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VOL. 10 NUMBER 1: February 2014






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Success Story: A Mother's Love

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11 Kids — That's Love (Meet the Hollmans)

We asked. You answered… Find your passion in life

Why do you love your job?


We improve lives.


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Chari-T2000 update: OVER $37,000 DONATED IN 2013!

Editorial Staff

SUCCESS STORY: ANGEL Jerre van den Bent, PT

Perla was a frustrated.


She felt as

though she wasn’t getting through or connecting with her son Angel. The

Kyle Butler

3-year-old was having a hard time com-


municating and used virtually no words or gestures. He had a very small at-

Alex Paris

tention span and could not follow


simple directions like, “Go and get your


shoes.” Angel couldn’t point to his eyes, nose or mouth. Perla was worried. She watched as younger children passed him by complet-


ing age appropriate tasks. Sending Angel to school one day seemed impossible. Angel was diagnosed with an autism spectrum disorder last year. With a proper diagnosis in hand Perla was eager for him to begin therapy and to provide Angel the tools he needed to help him communicate. Katharine Hayes, STA, took Angel as a patient in June 2013. Katharine has been seeing Angel ten times a month since July. He has been very busy learning new skills to help him communicate. His mom Perla is learning too. She listens in on sessions with Angel and requests strategies to help Angel improve. Perla always follows through on therapy suggestions given to her. Angel and his mother are bilingual and Angel does his therapy in English. In order to better advocate for Angel, Perla requested autism spectrum disorder materials in Spanish to share with the rest of the family.The whole extended family is on board and using the strategies learned in therapy to help Angel develop to his fullest potential.

Inside This Issue: • Success Story ............................2-3 • Customer Service ..................4-5 • Team Hollman .........................6-9 • 3-D Care ............................. 10-12 • Everyone's Disability .............. 13 • Double Trouble ..................14-15 • Chari-T2000 ....................... 16-17 • Blogs We Love ................... 18-19 • Survey Says ......................... 20-21 • Holiday Party...................... 22-23 • Events......................................... 24

Angel and Katharine hard at work!


In the six months since Angel has been working with Katharine he has grown by leaps and bounds. His progress is clearly evident. Not only is he now communicating in sign language, he is also using words. Angel understands directions and can point to his nose, eyes and mouth. His mom shared with joy that he can now count like other preschoolers his age. He even began Preschool Program for Children with Disabilities (PPCD) in November, something that six Angel and Katharine

months ago seemed improbable to his worried mother. Perla shared, “Angel loves getting on his backpack and waiting for the school bus. I know he is happy because he smiles at me out the window when the bus is leaving.�

Perla and Angel

Perla and Angel



hat do the THERAPY 2000 marketing department and the THERAPY 2000 business office have in common? They are passionate about being customer focused. At the end of 2013, the executive leadership, division, and support department directors established strategic priorities for THERAPY 2000 in 2014. Based on feedback, input, and insight, customer service was determined to be one of our company’s strategic priorities. Since Shannon Anderson and Marnie Stone, department directors for marketing and the business office, respectively, are passionate about customer service and what exceptional customer service looks like, they offered to write an article to introduce the priority to the T2K employees. Shannon speaks: Why marketing is passionate about customer service: Marketing is very passionate about customer service, because good customer service is what brings our clients back! It is easy to forget that every position in THERAPY 2000 is actually a customer service position. Customer service isn’t just about being polite when a potential client calls on the telephone with a referral. Every interaction we have with patients, referral sources, families, facilities, peer providers, insurance companies, and even our internal interactions give the community a clear picture of what THERAPY 2000 values. We need to make sure that every person within the company tries to represent our core values: • • • • • •

We strive for excellence. We unleash potential. We make it fun. We show integrity. We celebrate diversity. We give back.

Our core values all encompass great customer service, because great customer service is all about following the golden rules! We need to really listen, stop making promises we can’t keep, acknowledge complaints with empathy (a simple sorry can go a long way), be helpful, be courteous, have a little fun, and go that extra mile.


From the moment a potential client dials our phone number and we answer the phone, we need to make sure that customer service is our number one priority. Out in the marketing world, we hear stories about customer service and you would not believe what a difference it makes. I once went into a day care to drop off some materials and the director could not stop talking about how wonderful our therapist was and how helpful she had been to the staff. She went on and on about how the therapist had provided the teacher with activities to do with the child after therapy

to ensure carry-over throughout the week. The director was so impressed and loved the activities so much she was incorporating them into their curriculum, because she felt they could benefit not only our patient, but all the students. That is striving for excellence, and going the extra mile and it works! Unfortunately, the opposite can be true too. I have heard complaints about customer service from referral sources in the past that directly affected their willingness to refer to THERAPY 2000. Those moments are a marketer’s worst nightmare. Marketing’s first response to a complaint is always empathy. Next, we take the information we have gathered and bring it to the attention of the appropriate parties, so THERAPY 2000 can respond as a team. Even when I am having a difficult day, I always try to remember to smile, have a polite tone, actively listen, and to go the extra mile for my clients, because at the end of the day, no matter who you are within the company, you are the face of THERAPY 2000. And a smiling face makes the difference. Marnie speaks: Why the business office is passionate about a customer focused culture: Many times, THERAPY 2000 marketers are the first representatives of our company in the community. Intake specialists are often the next contact, although in many cases, they are the first contact with a potential THERAPY 2000 customer. For this reason, we know whatever impression we make, how we meet the customer’s needs and how we respond to the customer’s challenges, sets the stage for how that customer expects to be treated from that point on during their experience with THERAPY 2000. And for some of those customers, their length of experience could span more than a decade. Intake is a very important gatekeeper! With that in mind, we have worked to answer three questions to help us in the business office determine how we can establish a culture of customer focus. These questions are: 1. Who are our customers? 2. What are the needs of our customers? 3. How do we best assist customers with meeting their needs or responding to


them when their needs have not been met? Who are our customers? That’s easy, you may say. The patients and patient families are our customers. While that is true, especially for field staff, what we determined for intakes is that we have two more direct customers: referral sources and THERAPY 2000 division staffers. These are the customers for whom we perform most of our intake duties. For referral sources, we strive to act promptly and politely and to make sure their questions are answered within a very quick turn-around time. For division staffers, we strive to provide accurate and comprehensive information regarding patients that are requesting therapy services and to provide that patient information in a format that is easily accessible, understood and able to be transmitted quickly to therapists who determine if they can evaluate and serve those patients. What are the needs of our customers? Determining exactly who you are serving assists with the next step. This step is to determine what the customers’ needs are and to ensure you are listening to and meeting their needs through how you interact with them and the processes with which you meet those needs. To find out what our customers needed, we asked. We asked for input through surveys and lots of conversations. Then we went to work adjusting what we do and how we do it in order to accommodate those needs. For example, based on input from division staffers and a sampling of therapists, we adjusted our referral template through which we communicate patient information received during intake from patients’ families. We flipped the template, putting information that was originally at the end of the template to the top. Simple. Then we added an availability grid so that staffers, and therapists looking at the information typically on a cell phone, could easily determine when patients can be served. How do we meet the needs of customers and how do we respond if they are not happy customers? Determining what the needs of customers are goes a long way in making happy customers. But, we all fail. We have bad days. We make mistakes. Or, other variables occur that are out of our control and we have to deal with the results or fall out. How do we respond so that those

referral sources refer again? So those parents tell their friends about THERAPY 2000? To learn and remind ourselves of skills that assist with damage control, we invested in a customer focus training series. The business office is currently going through 10 customer focus clinics to learn and practice proven customer focus tactics and strategies. One tactic we have been reminded of and are starting to practice is called Apologize and Acknowledge. It is a simple concept. When there is a dissatisfied customer due to a variable that is either in or out of our control, we stop and take a moment to apologize for the situation and acknowledge the customer’s frustration. For example, “I apologize for any miscommunication; I understand how upsetting that can be.” Then we follow up with how we can realign with the customer’s request and communicate how we can help them with what they are seeking to receive or communicate. When an upset customer hears an apology and their feelings are acknowledged and validated, and hears how we are going to assist them, they usually calm down and re-engage with the process and, most importantly, re-engage in the relationship with THERAPY 2000. As we have been working to create a strong customer focus culture in the business office, I received the recommendation from a San Antonio division team manager, Josh Florence, to read the book United Breaks Guitars. The book details the lack of customer service the author, Dave Carroll, experienced from United Airlines when his guitar was broken while on a flight. One point that Carroll makes is that it took over one year of interactions with various United representatives before he received an apology. More than one year! That is mind-numbing to me. He makes the statement, “Sometimes saying you’re sorry is not only the right thing to do, but also the least expensive.” In the end, Carroll did not ask for reimbursement for his broken guitar, he only asked for an apology and acknowledgement that it should not have happened. Baggage carriers should be more careful. That’s all. Because United did not immediately listen, apologize, acknowledge or offer a solution, Carroll created three songs about the experience and put them up on YouTube. The first song received 1 million hits in four days. United stock went down 10%, losing $180 million in value. That was expensive. And it could have been avoided with an apology. Hopefully this article will help you catch the passion for creating a company-wide customer focus culture. Ask yourself, who are my customers? What do they need? What can I do to ensure they feel heard and validated when something goes wrong? If we all do this, like Shannon said, we will convey the values of THERAPY 2000 and invite our customers to be life-long customers. 5

TEAM HOLLMAN RULES! When you walk into the Hollman house the first thing you

They received a call from Child Protective Services about

notice is how neat and clean it is. You would never imagine

a sibling group of three brothers needing a home. At the

that nine kids live there. Tonight the table is set and “break-

time the boys were aged two and a half, fourteen months,

fast for dinner” is being served. It’s a special day at the Hol-

and two days old.The Hollmans fostered the three boys and

lman house, because it’s Jackson’s eleventh birthday. The

quickly bonded. For the next sixteen months they enjoyed

birthday boy gets to pick what’s for dinner that night and

their new, expanded family with the three brothers thriving.

his choice is “breakfast for dinner.” Jackson, McKinley, Pierce, After sixteen months the state decided to return the boys Ford, Kennedy, Reagan, Carter, Monroe and Tyler sit down

to their original family. The Hollmans were devastated with

for a dinner of pancakes and egg casserole. In addition to

the loss but they knew the separation was coming. They

picking the menu, Jackson also gets a break from his house-

were open to fostering more children and accepted when

hold chores for the night since it is his big day. The Hollman

CPS called offering them a chance to foster yet another sib-

household runs like a well-oiled machine.

ling group of three. This time it was a little boy aged three, and twin girls, who were 10 months old. They did not hesi-

Michael and Suzanne Hollman never dreamed of having such

tate to take the new sibling family. There was actually two

a big family; but it seems it was meant to be. The Hollmans

weeks when all six foster kids were in the house at the same

originally met and dated in college.They moved on from the

time — a foreshadowing of what was to come

relationship and ended up marrying other people. Each of their relationships produced one child, Michael had a son, The Hollmans were adjusting to life with the three new sibMichael, and Suzanne adopted Britni with her first husband.

lings when another opportunity for a baby presented itself. In June 2008 a birth mother picked the Hollmans as adoptive

After each of their relationships ended, they reconnected

parents to raise her daughter. Suzanne left the hospital with

and started their journey together as a couple. They began

the newborn baby girl, Carter. So now there were 6 kids;

their life as a blended family each with a child from a previ-

Michael, Britni, McKinley, Kennedy, Reagan and the new baby,

ous marriage. They wanted children together but after hav-

Carter. It was at this point, once everyone was getting set-

ing fertility issues which were treated unsuccessfully began

tled into their new lives that the Hollmans received another

to consider other options.

call from CPS saying the original boys they had fostered were back in cus-

All this began be-

tody and looking for

cause the Hollmans

a permanent home.



The Hollmans didn’t

could have children

hesitate to take the

on their own.


boys again. Just one

love of children led

week after the orig-

them to fostering.

inal three brothers


were back in the Once they began

house the adoption

the fostering pro-

of McKinley, Rea-

cess it didn’t take

gan and Kennedy,

long for their family to come together.

Lockers help keep the family organized.

became final. The Hollmans began the


Annual Hollman Family Picture adoption process to permanently raise the three brothers, lege. The rest of the nine kids living in the house, Jackson, Jackson, Pierce and Ford.

McKinley, Pierce, Reagan and Kennedy (twins), Ford, Carter, Monroe and Tyler, range from aged eleven down to two.

After all the kids were settled a seeming miracle occurred. Mrs. Hollman, after twenty years of fertility issues, was preg-

How do they make it work? Michael shared, “Were a team

nant. Suzanne and Michael had a baby boy, Monroe, and then

and everybody has their part.” Michael gives a lot of the

a little girl, Tyler. So that’s how the Hollmans have eleven

credit to Suzanne who is responsible for the day-to-day


running of the household. The Hollman house is spotless thanks to a thorough chore list. Everyone, even the littlest

Michael is the oldest and lives with his mother in Louisiana. guys, pitch in. Everyone knows his role and does his or her Next in line of age is Britni who is currently attending col-

chores. Setting the table, sweeping, washing dishes—every(continued on next page)

plenty of outdoor space for the kids to run and play. They also have a tree farm further north where they grow and sell live oak, red oak and bald cypress. Michael, an outdoors lover, takes the six older kids there on weekends where they ride bikes, fish and most importantly, work with their hands. Teaching the children life skills and self-sufficiency is an important goal for the Hollmans. Three of the children have special needs. Michael shared, “Our job as parents is to train the kids to be productive adults.” The Hollman family is the perfect candidates for in-home therapy! Three kids are currently seeing THERAPY 2000 occupational therapist, Danielle Harston. Four of the children Teamwork: Moving the chicken coop.

see Erin Bellue (SLP CCC), for speech therapy. Erin has been seeing kids in the Hollman family for eight and half years

one has his part. If you are eight or older you are respon-

since Jackson was a kid.

sible for your own laundry. And believe it or not, the kids do their chores with little complaint. Suzanne shared, “With

When asked what the hardest part of having a brood so big,

kids doing a lot of the chores you might have to lower your

Michael shared without a moment’s hesitation, "Logistics.”

cleaning standards a bit.” Michael added, “Kids can do more

For example, all the kids take a bus to school, but three dif-

that you expect them to.”

ferent buses. The kids aren’t in organized sports as getting them to practice and games would be close to impossible.

Suzanne chimed in, “Organization is key!” when it comes to

This might change as Suzanne’s parents recently moved up

running this household. A row of lockers line the garage for

the road and can now lend a helping hand. The Hollmans

each kid to store their shoes and backpacks. Inside, a mud

don’t lack a sense of humor as Michael shared, “Who needs

room with hooks for each kid keeps the rest of their be-

organized sports when we can actually play three-on-three

longings organized. All the bins in the playroom are labeled

football with the boys right outside? Not many parents can

and ordered. You put away what you take out. The night

do that!”

we visited the older boys were pulling the chicken coop into the large garage so the freezing temperatures wouldn’t

Even with a brood of their size it is very important to the

harm the birds. They worked as a team to move the fifty pound coop across the back yard and into the garage. No complaints. In the Hollman house love is demonstrated through affection but also in teaching the children how to be independent and self-sufficient. Three of the kids have special needs. The Hollmans are realistic about the future of nine kids. It’s not probable that every kid is going to medical school, so they need to be prepared for what life brings. The 8

Hollmans have a beautiful house in Prosper with

Nine Hollmans dine.

Hollmans to do as many things as possible as a family. Popular outings include the Heard museum in McKinney, the Grapevine Aquarium and the Dallas Zoo. The boys enjoy watching and playing football. Movie night is a popular activity. Now that the kids are getting older the Hollmans have incorporated game night. One thing you won’t hear at the Hollmans is the kids clamoring to watch TV or play video games. The kids spend a lot of time outdoors; TV and video games are reserved for special occasions only. Craft time and manipulatives are popular pastimes for Suzanne and the girls.What about fighting? Suzanne shared, “The kids do well and generally they don’t bicker.” They Hollmans have a strong community of support. Their church serves as an extended family. Even with their busy lives the Hollman parents take time out of their schedules to give back to their community. They recharge by teaching Bible study and mentoring other parents. The Hollmans are a testament to the power of love, commitment and organization.When asked how they do it all Michael openly shared, “Failure is not an option.” More about the Hollmans... Food! You might shop at Costco and the Hollmans do too. But they also take it to the next level and shop where restaurants shop, at Restaurant Depot. Here, Suzanne can purchase twenty pounds of spaghetti and macaroni pasta. They have three fridges and a deep freeze. Picky eaters? Not here. Suzanne shared, “You get what you get and you don’t throw a fit.” There’s not too much eating out for this gang; it would be a logistical nightmare. The parents do share date nights out without the kids. When we visited they had a sitter lined up so they could have a dinner date night at the newly opened Frisco Gun Club. What’s in a name?

Erin Bellue, SLP has been seeing kids in the Hollman family for 8.5 years

Tyler. The naming started of necessity when they fostered the three siblings, Reagan and twins, Kennedy and McKinley, The siblings had been a high profile case in the news and needed to be renamed for safety. Suzanne always liked last names as first names, so the presidential name trend began. Helping Others It is important for the Hollmans to give their kid experiences and not just stuff. They don’t sugarcoat life and want the kids to be exposed to the real world. The Hollmans make time as a family to help others in need. They put together “blessing bags,” backpacks filled with snacks, toiletries, jackets, blankets and other cold weather necessities, and passed them out the week of Christmas. This year they did sixty as a family. The Hollmans drive as a family and pass them out to homeless people they see around the city. Giving to the community gives back to them and helps the whole family keep life in perspective. It is important for the Hollmans to teach their children that not everybody has the opportunities their family has been afforded.

Do the Hollman kids’ names sound presidential? That’s because they are! The bottom nine Hollman kids from aged eleven down to age two are named after presidents Jackson, McKinley, Pierce, Reagan, Kennedy, Ford, Carter, Monroe and

To learn more about Team Hollman, visit: http://www.twowithazoo.com 9

TEAMING WITH FAMILIES: 3-D CARE 2-D is out! 3-D is in! Last issue I introduced the meme of 3-D care. 3-D care emphasizes the need to enhance communication and teaching of the parents/caregivers and providing family-guided activities and routines-based programming that supports participation based goals. We asked for your ideas and received some wonderful feedback! Thanks to each of you, who shared the following ideas. I leave simple "worksheets," projects, etc. for the family to complete together. I always follow up at the next session and ask about the "homework" I left at the last session. They know I'm going to ask, so again, it holds them accountable. I give simple "to-do" exercises to do during teeth brushing, dinner time, car ride home, etc so that they don't have to set aside "special" or "more" time to work on speech. I stress that speech can be worked in anywhere and anytime, so it fits into a busy schedule. I ask about goals, concerns, etc that the family has and wants me to work on. I have found that if they see functional progress on daily things they are more inclined to "help" me with carryover activities. — Kristin Giggleman, SLP (East Texas)

In instances where maybe the parents are on board but the kiddo is less motivated, I have found that nothing motivates quite like a good old fashioned “star chart.” Since we have those fridge calendar magnets, perhaps the families could be given a pack of reusable stickers and on days where the kiddo participates in the home exercise plan, they could place a sticker of their choosing on the day.

much about therapy. They want their baby to reach her milestone. If I teach a kiddo one step of the activity as a discreet trial (trap the ball) of a familiar game, sometimes a sibling comes along to coach them (roll the ball to me) just because it's fun. Siblings are powerful motivators. Get on board! If it's important to the family, it better be important to me. So...if they want a non-ambulatory child to salsa-dance, all of my specific gait training will be "in tune"...one small step forward, weight shift, one large step backward. It's still gait. If my intervention isn't hitting home and I see little carryover, I change. There's a dozen ways to achieve my goal. What's engaging and likely to stick is "the best" evidence-based intervention. — Heather Renders, PTA (West Division, DFW) Have the parent hold the articulation flash cards, state the picture before showing it (for imitation), then have them show it to the child while SLP sits with patient and manipulates oral exercises to produce the tithe sound.

— Melissa Munoz, MSW (San Antonio and Austin) I know that my challenge is to determine WHY this parent would VALUE this intervention. For example, "When you put her on her tummy for playtime, her whole body learns symmetry. She needs that to crawl." Parents don't care so 10

— Molly Webb, SLP (East Texas Division)


I try to make the HEP part of the everyday routine, rather than something "more" a parent has to do. For ex-


ample, when working on head control, I advise the parent/ caregiver to carry the child with legs around the trunk of the caregiver, so that the kid is positioned in a nearly gravity eliminated position as they move from one place to another. It allows for multiple opportunities to work on head & trunk control while moving the child from place to place throughout the day, without adding another activity. — Joan Rubin, PT (DFW Central) If the child is old enough, I get him/ her to tell me a goal that they have for themselves (ex — "Playing on a 'real' basketball team"), and each session, we talk about how their HEP components will help get them to that goal. I have the child check off (on the written handout I make him/her) with a date and time that they performed each exercise on their HEP and show me at the next session. If they did it the number of times they were supposed to, they get to choose one of the activities we do that session, which usually ends up being the iPad!


At the start of the session, I have a competition with him/her on performing the HEP (without looking at their written handout)- — whoever has the best technique &/or holds it for the longest, etc, wins!

If I have a family with a young child, I make sure to discuss the reasoning for each HEP component (and keep it to 2-3/day).That way, they understand that the HEP

is more than just some random suggestions, but custom designed for their child. For families with a younger child- — I have families perform the components for me prior to me leaving and when I return for the next session, I ask for them to show what they have been doing for their HEP. At this time, I will know 1) if they've been doing it, and 2) if they've been using correct technique. Then we talk about it in relation to how their child does in PT that session. I draw stick figure pictures with all my exercises!! Or try to! — Michelle Coulter, PT (Austin) I've found that it helps to give families something in writing outlining specifics of what they need to do. Example: if working on language, I specifically say — this week, present these three new descriptive words and model them each day or, present these three spatial concepts and model them each day. Giving families specifics, in writing, seems to help a lot. — Kristy Winiger, SLP, (DFW East) For some of my young kids, we start with “kissing therapy” – games that involve parent and child going back and forth with kisses. It is usually something they already do, so we just add something new into the game (more lip rounding, parent waiting for a word or communicative attempt before continuing the game, etc). I try to use the items and games already in the house so parent can duplicate the activity (paper towel rolls, boxes, random items lying around, books the family already has). Sometimes families see us with “special” toys they don’t have, and they think they can’t do what we do. I don’t use an iPad because it sets parents up to expect they have to have one to teach their child, and it also makes it easy for the child to tune out adults while focusing on the iPad. — AnnMarie Pinkenberg, SLP (DFW West) I do my best to try to engage families and incorporate them into my sessions. They should have ownership over success. Seeing what their kids can do in therapy and feel(continued on next page)


ing involved often help with getting parents to do things at home. I try to make things I want families to continue as easy as I can to fit into daily routines.

produce the words orally, by using a picture symbol, or even with a communication device. This helps the parent transition from the role of "entertainer" to facilitator.

— Rhiannon Thomas, OTR (East Texas)

I also train parents in the art of "gentle sabotage." As parents, we're hard-wired to meet our child's needs as quickly and efficiently as possible. However, I model and encourage parents to place a child's sippy cup, snack, or preferred toy in sight but out of reach. That way, the child is motivated to communicate to get that highly desired item. Also, during snack time, I ask parents to give just a few snack items at a time, such as 2-3 goldfish, so the child has an opportunity to request "more." When parents see their child spontaneously communicating, they are encouraged to keep providing their child with those opportunities within their daily routines.

My 8-month-old patient with torticollis wasn't tolerating her mom stretching her in the football hold while walking around anymore, so now I have Mom hold her baby in the stretch position and gently "run and chase" her 4-year-old daughter around which totally distracts her baby from noticing that she is being stretched. She even laughs when "catching" her sister. — Janet Stanford, PT (East Texas) For HEPs, I like to give parents of very young children ideas that they can incorporate into their day. For example, I will teach torticollis stretches after diaper changes and baths, or give them just one activity to work on for that week that seems to be what they are having the hardest time with. For older children that can have some responsibility in remembering their exercises, I will give two pertinent exercises and have them demo each visit until they are independent and can add something else.

— Melissa Cooprider, SLP (East Texas) During birthdays or Christmas I give suggestions to families on gift ideas families can get that will help increase independence with ADLs. I have been able to get a lot of items such as electric toothbrushes that way.

— Ashley Sparkman, PT (East Texas) Stressing the importance of activities and explaining that the carryover the family does at home will really impact the outcomes. Make it FUN so it is not a ‘chore’ to complete.


— Yeisha Culp(East Division DFW) Many parents have routines revolving around singing the child's favorite song(s). I encourage the parents to pause several times during a song so that the child has an opportunity to fill-in some of the familiar words. The child can

I sewed a simple body sock out of spandex to use for sensory diet; four of my families went out to buy the material and had either me or a family member sew one up for their child to use at home. ST and PT also find it useful to use during their sessions when child is seeking sensory input. — Michiko Escobido, OT (DFW Central)

I like to include PT interventions in community, like taking children to the park to incorporate stairs, climbing, vestibular integration with slides and swings. Having parents work on stairs and curbs whenever possible in community instead if carrying children. — Amber Stewart, PT ( West Divison )



Joshua Florence will be writing a recurring column from his unique perspective. Not only is he a pediatric PT, he also has a daughter with special needs. He see patients in the San Antonio region of THERAPY 2000.

2013 has come and gone and 2014 is here to stay for at least a year. With the New Year comes new commitments, new resolutions and promises that we make to ourselves, many of which just fade away with the passing of the winter cold. This year I want you to take a challenge with me. The Florence Family

As a therapist I have had many conversations with parents and other therapists, documenting in report after report, the many impairments and limitations a child might have. One impairment that always seems to come up with special needs children is the child’s lack of safety awareness. The child does not seem to know what will hurt him; or maybe the child does know, but doesn’t recognize the potential consequences of the action. Sharon and I have witnessed this over and over with Elle throughout the years. I can not tell you how thrilled we were the first time we saw Elle pull herself to standing in the crib. It was amazing! We were yelling at each other every time to, “HURRY UP, GET IN HERE,YOU ARE GOING TO MISS IT!” She had gotten pretty good at it, but there was one problem. She didn’t quite understand that if she let go she would fall back and eventually hit the back of her head on the crib. Now when I say hit, I actually mean bash. So picture this: a two-year-old girl slowly and unsteadily pulling herself to stand, then instead of lowering down into sitting position, letting go with both hands while keeping her knees straight, crashing back and colliding with the wall of a crib as if she were a giant redwood being chopped down. So now we had this new and great skill that was met with a high degree of danger. Hour after hour and night after night Sharon would look over at the baby monitor and sound the alarm, “SHE’S UP, SHE’S UP!” We would jump up and take off running in an effort to catch her or slow her descent. But more often than not it was to pick her up and console as she would be screaming from hitting her head. I used to think to myself and also tell her out loud hoping for some reason she would understand, “You’ve got to stop doing that sweetie, or you are going to really hurt yourself.” I thought if she could just figure out how to slowly lower herself down, we would all be good. Well, instead of learning the safe way, she figured out that she could pull herself to stand and then rotate her body and literally push-off as

if attempting to plant herself head first into the mattress or, in this case, the crib railing. As a parent, running down the hallway at 3:00 AM in an effort to catch her, I would wonder if she would ever stop. She eventually stopped, but then replaced it with some other daredevil stunt. To this day she loves to get on her knees when she is on our bed, and then fall forward planting her face into the comforter or sometimes into my or Sharon’s legs. Once again she bashes her head because she doesn’t look at where she is falling. The more I would watch Elle the more I would become in awe of her. She lived life without fear, without consideration to what might happen or the potentials involved. She was living life in the moment. I will never forget when my biggest fear came at me, sat right before me, stared me down, asking me, no challenging me – what are you going to do? As a pediatric physical therapist, I was the one who was supposed to help children and families with special needs, never be the family with a special needs child. Yet there I sat in the exam room with Sharon, karyotype in hand, showing the extra chromosomal material. The piece of paper that was interpreted by the perinatologist as a child that will have “severe and profound, cognitive and physical impairments,” a child that, “probably will not be compatible with life,” a child that, “will not have any quality of life.” I was there, nose to nose with fear itself, a surreal moment that I couldn’t quite understand at the time. I sat there feeling more disabled, physically, cognitively and emotionally, than any of the patients I had ever seen. Something happened in the room that day, the only thing that can happen when you allow yourself to face fear head on, live in moment and not worry about tomorrow. We replied, “We will keep moving forward with the pregnancy.” What happens from here on out we will face together as a family of four. So my question to you is, what are you afraid you? How different would your life look if you lived your life without fear? What job would you have taken if you weren’t afraid of failure? Who would you have reached out and helped if you weren’t afraid of what others would think about you? What relationship would you have mended if you weren’t afraid about being hurt? You see, the world may see Elle as disabled, but I see her as the one that is living beyond herself because she isn’t afraid. I am the one who is truly disabled, I am the one who has passed on opportunities, not spoken up and let relationships be destroyed simply because I was afraid of rejection and being hurt.

How will 2014 be different if you live without fear?

DOUBLE TROUBLE: TWINS ON THE RISE AT T2K recently born and two more sets are on their way. We did a little research and learned that you aren’t just seeing double, twins are actually on the rise! The number of twin births in the USA has more than doubled from 1980 to 2009. In 2009, 1 in every 30 babies born was a twin. Increases in twin birth rates are up for all age groups, racial and ethnic groups — nobody is safe! What’s with the double baby boom? Apparently, women in their thirties are more likely to have twins than women in their twenties. More women are waiting to have babies and a higher maternal age is an independent risk factor for twins. Women of higher age also tend to correlate with increased use of fertility treatments, which was likely the biggest contributor to the spike in twin births.

Twin Edition: Did you know? Some Families Are Prone to Multiple Multiples Some woman inherit a gene that causes them to hyperovulate (release multiple eggs during ovulation) upping her chance of having fraternal twins, which are produced from two separate eggs.

Remember the YouTube video of two chatty twins that went viral? Scan the QR code to watch if you haven't seen it, or even if you have...

Twins Can Have Different Dads It’s rare but technically a woman could release two eggs during ovulation and get impregnated by two different men at the same time. It is known as heteropaternal superfecundation. Hilda Hutcherson, MD, clinical professor of obstetrics and gynecology at Columbia University believes that 1-2% of all fraternal twins have different fathers. Twins Can Become Besties in Mom’s Belly Researchers studied 3D ultrasound videos of five sets of twins in the womb. They noticed at as young as 14 weeks the pairs seemed to reach out to touch each other. At 18 weeks, they were stroking each other more often and were in physical contact about 30% of the time and being extra careful when they touched around the other’s eye area. Twins also interact with each other just hours after birth.

You Can Double your Chances of Having Twins You need to stock up on cheese and drink milk. According to new research women who consume dairy products may increase their chances of conceiving twins. Non-vegans are five times more likely than vegans (who don’t eat any animal products, including dairy) to have twins.

For the SLPS…40% of Twins Invent Their Own Language Researchers believe that super-close siblings (mostly twins) use each other as models for learning vocabulary and applying meaning to sounds. Usually their special lingo disappears as their vocabulary expands. 14

Figure 1. Number and rate of twin births: United States, 1980–2009 160




120 Births in thousands

The level of a certain protein is 13 times higher in women who consume dairy than in vegans. This protein increases the ovaries’ sensitivity to follicle stimulating hormone, which triggers ovulation.

One in every 30 infants born in 2009 was a twin.


25 Rate


80 60






20 0








0 2008 2009

Per 1,000 births


Twin birth rates increased in all states from 1980 through 2009. Figure 2. Percentage increase in twin birth rates: United States and each state, 1980–2009

































Tristan and Aiden (Areti Hadjigeorgiou)




Total U.S. increase: 76.0% Less than 50.0%







50.0%–74.9% 75.0%–99.9% 100.0% and greater

Vanessa Flores (Gender Reveal Party-TWO GIRLS!)


Megan Ramos (Still Cookin')

Twins Gwen and Bree and brother Jax (Cuyler Romeo)

CHARI-T2000 TAKES AUCTION ONLINE OUR FIRST EVER CHARI-T2000 ONLINE AUCTION WAS A HUGE SUCCESS! Over $8,600 was raised online and through live auctions during regional THERAPY 2000 holiday parties. All proceeds of the auction go directly to Chari-T2000 to support its mission to help children by providing needed therapy equipment and services. We would like to thank all of our generous donors and shoppers for helping children reach their full potential. Chari-T2000 donated $37,183.98 in charitable assistance to a total of 28 recipients in 2013. The charity helped purchase four lifts and/or adapted vehicles, a Rifton transfer tram, multiple feeder seats and a large number of sensory items. We look forward to supporting even more children his year!

Thank you to our generous sponsors PLATINUM $500+ GOLD $250-500 Jerre van den Bent Crisann Skinner THERAPY 2000 Robin Jackson Photography CPO Kids Hibiscus Marcia Thomas Jim and Marva Mount Wine Cup Landscaping Mythology Anthology Photography Omni Hotels Angie Phillips Stacey Vance — Lola Jewelry Additional Thanks Teri and Randy Speer Nancy Estes Megan Ramos Michael Nieto Lizze Norlander's Team Johnnie Aven Ashley Fairleigh Bruce & Nancy Muskrat Anne Byrom Courtni Marshall Yeisha Culp Alex Paris Jennifer Riley Kathryn Clapsaddle Justin Vance Oma van den Bent Victor Tango's Denovo Spa Celebration Restaurant, Market and Catering Z Artist Ashley Fairleigh-Abori Jewelry Stern's Catering Co. Texas Data and Revenue Systems On the Border Sports Clips Muskrat Musik Studio The Parlor Salon & Spa Atelier Creek Salon Six Flags Over Texas JR's Grill Sync Yoga & Wellbeing Hair by Arthur at Select Salon FC Dallas Soccer Team Misty Groetken — Stella and Dot Becks Prime Restaurants Modl Furnishings Uptown Players Audi Dallas Houston Opera Stacey Vance 16

Here is a list of our 2013 recipients: Ashton — PECS training for mom Breanna — weighted blanket Camaro — orthotic shoes CJ — weighted vest Colby — seating system Collin — weighted vest Dylan — wheelchair accessible van Elie — weighted vest Edward — social skills camp Haley — compression vest Jaelynn — talking tools Jason — communication device Jet — highchair Jocelyn — wheelchair accessible van Jordan — wheelchair lift for van Juan — Rifton Tram Kevin — seating system Makenzie — weighted blanket Micaiah — weighted vest Michelle — weighted blanket Adrian and Diego — wheelchair lift for van Rebeca — weighted vest Ryan — compression vest Sophia — wheelchair lift and Turney chair for van

Have a great fund raising idea for Chari-T2000? Interested in helping more kids? Chari-T2000 would love the help. Please reach out to Chari-T2000 by contacting: kimberley.gibson@t2000.com

BLOGS WE LOVE Here are some of our favorite places to stop by and visit on the internet right now.

PARENTAL SUPPORT FOR CHILDREN WITH SPECIAL NEEDS We're Hopeful Parents...Are You? http://www.hopefulparents.org/ Grass roots support for parents of special needs. A place for parents of special needs kids to come together and share. Stories and support can be found here. "Our kids have all kinds of special needs, mild to severe. Some of us grieve the loss of our children.We do the very best we can, which often takes a toll on us.We come here to share our feelings with other parents who understand. We're searching for every parent of a child with special needs. Welcome!" Enjoying the Small Things http://www.kellehampton.com/ This blog is written by a mom of four children. Her daughter, Nella Cordelia, was born with Down syndrome. It chronicles the up and downs of their lives. "Between the outpouring of love and support we received, some hard core life analysis and therapeutic insights I made on this blog through it all, I have arrived at the very beautiful place of Life is hard. But it's also amazing, and I will rock the hell out of it." A Diary of a Mom http://adiaryofamom.wordpress.com/ Advocating for and shedding light on what it is really like to parent a child with autism spectrum disorder. "I will be forever grateful to Brooke for unwittingly breaking my insular little world wide open. For allowing me — nay, forcing me — to see the beauty of difference, the light and color and startling depth of dimension in the full range of the human spectrum. For giving me the gift of a

life well-lived thanks to the variety and the quality of the people in it. I owe her — and autism — more than I can ever begin to repay. " PARENTING ADVICE,TIPS and TRENDS Huffington Post Parents http://www.huffingtonpost.com/parents/ Part of the Huffington Post brand, this parenting outlet is a go-to site for all things parenting. It aggregates some of the best blog post on parenting from the web and has regular contributors. It has an interesting range of voices on all subjects having to do with parenting from kids, health and self. No Time for Flash Cards www.notimeforflashcards.com Learning and play ideas for toddlers and kids. "To share the knowledge I have acquired working with preschoolers and their parents for more than 10 years. To provide an accessible resource for parents and teachers filled with multi-level, easy to follow , and fun activities for young children. To support these activities with books, songs and play. To add some fun and learning to your day at home, or some new activities to your classroom. To promote the importance of early childhood education at home and at school. To ditch the flash cards!"

MommyShorts www.mommyshorts.com/ War stories in the battle of mommy vs. baby-plus parenting tips, insights, bursts of wisdom, unique baby gifts and funny baby videos. "My name is Ilana. I'm a working mom from NYC who writes a blog instead of sleeping. I have two daughters. Mazzy just turned three and Harlow is three months but by the time you read this they might both be in college. Provided their NYC preschool education hasn't already bled us dry. If you think you have more adorable children, Mazzy and Harlow will challenge your children to a cuteness contest. Where everyone will automatically tie. Because pitting our kids against each other is totally NOT COOL. (Although I do it all the time.)" THERAPY BLOGS Kendra Ped PT http://kendrapedpt.com/ Wife, mother, professor, & physical therapist specializing in pediatrics. Blogging about child development, family, PT practice, teaching, research, & life. "I believe parents are a child’s first (and best) teacher, and that physical therapy is most meaningful and effective for children and families when it is carried out in natural environments and embedded into daily routines. Although I love physical therapy practice, I’ve found academia to be a perfect setting for me to continue to grow, change, evolve, and discover new ways to make my mark on the world." THERAPY APP 411 http://www.therapyapp411.com/ Integrating mobile technology in assessment and intervention. "This blog is collaboration between four #slpeeps on Twitter, springing from the goal of developing a centralized location for information on mobile devices and their uses in therapy. Our mission is to provide reviews and other con-

tent regarding apps and devices from a therapist’s perspective — SLPs, OTs, PTs or other disciplines who would like to contribute" The Speech Bubble http://www.thespeechbubbleslp.com/ Ideas and resources for speech therapy. "Hi! Thanks for stopping by my blog. I am a card carrying ASHA member and school-based Speech-Language Pathologist. I adore every minute of it! My speech room is always covered with post-it notes and thoughts. I love blogging and sharing ideas. Feel free to look around and check out the freebies, activities, reviews, and information. " Therapy Fun Zone http://therapyfunzone.net/ Keeping the fun in function. Occupational therapy activities that help develop skills. "My goal with this website is that I can help stimulate creativity and information sharing. As a therapist, I am always creating new things to use in therapy or adapting things. I love sharing my projects and solutions. I started this site in order to provide a service to people using what I know, and to reach a wider audience than just my current patients and their caregivers." FOR HOME I Heart Organizing http://iheartorganizing.blogspot.com/ This is a fun blog about what everyone seems to focus on this time of year — organizing. Jen shares smart tips to organize your home and life and shares her fun design style. Houzz http://www.houzz.com Inspiring interior design ideas for the entire home. Browse and curate collections for rooms you are looking to update. Garner inspiration and save your ideas to help you implement.

Survey: WORK LIFE/HOME LIFE — HOME LIFE/WORK LIFE Work life/ home life. Home life/ work Life. It’s a balancing act. We asked the jugglers of T2K to share their advice on how to balance home and work life. Q: Can you share tips on how to balance your home and work life? I try my best to have a schedule and when it is family time it is FAMILY TIME. I also try and do as much work as I can while my husband is at work and kids are at school or when they go to bed. I don't want it to seem as if I am ALWAYS working even when I am at home. – Marisha George, SLP Family always comes first for me.The most important balance is scheduling my caseload so that I don't miss any important moments with my family and still get to do the work I love. – Aubrie Back, OT Schedules! I use my work and personal e-calendars to manager appointments, dates, even finances. – Josh Hubbard, Recruiter Tackle the paperwork ASAP so it's not hanging over my head on my off time, especially holidays & weekends. – Kathy Gamble, PTA Make a written list of ACHIEVABLE daily goals for work related


tasks and household tasks. Scratch out tasks as you complete them. – Debbie Schumacher, SLP Working at T2K is a great start! I love the flexibility this company offers! I also save time on therapy planning by using themes related to current holidays or topics, such as transportation. Once you choose your theme, it's easy to find materials that will carry you through 3-4 weeks of therapy sessions. I print out activities appropriate for each patient, and store them in an expandable file folder labeled with each patient's name. – Melissa Cooprider, SLP I try to have some time each day to do something creative whether it is making something special for dinner or doing a craft before working on paperwork in the evening. – Pam Simpson, PT Careful planning and scheduling. Get ahead of things early in the month so I am not stressed at the end. – Yeisha Culp, PT


T2K-ers are a passionate bunch, you truly love what you do! Pediatrics, therapy, what’s not to love! Q: What do you love most about what you do for work? The children. They give me way more than I give them. – Laura Gowdy, OT I love the "sponge factor" in little kids. – Kristin Giggleman, SLP I love seeing the kids’ faces when they finally accomplish something they have been working so hard on.Their smiles are priceless. – Melissa Kurth, OT I love it when a child does something for the first time and both the parent and I get to witness it together! – Susan Hart, OT Getting to build relationships with the patients and caregivers and being a part of the patient’s growth. Nothing is better than watching child take their first steps!! – Jennifer Ellis, PT As a parent of a special needs child, I love being in the community of others who know how I feel. – Joshua Florence, PT

Getting to know families and patients, understanding the dynamics of their home and what my contribution does to enrich their experiences w with their child. – Aubrie Baack, OT Hugs & kisses from my patients, & the gratitude & excitement from their families when they achieve a new milestone. – Kathy Gamble, PTA Being a part of a child accomplishing something for the first time...seeing the excitement in their face and their parents faces when they finally accomplish a goal. – Rebecca Mastrovich, PT Watching a parent or sibling realize there is so much more to the special needs child in their family and when they begin to initiate and enjoy playing, interacting, and having fun in w ways that bring joy instead of stress into the w whole family. – Elizabeth Bryant, PT Helping parents get the resources they need to better meet the needs of their family. — Amy Bihl, Social Work Flexibility and healthy work life balance. – Ashley Fairleigh, ST



In a recent survey we asked T2K employees what they like to do with their free time.Talk about a varied group of employees, their interests run the gamut! From photography to playing in a jazz band!

Q: What do you love to do in your off time? Spend time with my family and I really enjoy dabbling in photography. – Courtney Mullaney, SLP

I love to sew and cook! Super fun and relaxing! – Pam Simpson, PT

Travel, especially cruises, and go to Baylor sporting events, especially football!! – Erin Bellue, SLP

– Tanya Benson, SLP

I like to bake and hang out with my family! I love watching my son experience something new for the first time! – Jennifer Ellis , PT Anything outdoors, hiking, camping, or just sitting on a patio. – Amber Stewart, PT Watch my daughter see and learn things for the first time.Travel anywhere and everywhere. – Elizabeth Bryant, PT I love to play and spend time exploring with my boys. – Michele Flechenstein, SLP


Travel, gamble, and play in a jazz band. Soccer is my passion; I enjoy playing soccer and also seeing my son playing soccer. – Alejandro Chaparro, AOS I love to enjoy my time with my husband, cooking together or eating out, watching movies, working out, meeting up with friends and sometimes doing nothing but relaxing and cuddling. – Rebecca Goncalves, BO specialist Hang with friends, flea markets, quilting. – Crisann, SLP, Manager Watch basketball! Read, walk the dog, text friends. – Marnie Stone


Talk about inspiring. We asked the T2K team how to help others to find their passion in life. You guys had some motivating answers! Time to start searching…

Q: How do you suggest people find their own passion? Try lots of things until something sets a spark off for you. – Nancy Estes, SLP Listen to your heart; pay attention to what it is in life that you are excited about doing. – Melissa Kurth, OT Start with your interests and decide what motivates you to do what you do. What gives you purpose in your life? – Erin Bellue, SLP Keep your heart and mind open to new ideas and experiences. At the end of the day reflect on your day and how you felt deep inside about it. – Susan Hart, OT Do what makes you smile the most.

people confuse passion with that warm fuzzy feeling we get when we do something. In reality, passion is that feeling that breaks your heart. I am passionate about serving families that have children with special needs, not because it's fun or at the end of day I feel good because it helped a family. No, I am passionate about it because I know first-hand the pain, heartache and daily struggles that go along with being a parent of a child with special needs. So when you ask me to help you find your passion I will ask you,What hurts you the most? What's the one thing that causes you the deepest pain? And then I will tell you to start there. – Joshua Florence , PT


– Carol Kretchmar, SLP Tony Robbins was quoted saying, “It is in the realm of uncertainty, that your passion is found.” So, passion is not something you can just go out and find.You have to put yourself out there. You have to be willing to think beyond yourself.The actual word passion comes from the Latin verb Pati meaning to suffer. Many


FIRE & ICE, Oh So Nice!

It was a night to remember — dinner, dancing and an entertaining presentation by Jerre. An online and live auction benefitting Chari-T2000 got the competition rolling and $8,500 was raised for the charity! A good time was had by all! A huge thank you goes to the Social Events Committee members for putting together such a great party. Theresa Hill (District Manager) Keane Byrom (Division Director) Crisann Skinner (Division Director) Alejandra Chaparro (AOS) Sandra Ordaz (AOS)

THERAPY 2000 2535 Lone Star Dr. Dallas, TX 75212

UPCOMING EVENTS HOUSTON Friday, February 28 Children's Case Management Coalition Conference The Children’s Case Management Coalition (CCMC) is a communitybased program that promotes continuity, quality, as well as resources for members of the coalition. CCMC is supported by Case Managers of the Houston Area and surrounding Counties who chose to be party of this coalition in order to bring the services to our youth. AUSTIN Saturday, February 22 MDA Muscle Walk The MDA Muscle Walk® is a series of fun, non-competitive local walks held across the country, and it is the largest event of its kind in the United States. walk.mda.org/ SAN ANTONIO Wednesday, February 26 ECI Advocacy Coalition Join with advocates, business leaders and community leaders from across the state as we come together to discuss challenges faced by Texas children and potential solutions to improve their lives and build a strong Texas future. Topics covered will include: equity and disproportionality, juvenile justice, infant health, women's health, obesity, nutrition, mental health, substance use, early education, child welfare, and health coverage. http://txchildren.org/conference

SAN ANTONIO (cont'd) Monday and Tuesday, March 3-4 Child Abuse Prevention Conference A statewide conference designed to offer quality training and information on topics and model programs of interest to leaders in child abuse prevention: social workers, counselors, educators, child care and youth workers, law enforcement personnel, medical and legal professionals, foster parents, child welfare board volunteers, elected officials, and other interested child advocates. Participants may attend their choice of a variety of workshop son child abuse and neglect prevention and educational programs or may select workshops for special training credits and professional developments http://www.preventchildabusetexas.org/nextconference.html Friday, March 21 Autism Community Forum The fourth annual Autism Community Forum will bring together autism service providers throughout Texas to learn about autism research and best practices for children with autism. Professional CEUs will be available for: TEA/BACB/TOTA/ASHA http://www.autismcommunitynetwork-sa.org/autism-community-forum/ Thursday, April 17 Fiesta Especial Fiesta Especial® is an official Fiesta® San Antonio event created for children and adults with physical, cognitive and developmental differences and the family and friends who love them. http://www.fiestaespecial.com/

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The Insider: February 2014  

THERAPY 2000 presents the February 2014 edition of the Insider. Check out the "LOVE" issue!

The Insider: February 2014  

THERAPY 2000 presents the February 2014 edition of the Insider. Check out the "LOVE" issue!

Profile for t2kit