The Wake Area Telehealth Collaborative

Helping Children with Special Needs
June 2008
In This Issue
What is CranioSacral Therapy
WATCH Sessions
Wake County Services and Resources Webpage
WATCH Program Updates
Complete the WATCH Survey
Healing Trauma in Early Childhood Session review
Abstracts of Interest
Great News for WATCH!
The Honours Tournament
WATCH Session Updates
Fun at Marbles
CranioSacral Therapy
byTad Wanveer,LMBT,CST-D  
CranioSacral Therapy (CST) can help children with disabilities  attain optimal function by reducing abnormal strain upon their  cells. Each cell receives vital elements, discharges waste,  communicates with other cells, and organizes musculoskeletal  motion within its surrounding medium.  Helping a child decrease  restrictive or imbalanced body patterns may improve cell  environment, and this can boost cell function. In response a child  can maximize her ability to correct dysfunction.

A primary focus of CST is to gently reduce adverse strain upon:  the craniosacral system (CSS) which surrounds, protects, nourishes  and cleanses the central nervous system tissue; and the body  fascial system which surrounds all cells of the body. Cell  structure and function can improve as abnormal strain of the CSS  and fascial system decrease.

CST was created by John Upledger, D.O., O.M.M., in the early  1980's and is based upon a model of the CSS he developed called  the Pressurestat Model.  The Presurestat Model shows how the  motion of the CSS, called the craniosacral rhythm (CSR),  delicately moves the central nervous system and body as a whole.

Practitioners of CST can locate restrictive structural patterns by  feeling the way the body moves in response to the CSR.  The CSR is  also used as a tool to aid correction of adverse tissue patterns.   As abnormal patterns correct, cell environment and cell health can  improve, which helps promote improved function. 
To learn more about CranioSacral therapy joing the WATCH videconference session on June 13th,  visit the Cary Center CST website, or read some of the articles listed below.
CST Articles: 
 A Look Inside the CranioSacral System and How CST Helps
By John Upledger, DO., OMM 

Exploring the Therapeutic Value of CranioSacral Therapy
By John Upledger, DO, OMM 
Helping the Brain Drain: How CranioSacral Therapy Aids ADD/ADHD
By John Upledger, DO, OMM andTad Wanveer,LMT,CST-D 

When a Child Wants to Move But Can't
By Tad Wanveer,LMBT,CST-D
The WATCH Summer Professional Development
Videoconference Series

-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 will include Developmental Therapy Associates, The Tammy Lynn Center, Community Partnerships and the TelAbility office.  
- Fetal Alcohol Syndrome, Prevention and Response, Friday, July 11th from 1:00-3:00
This is a follow up to the Wake AHEC Session to be held on June 20th.  Hear from Leslie McCrory of the NC Teratogen Information Services about resources for caring for children affected by Fetal Alcohol Syndrome and their families. Host sites will include Community Partnerships, the Wilmington CDSA and the TelAbility office.  Spaces are still available.  To register contact Juliellen at
-Take Time for Yourself: Caring for the Caregiver, Friday, July 18th from 1:00-3:00
You spend so much time and energy taking care of others.  Come and learn how to take time to care for yourself.  Cara O'Connell-Edwards, Ph.D, an Assistant Professor in the Department of Physical Medicine and Rehab at UNC-CH will lead this refreshing and engaging discussion.  Contact Juliellen at  to register.  Host sites will include The Tammy Lynn Center, Community Partnerships and the TelAbility office.  One more host site is welcome. Spaces are still available.  To register contact Julellen at
WATCH Numbers for 
April and May 
WATCH Members were busier than any time to date during the months of April and May.  You broke a record for the number of videoclinics and professional development sessions held in a two month period and also utilized the list serv effectively more than ever before.
Videoconferencing was utilized 10 times in April and May.  Five times for educational purposes, four times for videoclinics and once for administrative purposes.
140 people attended these sessions.  Evaluations show the average satisfaction level scored a 4.4  out of 5.0 and comfort level scored a 4.6 out of 5.0. Those involved in the educational sessions all strongly agreed that the sessions provided them with new knowledge applicable to their work. 
The total mileage savings for these 10 videoconference sessions comes to $1557.00!
The WATCH listserv was also often used successfully to answer WATCH Member questions and provide feedback for future WATCH sessions.  Questions included:
  • information on schools that might a good fit for a 6 year old child with ADHD
  • information on finding an adaptive car seat for a child with autism

We have recently posted the questions and responses to the TelAbility website.  From now on, to retrieve WATCH listserv questions and answers just type WATCH Listserv into the search box and a list of all WATCH listserv questions and responses will now be listed by date with the most recent questions first.

Thank you for your continued engagement and responsiveness to the WATCH Collaborative. 
Wake County Services and Resources for Children Birth-Five Webpage TR
We now have 46 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

Pediatric Therapy Associates (PTA)-  PTA is sponsoring  Constraint Induced Therapy and Handwriting Camps this summer.  Check out their website or the TelAbility calendar for more details.
Developmental Therapy Associates invites you to
Save the Date!
Date: October 25, 2008 (8:30am - 4:30pm)
Course: Evidenced-Based Practice of Sensory Integration
Presenter: Teresa May-Benson, Sc.D, OTR/L
Location: McKimmon Center, Raleigh, NC

For more information visit DTA's webpage at or call 919-493-7002.  
New from Learning Together 
Learning Together is very excited about their new summer collaboration with YouthWorks, a nonprofit corporation based in Minneapolis, Minnesota dedicated to providing life-changing opportunities to youth entering 7th grade to graduating seniors as well as the communities in which they serve.
This summer Learning Together and YouthWorks will collaborate once each week. The YouthWorks students will have the opportunity to work one on one with the Learning Together students by creating mini-field days for them. Our collaboration will conclude with a school-wide field day to which all of our LT friends and families will be invited to attend.
For more information on the program, please visit the YouthWorks website 
"Tees for Tots"
Join Learning Together's at their 4th Annual Golf Tournament Friday, June 13th at Crooked Creek Golf Course in Fuquay-Varina. All proceeds benefit Learning Together's Developmental Day Scholarship program.
Player registrations are $90/person and Sponsorship opportunities begin at $100.  Please come out to enjoy a great course to help a great cause!

To register, please download our player registration brochure from our website, or call Heather Stephenson at 919-856-2605 for more information. 
Learning Together Receives NAEYC Re-Accreditation
The National Association for the Education of Young Children (NAEYC) accreditation has become a widely recognized sign of high-quality early childhood education. Recently Learning Together underwent re-accreditation through the new NAEYC system. The new standards reflect the latest research and best practices in early childhood education and development. Currently only 8 percent of all preschools and other early childhood programs are NAEYC accredited.

Upcoming Events: 
June 13th-1:00-3:00 pm
WATCH CranioSacral Therapy Videoconference
June 20th-
Wake AHEC Fetal Alcohol Syndrome Session
July 11th- 1:00-3:00 pm
WATCH Fetal Alcohol Syndrome Follow up Session
July 18th- 1:00-3:00 pm
WATCH Caring for the Caregiver Session
For more information on any of these session and for more professional development opportunities check out the TelAbility calendar.
Join Our Mailing List
Hello WATCH Members!
Welcome to summer!  We all deserve some down time and the relaxation that summer brings after a very busy spring season.  The newsletter will attempt to highlight just a few of our many activities:
  • Check out the WATCH Numbers article on the sidebar to see how the videoconference units were used this Spring. 
  • Check out the videoconference updates in the articles below to access resources from previous videoconferences and monitor videoconference evaluation results. 
  • And finally, check out this great article found in the John Rex Endowment 2007 Progress Report about how WATCH serves as a wonderful example of how a community of collaboration is built and sustained.

Happy reading.  Enjoy your summer!

WATCH Needs your Feedback!
It's time for the WATCH Project End of Year Survey! The survey take only 5 minutes and is available for you to complete by simply clicking this link.
We are hoping for a great response rate from WATCH Participants in order to help us share WATCH outcomes and progress with the John Rex Endowment.  To tempt (or bribe??) you, we'll be giving away two $75.00 gift cards to Panera--one to the site with the highest percentage response rate and one to the site with the most responses (to be fair to our smaller and larger sites). 
Right now it's a tight race between the Raleigh CDSA, Pediatric Therapy Associates and The Tammy Lynn Center for the gift cards.  Who is going to give them a run for it??
The survey will be available until the end of the day on Thursday, June 12th. 
I'd also love for you to share any other thoughts or comments you have about WATCH that don't seem to fit within the context of the survey.

Josh and I thank you all for a fantastically engaging and exciting year!
Recognizing and Healing Trauma in Early Childhood
Patti M. Zordich, Ph.D.
Triangle Psychological Services
WATCH Videoconference Review
by, Sue Powell, OTR/L, Easter Seals UCP 

This was a wonderful videoconference, which was very well presented and very relevant to practitioners as well as parents.  The focus of the videoconference was recognizing Post Traumatic Stress Disorder criteria in infants and children as well as interventions to begin the healing process. 
Dr. Zordich reviewed the DSM IV criteria for PTSD  (click link for a copy of the criteria) and the proposed criteria for infant and children.  The main criteria include:
Difficulty regulating affect
Variations in consciousness
Poor self-identity
Problematic relations with others
Varied changes in the perception of the perpetrator
I found it interesting that these signs are often overlooked or misdiagnosed as ADHD/ADD, ODD, Conduct Disorder, Bipolar Disorder, or even diagnoses on the Autism spectrum. These children are often living in a "vigilant" psychological state due to their experiences and therefore, exhibit "behaviors" or aggression.  Furthermore, they may have environmental triggers that cause regression.  Every aspect of their lives has been affected by their trauma.
Dr. Zordich spoke of the Blueprint for Attachment-Trauma Therapy to address healing in these infants and children.  The primary intervention is to ensure the child is in a safe and protective environment.  The therapy then addresses self-identity, relationship building, exploring the trauma and mourning losses; affect tolerance and modulation, and behavior mastery. This is an involved process that helps the child to recognize their feelings, address their trauma in an honest fashion, begin to build positive relationships, increase appropriate expressions of emotions, and take responsibility for their actions.
As a therapist, this reinforced the idea of seeing the child as a whole and considering the emotional foundation of the individual and its importance on their outcomes in therapy.  It is a different approach to consider as we work with all of our kids.  It emphasizes the importance of working along side the family and supporting them.  This may include referring the children to services such as psychologists to assist with these issues.
This was a nice venue to learn on this topic and to touch base with others who are also interested in this topic.  I was able to speak with other therapist and also with several adoptive parents.  It was nice to get their viewpoint as a parent and moving to see their dedication to their adoptive children whom they show such great concern over.
Twenty five people participated in this session. 96% of the participants were comfortable attending a videoconference session. 100% agreed that the session provided them with new knowledge and skills. A total of $77.00 was saved in travel costs and over 4 hours was saved in travel time by holding this session via videoconference. To view the session evaluation results please click here.
For a copy of the references and resources provided during this session click here.  



Abstracts of Interest (June 2008)
compiled by Dr. Alexander
The follow two abstracts come from evidence-based articles about children with special needs.  These two topics were chosen for this newsletter based upon recent WATCH list serv questions and discussions.  Please let us know about other research or literature reviews you'd like to see in WATCH Newsletters.
Early Identification of Language Delay by Direct Language Assessment or Parent Report?
Journal of Developmental & Behavioral Pediatrics. 29(1):34-41, February 2008
Objective: The goal of the study was to compare the accuracy and diagnostic power of a parent report measure and direct language assessment for early identification of children with language delay.
Method: The parent language report and direct language measures were compared for 47 typically developing toddlers and 70 late-talking toddlers aged 24 to 26 months. One year later, language abilities of 102 of the 117 children were reassessed.
Results: The concurrent validity of the parent report was high both for judging language skills and for identifying language delay. No evidence was found of differences in the rating accuracy of mothers with different educational levels. Language abilities 1 year later were predicted better with direct language measurement than with the parent report. However, there were no differences between the accuracy of the parent report and individual language assessment concerning the prediction of language delay at age 3.

Conclusion: The results suggest that the parent language report is a valid and efficient tool for assessing productive language abilities and judging expressive language delay in 2-year-old toddlers. The measurement characteristics of the parent report are comparable with those of direct language measures.

Randomized trial of botulinum toxin injections into the salivary glands to reduce drooling in children with neurological disorders
Developmental Medicine & Child Neurology, February 2008, Volume 50, pages 123-128 

The primary aim of this randomized, controlled trial was to assess the effectiveness of botulinum toxin A (BoNT-A) injections into the submandibular and parotid glands on drooling in children with cerebral palsy (CP) and other neurological disorders. Secondary aims were to ascertain the duration of any such effect and the timing of maximal response. Of the 48 participants (27 males, 21 females; mean age 11y 4mo [SD 3y 3mo], range 6-18y), 31 had a diagnosis of CP and 15 had a primary intellectual disability; 27 children were non-ambulant. Twenty-four children randomized to the treatment group received 25 units of BoNT-A into each parotid and submandibular gland. Those randomized to the control group received no treatment. The degree and impact of drooling was assessed by carers using the Drooling Impact Scale questionnaire at baseline and at monthly intervals up to 6 months postinjection/baseline,  and again at 1 year. Maximal response was at 1 month at which time there was a highly significant difference in the mean scores between the groups. This difference remained statistically significant at 6 months. Four children failed to respond to the injections, four had mediocre results, and 16 had good results. While the use of BoNT-A can help to manage drooling in many children with neurological disorders, further research is needed to fully understand the range of responses

Great News for WATCH
Thanks to a generous gift from Wake County Smart Start, the WATCH Project will be able to upgrade two of our videoconference systems to large screen units, allowing more people to participate at these locations and providing a higher quality viewing experience for all. The funding serves as recognition of the WATCH Project's success in strengthening the early intervention network in Wake County. WATCH Project activities such as videoclinics (which improve care coordination among a child's care team) and professional development sessions(which have improved and enhanced the leadership development and professional competency of early intervention professionals) help to meet Wake County Smart Start goals to increase identification and connection to early intervention services for children with special needs and increase the knowledge base of early intervention service providers.
TelAbility and WATCH is grateful for this gift and the support of Wake County Smart Start.  We believe it speaks volumes for the success and sustainability of WATCH. We will be making the decision as to who will receive the new units based upon site usage data and conference room space.  We will let you know who will be receiving the new units soon!
Many thanks again to Wake County Smart Start! 


The amazing and talented Jennifer Pflatzgraff has been chosen as the honoree for:
The 7th Annual Honours Golf Tournament to benefit the
TelAbility/WATCH Program
within the Department of Physical Medicine and Rehabilitation at UNC Hospitals.             
Saturday, September 27, 2008
2:00 pm
The Preserve at Jordan Lake
The Honours golf tournament was established to honor someone in the community who has inspired those around them, while also raising money for a charity or cause special to the honoree. 
We are so pleased to anounce that the 2008 Honoree is Jennifer Pfaltzgraff.  Many of you know Jennifer  as Ethan's mom and Parent Co-chair of the Wake County Local Interagency Cooridinating Council (LICC).  Jennifer's dedication to strengthening the early intervention system has been unfaltering and realized in many ways.  If you've gone to  Wake LICC website you've seen Jennifer's work. If you've used the Wake County Early Intervention Road Map, you've utilized one of her many creations.  If you've received any number of flyers announcing EI events in Wake County chances are Jennifer not only created the flyer, but was instrumental in coordinating the event, as well.   If you've been to a Wake LICC meeting, you've seen her in action.  If you've ever seen the smile on Ethan's face, you've seen one of her proudest and most memorable accomplishments.
Jennifer and Dr. Alexander have worked together over the past 3 years to provide the best possible care for Ethan, as well as help to provide education and resources for families and early intervention providers.  Because of their dedication to the same causes, the TelAbility/WATCH Program will be this year's benefactor of the Honour's proceeds. 
The WATCH Project invites you partner with us to honor Jennifer and help us help you by supporting TelAbility and the WATCH Project.  You, your agency, or a team of collective agencies can sign up as a player, a sponsor or a donor.  Wouldn't it be fun to have a WATCH team or have several WATCH sites sponsor a hole in honor of Jennifer?  For more information on how to get involved please call Nicole Pratapas, Director of Development for the Department of Physical Medicine & Rehabilitation with UNC School of Medicine at 919.966.8494 or email her at  You can also find information at The Honours website.

 WATCH Professional Development Session Updates

Autism Resource Panel-
The WATCH Program hosted a videoconference panel on May 2nd comprised of local agency representatives that provide services for children diagnosed on the autism spectrum. Panel members included Ann Palmer from the NC Autism Society, Jaqueline Gottleib of the Mariposa School, Kathryn Cole from the Meredith College Lovaas Lab, Karen Scofied, OT at Developmental Therapy Associates, Hal Shigley from Southeast Family Services and Emily William and Elizabeth Tomlinson from the Raleigh CDSA. 29 people participated in this session. 100% of the participants were comfortable attending a videoconference session and 83% were satisfied with the session. 92% agreed that the session provided them with new knowledge. A total of $159.58 was saved in travel costs and 8 hours of travel time was saved by holding this session via videoconference.
Testing 1,2,3-
The WATCH Program hosted a videoconference session entitled, "Testing 1,2,3" on May 16, 2008. The session was facilitated by Donna Wells, PT. Nine people participated in this session. 100% of the participants were comfortable attending a videoconference session. 100% were also satisfied with the session and agreed that the session provided them with new knowledge. Staff from The Tammy Lynn Center for Developmental Disabilities, the Raleigh CDSA, Pediatric Therapy Associates and the Wilmington CDSA attended this session. A total of $674.68 was saved in travel costs and 21 hours of travel time was saved by holding this session via videoconference.

Yes, They Can!  Children with Significant Disabilities as Readers, Writers and Communicators-
The WATCH Program hosted a videoconference session entitled, "Yes, They Can! Students with Significant Disabilities, Including Deaf-Blindness as Communicators, Readers and Writers" on Tuesday, May 20th, 2008. The session was facilitated by Gretchen Hanser, OTR/L and Karen Casey, SLP. Over 60 people across the state of NC participated in this session. 35 of those were from the WATCH Network or Wake County area. Of those within the WATCH Network, 91% were comfortable attending a videoconference session. 85% were satisfied with the session and 100% agreed that the session provided them with new knowledge. Staff from The Tammy Lynn Center for Developmental Disabilities, the Raleigh CDSA, Wake County Preschool Services, and Hilltop Home for Children attended this session. We also had participants from the Wilmington and Greenville areas. A total of $96.96 was saved in travel costs and 6 hours of travel time was saved for WATCH Members by holding this session via videoconference.

There were several excellent resources provided during this session.  To retrieve a copy for yourself go to the TelAbility website and type Karen Casey or Gretchen Hanser into the search box.
Understanding and Caring for the Premature Infant-
The WATCH Program hosted a videoconference session entitled, "Understanding and Caring for the Premature Infant" on May 30, 2008. The session was facilitated by Nathalie Maitre, a UNC Hospital NICU Fellow, Beth Cooper, M.Ed of the Wake Med Hospital to Home Intervention Team, and Tara Bristol of the March of Dimes NICU Family Support Team. Sixteen people participated in this session. 100% of the participants were comfortable attending a videoconference session. 93% were satisfied with the session and 100%agreed that the session provided them with new knowledge. Staff from The Tammy Lynn Center for Developmental Disabilities, the Raleigh CDSA, Pediatric Therapy Associates Hilltop Home for Children and Tender Health Care attended this session. A total of $475.71 was saved in travel costs and 18 hours of travel time was saved by holding this session via videoconference.
You can view the powerpoint presentations and session evaluation by clicking the links below.
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.  The summer dates have not yet been decided, but will be scheduled soon.  Please check the ARC of Wake County website or the Marbles website periodically to find out the summer dates. 
The evening times will be from 5:30-8:00 pm.   Marbles Kids' Museum is located at 201 E. Hargett Street, Raleigh.  The cost is $5 per person or $20 per family.

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)

Visit Our Sponsor
Many thanks to the John Rex Endowment for their continued support of the WATCH Program into 2010!