The Wake Area Telehealth Collaborative

Helping Children with Special Needs
February 2008
In This Issue
WATCH Spring Series
WATCH Numbers
WCLICC Webpage
WATCH Program Updates
Inclusion Institute
Dates to Remember
The Power of K
First Flex Session Review
Communication Deficits Session Review
Watch WATCH Sessions from your Desk!

Quick Links
The WATCH Spring Professional Development
Videoconference Series

Thanks to a lot of help and input, the WATCH Spring Professional Development Videoconference Series is shaping up to be our most active and diverse to date!  Read on to see what you have to look forward to:
-First Fridays Focus on Young Children's Mental Health
WATCH has teamed up with the Young Children's Mental Health Collaborative and Wake AHEC to provide 5 follow up videoconference sessions to the Wake AHEC Young Children's Mental Health Series.  These will occur on the First Friday of every month (March through July) from 1:00-3:00.  You need not have attended the AHEC sessions to participate in a follow up session.  The follow up sessions will provide practical applications on each topic and a chance for questions and discussion. 
The first session will be held on Friday, March 7th.  Betty Rintoul will continue her discussion on Bridging the Social Synapse.  Host sites will be TelAbility, Developmental Therapy Associates, Community Partnerships, and Learning Together.  There are a few spaces still remaining for this session.  Contact Juliellen at to register.
-The Power of K
Friday, March 28th 1:00-3:00
Join Eva Phillips and Amy Smith, from the NC Department of Public Instruction and authors of the adjacent article, to learn more about new statewide initiatives to help provide the most developmentally appropriate and stimulating learning environment for all young children entering school.  Host sites are yet to be determined.  Contact Juliellen to register.
-Cranial Sacral Therapy, Friday June 13th, 1:00-3:00
Learn more about this therapy approach from Tad Wanveer, LMBT, CST-D and founder of the Cary Center CST.  Host sites yet to be determined.  Contact Juliellen to register. 
Other sessions we are working on include a series on assistive technology and augmentative communication and working with premature infants.
More details and dates to come, so watch closely!
WATCH Numbers for December and January
WATCH Members were very active during the months of December and January, utilizing a number of WATCH resources for a variety of purposes.
Videoconferencing was utilized 13 times in December and January.  Once for both consultation and administration purposes, four times for educational purposes and seven times for video clinics.
149 people participated in these sessions.  Evaluations show the average satisfaction and comfort level rated a 4.72 out of 5.0.
The WATCH listserv was also often used successfully to answer WATCH Member questions and provide feedback for future WATCH sessions.  Questions included:
  • information on the Beginnings Program, how to locate pigeon nipples, and resources for children adopted outside the US;
  • locating GI Doctors for children with food intolerances and appropriate play groups and child care environments;
  • book recommendations for children with Sensory Processing Disorder and Cerebral Palsy

Thanks to you ALL for your questions, input, timely responses, and useful resources.  YOU all are the reason WATCH works!

Wake County Services and Resources for Children Birth-Five Webpage
Simple and useful changes are being made to the Wake County Services and Resources for Children Birth -Five Webpage, located on the TelAbility website.  The changes reflect suggestions made by the Wake County LICC and  agencies that entered their contact information during the initial phase of the webpage.  We anticipate the changes to be in place by early February.  An email will be sent to all agencies currently registered to the webpage, informing them of the changes and how to update their agency's contact information.
There are currently 37 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

Kathi Gillaspi has resumed supervision of the Early Intervention Programs at Community Partnerships, Inc.  Please contact her directly with any EI related questions. 
Tender Health Care is pleased to announce the arrival of 
2 nurses who joined their staff in October 2007.  Mary Maultsby, RN,  graduated from ECU and comes from the  ICN and UNC.  She also has 5 years experience in child care.  Rosalyn Surrell, LPN, graduated from Durham Technical Institute and worked at Hilltop Home for 30 years. She retired and since has come back into nursing to work with us per diem.
White Plains Children's Center is searching for a BK Certified Teacher for their 3-5 year old classroom.  The teacher must also have a Preschool Add On certificate.  Interested candidates can contact Cheri Miller at
White Plains is also sad to announce their director, Connie Mullins resigned as of January 4th.  They are actively recruiting a new director.
Community Partnerships, Inc. (CPI)
is pleased to present the
2008 Inclusion Institute
To be held on February 21, 2008 from 8:30- 4:15 at the Radission Hotel in Research Triangle Park.
This interactive, one day session is an opportunity for childcare and recreation provides to learn a new way of working with children and youth with disabilities and to learn practical strategies for including children of all abilities in their programs.  Join CPI on this inspiring day when they will team up with Kids Included Together (KIT) to share over 60 years of combined experience in inclusive practices. 
Register by February 2.  Cost is $90.00
Contact Kathi Gillaspi at 919.781.3616 ext. 235 for more information.
Upcoming Dates: 
Feb. 15th from 8:30-4:00
Wake AHEC- Bridging the Social Synapse with Betty Rintoul
Feb. 21st, 8:30-4:15
CPI, Inclusion Institute
Feb. 22nd, 9:00-11:00
Videoclinics with Pediatric Therapy Associates
Feb. 25th, 10:00-11:30 am, and 6:30-8:00 pm
March 7th from 1:00-3:00
First Friday's Focus on Young Children's Mental Health- Bridging the Social Synapse WATCH Videoconference Follow-up with Betty Rintoul
March 14th, 8:30-4:00
Wake AHEC- Identifying and Understanding Trauma
March 14th , 9:00-11:00
Videoclinics with Pediatric Therapy Associates
March 28th, 1:00-3:00
The Power of K,
WATCH  Videoconference
April 4th from 1:00-3:00
First Fridays' Focus on Young Children's Mental Health- Identifying Children with Trauma WATCH Videoconference Follow-up.
April 11th from 8:30-4:00
Wake AHEC- Finding the Right Communication Strategy for Children on the Autism Spectrum
April 18th from 1:00-3:00
Cranial Sacral Therapy,
WATCH Videoconference
For more information on any of these session and for more professional development opportunities check out the TelAbility calendar.

Visit Our Sponsor
Many thanks to the John Rex Endowment for their continued support of the WATCH Program in 2010!
Join Our Mailing List
Hello WATCH Members!
This newsletter is FULL of great updates and information, so I will make this introduction short and sweet.  Thanks to Joan, Eva, Brian, and Charese for their contributions and articles below.  Thanks to all of YOU for your active involvement in the videoconferences and listserv the past few months.  What a great amount of information we have exchanged!
Dr. Alexander and I will have a chance to share the successes of the WATCH Project at the Building Bridges Conference in Richmond, VA on Friday, April 11th.  We will be offering the WATCH Project as a model for medical and early intervention professionals in other states.
On Wednesday, May 7th, I, along with a panel of WATCH Members,  will have the pleasure of presenting the WATCH Model at the National Smart Start Conference.  Many thanks to Nora Roehm of CPI, Brian Gentry of PTA, Charles Kronberg of Project Enlightenment, Emily Williams of the Raleigh CDSA, and Lillian Matthews of the Tammy Lynn Center for agreeing to present with me.
What amazing things we can do together! 
Happy reading,
WATCH Welcomes...
Carolina Pediatric Dysphagia as the newest member of our collaborative.

Carolina Pediatric Dysphagia (CPD) strives to provide the highest quality and most comprehensive dysphagia/swallowing/feeding and speech/language services to infants and children in the environment best suited for them (clinical or natural environment).  CPD provides family education and support to enable their children to reach their maximum potential.  We also dedicate our time and resources to provide education and clinical research on variety of topics regarding pediatric dysphagia to physicians, the community, and state universities.  This is accomplished through educational papers on their website (FAQ's at ) and through local and national conferences, training and consultation. 


Carolina Pediatric Dysphagia was established by Joan Dietrich Comrie, M.S., CCC-SLP in 1996 to provide  feeding and swallowing services to infants and children in a clinical setting allowing easier access of services for the community.  To better meet the needs of our patients and the community we have recently added speech and language services. 


Our program is unique due to its focus on Pediatric Dysphagia with over 30,000 clinical hours logged.  Approximately 90% of our patients have a diagnosis related to feeding and swallowing disorders.   We help infants and children with the entire range of feeding and swallowing  disorders including breast feeding difficulties, feeding tube dependency, children with oral and sensory feeding difficulties, behavioral feeding disorders, gastrointestinal or reflux disorders, GERD and food allergies/intolerances, and aspiration.  The staff at CPD has the expertise to complete our own x-ray evaluation of swallowing in conjunction with a radiologist. 


CPD is very excited to participate in the WATCH Project.  We look forward to expanding our knowledge base, to network with other agencies, and to share our expertise and knowledge on pediatric dysphagia. 

-by Joan Dietrich Comrie

NC Position Statement

 on Kindergartens of the

                   21st Century

The Power of K

by Eva Phillips

The NC Department of Public Instruction's Primary Team, along with a task force of kindergarten teachers, administrators, consultants and B-K Higher Education faculty has created a position paper: The Power of K:  North Carolina Position Statement on Kindergartens of the 21st Century.  This paper is in response to the many challenges facing kindergarten teachers across our state and nation. Because the early childhood years, birth through age 8, are the most powerful years for learning, growth and development in the life of a child and because kindergarten holds a place in the education of a student as one of the foundations for the attitudes about learning that children and families will carry with them throughout their years of schooling and beyond, it is critical that NC kindergarten programs provide a solid educational and developmental base for all children. Early childhood professionals across the state have asked that a state-level position be established regarding effective practices in kindergarten.


The Primary Team also realizes that kindergartens today must prepare our students to successfully live and work in the world of the 21st Century.  We must prepare our students to be critical thinkers, strong communicators, effective leaders, collaborative team players who are globally aware, literate and active citizens in our world. This position paper outlines the components of engaging and effective programs for our kindergarten students and families that include rigorous and relevant environments and experiences that build positive relationships with each child and family.  This paper promotes research and evidenced-based effective practices for working with young children from a variety of circumstances and with varying levels of abilities. This position paper also supports the development of well-trained and knowledgeable kindergarten teachers who can provide the type of environments and experiences that will promote future-ready students. 


We are pleased to announce that this position paper received endorsement from the NC State Board of Education on June 6, 2007.  We also received letters of support from the following agencies and organizations:


  • North Carolina Birth through Kindergarten Higher Education Consortium
  • The North Carolina Office of School Readiness
  • North Carolina Association for the Education of Young Children
  • North Carolina Association of Elementary Educators
  • First School PK-3 Initiative
  • Action for Children North Carolina

The Primary Team at NC DPI is also proud of its first North Carolina Kindergarten Teacher Leader Initiative. In response to the above mentioned challenges, a new project designed to enhance the leadership skills and content knowledge of a selected group of kindergarten teachers from each region of our state has been launched. The goal of this initiative is to establish a group of kindergarten teacher leaders for North Carolina. 


We are excited about the potential of this work and look forward to working together to strengthen our kindergarten programs across the state and are encouraged by the conversations that are occurring across this state and nation related to appropriate expectations and practices in our kindergarten classrooms.  There is great potential for North Carolina to, once again, be a leader in the early childhood field by defining and promoting appropriate kindergarten programs for the 21st Century.


For more information about the Power of K position paper and the Power of K Teacher Leader Initiative, please contact Eva Phillips at 919-807-3850 or by email at

Please also join us on Friday, March 28th from 1:00-3:00 via videoconference to learn more about this exciting initiative.  Contact Juliellen at if you'd like to register and/or be a host site.
First Flex WATCH Videoconference Review
by Brian Gentry, PT, Pediatric Therapy Associates
On Friday, December 7th, Pediatric Therapy Associates sponsored at WATCH Videoconference Session, discussing the benefits of the First Flex, which combines bracing technology with neuromuscular electrical stimulation (NMES) to model and train the neuro-musculoskeletal system in very specific ways in children ages 3-20 with spastic hemiplegia affecting the upper extremity.  The session was led by Taffy Bowman of Ultraflex Systems, Inc.  The participants included physical therapists, occupational therapists, Dr. Alexander and a UNC-CH Medical Student.
The FirstFlex is designed for use with children with mild to moderate spasticity in the scapula, shoulder, and elbow and moderate to severe spasticity in the wrist and fingers.  The treatment program addresses postural deformaties, grip and pinch weakness, and loss of inhibitory control over pinch, reach, grasp, and release.  Some of the most important factors in determining if the FirstFlex will be successful with children are cognition, motivation, and parental/family support.  The program requires an extensive daily time commitment from both the child and caregivers, so these factors must be evaluated prior to the initiation of the FirstFlex program.
The custom bracing utilized with FirstFlex is a dynamic tension and static control to the brace for therapeutic purposes. Used in conjunction with an electrical stimulation unit, the protocol for treatment includes two daily half hour sessions of movement pattern training.  It also includes wearing of the brace at night.  Treatment usually last 6-12 months, but may need to reinstituted at a later time.  Occupational or physical therapy is also recommended to focus on facilitation of the extensor muscles with NMES.
Retrospective and prospective studies were performed using dynamic bracing and NMES and found a noticeable improvement in global hand functioning compared with use of one or the other.
Ms. Bowman stated that most insurance companies will cover the FirstFlex if the policy includes coverage for DME and orthotics and prosthetics.  For more information on the FirstFlex, click here. Or you can call 1.800.220.6670.
A total of approximately $81.00 was saved in travel costs and 2.8 hour saved in travel time by holding this session via videoconference.  To view the full evaluation results click here.
Communication Deficits WATCH Videoconference Review
by Charese Motta-Payne, Chesire Center

I had the pleasure of attending my first WATCH video conference on January 11th.  The session was entitled,

Identifying Infants and Toddlers with (or at risk for) Communication Deficits: It takes A VillageIt was facilitated by Dr. Elizabeth Crais, a speech-language pathologist and professor at UNC-CH.  I participated in this session at the Tammy Lynn Center.  The other three host sites included the Raleigh CDSA, Learning Together and the TelAbility Center. In total, 34 people attended this session.  I think everyone would agree that the 2 hours held our attention as it was packed FULL of thought provoking and exciting information, that reinforces the importance of Early Intervention.


Dr. Crais' passion about the early identification of children with communication disorders and/or Autism Spectrum Disorders was evident and some very interesting information was shared. Some of the things that stood out to me were the importance of a child's ability to use gestures and symbolic play as predictors of later language, the relationship between play behaviors and gesture use, and the "Red Flags Approach" when looking at social concerns, intentionality, play and language skills.


Regarding gestures and symbolic play, Dr. Crais highlighted the importance of looking at a child's "pointing-giving-showing" behaviors. I liked this wording as I felt like as an interventionist, I could talk about these abilities with parents and caregivers and in any activity we may be working on, these skills could be targeted.  Someone raised the question about "late bloomers" or "late talkers" and I found it interesting that the research actually has been able to distinguish between them and true language deficits by looking at gesture use! Late talkers will have a lot of varied gesture use early on and good comprehension whereas true delay has decreased gesture use, variety and difficulty with receptive skills. 


Play behaviors and gestures use being so closely related, made me think about the important relationship between the disciplines that may be providing Early Intervention Services to a child. Throughout the Levels of Play Development, the child's ability to use variety kept showing up as an important indicator. For example, in studies of gesture use and play in children with an Autism diagnosis and those without, gesture use and play may be present, but one gesture or game may be prevalent vs. the use of many. As a CBRS therapist, this is something I feel we focus on frequently and it seems that improving a child's repertoire of play related behaviors or gestures can help a child better receive Speech  or Behavioral Therapy.  The concept that "first words and first play schemes coincide" clarifies for me the relationship between all disciplines when working in early intervention.


Finally, the Red Flags Approach gave a concrete framework to look at. Looking at Social development, intentionality, play skills, comprehension skills, sound production and word productions and combinations, the guides give end ranges for seeing a child use a skill or strategy.  For example, by 18 months, you should be able to observe a child communicating for a variety of reasons such as protesting, requesting, seeking social interaction, and commenting. If a child only shows one type of social communication, there may be cause for concern. The evidenced based information that was presented supports(as usual) the presence of indicators early on in a child's life can tell us where others concerns may be present. For example, language skills are a strong predictor of cognitive skills--the child's ability to communicate in their first and second year of life is indicative of later ability.


This format was interesting to me because I think sometimes the general population still perceives children with social/communication disorders as non-communicative or non-interactive. Dr.Crais pointed out the research that shows children with autism may have language, but they aren't using it to be social. Or there may be gestures and interaction, but the array is limited and repetitive.


Of course there was so much more and  we were only able to scratch the surface of these issues during  this presentation!
This being my first videoconference, I was pleased to see how easy it was. I wondered if it would feel impersonal and the technology would be a barrier to really getting something out if the presentation, but that was definitely NOT the case! It was nice to meet new people at my site, and to hear the questions of the other participants. The use of both the powerpoint and video clips varied the presentation and Dr. Crais expertise made the experience well worth attending! I strongly encourage anyone considering this forum for continuing education to check it out!!
A total of approximately $935.00 in travel costs and 32.5 hours of travel time was saved by holding this session via videoconference.  97% of the participants stated the session provided them with new knowledge and skills. 100% of the participants were highly satisfied with the session. All of the participants stated they were comfortable participating via videoconference.  To view the full evaluation results click here.
You can access articles (The First Years Inventory and Early Identification of Autism) related to this topic via the Quick Links section of the newsletter.
View WATCH Videoconference Sessions from your desk!
We have digitally recorded several WATCH videoconference sessions.  These are available on disc for you to borrow and view from your computer. The sessions we currently have available on DVD are:
  • Krisi Brackett's 7/19/07 Feeding Session
  • Linn Wakeford and Grace Baranek's 11/02/07 session on Autism
  • The 11/16/07 session on Ethical Dilemmas in Early Intervention
  • Dr. Crais' 1/11/08 Communication Deficits session

The Music Therapy videoconference session 12/07/07 is also available to view via webcast.  Cut and paste this URL into your web browser to view this session. 

We hope to be able to offer more sessions via webcast in the future.  Stay tuned to the WATCH list serv for more information.
Contact Juliellen at if you are interested in borrowing any of the recordings.
 Something to Brighten Your Day
Take a minute to watch this short and beautiful video.  The band, Five for Fighting, is generoulsy donating .49 cents to Autism Speaks every time this video is watched.  The funding will go toward autism research and intervention.  The hope is to reach 10,000 hits.  I think we can help them do that!
Thanks to Patti Beardsley, at WCHS, for sharing this message.

The next WATCH Newsletter will come out in April. Please feel free to send your topics of interest and contributions!