Children who have Down syndrome and other cognitive impairments typically have low muscle tone throughout their body. Low muscle tone impacts on all areas of functioning from eating to walking, to speaking. The Stepping Stones School Therapeutic Program specializes in addressing the physical strength needed to develop essential skills impacted by low tone. Individual, group, and integrated therapies are incorporated into each student’s day, resulting in an all-day therapeutic experience that facilitates the strength and growth needed for all areas of development. The success of our students demonstrates the importance of an experienced, multidisciplinary, therapeutic approach for children with Down syndrome or other cognitive disabilities. The specialized therapeutic programs offered at Stepping Stones are like no other school program.
INDIVIDUAL, GROUP, AND INTEGRATED THERAPIES
Our Speech and Language Therapy Program is a key component of the Stepping Stones School program. The Speech and Language Program at Stepping Stones is the most valuable resource your child will have to communicate both expressively and receptively. Many students begin the program needing to find a way to communicate their needs, wants, and ideas and to develop the use of words. Through the use of a wide array of speech & language activities, oral motor strengthening and training, and a variety of communication modalities, students are given daily opportunities to increase their ability to express themselves in their classroom, at home and in community settings. These speech and language development experiences ultimately set the ground work for greater inclusion and participation for the future.
Stepping Stones’ speech therapists provide individual and group speech and language therapy sessions, all carefully designed to focus on each child’s unique needs. Our Speech Therapists use the most advanced practices, tools, and approaches to help our students maximize their speech and language potential; most of the students surpass their speech and language goals.
Some examples of speech and language modalities include: sign language; oral, auditory, written and visual aids; gestures; pictures; visual and physical prompts; and augmentative devices. Speech and language programs that are infused into the Stepping Stones Speech and Language Program are: TalkTools©; PROMPT ©(Prompt for Reconstructing Oral Muscular Phonetic Targets); Kaufman Speech to Language Protocol ©; and Beckman Oral Motor©. Therapists work collaboratively with all instructional staff to incorporate speech goals, techniques, and approaches into each student’s academic day.
Sign Language: Total Communication
As students are developing their communication skills, all of our speech therapists and educational staff use Total Communication© to enhance each students ability to communicate.
A feature of the Total Communication program is using sign language along with the use of the spoken word. This program allows students to communicate their needs and wants, and helps decrease frustration when they cannot be understood. As soon as the verbal word is learned by each student, the sign language component for that word is dropped from use. This program approach has demonstrated repeated success in our student’s ability to learn the spoken word and communicate independently.
Children with developmental disabilities can have physical difficulty eating foods in general as well as eating foods that have a variety textures, smells, and tastes. Reduced muscle tone in the mouth impacts jaw stability which can make biting off and fully chewing solids, a difficult task. Jaw stability is necessary for tongue lateralization (ability to move the tongue side to side) which is needed to effectively shift food from each side of the mouth and clear food from the sides of the mouth when we chew food. Overall sensory issues in the mouth contribute to the child only eating limited foods. The lack of development in this essential area can impact on a child’s speech development. With over 40 years of experience providing outstanding educational and therapeutic support to students who have these types of needs, the Stepping Stones School has developed a state of the art Oral Motor/Therapeutic Feeding Program.
The Oral Motor and Therapeutic Feeding Program consists of a multidisciplinary approach in which a speech, occupational and physical therapist works collaboratively during each student’s snack and lunch periods. The therapists are present during snack and lunch times when each student receives individualized oral motor warm-ups and 1:1 attention. Each therapist focuses on skill development with the goal to improve self-feeding, increase volumes and textures of food and liquid, strengthen jaw and oral motor muscles, swallowing, and improve development of oral motor skills for feeding and speech.
The five tenants of our Oral Motor/Therapeutic Feeding Program are as follows:
- To increase your child’s awareness of the structures used during feeding and in speech (i.e. tongue, teeth, lips, etc.)
- To increase or decrease your child’s sensitivity to touch and texture in their mouth and jaw area.
- To facilitate more normal oral movement patterns.
- To increase your child’s ability to differentiate movement of the jaw, lips and tongue.
- To help your child achieve successful speech sound production and successful food manipulation.
Each student has their own warm-up tools and warm up exercises which are implemented by a therapist or trained staff member prior to each snack or lunch period. These tools are uniquely chosen for the oral motor needs of each child. All warm-ups are performed to achieve success for independent feeding and speech and language development. The therapeutic use of PROMPT (Prompt for Reconstructing Oral Muscular Phonetic Targets) in speech therapy facilitates success in all verbal communication skills and is used throughout this program.
The basic warm-up tools and their related importance are as follows:
- Gum massage: to increase oral awareness
Importance: to provide tactile input, decrease defensiveness and to prevent food pocketing by increased oral awareness.
- Chewy tube: to improve chewing and jaw strength
Importance: to increase the ability to bite off solids and create stability for self-feeding and later the development of language and articulation skills.
- Nuk: to improve tongue mobility and lateralization (ability to move tongue from side to side).
Importance: to improve the ability to move food from molar to molar, help create a mass of food when chewing, and to increase the ability to make contact between the tongue and palate and the number of speech sounds.
At Stepping Stones, our Occupational Therapy program focuses on building the foundational skills necessary for fine and gross motor development, sensory processing, perceptual skills, and written communication skills. Many students with Down syndrome or other cognitive disabilities have underlying sensory processing disorders that contribute to difficulties with attention, hand-eye coordination, and emotional regulation. Using our multi-faceted approach to learning, the Stepping Stones’ occupational therapist assesses each student’s underlying sensory processing needs and develops a comprehensive individualized program.
The therapist implements each student’s program in a group setting within the classroom or in an individual setting in our state-of-the-art therapy suite. Goals including pre-handwriting and handwriting, posture, fine motor, and problem solving skills are implemented using specialized programs including Handwriting without Tears©, Jean Ayres Sensory Integration theory and Greenspan’s DIR/Floortime© approach.
The Stepping Stones Schools’ Occupational Therapy Program includes:
- Activities to develop fine motor skills
- Sensory integration therapy/sensory diet implementation
- Emphasis on visual motor integration
- Therapeutic exercises to improve oral motor muscles
- Assistance with self-care, feeding, and activities of daily living
- Focus on appropriate play and social skills
- Specialized writing equipment to maximize proper hand placement and letter/word development
- Use of adaptive equipment including pencil grips, straw stoppers, Benik© supports, weighted vests, weighted blankets.
- Movement therapy
- Individualized seating adaptations
- Information and training for families to ensure carry over from school to home
At Stepping Stones, our Physical Therapy Program focuses on building essential foundation skills needed to accomplish a wide array of gross motor developmental milestones. After a comprehensive assessment is conducted, the physical therapist designs an individual and specialized program for each student. Individual and group therapy sessions are integrated into the students’ daily routine and can occur in the classrooms, in our state-of-the-art physical therapy gym, in outdoor areas of the campus, and/or the playground on customized equipment and a rubberized ground surface. Through these modalities, students work on strengthening large motor muscles, maintaining good posture, ensuring proper foot alignment and walking patterns, and the ability to navigate group physical games. Students learn the needed skills from our program to successfully navigate group activities with their families and peers.
The school’s Physical Therapy Program includes:
- Activities to develop gross motor skills
- Individualized movement plans to help navigate the classroom, school, and community
- Therapeutic exercises to improve strength, balance, coordination, and flexibility
- Specialized treadmills to provide partial weight gait training and an inventory of traditional and innovative walkers, standers, and powered wheelchairs.
- Use of adaptive equipment, orthotics, and assistive technology to facilitate independence and mobility
- Use of standers and walkers so students can assume upright positioning in order to interact with their peers during math, science, reading, and all aspects of the curriculum
- Information and training for families in the management of physical barriers
- Instruction in skills important for lifelong fitness and participation in play and recreational activities