The Wake Area Telehealth Collaborative

Helping Children with Special Needs 
December 2008
In This Issue
Update on the Honours
Wake County Services and Resources Webpage
WATCH Program Updates
Employment Opportunities
WATCH Directory
Area Resources
Save the Dates
PM&R Rehab Reader
Run, Walk & Roll for WATCH
VBA Videconference Resources
WATCH Videconference Review
Spina Bifida Session Follow-Up
Research and Resources
CP Presentation
Upcoming WATCH Professional Development Sessions
Research Articles of Interest
Using the WATCH Listserv
Fun at Marbles

anna and units
Honours Golf Tournament
 a Big Success!

The Honours 
Golf Tournament, held on September 27th, raised over $7000 to support the TelAbility program. 
 The funds will help
advance videoconference technology and educational programming  provided 
through  the WATCH Project. 
We thank Jennifer and Ethan Pfaltzgraff for being our hosts and all of you
who contributed and
donated money
in their honor.
WATCH Numbers

 continued  to be busy
the last two months. 
Videoconferencing was utilized  8 times in October, November and the beginning of December. Five times for educational purposes, three times for videoclinics, and twice for administrative meetings.
A total of 146 people attended these sessions.  Evaluations show the average session's satisfaction and comfort  level's were a 4.7  out of 5.0. Those involved in the educational session all strongly agreed that the session provided them with new knowledge applicable to their work. 
Wake County Services and Resources for Children Birth-Five Webpage TR
We now have 60 programs included in the Services and Resources webpage. 
Is your agency one of them? 
For more information or to obtain an enrollment form contact Juliellen at

WATCH  Program Updates

The Project Enlightenment Book Drive is underway. In December, Project Enlightenment will have books to distribute to agencies in Wake County to give their families. The purpose of this book drive is to provide books for families that would not be able to purchase them.

If your agency is in Wake County and would like books to give to families, please contact Anne Sherman directly at 856-7804 or 

Please give your name, the name of your agency, the ages of the children you serve, and how many books you would

Most of our books are for young children. However, we do receive some chapter books. We will call you when the books are ready and you can pick them up at Project Enlightenment, 501 S. Boylan Ave. Raleigh, N.C.

Beginning in January, Project Enlightenment  is also offering Off to a Good Start sessions for parents of children entering kindergarten in 2009.  The sessions are free and will be offered at several schools throughout Wake County.  Please go to the Project Enlightenment website for information on dates, times and locations.

Pediatric Therapy Associates
is now offering Yoga Classes for children with special needs.  Yoga Fun classes will explore a new theme through movement, group games, art and more. Children will stretch their bodies as well as their imagination as we combine traditional yoga poses with creative play. Focus will be on strengthening, increasing flexibility, balance and attention. Each class ends with relaxation time designed to help children learn calming strategies and techniques. Social skills and self esteem are emphasized. No previous yoga experience required. Mats will be provided

Classes will be offered at the PTA Lake Boone Trail location on Thursdays and Saturdays, beginning the end of January and will end in March.  The cost is $14/per week (6 weeks total).  Call 781.4434 to register or for more information.
In April, PTA will be sponsoring a two day training workshop, focusing on The READY Approach- a technique to help identify and meet the needs of persons with maladaptive responses associated with sensory needs.

The cost of the session is $295 if registered by 3/23. Please contact Abigail Calalang at 919-854-0404 x231 for more information.

Learning Together offers services for families with children experiencing difficulties with transitions, relating to peers, showing affection, processing language and following directions.  For more information call 919.856.5386 or go to their website.

Developmental Therapy Associates is offering a social language group to help preschool-aged children use their words to work together in play. Two licensed speech-language pathologists will instruct the group.  Registration deadline is December 12, 2008.
Congratulations to Julie Rockefeller, SLP and videoconference tech support extraordinaire, from the Tammy Lynn Center.  Julie's son,  Carter Joseph Rockefeller,  was born at 10:38pm on December 9th.   Mom and baby are doing fine!
(I'm not quite sure what I'll do without Julie's tech support at TLC for the next few months, but we'll all muddle by somehow. :) )
anna and units 
Employment Opportunities
The Tammy Lynn Center for Development Disabilities
 is looking for a Speech Language Pathologist to provide maternity leave coverage (approx 10 weeks) from January to March.  All services are center-based so there would be no travel involved.  The children range in age from 3 -22 years and are severe-profoundly disabled.
For more information, please contact:
Lillian M. Matthews
Community Services Director
Tammy Lynn Center for Developmental Disabilities
739 Chappell Dr
Raleigh, North Carolina 27606
(919) 755-2676
fax (919) 755-7421
Are You Connected?
v/con session
We are currently updating all our WATCH Member information and want to make sure you are included! 
Please complete the
 WATCH Directory Form and email it back to me (  
at your earliest convenience. 

Wake County Area Resources and Information
 The Carolina Center for Music Therapy, LLC, announces a new music playgroup for chidlren 0-5.  Beginning in December, The Music & Me playgroups will be held in Cary, Raleigh and Durham.  Cost is $10 per family.  You will learn songs and activities to play interactively with your child.  Families will received a number of resources, including props, CD recordings and copies of song. 
The Carolina Center for Music Therapy also provides Developmental Therapy (CBRS) through their partner, Pediatric Therapy Associates.  
The Wake County Cerebral Palsy Support Group meets the second Tuesday of every month @ 7:00 pm at Michael Dean's Restaurant in Raleigh on Fall of Neuse.  Come for dessert, coffee, dinner or just to meet other mom's and dad's who understand your daily joys and struggles.  We meet in a private room and enjoy wonderful food and great conversation.  We welcome anyone regardles of their special needs diagnoses that is looking for a support home.  Contact Rachel Pack at 319.0286 with questions. 
Upcoming Events: 

Friday, December 12th
"An Introduction to Mindfulness"  WATCH videoconference session

Wednesday, January 21st
A Modified Constraint Induced Movement Program for Children in the Infant Toddler Program
WATCH videoconference session

Wednesday, January 28th
Routines Based Assessment for Premature Infants
WATCH videoconference session
For more information on any of these sessions and for more professional development opportunities check out the TelAbility calendar.
Join Our Mailing List

Visit Our Sponsor
Many thanks to the John Rex Endowment for their continued support of the WATCH Program into 2010!
Happy Holidays WATCH Members!
While I'd like to be wrapping gifts, I've actually been working on wrapping up this issue of the WATCH Newsletter.  This issues includes links to great articles about our own Dr.  Alexander and the TelAbility project; recaps on videoconference sessions held over the past 2 months; descriptions of sessions yet to come; and a myriad of resources from our WATCH Sites.
Dr. Alexander and I spent some time talking with WATCH Site Directors this month and received some really good thoughts about projects to start in the new year.  Some ideas include:
-having each WATCH Site host a monthly transdisciplinary case study or  peer review conversation on a topic of their choice;
-offering more early childhood education and inclusion sessions;
-hosting parent support lunch and learn sessions via videoconference;
-beginning mentoring partnerships via videoconference. 
I certainly won't be able to do all that on my own, so look for emails asking for your help and participation in coming up with topics, session coordinators and session facilitators. 
I know we are all well aware and highly attuned to the economic climate and the pressures it puts on our agencies and the families we serve.  We certainly are in uncertain and tenuous times.  What I do know for certain is that WATCH remains a safe and vital collaborative that can sustain economic hardships because it is made up of people who give of themselves and their knowledge and expertise freely and willingly.  I am always grateful and amazed by that fact!
May you all have a joyous holiday season and may that joy follow you into the new year and beyond!

Dr. Alexander and TelAbility Featured in this Month's Issue of the PM&R  Rehab Reader
This month, Dr. Alexander and the TelAbility Program were featured in the Department of Physical Medicine and Rehabilitation's Rehab Reader.  Also featured was Jennifer and Ethan Pfaltzgraff's inspiring story and the resources offered through TelAbility and WATCH
To read about Dr. Alexander's approach to integrative care,  teaching methods with residents, Jennifer's story, and the resources offered through TelAbility follow these links:

Jennifer's story/TelAbility resources

Dr. Alexander's approach to integrative care

Run, Walk and Roll for TelAbility 
The Department of Physical Medicine and Rehabilitation at UNC is planning to sponsor a Run, Walk and Roll-A-Thon to benefit the TelAbility/WATCH Program at Crowder Park in Cary in May 2009.  In order for this event to be a HUGE success we are seeking your help.  If you are interested in joining our planning committee, please send me an email at  I will get back to you in the New Year with information about our first meeting.
We are hopeful that you all can find some way to support the event, either through your work on the planning committee, offering donations or monetary support, or by participating in the event itself!  I have this great vision of every WATCH Member, family and child running, walking, or rolling through the park.  What a great way to celebrate this successful collaboration!
If you can't participate in the planning committee, but have ideas you would like to share, don't hesitate to contact me.

 anna and units                             

Using Functional Communication with Children with Autism 
On Friday, December 5th, Katie Cole and Casey Gayman from the Mariposa School presented a videoconference session on Using  A Verbal Behavior Approach to Teaching Language to Children with Autism.  Through their detailed powerpoint presentation and videoclips the 20 participants received a comprehensive overview of this approach.
The Mariposa School uses this approach in their work with children on the autism spectrum.  Katie and Casey invite you all visit the Mariposa School and their website, which offers many resources and a varied training calendar.

WATCH Videoconference Review:  Supporting Premature Infants and Their Families:  The Transition from Hospital to Home

by Besty Shpurker, Developmental Therapist, Pediatric Therapy Associates

On October 24, more than 25 professionals gathered via videoconference to participate in  the 'Supporting Premature Infants and their Families - Transition from Hospital to Home'. session, facilitated by Cindy Redd, member of the Wake Med Hospital to Home Intervention Team

The presentation began with descriptions of the various transitions the infant and family experience.  We were reminded that even if a transition is a 'good' one, that there can still be stress involved.  We were also provided with examples of how transitions can, on many fronts, be vague and supports must be fluid in order to best meet current needs.  The presentation continued with a discussion and elaboration of the needs of premature infants.  These basic needs are: feeding, sleep, self-regulation, social interactions, motor development, and infection control.

Ms. Redd elaborated on each of these needs as well as the concerns associated with each need.  She offered several activities and other tools to support 'success' in each of these spheres when working with premature infants and their families. 

The session concluded with needs of families and recommendations for services needed after hospital discharge.  This section was especially of interest to me since it included concrete methods to directly help the families and thereby indirectly help the premature babies.  The needs of families include emotional responses and support networks, shift of trust from hospital to community providers, and compensatory parenting.  Services need to include consultations and anticipatory guidance, observation and mentoring, initial home visits, and coordination of services.

With the growing number of premature infants and the realization that each of these children and their families will transition from hospital to home, this teleconference was both timely and very applicable to those of us who work with this population.  Those of us without much previous experience working with premature infants and their families were provided many useful 'tricks' of the trade while those of us with previous experience in this realm were reminded of some of the considerations that we need to best work with premature infants and their families after the transition from hospital to home.

Spina Bifida Session Follow-Up
For those of you who heard me talk about the most important prognostic indicators for future independence and self-esteem in children with spina bifida, I just wanted to alert you to a new article from researchers in Australia who compared the self-concept of children with spina bifida and those who were typically developing.

Their results showed that the children with spina bifida scored significantly lower than children with typical development for the domains of global self-worth, physical appearance, athletic competence, scholastic competence and social acceptance.

Another reminder of the importance of working with parents and children (able-bodied and disabled) to bring about social interactions and environments that foster equal and mutually beneficial relationships for all our children.
If you want to view the article abstract, you can find it at;18834386
Be Well,
WATCH Resources Update 
(From Karen Haas, Regional PT Consultant) 

Changes for Medicaid outpatient specialized therapy services

Effective with date of service December 22, 2008, prior approval through the Carolinas Center for Medical Excellence (CCME) will NO longer be required for outpatient specialized therapy treatment services. Do not send requests to CCME after this date.

DMA will announce changes to the limits on adult services and updates to Clinical Coverage Policy 10A, Outpatient Specialized Therapies (, in a future Medicaid bulletin. Visit limits for children will remain at 52 visits per 6 months, per discipline, with prior approval requests required for visits over 52.

ALL policy guidelines for Clinical Coverage Policy 10A remain in effect except for the prior approval requirements. Post-payment validation will be conducted to ensure that all policy requirements and medical necessity criteria are met.

Important: All providers who bill using the CMS-1500 claim form still must enter the V code as a secondary diagnosis on the claim even after prior approval is terminated.

Web link:

Karen K. Haas, PT, MPH
Regional Pediatric Physical Therapy Consultant
NC Division of Public Health
Eastern Regional Office
404 St. Andrews Drive
Greenville, NC 27834
252-355-1025 ext. 13 (phone)
252-355-1981 (fax) (e-mail)

ethan pic
Cerebral Palsy:  What Every Early Intervention Provider Should Know 
On Friday, November 21st, Dr. Alexander (with the help of Jennifer and Ethan Pfaltzgraff) presented a video-conference overview on cerebral palsy.  To download his powerpoint presentation click here. 

Upcoming WATCH  Professional Development Sessions: 

An Introduction to Mindfulness to be held on Friday, December 12th from 12:30-2:30.  This session will be led by Will Frey, a Mindfulness Instruction for the Program of Integrative Medicine at UNC-CH.  This is a follow up session to the Caring for the Caregiver session held this past summer.  The Mindfulness session will provide participants with an introduction to this stress relieving practice.  There will be an overview of the key concepts and time to practice the techniques.  If people are interested we are willing to look into offering this as a weekly series. 
To register for the December 12th session contact Juliellen at

A Modified Constraint Induced Movement Program for Children in the Infant Toddler Program to be held on Wednesday, January 21st from 12:30-2:30.  This session will be led by Margo Prim Haynes, pediatric physical therapist. In 2008, Margo completed her transitional DPT program from UNC-CH where her doctoral project focused on modified Constraint Induced Movement Therapy for infants and toddlers.
Modified Constraint Induced Movement Therapy (mCIMT) is a treatment for children with hemiplegia for the management of upper extremity function.  Using a treatment protocol of upper extremity (UE) constraint wear on the more used extremity plus child friendly play during daily routines, positive mCIMT changes in functional status are documented in young children.  This presentation will demonstrate the integration of a child friendly mCIMT program into early intervention services and the perspective role of each member of the child's team. Six categories of child friendly play are outlined with examples of activities to use with young children (ages 7 - 36 months). Included in the presentation is research that supports mCIMT as well as case studies of two children that participated in a mCIMT program as part of their Individualized Family Service Plan (IFSP).
  Describe two key features/components of modified Constraint Induced Movement Therapy (mCIMT) presented in today's program.
Identify team members responsible for the daily operations of the child friendly mCIMT program.
 Explain guidelines for children recommended for / or participating in mCIMT. 
 State two strategies used to provide positive reinforcement during play.
  Discuss three age appropriate play strategies for young children in the Infant Toddler Program (ITP).
To register for the January 21st CIMT session or to be a host site, please contact Juliellen at  

Routines Based Assessment for Premature Infants to be held on Wednesday, January 28th from 12:30-2:30.  This session will be led by Dawn Phillips, PT and Assistant Professor in the Department of Physical Therapy at UNC-CH.  A description and objectives will be sent via the WATCH listserv in early January. 
To register for this session or be a host site, please contact Juliellen at

Using  Electrical Stimulation for the Child with Brachial Plexus injuries, CNS injuries and for other neuromuscular conditions with Pia Stampe, PT, DPT  of Advanced Muscle Stimulators.   This session will be held in February. Date and time TBA.

Sensory Processing Disorder Question and Answer-  This session will be led by the staff at Developmental Therapy Associates.  More details will be available via the WATCH listserv in January.
Leisure Research Reading Over the Holidays... 
Dr. Alexander has found three research articles published in various Telemedicine Journals that might be of interest to you.  The articles discuss using telerehabilitation therapy to enhance children's communication function at home, remote wheelchair consultation via telerehabiliation, and assessing interprofessional teamwork using videoconferencing.  The ideas discussed in the articles might spark some new ideas about ways your agency could utilize videoconferencing to enhance your services or practice.
We would be very interested in holding a videoconference disucssion about any or all of these journal articles.  If you have an interest in reading and discussing one (or more) of the articles, contact Juliellen at  I will send you a copy of the article and we can set a date for a videoconference discussion. 

WATCH Listserv Questionsanna and units

The WATCH Listserv has continued to be an incredible resource to WATCH Members over the past two months.  To view any question and answer posted to the listserv over the past few months simply type the words WATCH Question into the search box on the TelAbility website.  Links to all questions and answers will be available. 
Some current topics include:
-Car Seat Restraints
-Questions to ask your doctor re: seizure medications
-Concerns about head banging
-Where to find toys for children in need in Wake County
-Yoga classes and Infant Massage resources in Wake County
-Uses of Cod Liver Oil
Marbles Family Fun Night 
for kids with special needs and their families!
Through a community wide collaborative, the museum will be open one (1) evening a month specifically for children with special needs and their families.  You can find out more information and the date for the January Family Fun Night and the Marble's exhibit's on the Marbles website.   
Marbles Kids' Museum is located at 201 E. Hargett Street, Raleigh. 

proudly partnering with:
Triangle Down Syndrome Network
Wake County Cerebral Palsy Support Group
Wake County LICC (Local Inter-Agency Coordinating Council)
Wake County SEPTA (Special Education PTA)