Gateway Therapies
Brisbane occupational therapy, speech therapy, autism therapies and NDIS services for all ages

Get Help With Autism and NDIS Services Brisbane

Featuring articles from our principal Occupational Therapist, Dr Nicole Grant, members of the therapy team, and guest posts from members of our community.  

Gateway Therapies Professional Development Day

Here at Gateway Therapies, we strive to learn consistently and develop new skills to ensure we are informed and prepared for every client. To achieve this, we regularly have group meetings and take part in professional development days to not only gain innovative skills, but it also gives our team the opportunity to share their knowledge, prepare competent presenting skills and enables us to come together and work as a coherent and professional team.

See the video below for a snippet of our professional development day!

Grace Holgate
Tips for creating a safe and functional bathroom for the blind or visually impaired

Guest Post: Ashley (Disabled Parents)

While the bathroom is one of the smaller rooms in the house, it can still present big hazards and safety issues for people who are blind or visually impaired if it is not set up correctly. Taking special care to follow safety tips can create a safe and warm environment.

Shared bathrooms mean more hazards

Unless you live in a house with several bathrooms, more than likely, the bathroom is a shared space. This means there may be family members leaving towels, puddles of water, bath toys, or other items on the floor that can become tripping hazards. When living with a visually impaired family member, it is very important for the rest of the family to become more aware of dangers and to regularly check the floors for items that could be tripped on.

Open floor plans give freedom of movement

A bathroom with wide walkways is best for someone with a visual impairment. This includes keeping walkways free of things like laundry hampers, shelves, or even garbage cans. In spaces that are narrow, something as simple as an open drawer can become a hazard for someone with limited or no vision.

Replace shower curtains with shower doors

Replacing a shower curtain with a solid shower door can cut down on accidents in the bathroom. It is very easy for someone with a visual impairment to get caught up in a shower curtain and fall. Using a door that the person can feel is open or closed reduces the chances of tripping.

Colours matter

When choosing colours for things like towels, soap dishes, toothbrush holders, and other bathroom items, you should select colours that can be easily identified. Avoid towels that are light in color or too close to the shades of the floor, counters, or walls. This will help people who are visually impaired locate towel racks and watch for a towel accidentally left on the floor. Keep color choice in mind for things like the shower doors as well, so there is a well-defined difference between the walls, bathtub, and door.

 

Another place where color can help is defining the top of the tub if you have a bathtub/shower combo one needs to step into. Something as simple as a bright stripe of wide waterproof tape can alert users to the top of the tub so they can step over it.

Install bright lights and motion sensors

Unless someone is light sensitive, the bathroom should be well lit. Bright lights that fill the entire room with light will help people who are visually impaired avoid hazards. You can also consider installing lights that are triggered by motion to keep all members of the family safe on midnight bathroom runs.

Add user-friendly water fixtures and labels

Using a system of two different handles for hot and cold water can be both positive and negative. While it may be easy at first for the visually impaired to mix up the two dials, it does eventually offer more control. Whether you have one handle or two, clearly labelling or marking hot versus cold is important. If the user can see colors, this can be done with red and blue labels. If the user can’t see colors, braille can be used.

Anchor the bath mats and rugs

Many people use small bath rugs to keep their tile or vinyl floors from becoming slippery, but the rugs themselves can be a hazard if they are not anchored to the floor. The same thing can be said about mats used in the shower. Things like non-stick decals for the bathtub are much safer than suction-cupped bath mats that can slip and move around. Furthermore, adding a bench or chair to a tub or shower reduces the chances for falls, especially if the surrounding surface is slip-proof so that sitting down on and getting up from the seat are hazard-free.

Install soap and shampoo dispensers

Instead of fumbling with multiple bottles of shampoo and other products in the shower, it may be easier to install a dispenser that can be refilled with products in a predictable order. This clears the clutter of too many bottles in the shower and makes it less likely they’ll get mixed up or dropped.

Add grab bars in shower and near toilet

One of the most important things you can do to make your bathroom safer for a visually impaired family member is to install grab bars in the shower and next to the toilet. Grab bars are very helpful and can prevent falls and injuries. They can help with balance, particularly in a slippery shower. Make sure to place grab bars in spots that are easily accessible.

Bathroom safety is crucial for those who are visually impaired, particularly when the bathroom is shared with other family members. When creating a safe bathroom environment, it’s essential to think about space and color, and you need to consider lighting, water fixtures, bath mats, dispensers, and grab bars as well.

 

Image by MikesPhotos via Pixabay

 

 

 

The National Disability Insurance Scheme and Brisbane Families - What you need to know

The National Disability Insurance Scheme or NDIS is a federal government initiative that provides funding for adults and children with disabilities to access services and supports needed to achieve their life goals. It's a wonderful opportunity for people with disabilities to have the support they need to participate in education, vocational, leisure, community activities and more.  

In Brisbane, the NDIS rolls out in July 2018. If you are eligible and hoping to obtain funding, you need to apply NOW.  

You may be eligible for funding if you:

  1. Have a disability
  2. Are aged between 0 and 65
  3. Are an Australian resident

Your eligibility for funding is determined by a representative of the National Disability Insurance Agency (NDIA). Your application will be reviewed by either a Planner or Local Area Coordinator. The person assessing your application will ask you to state the applicant's goals. A goal may be to obtain a job in hospitality, make new friends who share similar interests, or learn how to independently access public transport.

Ready to apply? Here's what you need to do:

  1. Call the NDIS on 1800 800 110 and request an ACCESS REQUEST FORM.
  2. Decide what your primary and secondary goals will be.
  3. Decide what services you may like to access so you are clear on what to ask for in your plan. 
  4. Get together all your supporting documents. Gateway Therapies can provide you with a report outlining all your support needs and an overview of the applicant's needs to justify your funding request. We can also help you better understand the types of services you can access under the NDIS. Call us on 3398 9367 or use our booking form to request an NDIS planning Assessment.
  5. Once you've received your plan, it's time to choose a provider who can help you achieve your goals. Gateway Therapies is an approved provider of many NDIS approved services, however you can also find other service providers HERE.

 

For more information, you can download the NDIS Pathway fact sheet HERE


 

Careful Planning: Arranging for Long-Term Support of a Special Needs Child

Careful Planning: Arranging for Long-Term Support of a Special Needs Child

GUEST BLOG

Note: Some of the information included regarding funding is relevant for our American readers only. Australian readers can visit www.ndis.gov.au for more information about funding options for Australian familes. 


Parents who have a special needs child are the sole managers of their dependent’s personal and financial affairs, a role they often needs to be extended beyond their child’s 18th birthday depending on the severity of the disability and level of need. That role includes coming up with a future care plan should one or both parent die unexpectedly or become unable to continue providing care.

It’s a difficult responsibility because it means weeding through a daunting pile of information about government programs and relying on the continued presence of those resources well into the future. A financial planner or tax expert can provide valuable advice and guide you through the details and pitfalls, but parents should have a good general understanding of what to do and what options are available to them.

Support group

Seek out the assistance of a support group, which should include a financial counselor who has expertise in special needs issues. The make-up of your support team may vary based on your child’s needs and your circumstances, though in general it should include a lawyer, your child’s therapist (or therapists), and someone close to your family who can help look out for your needs in light of other expenses, such as a disability ramp. According to Home Advisor, most homeowners spend an average of $1,750 to have a disability ramp built.

Prepare your will

The disposition of your estate is an important step and one that should be taken carefully. Many people confidently leave their assets to a special needs child, knowing how much that money will be needed in the future. However, your will needs to be written with government regulations and tax laws in mind where your child is concerned. For example, if he or she receives assets of $2,000 or more it means disqualification from federal assistance, a vital source of ongoing aid. Discuss the ramifications of passing assets onto your child with a lawyer before finalizing your will.

 

Special needs trust

A special needs trust allows parents or guardians to make provisions for a special needs child that won’t disqualify them from federal aid. The money must be used to support a child’s quality of life and can help supplement government aid. It’s an agile resource and contributions can be made gradually, or the trust itself may be named beneficiary of a life insurance policy or inheritance. 

Coordinate with friends and family

The danger of losing federal assistance over the $2,000 special needs dependency asset rule is clear enough to parents when making their own last will and testament. But it may not be evident to friends and family members who want to name a special needs friend or relative as a beneficiary. Talk to people who are close to you, those with assets that could go to your child. If they’ve named your child as a beneficiary, ask them to leave assets of $2,000 or more to the special needs trust so your child’s right to federal assistance is protected.

The ABLE

For people who want to avoid the cost of establishing a special needs trust (which can cost up to $3,000), the ABLE, or 529A account, is similar to a 529 education savings account in that anyone can contribute. The funds are available tax-free so long as they are used for quality-of-life-enhancing purposes. There are some negatives that should be considered, though. Total yearly contributions are limited to $14,000. Contributions to the 529A aren’t tax deductible, and after the dependent passes away the money can be absorbed by Medicaid.

Plan carefully when making long-term plans for your special needs child. Seek the advice of people who have an extensive body of knowledge when it comes to special needs financial planning. And always bear in mind that there are complications to distributing assets after you’re gone.

Courtesy of Pixabay.com.

 

 

 

 

 

 

 

 

 

 

 

Nicole Grant
What's Best - Handwriting or Typing?

A few years ago, I conducted an Ergonomic Workstation Assessment for an adult who was employed in an administrative role. This particular employee had the task of completing a large number of forms by hand and she was experiencing symptoms that her GP thought might be early signs of Carpal Tunnel Syndrome. This recent assessment again got me thinking about writing.

Computers and other electronic devices are being used more frequently to communicate - either in real time or to convey a story or recount an experience. It appears as though typing has become the preferred method of communicating over writing and even at times over speaking. I wonder if this is the reason why there is an increasing number of both kids and adults who struggle with writing - either by writing poorly or by developing pain in their hands and wrists during this task?

It's important with any skill to practice often. Use it or you lose it - basically. My approach with working with kids is to firstly correct their pencil grasp, and then practice, practice, practice. Work on letter formation, letter height, width and word spacing. With adults who are reporting pain or other symptoms e.g tingling in the hands, I encourage them to continue writing, but to alternate written tasks with other activities. I encourage all clients, both young and old, to perform hand stretches before commencing writing tasks - just like a footy player would stretch his muscles before running onto the field.

I would love some feedback on this post. Which is more important - handwriting or keyboard skills? Do you experience hand or wrist pain if writing? What about your kids?

Please note, if you experience pain, numbness or tingling when writing or typing, and it does not go away, seek medical attention.

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The importance of building rapport in therapy

As the end of the school year draws to a close, I find that my school age clients get a little bit impatient, frustrated and less cooperative. I think it's a combination of fatigue, burn out, and anticipation of the holidays and Christmas.

One particular client, a boy with Cerebral Palsy, flatly refused to cooperate one day. Knowing that he was likely to be a little difficult, I had prepared activities that I thought would be fun. I only had a few things with me as I was seeing this boy in his home. When he showed no interest in any of the tasks I had on offer, I knew I had to try harder, as there was no alternative. In my therapy room I have a huge range of resources, but on home and school visits I am limited.

"I don't want you in my house", said the boy. "I'm the boss here" he added.

I told him that he wasn't and that we were there to work, that his father would be disappointed if we did nothing, and that it was to help him to use his arm better. "You need to practice using both your left and right hands to play the Wii!" His favourite thing to do.

"I don't want to", he said when I offered him different games. He had not even looked at them.

Complete resistence.

I needed him to understand that I wasn't going anywhere.

"I like you", I said. "I want to be here, and I would really like you to play this game with me".

Well those first three little words made the biggest different. The boy looked at the game I had in front of us, looked up in to my eyes and said "OK". For the rest of the session he was involved, he participated, and he worked hard. I was so proud of him and so thrilled that our therapy session was productive.

I think there are so many messages here in this story. It's important to show consideration and care for other people. It's nice to be told nice things, and it's nice to be nice. I meant what I said, and I think that's important too.

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How occupational therapy helps children with autism

Article originally posted as a Guest Post, Authored by Dr Nicole Grant at Baby Hits and Tips.

Occupational Therapists are highly underrated allied health professionals. Being one, I can say that with some authority. Seriously though, having just returned from a conference attended by about 750 of us, I can definitely say that they are an amazing bunch of people. The thing is, if you haven’t needed one, chances are you don’t know what an OT is, and how much you are missing out on!

OT’s are university qualified health professionals who are specifically interested in helping people to independently undertake those activities that matter to them most. For children, this quite often means helping them to play. We look at all of those things that can impact on a child’s ability to play – like physical injuries, intellectual impairment or developmental delay. We find out what kids love to do, need to do, and want to do, and help them to do it. This may include giving them special equipment or tools, modifying their environment to better support them, or engaging them in therapy aimed at improving their ability to play.

Children with autism can benefit from Occupational Therapy in many different ways. We can help to develop fine motor skills (handwriting, using cutlery, stacking blocks) as well as improve social skills (turn taking, joint attention, making friends). We can help establish alternate methods of communication where speech is limited (PECS, Makaton signing) or provide strategies to help overcome sensory dysfunction(such as hypersensitivity to noises and smells).  OT’s can also help with self-care skills such as toileting and dressing.

Many OT’s will undergo ongoing professional development or seek further education to become specialized in different fields. To work with children on the autism spectrum, you will usually find that your therapist has undergone specific training in interventions tailored towards helping children with autism.

If you are a parent of a child with autism, there are questions that you should always ask your therapist, before deciding if they are the right person for you. The following questions are adapted from the Early Intervention for Children With Autism Spectrum Disorders: “Guidelines for Good Practice”  (Roberts & Prior, 2012).

Questions to ask your OT

  • What are the specific aims of the program or service you offer?
  • Are there any medical or physical risks?
  • What assessments are carried out prior to the intervention?
  • What is the evidence base for this intervention? (i.e. what proof is there that this works?)
  • What evaluation methods have been used to assess the outcome of intervention? (i.e. how good are the studies that have tested this treatment option?)
  • Do you make money out of the intervention you are promoting?
  • What is known about the long-term effects of this treatment?
  •  How much does it cost?
  •  How much time will be involved?

At Gateway Therapies, we specialise in helping children with autism. Contact us now on 3398 9367 to make an appointment. 

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Should my child get a diagnosis?

A post from Director, Nicole.....

I often receive requests to assess for delays with development or dysfunction in the areas of sensory processing, fine and gross motor development, attention/ concentration and other areas of function. One of the questions I am frequently asked by parents, particularly when obvious issues become apparent, is - what do you think it is? Many parents are aware of neurodevelopmental disorders like those on the autism spectrum, and I often get asked about ADHD and sensory processing disorder.

I will always refer to a paediatrician for diagnosis, but can assist with the process by providing a report outlining my observations and recommendations.

Parents often feel reassured when they at least have a little more information as a result of an initial assessment, particularly as my focus is always on providing information and strategies to assist - regardless of whether or not a name is given to the challenges identified.

Once specific issues are identified, the treatment options or interventions used tend to be the same, regardless of what the diagnosis is, or will be. The problem here is that without a diagnosis, parents can have limited access to Occupational Therapy services. Government funding is available in Australia for children with special needs via such schemes as Helping Children with Autism and the Enhanced Primary Care Scheme. However, a diagnosis is required. Parents who wish to pursue intervention with a private allied health professional, and do not have a diagnosis, may be able to claim some of the expenses from their private health fund, or self-fund the fees.

Occupational Therapy services are available to the community via community services and more specifically to school age children through the Department of Education and Training. Waiting lists are often lengthy, which can affect access to early intervention services, however it's worth contacting your local department to check.

My concern with seeking a specific diagnosis or giving a name to the difficulties a child is experiencing, is that some children just do not meet all the criteria to be given a diagnosis. This doesn't mean they are any less in need of assistance. Many children can benefit from Occupational Therapy services, to develop skills to help them with their school work, social interaction, and self care. Click on the links or email me for more information.

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Low Muscle Tone and Poor Attention - A Case Study

A young boy, 4 years of age, was brought to me for assessment about 9 years ago. He had not been diagnosed with any particular disorder, but was easily distracted and found it difficult to pay attention to the task at hand. He had been seeing a Speech Therapist for some time due to a slight delay in his speech development and he dribbled.

The boy's mum was mostly concerned that he would not be able to concentrate in class when he started prep next year. She wondered what she could do to help him at home, in readiness for school.

I gave the child some activities to complete and observed that he fidgeted in his chair, and was easily distracted, and yes - had difficulty paying attention. One of the first things I noticed was that when needing to apply force or pressure, e.g to mould playdough, he would move to position himself over the table to use all his strength, rather than relying on his hand strength alone. When I asked him to throw a ring or ball, he needed to use two hands to get any sort of distance. Throughout the assessment I asked the boy to complete desk-based tasks that assessed things like posture, attention, and fine-motor skills, and more active tasks that assessed his balance, coordination and proprioception.

During the assessment, the 4-year-old managed to respond to multi-step directions, and complete age appropriate puzzles and games. I found that when he began to lose focus and become distracted, his posture also changed and he would recruit compensatory muscle groups to move or exert force on an object. I asked this child if he ever got tired in the neck, back, arms or legs when sitting for a long time. He thought for a second then answered "Yes. Sometimes my elbows hurt." His mum hadn't heard this before and wasn't sure what he meant by this.

By the end of the assessment, it had become apparent that the attention difficulties experienced by this boy were more likely due to low tone, than because of any cognitive or intellectual dysfunction.

Low tone or hypotonia is explained well in Wikipedia:

"Hypotonia is a disorder that causes low muscle tone (the amount of tension or resistance to movement in a muscle), often involving reduced muscle strength. Hypotonia is not a specific medical disorder, but a potential manifestation of many different diseases and disorders that affect motor nerve control by the brain or muscle strength".

I recommended that the child engage in physical activities that promote muscle strength, balance and coordination, like climbing, running, and bike riding. He was already taking swimming lessons and going to structured gym classes, so he was already on his way.

With regards to desk-based work, I suggested that the boy be given a seat and chair that was appropriate for his size and that enabled him to sit with his feet flat on the floor and his back well supported. When performing desk-based tasks, it was probable that the child would become easily fatigued and possibly develop joint or muscle pain. He needed to be given the opportunity to stretch and change postures frequently.

With these strategies in place, and ongoing review of his progress and awareness of his needs, the 4-year-old boy should have no difficulty keeping up with his peers on commencing prep.

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Animal Assisted Therapy

Director Nicole reflects on her dream to become an Animal Assisted Therapist....

I've always been an animal lover with a keen interest in Animal Assisted Therapy. Following my graduation as an Occupational Therapist in 2002 I was keen to undertake a research project exploring the benefits of Pet Therapy, and even had lined up a supervisor at Latrobe University, however I needed to prioritise full time employment.

My interest was again piqued a few years later in 2009, when my daughter's swimming instructor took temporary ownership of a Guide Dog puppy in training. The little pup came along to the pool and I was fortunate enough to get a cuddle. I must have been besotted, as I wrote about the experience in a blog post on another forum at the time. 

Guide Dogs are well known to the general community, and most people are aware that these dogs are great companions for people who have a visual impairment. The many other benefits of dog ownership and the use of dogs in therapeutic situations, are not as well known.

Most dog owners will tell you that their pets are great company, good for keeping away unwanted guests, great at eating food thrown on the floor, and provide motivation for getting some exercise. These benefits are fairly obvious. What you may not realise, is that there are also health benefits to dog ownership. There has been some excellent research conducted by psychologists and other health professionals, that has found that pets can improve your mood and help depression and loneliness, reduce stress and lower blood pressure, and promote a healthier lifestyle.

Because of these benefits, dogs have been introduced into therapeutic situations. They can be used to provide motivation for children with movement difficulties, or act as a calming influence for people who may have an anxiety disorder. Read this abstract from an article to find out how a dog helped a child with Post Traumatic Stress Disorder (PTSD).

In addition to being used in therapy settings, (just like Darcy and I!) dogs have also been trained as Assistance Dogs. These animals are able to help people who have a disability that prevents them from independently completing some tasks such as opening doors and retrieving items.

If you are interested in reading more, or in helping to support one of these fantastic causes, please click on these links:

Delta Society Australia

Smart Pups

Assistance Dogs

Guide Dogs - Pets as Therapy Program

Interact Therapy Dog Program

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Darcy and Nicole graduate as an Animal Assisted Therapy team (2016)