A dad’s story: One family’s long road to recovery

Unlike many other types of injuries, a traumatic brain injury leads to many struggles on many different fronts as we have come to find out. I would like to share the steps we have taken, good and bad, so that anyone else who has to travel this road will have an idea of how to make their way.

That is one thing that has always frustrated me: being out there trying to figure out the road ourselves.

We are a family of four. Erin and I have been married for 27 years. We have two children, Jason (18) and Kiana (21). Kiana suffered her TBI in a car accident on Aug. 27, 2005. She and Erin were on their way to school for a basketball open gym when another car slammed into theirs broadside. The force of the impact shattered Kiana’s face from her eyes up. She was 11 years old.

That day turned all of our lives upside down. Jason, who was a happy kid in third grade at the time, had to stay with multiple friends and family as we spent time with Kiana at Hershey Medical Center. Kiana was a good student and a successful athlete. She played both softball and basketball and competed in horse-riding competitions. But she has spent the past 10 years trying to work her way back, a struggle that still goes on and, of course, has its ups and downs.

Kiana had to relearn everything. In her 84 days in Hershey, she went the full spectrum from not being supposed to survive to coming home right before Thanksgiving and her birthday, then going to Schrieber Pediatric for physical, speech and occupational therapy.

We are 10 years into this journey, and, yes, there were and are some really tall hurdles to get over for all of us. But God has been so good to us. Kiana continues to improve and fight to get back what was lost.

If you’d like to check out more information on her journey, please feel free to check out her story on CarePages.com (registration required), an online community for visitors to share the challenges, hopes and triumphs of anyone facing a life-changing health event. We started this page only a few days after her accident and have continued it to this day.

We have learned many things along the way, and I have a few topics in mind for future blog posts, including:

  • Living with the aftermath of a traumatic brain injury
  • Navigating the school system when you have a child with a physical and mental challenge
  • Advice for parents whose kids are transitioning to adulthood
If you have questions or suggestions for topics to cover, I’d love to hear from you. Contact me at keeya@epix.net.

Troy Brown and his family live in Gap.

New group offers resources for parents


Hi everyone!

This is just a recap of our get-together held Sept. 17 at the Olde Hickory Grille. About 15 of us met in the party room. There was lots of chatting and making friends.

Some parents gave information on applying for Social Security’s Supplemental Security Income (SSI). Their information came from experience, and we had handouts printed from the SSI website. REMEMBER, none of us are SSI employees, so the info shared is coming from parental experience. You have to do what is right for you and your kiddo. Apply in person, online, phone, whatever works for you. Now you know there are options.

We also shared information on a new exercise class available for teens and young adults with special needs at Spooky Nook. Classes are being run by the I AM ABLE Foundation and will start at Spooky Nook in mid-October.

The next Parents 625 get-together will be 6:30-8:30 p.m. Friday, Oct. 23, at Schrieber Pediatric. We may have a physical trainer from I AM ABLE speaking to us that night for a bit, then afterwards… you know, chatting and Halloween fun! Yes, I’ll be in costume.

Club 625 is having its Halloween Party that night, you can email Carla Yando or Jay Graver for more information on that.

See you soon!

Reenie Panzini lives in Lancaster, Pennsylvania (originally from Brooklyn, NY) and is the mother of three. Her 18-year-old daughter has a diagnosis of autism spectrum disorder (ASD) and is transitioning into adulthood… whatever that means.

The best things in life are dirty

Most adults remember playing in the mud, but ask children now and you will hear a different story. For reasons too numerous to list, children are not touching dirt or playing in it. And if they do, immediately out comes the hand sanitizer!

The Schreiber courtyard was formed when an addition to the building was built back in 2006. At that time, the courtyard was little more than concrete and a drain. Under the guidance of Recreation Therapist Lisa Gilbert and with help from volunteer Don Grayson, we built a few raised beds for strawberries and flowers.

In the 10 years since, we have added more containers for grapes, rasberries and blackberries, along with some wind chimes and wind-blown decorations. Kids can paint the containers in bright colors. A gift from Edna’s Angels, our women’s giving circle, allowed us to add slate blackboards and large chimes for the kids to play.

The kids completed a unit this spring on planting and caring for seeds. The seeds and peat pots were generously donated by KimRik Garden Center, Willow Street. The kids transplanted the seedlings into the courtyard containers with their identifying popsicle sticks to foster engagement and ownership. The children have been able to check on their plants, and we’ve had some kids harvest some of their plantings. For many, this will be the first time they pick a vegetable and taste it!

For some of our Schreiber kids, this has been their first time to touch dirt. As part of her occupational therapy session, Kiera K. was positioned so that she could stand and shovel dirt into the peat pot for the seeds. Kiera is just beginning to learn to use a spoon because all of her life so far she has been fed through a stomach tube. Kiera’s parents were amazed at how much she enjoyed touching the dirt!

With all the intensive medical care she has required in her 7 years, her mother said, “I never thought to let her play in dirt!”

In fact, gardening with children not only yields flowers, fruits and vegetables; the children are part of the growth, too!

There’s plenty of evidence to support gardening as a valuable therapy strategy. At Schreiber, we use gardening as part of our normal treatment plans. From our experience, children are more willing to taste or sample vegetables and fruits they have helped raise. There are many reasons, both medical and psychological, for children to develop food aversions. Once those food aversions have become entrenched they are difficult to change. Gardening is one strategy used in desensitizing a child to try a non-preferred food such as vegetables.

We plant varieties (usually heirloom varieties), of vegetables, fruits and herbs to provide our clients a multisensory experience when they enter the garden. We include the typical (chives, parsley, onions, thyme,) to the unusual (a plant that smells like buttered popcorn).

We incorporate other activities into these courtyard sessions: writing on the chalkboard; carrying a watering can, squeezing a sponge, all of which provide sensory benefits.

Because of their children’s experiences in the courtyard garden, more Schreiber families are planting flowers and vegetables at home in their gardens or in containers. They are incorporating into their daily lives the lesson they learned here.

And they are finding out that, yes, the best things in life really are dirty.

Bernie Hershey is an occupational therapist at Schreiber Pediatric Rehab Center in Lancaster, Pa. She has been helping kids slide on scooters, balance on balls and climb on ropes for more than 30 years, all in the name of helping improve the quality of their lives.

No, really. Thank you

Here’s one from April, just after the news broke about the United Way of Lancaster County’s decision to end its funding for Schreiber.

Dear Mr. DeBord,
On August 4, 1955, our second child was born in Lancaster General Hospital. A little girl, she weighedijn at 5 pounds, 4 ounces, and was healthy. However, by the one month check-up, our doctor had some questions about her neck and hip, and he sent us to see Dr. Goodman, an orthopedic physician in Lancaster.

Dr. Goodman diagnosed a congenital dislocation of the left hip, early club foot, and a wry neck. She was to wear a bar 24 hours a day to separate her legs and straighten her legs while her body grew a hip. He assured us that with lots of therapy our little (daughter’s name withheld for privacy) would be normal. He explained that help was available at the Crippled Children’s Society, which was then in Rossmere, and referred us to Miss (Edna) Schreiber. That was the beginning of our daughter’s healing.

We did her exercises daily, and a neighbor came up to help me to hold her down on the table while I gently pulled her neck and twisted the muscles. Miss Schreiber’s assuring words, “Do this religiously, and she will get better,” were the commands that carried us on as (the daughter) began to improve. Miss Schreiber saw us regularly, and we do not remember ever being charged for the service.

Our daughter was a competitive swimmer in her teens, and is now a registered pharmacist working in Lancaster. She lives in Lancaster with her husband. They have two children and one grandson. She has been able to live a normal life and seems free of any complications of the hip.

We have tried to support the Society’s fundraising campaigns, because we have been extremely thankful for all you did for us then. The news in today’s Lancaster paper caused us to think how we were aided then and how you continue to help people. We want to help now. Our check for $1,000 is enclosed.

Here’s another one, sent in just last month.

To everyone at Schreiber,

Thank you, thank you, thank you! This note is a long time coming, but very well owed.

Our only child, (name withheld for privacy), who is now almost 17, was born 61/2 weeks early back in 1998. She weighed 4 pounds, 4 ounces, came home from the NICU at 11 days old at exactly 4 pounds, and started with Early Intervention the next day or so.

When she turned 1 is when Schreiber took over. If Mari Cunningham is still with Schreiber, please let her know that we truly do appreciate and will never forget what she did for us as far as helping our daughter. Today, she is a beautiful, healthy young lady getting ready to start her senior year of high school. She’s an A-B student who makes the honor roll every marking period. She plays tennis, does track, plays softball, plays lacrosse and loves every minute of it.

So, again, we say thank you to all of the therapists for doing what they do every day. It truly does make a difference. Thank you to everyone else at Schreiber as well. We wish we could give more, but, unfortunately, right now that’s not possible. Some day it will be though, at least we hope.

Thanks so much again, and keep up the good work!

And sometimes, the notes are shorter. We received this one in June after Schreiber President James DeBord visited Schaffer Elementary School to accept the money raised by students in Laurie Fellenbaum’s second-grade class.

Thank you! Schreiber is COOL!

So to those second graders, to the proud parents of a teenager, and to the folks we helped 60 years ago who all find it in their hearts to remember us and support us, we can only say:

No, really. Thank you.

Duckie sales start this week

DuckiePalooza Weekend

Schreiberpalooza is the music festival we’ve been doing in September for several years. Once we moved the Rubber Duckie Race date to September, it only made sense to put them together. For the first time, we will offer DuckiePalooza Weekend, Sept. 12-13.
So, to summarize:
Rubber Duckie Race + Schreiberpalooza = a great late-summer weekend of fun for all ages.

Schreiber Night at the Barnstormers

This Friday, July 3, will be Schreiber Night at Clipper Magazine Stadium. Join us for the big party we’re throwing to mark the start of Duckie ticket sales. Before the game starts, Schreiber kiddoes and their parents can join players on the field for what should be a moving version of “The Star-Spangled Banner.” Contact Dan Fink in the Fund Development Office if you’re interested. After the game, we’ll have a spectacular helicopter drop of 750 rubber ducks onto the stadium outfield, where three kiddie pools will serve as targets. Buy a ticket in the duck drop, and if you’re duck lands closest to the mark in the center of one of the pools, you could win one of the three awesome prizes we have lined up: a Weber Spirit grill (retails for $500), a 32-inch Samsung flatscreen TV (retails for $250) or a family fun amusement park package. And remember: Use the ‘duck15’ promo code when you buy your tickets, and $4 from each ticket sold comes to Schreiber.

New ducks, part 1: Debut of the specialty ducks

For the first time, we will sell tickets for 5,000 blue specialty ducks — at $20 per ticket — you will have a chance to win one of 10 premium prizes. So while our traditional race will have the usual array of fun prizes, this specialty duck race offers a chance at a Weber Genesis 330 copper grill (retails $850), Sharp a 43-inch flatscreen (retails for $400) and other great items. So while you’re picking out your Quack Packs and your Daffy Dozens, pick up a specialty duck or two, and you could win the TV or the grill.

New ducks, part 2: Out with the old racing ducks, in with the new

After years of bouncing down the Conestoga River, our trusty old racing ducks were showing their age. Thanks to a generous donation from LCBC, we were able to buy 25,000 new ducks — 20,000 of our traditional racing ducks and 5,000 specialty ducks.

Play Where’s the Duckie

on Facebook

Every Monday, we post a photo of one of our Rubber Duckies at a Lancaster County landmark on our Facebook page. So far, he’s been spotted at Park City, Long’s Park, Clipper Stadium and a bunch of other well-known Lancaster County locations. Keep visiting our Facebook page for the latest Duckie photo, make your guess and tag three friends to get them to guess. Each weekly winner receives four tickets to Schreiberpalooza Sept. 12 and will be entered into a drawing for a $50 restaurant gift card. And please consider making a $9.13 Where’s the Duckie donation to Schreiber, and encourage your friends to do the same. Every dollar we raise through the Rubber Duckie Race and all of our special events helps us provide services to nearly 4,000 children, regardless of need or ability to pay.

Skipping like the wind

Remy has cerebral palsy, a disorder that’s the result of damage to the developing brain. It’s one of the more common causes of chronic childhood disability: About 10,000 infants in the U.S. are diagnosed with it each year, according to WebMD.

The condition affects the left side of Remy’s body, and she wears a brace on her left leg to prevent her achilles tendon from tightening, said Schreiber physical therapist Diane Weis.

Heather Colosi, Remy’s mom, had been taking Remy to a traditional physical therapist — one who treats mostly adults — with little to show for it.

“We went for a year and didn’t see any progress,” Heather says. “Finally, I got fed up.”

They started at Schreiber in August, and Heather could see a difference immediately.

“The other place wasn’t focused on children,” she says. “Here, they have the bright colors and the toys and games. It makes it more enjoyable.”

And Remy’s mobility improved, too. But Mom thought Remy would benefit from a little extra motivation. When she saw the Fulton Theatre would be presenting “The Wizard of Oz” this summer, she talked with Remy about trying out.

“My mom asked me if I wanted to do it, and I said, ‘Yeah,'” Remy says.

To be a Munchkin, though, Remy had to learn to skip. And as her therapist says: “Skipping was not in her wheelhouse.”

Diane’s work with Remy has focused on strengthening Remy’s left leg and improving her one-foot balance. Remy has gradually learned to step up on increasingly higher steps. She does a lot of climbing.

Skipping required a little extra work. Diane added some new strengthening and stretching, and she walked Remy through the step-hop pattern. And Remy practiced skipping. Over and over and over. One week before her audition in May, she had it down.

“When she finally got it, she was so excited,” Heather says. “You could see the lightbulb go off. She said, ‘I got it. I understand it. I can do it.'”

On Thursday, she will put her new skipping skills to work — for opening night at the Fulton. If you see a Munchkin with a little extra determination in her eye and a little more joy in her step, that’s probably Remy, following a Yellow Brick Road to her own version of Oz.

My Story, Joanne Martin: Why I love Schreiber

On June 6, Chris will be participating in Schreiber’s Softball Weekend to raise money for the services Schreiber Pediatric provides. Since birth, Chris has been a client of Schreiber, first with occupational therapy and physical therapy more recently for weekly Friday appointments to get his fingers and fine motor skills working better.

They have been truly instrumental in his progress over these nine years. We would not be where we are today if Schreiber wasn’t part of our lives. They do change lives. Schreiber provides cccupational therapy, speech therapy and physical therapy to more than 4,000 children annually who have special needs. Chris’ therapists have been amazing at helping him learn to tie his shoes or write with a pencil. All of these tasks are easy for most of us but not for many of the children being served by Schreiber. They are dedicated to helping children.

On a recent Friday at Schreiber, I watched Chris draw a perfect dog on an art wall at the center. They know how to motivate Chris to do difficult tasks. We are truly blessed by Schreiber.

The Martin family was blessed to begin receiving services at the Center for Autism and Developmental Disabilities (CADD) for Chris to help him with social skills and how to handle social situations at school and home. This has been an amazing organization for Chris when it comes to learning appropriate things to say and not to say. We have a long road ahead of us, but Chris talks weekly with other kids who struggle with social skills and he LOVES going. This social skills class is facilitated by his amazing child therapist, Colette. She helps direct the group, teaching the boys in the group how to behave, react, even engage in things as simple as a game of Lego’s.

She also works with Chris one on one to help with things that Chris struggles with, like how to show frustration or anger. This program is really amazing because they are a full-service support center for children and adults with autism. We are blessed with CADD because as Chris grows, the services and programs they provide will grow with him. That is very RARE!

Last year, with your help, the Martin Family raised $3,000 for Schreiber. Can you help us again? Would you help us support Schreiber, CADD or both?

We need your help! If you want to contribute, you can mail a check to me payable to Schreiber Pediatrics or CADD. Any amount can help. Put “Chris Martin Fundraiser” in the memo section.

If that is too much and you want a faster way – you can log on to this link – https://www.schreiberpediatric.org/donate/ – and make sure you note “pledges for Chris Martin for Softball” in the Dedication section. It would help if you let me know that you gave so I can make sure it is counted for Chris’ game.

Or you can go to https://www.philhaven.org/ProgramsandServices/CenterforAutismandDevelopmentalDisabilities.aspx
and make your donation to Pilhaven. Please make sure that in the note section that it states this is for Chris Martin’s fundraising project for CADD.

We appreciate any support you can provide. These two organizations have made a huge improvement in Chris’ life and ours, and we are just one family; they both serve thousands of families in the same situation. Check out both organizations to learn more and spread the word about them.

The Martin family thanks you!


Schreiber’s 33rd Annual Softball Weekend starts Friday, June 5, and runs through Sunday at Froelich Park in Mountville. Registration deadline for Marathon Play is Thursday, June 4, and there are a few slots left (register online here). Thanks to our presenting sponsors Fraternal Order of Police Red Rose Lodge #16 and Lancaster Toyota. This year’s other sponsors include Abram Subcontracting, E&E Metal Fab. Inc. and Integrity Pools and Spas, with FM97 our exclusive media sponsor for the weekend. And special thanks to our other supporting businesses: B&T Sportswear, Manheim Sertoma, Crystal Springs, Family Owned Markets, Gayle Kline RV Center Inc., Herr Foods Inc., Kunzler & Company Inc., Pepperidge Farm, Pepsi Beverages, Turkey Hill Dairy, Weis Markets and Y&S Candies.

My Story: Jana Kuhns

My name is Jana Kuhns, and I am 15 years old. I received my injuries from a car accident. My parents and my younger sister Jennie were in the accident as well, but my sister Jennie went to be with Jesus.

The night of the accident I was taken to Lancaster General Hospital then transferred to Hershey Medical Center right away because Lancaster General doesn’t accept trauma pediatric patients. I was in Hershey’s pediatric intensive care unit for 18 days with many differnt injuries, including a severe brain injury. Then spent 3 months and 3 days in the Lancaster Rehab Hospital.

I am told I had a breathing tube and a brain probe, and they also had me on life support at Hershey. But I don’t remember any of that.

The day of Jennie’s viewing they removed my breathing tube.

I don’t remember the first two months, but I remember the big events. My nurses, techs and therapists sang “You are my sunshine.” I remember being sung to, but I don’t remember when.

I had no physical abilities because my left side was stiff, and my right side was curled. But now my left side is my good side, my right side doesn’t work. I also had a fractured jaw and pelvis, but I don’t remember any pain. I am told I had a feeding tube as well. I wasn’t responsive in Hershey or when I first came to the rehab hospital.

Jana couldn’t talk for the first two months after the accident. It took another month to be able to get around without a wheelchair. She has made huge improvements since then, but the effects of her injuries linger. The damage to the left side of her brain has left her with limited function on the right side of her body.

She started coming to Schreiber for therapy in July, about four months after the crash. She comes three times a week: for physical therapy (each visit), occupational therapy (twice a week) and speech therapy (once a week).

The physical therapy is the most arduous. PTs Laurie Miller and Lisa Stachler Volk are working to restore strength and range of motion to Jana’s right arm and leg. For the ankle and foot, Lisa and Laurie are using a therapy technique called serial casting. Because of the brain injury, Jana’s foot became locked in a flexed position. The muscles were stuck.

With serial casting, Jana’s doctor injected the muscles in her lower leg and foot with Botox to temporarily shut down and relax the muscles. Then Laurie and Lisa put her foot and ankle in a series of casts that will gradually allow her foot to be moved back toward the correct position. Each week, they take the old cast off, adjust the ankle position and put a new cast on. Each week is a little more progress toward normal.

When I started at Schreiber, I couldn’t do anything to help at home. Now, with my spare time, I wash dishes, read books, clean and sometimes cook.

I hate it when Lisa and Laurie put a cast on my leg and ask me not to talk, but I know what they’re doing is going to help me in the long run. Also, I love asking almost everyone to sign my cast, and I understand why they’re asking me, so that helps me to stand it.

I love it when Laurie does the exercise that helps me hold my shoulder back when I’m walking, because I just lay on the table and roll this way and that. I love it when Lisa has me do wall pushups because that’s making my left arm stronger. I love it when Isaak (Schreiber OT Isaak Ross) has me cooking because I’m doing something that will help me at home.


Jana’s mother RoseAnn didn’t know exactly what to expect when she started bringing Jana to Schreiber. She saw the progress in the first four months – learning to talk and walk again – and thought she had come a long way pretty quickly.

“I think I thought she’d get back to normal,” she says. “The more I learn about brain injuries, the more I know that ‘normal’ might take a long time, if ever. Jana has a new normal.”

The new Jana is a chatty, cheerful teenager who teases her therapists while taking some teasing from her little sister Jenessa. The new Jana shows no signs of any woe-is-me wallowing. The new Jana is a smart girl with lots of support from her family, her faith and her friends at Schreiber.

We will move on from United Way decision

The United Way and Schreiber have supported each other’s missions for many years. Schreiber has long been one of the largest recipients of United Way allocations. And the United Way has regularly used Schreiber children in its marketing efforts, because our kids and the work we do are make for such compelling stories.

We have been proud of that relationship, and we like to think it has been mutually beneficial.

But times change. We understand that. We really do. Obviously, we would have preferred the United Way had come to a different conclusion about the value of the collaborations we put forth in our application. Yes, we only listed three partners in our United Way filing. But the fact is we could have listed many more.

Here’s a partial list of the community organizations with whom we partner:

  • The Fulton Opera House
  • The Choo-Choo Barn
  • The Janus School
  • The Milton Hershey School
  • Lancaster-Lebanon Intermediate Unit 13
  • Lancaster County Behavioral Health and Developmental Services
  • Agora Cyber Charter School
  • Commonwealth Connections Academy
  • Elizabethtown College
  • Lancaster General Health’s Pennsylvania School of Health Sciences

The point here is that the United Way wants to encourage organizations to develop these collaborative partnerships to reduce redundancies and serve more people, all with an eye toward improving its four Bold Goals: to improve kindergarten readiness, to improve post-secondary achievement, to reduce poverty and to improve access to the health care system.

Schreiber’s work is already specifically addressing at least two of those goals. Our preschool and daycare services are providing high-quality early education that is sending dozens of kids a year to kindergarten ready to learn. Our therapy services offer the thousands of special-needs kids we see every year an important part of their medical care — services that help them say their first words, or hold their dad’s hand or take their first steps. And these are services that aren’t available anywhere else in central Pennsylvania.

But the United Way has made its decision. We accept it and move on.

We were already taking steps to make sure Schreiber remains in Lancaster County next month, next year and well into the future. Since 2012, we have nearly doubled the amount of money we raise through grants and private donations. In 2014, we created the Schreiber Endowment Fund, seeding it with a $100,000 grant and then raising another $100,000 from the community.

That work will continue, although now, of course, we will need more help from our many friends across Lancaster County and beyond. For those of you who know Schreiber only through our Rubber Duckie Race, take a minute to visit our website learn more.

If you already have a family member here or know a friend with a child here, and you know about the work we do, but you’ve never donated, take a minute to visit our donation page and explore how a gift might fit in with your values and your budget.

And if you aren’t able to support Schreiber financially right now, we understand. There are ways to give that don’t cost anything. You can like us on Facebook, sign up for our email list or follow us on Twitter. You can raise your hand for one of the many volunteer opportunities we have available.

Schreiber’s work is so critical to so many children that we simply do not accept the possibility that this community would allow such a valuable community resource to be buried under its financial burden.

We have seen difficult times before, and each time we weathered them. With your help, we will weather this one, too.

Gone buggie

Consider the case of little Elaina Sauder. Pink pants and a matching pink ribbon in her red hair. A happy, giggling little 5-year-old.

Except where bugs are concerned.

She’s on the autism spectrum with lots of sensory-processing issues. Her mom Joslyn says Elaina has been coming to Schreiber for occupational, physical and speech therapy for about two-and-a-half years. Show her a plastic container with some planting soil and earthworms, and she will pull away like there’s a spider in front of her.

“She’s afraid to go outside,” Joslyn says.

We hear similar versions of this story from the parents of the children they treat each spring through the summer. There are strategies occupational therapists and parents can use to help kids be more comfortable playing among the bugs and dirt.

1. Listen to the child to identify what exactly the anxiety is. Is it about crawling or flying insects in general? Or is there a particular insect that is upsetting? Once you narrow down the issue, begin to work through it.

2. Educate inside the house. We begin with non-threatening bug games like “Spin the Beetle” (Milton Bradley), “Up the Water Spout, a Spider Racing Game” (International Playthings), “Squiggly Worms” (Pressman), and move on to “Cootie” (Milton Bradley). The games are modified depending on the age level. For example, “Cootie” can be played with spelling words or math problems for elementary children.

3. Progress to more vivid illustrations of insects. The children design their own bugs using multiple media, including colored pencils or molding clay. And parents can use electronic games such as “Bugs N Buttons” (little bit studio, 2014) and “Bugs N Bubbles” (little bit studio, 2012) that have lifelike graphics.

4. Have the child build stories. Social sensory stories are written specific to the child with photos or pictures included. I work with Elaina to have her draw pictures in response to a series of prompts about what she can find outside. The combination of the prompts and the pictures helps Elaina create an Elaina book about things outside her house, starting with everyday objects she’s comfortable with (like grass and dogs and cars), then working gradually up to bugs. So one prompt and picture — “Dogs and cats like to play with people. Bugs are afraid of people” — leads to the next — “Because people are big, and bugs are small.”

5. Shift their focus. Sometimes, you can redirect a child’s attention to a goal-specific task, such as a treasure hunt. Praise every success, even if it’s just taking one step out the door. The next time hide more treasures.

These are just some of the steps that our OT’s have used successfully to desensitize children who fear bugs and won’t go outside. At Schreiber, we customize our treatment, so that each child has a specific program to suit their goals.

Bernie Hershey is an occupational therapist at Schreiber Pediatric Rehab Center in Lancaster, Pa. She has been helping kids slide on scooters, balance on balls and climb on ropes for more than 30 years, all in the name of helping improve the quality of their lives.