difficulty communicating can often be frustrating for the child and sometimes results in the use of behaviors that might be considered negative. If your child is struggling with communication, consider forms and functions. What forms does my child use? Are the forms that my child uses effective and efficient? If you believe that your child’s forms of communication are limited, consider what additional forms your child could be taught to use. If your child can only use gestures, could he/she be taught to use a sound, word, or picture exchange? If your child uses words but is difficult to understand, could he/she be given access to pictures to point to?

Next, consider how many functions your child is able to clearly communicate. If it seems that your child can communicate very few functions, consider what functions might be missing. Can they request desired items efficiently? Do they have an appropriate way of refusing items that they do not want? Do they have a way to name items and/or let you know what they understand? If you have concerns about your child’s communication and he/she receives speech-language therapy, ask your speech-language pathologist about your child’s forms and functions. The therapist can help you understand what forms are already in place to meet communicative functions, as well as what is already being done to target improving your child’s communication.

If your child does not receive speech-language therapy but you are concerned about his/her ability to communicate, talk to the therapist that treats your child about the possibility of a speech-language evaluation.

All children need to be able to communicate with those around them. Helping your child improve his or her ability to communicate will benefit them in their daily interactions, and help them connect to those around them not only today, but for the rest of their lives.

Eder, a ten year old patient who has a severe language delay, has been working on using a Dynavox to communicate, because his speech is unintelligible to the average listener. With a Dynavox, which is a device that allows the patient to point to items which will then be pronounced through the device, Eder will be able to convey his needs to unfamiliar listeners. Of course, this is a temporary fix, as speech therapy is also working on slow speech production and producing consonants clearly in order for him to be able speak on his own.

While Eder has been receiving speech therapy for almost eight months, lately he has been having a hard time focusing on his speech sessions. One session in particular was starting out exceptionally tough, and it didn’t help that Eder’s twin sisters were heading outside to feed their new baby lambs. Since Rebecca knew the session wouldn’t progress with Eder wanting to be outside with his sisters, she packed up her stuff and they both headed outside to try an unconventional type of therapy for the day.

Outside, after finally corralling a little lamb, Eder began bottle feeding her. He quickly became calm and joyful from feeding the lamb, so Rebecca started right in on their therapy, asking him to repeat his target words. His newfound distraction provided the perfect opportunity for him to focus and cooperate for the rest of their time together.

Rebecca says she and Eder will definitely do their therapy with the lambs again, and hopes that therapy may be something Eder looks forward to in the future if she continues to provide it in unique ways!

KidsCare Therapy – 2011 Special Olympics Bowling Team from MODassic on Vimeo.

At KidsCare Therapy, we take our commitment to providing quality home healthcare to children of the Dallas/Fort Worth metroplex very seriously. It’s important to us that these services are not only excellent, but also that they’re easily accessible. To ensure this, we are constantly seeking out knowledgeable, skilled therapists to join our team, as well as holding our current therapists to the highest of standards. However, unfortunately in today’s ever-changing world there are a number of factors that block access to quality care that are simply out of our hands, proposed legislation being one of them. Currently, the Texas House of Representatives and Senate are considering budget cuts that would have devastating consequences to health care service providers like KidsCare Therapy, our employees, and the children we treat.

Texas legislators are working now to balance our upcoming budget in the midst of a severe economic recession, and while we understand that cuts will need to be made across the board, our state is already drastically behind in efforts to provide health services to the developmentally delayed. Texas currently ranks 49 out of the 50 states in this area of performance! This lack of a priority on developmental services for the youth of our state is simply unacceptable.

While we are not able to directly shape the future of Texas, we do have a voice with our legislators, and our commitment calls us to actively use our voices. I, along with David Reimer, Director of Business Development, Melissa Scott, Administrator, and Debi Lindsey, Clinical Education Manager, have taken multiple trips to Austin, testifying before and meeting one-on-one with legislators, attending conference meetings, and even submitting some suggested amendments to current and proposed legislation. We are asking senators and house members to vote no to Senate Bill 1 and House Bill 1, respectively, which if passed could result in 28% cuts to funding to services like Medicaid.

High cuts such as this would have devastating effects on small businesses like KidsCare Therapy, which would not only make access to quality health care services even less affordable, but would also have a grave impact on the local economy. Our employees invest their salaries into the Texas economy when they support local restaurants and stores, as well as when they pay their taxes.

In addition to voting no to Senate Bill 1 and House Bill 1, we are also asking them to put regulations on Medicaid Managed Care Organizations (MCOs) that would require them to reimburse at rates even to the State Medicaid Fee Schedule (MFS)—not at rates that are substantially below the MFS, which is what many of them are currently offering. We believe that just this small step would allow many small businesses such as ourselves to sustain budget cuts. In addition, many of these MCO companies are based outside of Texas, resulting in millions of Texas dollars leaving the state and not entering back into our economy.

We hope that you’ll join this fight for Texas children. If you’re interested in learning about how you can get involved, please contact David Reimer, Director of Business Development, at dreimer@kidscaretherapy.com or (214) 575-2999.

“We must remember that one determined person can make a significant difference, and that a small group of determined people can change the course of history.”–Sonia Johnson, American Activist

Whew! Last week was definitely a crazy week for us at KidsCare Therapy! With near-record freezing temperatures and snowfall accumulation, our office was abuzz with updates regarding school cancellations, rolling power outages, road closures and delayed office openings. I don’t think I have ever been so thankful to see the sun! (And running water, considering the pipes at my house froze from the cold temperatures…) Nevertheless, we would like to thank our therapists for going above and beyond in their efforts to see patients despite less-than-ideal conditions. And not only that, but we would also like to thank them for keeping the communication lines open with us and patients’ families when cancelling or rescheduling due to hazardous road conditions. We are so glad everyone is safe and warmer weather is ahead of us!

In the midst of the weather crisis, Cortney, David and I headed to Austin to speak in front of the Senate Finance Committee regarding the proposed tax cuts to state services, as outlined in Senate Bill 1.  It has been reported that the state of Texas is facing an estimated $15-27 billion revenue shortfall for 2012-2013, resulting in a budget crisis that has lawmakers calling for major cuts in state services, including cuts to home care services. The Senate Finance Committee opened the doors for public testimony on Article II Health and Human Services regarding the proposed cuts Tuesday, February 1st, through Thursday, February 3rd, beginning at 9 a.m. each morning. The following are the proposed tax cuts outlined in Senate Bill 1 that directly affect agencies like KidsCare Therapy:

       • Primary Home Care: 30%
       • Community Based Alternatives: 37%
       • Community Attendant Services: 28%
       • Community Living Assistance and Support Services: 26%
       • EPSDT-Private Duty Nursing, Therapies, Home Health: 28%
   

(*Information provided from Texas Association for Home Care and Hospice Legislative Alert sent Friday, January 28th, to its members.)

Home health care agencies have already sustained 2% cuts in the last quarter, despite originally being underfunded. An additional 28% cut (to an existing 2% cut) would be devastating to agencies like KidsCare Therapy, causing widespread job loss and limited access of health care to medically-fragile children. Perhaps most disturbing of all is the eminent threat that a cut this drastic could result in agencies (KidsCare Therapy not exempt) across the state closing their doors to providing home health care, as businesses could not survive any more reductions in revenue.

Wow.

With so much riding on the line, I knew that I wanted my voice to be heard regarding my opposition to the proposed state-funded services cuts. Not often do we healthcare professionals and taxpayers get the chance to educate our lawmakers in person regarding the services we provide and the lives that we touch.

On February 3rd, 2011, Cortney and I practiced our speeches to each other nervously on the way to the capitol, as we tried to contain our experiences, successes, hopes and fears for KidsCare Therapy and for our patients into a measly three minute testimony. We were two of one hundred and fifty testimonies heard that day by the Senate Finance Committee consisting of State Sen. Steve Ogden, R-Bryan, as chairman of the Senate Finance Committee ,and the vice-chairman State Sen. Juan “Chui” Hinojosa, D-McAllen. Other state senators assigned to the committee are: Bob Deuell, R-Greenville; Robert Duncan, R-Lubbock; Kevin Eltife, R-Tyler; Craig Estes, R-Wichita Falls; Eddie Lucio, Jr., D-Brownsville; Jane Nelson, R-Flower Mound; Dan Patrick, R-Houston; Kel Seliger, R-Amarillo; Florence Shapiro, R-Plano; Royce West, D-Dallas; John Whitmire, D-Houston; Tommy Williams, R-The Woodlands; and Judith Zaffirini, D-Laredo. We heard testimonies from families and healthcare providers in opposition of the cuts. We heard testimonies that made us laugh, (a woman with Down Syndrome advocated for ECI services and touted her success as a small business owner, where she rents out margarita machines for parties; in fact, she offered her services to the Senate Committee for their next “company function”), and all were awe-inspiring.

Finally, after 11 long hours, Cortney and I were able to speak in front of the Committee. I must say, keeping my testimony to less than three minutes was the most difficult challenge of the whole day. The senators were not hesitant to cut you off if they felt you were exceeding your time limit. While I am sure my public speaking skills could use improvement, my testimony emphasized the value of home health in terms of cost efficiency and savings in prevention for larger health-care costs. I included my VitalStim® success story and stated my clear opposition to the proposed home care cuts. Cortney provided research regarding funding for home health and included a success story about a former patient that would tug on the heartstrings of even the toughest, most jaded politician. Finally, at 8:45 p.m., we were able to speak. It was a long, but good, day.

Walking through the capitol that night was surreal. As our steps echoed through the halls, I literally got chills when we entered the circular chamber at the heart of the building. I can’t describe the feeling that overcame me when I looked upward to see Texas star in the dome above me, illuminated by the moonlight. Breathtaking. I felt so small in comparison, but so humbled that I could experience the beauty of our capitol in solitude. How often does one get to experience the capitol at night with no visitors or tourists in sight? Realizing the rarity of the moment, and the history that was around me in the quiet of the night, I was so thankful that I was able to take part in the democratic process and grateful to represent the patients that we have the pleasure of serving at KidsCare Therapy .

That night, I began to wonder if my testimony made a difference. In my head, I went over all of the things I should have said and mulled over the other testimonies I had heard prior to mine. I was surprised to know that the senate committee members understand the gravity of the situation and are searching for solutions. Senator Whitmire even stated that this was an issue that transcended party lines. Many senators expressed sympathy, sharing with us that this was not an easy, or preferred, decision, and that they did not want to be responsible for denying care to thousands upon thousands of Texans in need of it. After a lot of thought, I came to the following conclusion: even though my testimony may not have radically changed the opinion of any senator or dramatically reversed a decision, I know I was part of an army that rallied to fiercely oppose these budget cuts to health care. I realized that every voice counts. Had I decided my voice was insignificant, and had others thought the same, we would have had no impact in this process.

YOUR VOICE COUNTS.
If you are an employee of KidsCare Therapy, it is important that you are active in this process. David Reimer will be sending educational emails with current updates, the meaning of these updates, and the steps that you as an individual can take to make a difference. I encourage you to educate yourself on these issues, as the consequences of these decisions will directly affect not only your job, but also your patients’ well-being. As therapists, we are capable of changing lives. Imagine the success we could accomplish if we came together to unite for a single cause! Let your voice be heard and help us build an army to defeat the budget cuts that could devastate the existence of KidsCare Therapy and our mission to provide therapeutic intervention to children who would otherwise not be able receive services. Thank you for all you do!
 

In August of 2009, I responded to an evaluation request for an infant feeding evaluation in my treatment area. When I met Sarah, I was instantly smitten. I learned that Sarah was given a rare diagnosis of VATER syndrome, a non-random association of birth defects caused by unknown genes or sets of genes. I discovered that Sarah had previously been hospitalized for aspiration pneumonia secondary to dysphagia, or swallowing difficulties. Her doctor had recommended a g-tube, but wanted to try speech therapy first, as he knew that speech therapists treat feeding and swallowing disorders, thereby preventing the need for a g-tube.

Sarah was a perfect candidate for a therapy called Neuromuscular Electrical Stimulation (NMES), a new treatment approved by the FDA that applies an electrical current to the muscles of the neck to improve swallowing function. I was trained and certified in VitalStim® for application of NMES (KidsCare Therapy hosted and paid for my training!) and knew that Sarah would benefit from the use of VitalStim®, combined with traditional swallowing therapy. Overall, Sarah underwent 24 treatments of VitalStim®, two times a week, for six weeks, for one hour sessions. Over time, we began to decrease the thickening of her formula with the use of NMES, until she needed no thickener at all! The doctor’s office reported that she was steadily gaining weight and that her lungs were clear. She eventually transitioned to Gerber Stage One food, and at re-evaluation time Sarah was a healthy little girl with an insatiable appetite for carrots and bananas, who no longer needed my services. I was saddened that our time was at an end, as I admit that holding my little patient had been quite therapeutic for me; however, I was so happy to see her make such profound progress. I still get periodic updates from her mother, complete with pictures and videos, informing me of her progress and her latest “ornery” act.

I will never forget Sarah and the feeling I get every time I see a picture of her, knowing that in the future when she gets a Happy Meal or eats a piece of birthday cake (with lots of frosting, of course!), that I had an important role in helping her overcome a disorder that would have kept her from a lot of the simple pleasures in life that we take for granted. Because of KidsCare Therapy’s willingness to provide me with the professional development to be trained in VitalStim®, I was able to change a life and make a difference in the world. At the end of the day, with all of the stresses and struggles of my career, I know in my heart that it is stories like Sarah’s that keep me going.

I would like to start out by saying that KidsCare Therapy is a great company to work for!  It is a very dedicated agency that caters to the needs of many children, both through therapy and by providing social workers with great experience to assist in other needs. 

I have worked here less than two years, but I already know how fortunate I am to be with this company and staff.  I love what I do. I call families on a two month basis to complete a case conference with the clients’ caregivers. These calls are a way to update any information that has changed, along with answering any questions or addressing concerns the families have. I feel that this plays an important role in the company because it assures that the family’s needs are being met, and that there’s good communication between families and therapists. I also assist our Quality Assurance Director in other areas such as grievances and compliance issues, as well as attend numerous company events as a translator. It’s so fun to see the children and families of the community and offer them a great resource they often didn’t even know about!

Emily, my supervisor, has done a tremendous job of educating me and assisting me with any questions I have. Emily has a very professional work ethic. She is open to new ideas, and very helpful in problem solving.  We are very lucky to have such a great Quality Assurance Director. It’s an important role, and she certainly fills it well.

In this position, I get to see the importance of each department and how their job roles make everything run smoothly make the work flow easier. I love working for a good company with tremendous room for growth. 

I look forward to many years to come with KidsCare Therapy, and to watch them grow even further.

I would like to thank Jason and Cortney for making a strong foundation for this company!

Have you ever had a rainy day?  Everyone has. Imagine the worst rainy day you’ve ever experienced. Who did you turn to for help?  Now, imagine having that same rainy day, but without anyone to turn to, or any idea of where to go for help. To help alleviate this problem, KidsCare Therapy provides case management services to the families of the patients we serve.  As a social worker, I connect a patient and his or her family to valuable community resources, and then guide them through the process of accessing services.  

Case management, in my eyes, is like a great adventure— you never know what type of challenge is around the corner, or how you are going to affect a person’s life.  As a case manager, I not only assist families in addressing their concerns regarding their child or family’s needs, but also help them identify resources of which they were unaware.  Case mangers assist families in gaining access to necessary medical, social/family, nutritional, educational, vocational, developmental and other health care services. 

During my time at KidsCare Therapy, I have had many opportunities to be that pot of gold at the end of the rainbow for our clients and their families on their rainy days.  I recall receiving a phone call from a mother who did not know what was going on with her son David, she just knew that something was not right. I not only was able to help the mother get David diagnosed with Autism, but I was also able to help her get him into a preschool program for children with disabilities.  Together, we worked to get her connected with community support groups and other specialized programs for children with Autism.  

On another occasion, I received a call from a mother who was having a lot of problems with her apartment complex, water and electric bills.  As you can imagine, the mother was very worried about being kicked out of the apartment and the possibility of being without water or electricity right when Dallas was expecting a big snow storm to hit the area.  The mother had requested, several times, that a water leak be repaired, but the apartment complex did not want to accept the responsibility and make the repair.  I was able to help this mother find out who she needed to contact in the city to help determine where the leak was coming from and who was responsible.   It was later discovered that it was the apartment complex’s responsibility. The city provided the mother the needed documentation to give the apartment complex to fix the leak. The mother was able to get her water bill reduced, but she was behind on her electric bill.  I was able to provide her with some community resources that assist families in paying their electricity bills. She called the agencies one by one and was able to get some assistance with her electric bill. In the end, the mother was able to find even more help through a local church that helped her pay the electric bill.  

Caring for a developmentally delayed child is difficult enough, but the added problems of everyday life can sometimes leave parents wondering how they’ll manage. I love that I’m able to connect them with the resources to help them provide the very best care and conditions for their child, and I’m proud to work for a company that sees this as a necessity.