Category Archives: Community Outreach

At Great Strides We Make Everyday Lives Better

At Great Strides We Make Everyday Lives Better
By Christina Swanson

Parenting a child with special needs requires meeting a host of challenges with positive determination, patience and unwavering persistence as the child grows and needs change. Eyes and hearts are opened as family members learn gratitude for everyday things and how simple hygiene and basic tasks, which are normally learned with ease and taken for granted, can be a difficult and pain-staking exercise for a disabled child and a time-intensive ritual for the child’s professional therapists, parents or caregiver.

A big part of Great Stride’s focus is to work as a team with the child, parents and/or caregiver, and teacher outside the classroom to help them learn the skills to be more independent which, in turn, increases the child’s confidence and potential to adapt and learn other skills while freeing-up the parent to meet the other many requirements of their day.

Recently, two Great Strides professional therapists extended their caring reach to teach a student/patient specific tasks by adapting equipment and creating specialized exercises that truly goes above and beyond their duties and speaks volumes to their dedication. Conquering something as seemingly simple as getting in and out of mom’s car and being able to clean oneself after using the toilet, has been a true victory for the child and family alike.

The Bidet Adaption Challenge

Young Brandon Belzer is a Great Strides outpatient who receives both occupational and physical therapy within a close collaborative team approach where his mom, Kimberly Belzer, is highly involved.   When Kimberly got the idea to install a bidet on her toilet to relieve her having to be with Brandon every time he used the bathroom, his therapists went to work at teaching Brandon about the many  hand and arm movements  needed for him to turn the small knob that operated this bidet so he could be self-sufficient.

But Brandon didn’t seem to have the strength or ability to understand the proper way to make the knob turn which set in motion another innovative Great Strides success story thanks to the creative construction of Great Strides Executive Director, Dr. Jon Edenfield, OTD, OTR/L, Brandon’s occupational therapist, Hilda Harrison, and an innovative installation at Brandon’s home by Hilda’s husband, Wayne Powell, who is an engineer.  This team looked into ways of adapting the equipment to the skill level of what Brandon could do. In looking for additional products that could change the bidet to have an easy button for Brandon to push instead of turning a knob, there was nothing available on the market. So, Edenfield, Harrison and Powell set to designing adaptive equipment from available parts and combining them together into a final “adaptive” product that’s not available in a store or even yet invented.

Using regular water lines, a lawn sprinkler valve, a low voltage power supply, and a Big Red button type switch, the bidet was adapted, allowing it to bypass the knob operation.  This adaptation resulted in a major functional outcome for Brandon who now independently operates his bidet every day using the Big Red switch.  Both Kimberly and Brandon are thrilled!


“As special needs parents, we are always trying to make our kids as independent as possible and have them be less vulnerable and dependent on others to perform everyday function which, of course, helps them grow and makes it a lot easier for us as parents,” explained Kimberly. “Now Brandon can go to the bathroom independent without me having to constantly get up and help him. The people at Great Strides are truly amazing in their caring because they know it is really about helping the children. It is a blessing to me that Great Strides is a true partner in helping our children become functional.”
The Entering/Leaving Car Challenge

Another easy to take for granted ability is to be able to get in and out of a car unaided. If you think about it, it’s kind of a complicated motion involving crouching forward, lifting the initial leg, ducking the head, etc.

Brandon’s physical therapist, John Kirkland, initiated a simulated car therapy based on observational gait analysis and Brandon’s known history of visual impairment, increased extensor tone, rigid adherence to routine, aversion to novel tasks and limited verbal and comprehension abilities. It appeared the inability of Brandon to transfer from the parking lot or driveway into his mom’s SUV keyed upon his inability to step up and translate his center of mass forward while in a crouch stance.  Kirkland determined that a small portion of this task was challenging for Brandon. However, this part task was essential due to the relatively low head clearance and high floorboard relative to the ground in mom’s SUV.  There were also concerns with his ability to pivot into his car seat once he steps into the car.

Kirkland used the principles of over-training, part task training, meaningful rewards, and verbal and tactile cueing with Brandon. He did this by creating a simulated physical situation where he hung a piece of cardboard horizontally from the clinic ceiling to replicate the car ceiling, used a step-up bench that approximated the height of the floorboard of the car and an object on the seat that required him to pivot in order to sit down.  The cardboard was painted to match the color of mom’s car and several other objects were used to simulate the bench seat of the car.

Then everything was set for Brandon to practice stepping up under a low ceiling with the bandwidth of reward, cueing, and assistance appropriately withdrawn.

The key was Brandon’s ability to generalize the task to his mom’s car, which he successfully accomplished after only two to three trials.  A total success and the cost of the project was a nominal $6.00 but helping make mom’s life easier is – PRICELESS!








Great Strides Super Hero: Kile Keene

Five Year ABA Student Plays Cello in Jr Symphony!
     By Christina Swanson

When the Jacksonville Symphony Youth Orchestra (JSYO) plays its first concert of the season in November, one of Great Strides youngsters will be performing at their first concert, too, as part of the Foundations Strings ensemble. At only eight years old, Kile Keene is another Great Stride super hero demonstrating how consistent hard work by “Team Kile” — his therapists and music teacher — can make all the difference in achieving developmental milestones.

Mary Westwood, Kile’s behavior therapist, has been working with Kile, both at his school and at the GS clinic, since he was three years old. This special relationship began when Kile first attended a special needs pre-kindergarten class at a private school. Westwood worked with Kile, a caring youngster with autism, helping him learn basic behavioral skills so he could eventually start attending his neighborhood’s public school, Hickory Creek Elementary, by the time he entered the first grade.

“Mary has been instrumental in integrating Kile into a classroom setting and his being able to go to public school,” said Windy Keene, Kile’s mom. “She instructs Kile on many skills, including social and academic, both with his teacher in the classroom and at the GS clinic, provides input to Kile’s IEP goals, and attends IEP meetings with me, all helping Kile to be successful.”

As Kile advances in such behaviors as interacting with his peers, Westwood has less classroom involvement in now his third grade year. She checks on him during recess, and works at the clinic with him for four hours per week, some of that one-on-one promoting motor planning skills to help the body and brain to work together in breaking down the steps involved in accomplishing specific tasks. Along with Westwood, Team Kile also includes Great Strides occupational, speech and physical therapists who help build upon his skills and accomplishments.

When Kile was three years old, his mom discovered he has a perfect pitch so they started him on piano lessons at the Orchard Kingdom. This was no easy task due to children on the autism spectrum having motor difficulties (where, in this case, the brain doesn’t cooperate in telling his fingers to press the right keys) involving more hands-on by both Westwood and mom.

Two years ago, Kile chose to add learning how to play the cello, diligently taking both piano and cello lessons several times a week. This has meant additional challenges in motor skills with Westwood working on such activities as how to pack and unpack his cello bag. When Kile’s cello teacher suggested him trying out for the JSYO this summer, he also worked with Kile on musical expectation for tryouts so he’d be ready.

String instruments are said to be the most difficult of musical instruments to learn and as mom noted, “It takes a lot for his brain to compute for even something as seemingly simple as holding the instrument.” If you google “learning to play the cello” you’ll learn that many accomplished musicians state that the cello is as “very hard to play as it is very easy to be out of tune” because the Cello has a very long fingerboard. This means it takes lots of practice to learn to find the right spot while requiring the player to focus both arms on the correct bowing and fingering, and requires learning to read music for the only instrument that uses three clefs — bass, treble, and tenor.

So, choosing to play the cello and winning a spot on the JSYO are no small feats! Kile and the JSYO’s first season performance is the Fall Concert on November 19 at the Jacoby Symphony Hall of the Florida Times Union Center for the Performing Arts in downtown Jacksonville.

Another huge accomplishment for Kile this summer was learning how to independently ride his bike. Kile’s GS physical therapist since he was four, John Kirkland, had been working with Kile for many months on balancing on his bike without training wheels and felt an added “push” might be just the boost Kile needed to make it happen. So, Kirkland suggested Kile attend “iCan Bike,” a bike camp for special needs children affiliated with the international nonprofit “iCan Shine.” This year, the five-day camp was offered in Florida in Orlando the first week of August, and was the perfect boost Kile needed to start riding independently and work on his social skills with new friends.

“Through the therapies at Great Strides, Kile is opening up and more willing to interact with his peers, in large part to his GS social skills group where they learn to listen and respond appropriately to peer interaction,” explained Keene.

“This has been a wonderful year of learning for Kile as he has been able to make friends and invite classmates over to ride bikes and swim together,” said Keene. “I am thankful to be around such great people and a talented team of therapists who are constantly on board promoting “Team Kile” — he’s a great kid who works very hard.”


— Here’s More About iCan Bike Camp

iCan Bike camp is a part of the international nonprofit iCan Shine that collaborates with area organizations to provide 100, five-day iCan Bike camps throughout the US and Canada each year. Their goal is to help children with disabilities (specifically geared to Down syndrome and autism) experience the joy of independently riding a conventional two-wheel bike.

For more information about the next bike camp in Florida, contact Camille Gardner at or call 407-760-9395.

Helping Children be Better People

Helping Children be Better People is Promoted by Relationship Between Pak’s Karate Academy of Mandarin and Great Strides Rehabilitation

By Christina Swanson

Chelsea loves practicing the high block, Cole likes saying “Kiai” (kee-yah) and Will takes a shine to kicking. Sounds like a typical elementary-school-aged kids’ response to beginning karate classes except these are children with special needs and the classes are just one way their rehabilitative school goes beyond the norm in expanding their daily learning process.

Great Strides Rehabilitation has been providing speech, physical and occupational therapy services for Northeast Florida for more than a decade with their main clinic, school and outpatient therapy support. Although they are located in Mandarin as part of the Jacksonville Pediatric Enrichment Center, their therapists also help children with disabilities at schools and medically fragile day care centers. Also located within this large Mandarin business complex on San Jose Boulevard is Pak’s Karate Academy of Mandarin, a mainstay in this area for 31 years.

Dr. Jon Edenfield, OTD, OTR/L, founder and executive director of Great Strides, wants his students to engage in a variety of leisure activities to help with their motor and social skills in a fun way. “Many special needs children have a hard time participating in sports teams or other typical activities such as riding a bike, and when they do, it can be a negative experience causing them to become self-conscious of their own behaviors which can lead to poor self-esteem,” said Edenfield.

When the students walk to the play ground each school day, they actually pass the Pak’s Academy building. One day about six months ago, when one of Pak’s owners, Master Christopher Tersak, saw the children, he approached the therapists with the group and struck up the idea of having the kids participate in some basic karate classes at no charge.

Edenfield already knew the benefits of karate for special needs children, especially those in the autism spectrum, in developing better balance, motor coordination, focus on a task, and improved eye contact and social skills. Tersak saw this as an opportunity to give back to the community and fulfill their core mission to extend the benefits of karate to all people, especially those with challenges and behavior issues.

“It’s all about form, discipline and focus rather than the physically aspect of fighting,” said Tersak. “Behavior is a huge part of advancing in karate…how they stand in line, address their instructors and interact with other students.”

“It’s inspiring to see how the instruction builds confidence to speak and perform in front of people which is one of life’s greatest fears even in adults,” explained Tersak. You see when the little ones first come here they are still holding onto mom’s leg; after three months they are standing in front of 300 people performing for their first belt.”

Working with the Great Strides’ students also challenges and grows Pak’s teachers to become more patient and understanding in their instruction methods. They are starting to receive feedback from the kids’ therapists and parents that the classes are showing a positive impact on the students’ everyday lives. “That is our payment because that is why we do it,” said Tersak.

Pak’s Academy is known for being family oriented where about 20 percent of the parents join their kids after they witness how beneficial learning the discipline of karate can be. “The greatest thing is to watch a father practicing moves with his child,” said Tersak. “We are in the business of developing community leaders in school and life, not just black belts. “ (The Pak’s Karate Academy of Mandarin — named after the grand master founder who has 150 schools world-wide and independently owned — was bought by two brothers who learned and have taught there for 20 years, Master Christopher and Master Nicholas Tersak, along with wife Angela Tersak.)

Recently, Edenfield attended his students’ first ceremony at Pak’s Academy, watching six to eight year olds pay strict attention to instructions and beam with pride after breaking their first boards. “It’s obvious the children are really into it and their behavior and focus improvements are extending into other crucial communication areas as shared by their parents,” said Edenfield.

For more information about Pak’s of Mandarin call 262-8200 or go to; to reach Great Strides Rehab call 886-3228 or visit