“It’s okay, you’re fine…”: Recognizing Childhood Depression

“Childhood is so fun, and kids are always happy!” “There’s no way my child is depressed, they laugh and have everything they want” The truth is childhood can be fun, kids are not always happy, and they can develop depressive symptoms.

I thought only adults experienced depression?

Children experience and feel many emotions, just as adults do, although they often require some help navigating, understanding, and managing those feelings. Depression is different than just feeling sad or ‘bummed out’ for an extended period of time. Many children who experience depression are not aware of their symptoms, why they might feel this way, or how to talk about these intense feelings. Discussing these feelings with your child and listening to their perspective can be intimidating. Be open to talking with your child about these feelings so you can build a trusting, supportive, and honest relationship.

What are the symptoms of depression?

Like many mental health diagnoses, depression symptoms can and do vary between each person. Depression is sometimes “missed” because it may look very similarly to emotional disturbances, aggressive outbursts, and defiant behaviors. While the key points of depression include increased feelings of sadness, feeling hopeless, and mood changes, here are some additional signs of depression in children:

  • Changes in sleep (sleeping too much or not enough)
  • Changes in appetite (eating more or less than usual)
  • Decreased energy and fatigue
  • Crying
  • Irritability and anger
  • Physical outbursts
  • Continuous feelings of sadness
  • Withdrawing from social activities
  • Difficulty concentrating or decreased focus
  • Physical body pains (stomachache, headache)
  • Thoughts, comments, or actions of self-harm, death, or suicide
  • Significant loss of interest in activities or hobbies that used to be exciting
  • Difficulty functioning in events with family and friends

Not all children will experience some or all of these symptoms. Many children will experience several of these throughout their childhood and lifetime through different times and different settings. Not all children who are diagnosed or are experiencing symptoms of depression will think about self-harm or attempt suicide. Symptoms of depression are dependent on the child’s extended family mental health history, environmental factors, prior trauma, and manifest differently in different genders. 

What can I do?

If you notice your child is struggling with any of those symptoms, approach your child with a gentle heart and listen to their concerns. Create an open discussion with your child about their feelings and express to your child, you are there for them and want to help them. Encourage your child to express their feelings and seek out counseling services whenever you and your child are ready.

Questions or concerns?

If you have questions or concerns about your child’s emotional well-being, please contact us at info@playworkschicago.com or 773-332-9439.

Kelly Scafidi, MSW, LCSW, DT
Licensed Clinical Social Worker
Developmental Therapist

Photo Credit: Kat J via Unsplash.com

Employee Spotlight: Claire Hacker

What do you love most about being a Speech Therapist?

I love the relationships I have with the children and families that I see. It’s so rewarding to see a new skill gained or milestone met and to get to share in those exciting moments with the family.

What is your favorite children’s book?

If the Dinosaurs Came Back by Bernard Most.

What do you enjoy most about living in Chicago?

I love getting to try new restaurants and being able to walk along the lake! I also have three siblings who live in the city and my parents are close by in the suburbs.

What is your favorite childhood memory?

My family would go camping every summer. I loved biking, swimming, the campfires, and making s’mores!

Would you rather a mountain or beach vacation?

Both! I lived near the Smoky Mountains for three years and enjoyed being able to go hiking. But a beach vacation always sounds amazing… especially during a Chicago winter!

Share a proud “therapy moment” with one of your clients.

I was seeing a child with apraxia of speech who started singing “Happy Birthday” while we were pretending to make birthday cupcakes. It was a moment that showed how far she had come and it was amazing to see the huge smile on her face and her parents faces!

What is your hometown?

Libertyville, IL.

What do you like to do in your free time?

My husband and I are big Tennessee football fans and we love watching their games in the fall. I also really enjoy baking and have a big sweet tooth!

What is your favorite therapy toy?

It’s hard to choose just one! I always have bubbles with me. Bubbles are always a favorite of the kids that I see and there are so many social and language goals that can be targeted.

Share a fun fact about yourself.

I used to work at a camp in the summers and got my license to drive a school bus!

Claire Hacker MS, CCC-SLP
Speech Language Pathologist

Jump into July! Social-Distancing Family Events and Activities

The Variety Juggling Comedy Show on Zoom

Date and time: Friday, July 10th from 1:00pm-2:00pm

Location: Online Zoom Event Sponsored by Round Lake Beach Cultural & Civic Center

Cost: Free! Register for the event here: https://www.eventbrite.com/e/family-fun-fridays-the-variety-juggling-comedy-show-on-zoom-tickets-91010435663?aff=erelpanelorg

About: The show features a whole lot of variety and big juggling and balancing stunts with balls, clubs, rings, spinning balls and Frisbees, giant beanbag chairs, much more, and a huge finale! There’s tons of zany comedy, improvisation, audience participation, energy and excitement!

The Frog Lady on Zoom

Date and time: Friday, July 24th from 1:00pm-2:00pm

Location: Online Zoom Event Sponsored by Round Lake Beach Cultural & Civic Center

Cost: Free! Register for the event here: https://www.eventbrite.com/e/family-fun-fridays-the-frog-lady-on-zoom-tickets-91013681371?aff=erelpanelorg

About: Learn the differences and similarities between reptiles and amphibians and meet over 20 live animals!

The Great Scott Magician on Zoom

Date and time: Friday, July 31st from 1:00pm-2:00pm

Location: Online Zoom Event Sponsored by Round Lake Beach Cultural & Civic Center

Cost: Free! Register for the event here: https://www.eventbrite.com/e/family-fun-fridays-the-great-scott-magician-on-zoom-tickets-47196371618

About: Enjoy a show by Chicago’s best-rated magician for children and family audiences. The Great Scott’s magic shows are hysterically funny for all ages!

 

Caitlin Chociej, MS, OTR/L
Occupational Therapist

 

Photo Credit: Orione Conceição via Pexels

Activities to Try If Your Toddler Is Not Yet Imitating New Words

When your child is learning new words, you may begin to notice that many words in their early vocabulary begin with the same sounds – “mama, more, moo, mine.” Is that typical in language development? Absolutely! Children learn certain speech sounds first based on ease of production, so it makes sense that the vocabulary they learn first would start with those same sounds. Research shows that the following speech sounds are typically acquired first: /m/, /b/, /p/, /w/, /h/ and /n/. When supporting your child’s language development, it is helpful to focus on words that begin with these sounds in order to encourage imitation. This will help your child develop functional language skills so that they can communicate their wants and needs effectively!

What’s the difference between speech and language?

According to the American Speech and Language Association, “Speech is the way we say sounds and words.” We articulate sounds by moving our mouth, tongue, and lips! We can voice these sounds by moving air through our vocal folds and shaping our mouth to produce different sounds. Modeling the oral movements you want your child to imitate is beneficial in teaching your child early developing sounds, such as /m/, /h/, /n/, /w/, /p/ and /b/ during play activities! These sounds should be in your child’s inventory around two years of age.

According to the American Speech and Language Association, “Language refers to the words we use and how we use them to share ideas and get what we want.” Language includes the meaning of words, how to put words together in a phrase or sentence, and what we should say depending on the context or situation. Teaching children to greet others, to request their wants and needs, and to comment during play are all great ways to support language skills at a young age!

If your child is slow to imitate new words with you, consider the specific speech sounds within the word you are trying to practice. Does it start with a later developing sound that they do not have in their inventory yet? If so, consider rephrasing or choosing another word with the same meaning that is easier to say, such as “milk” instead of “drink.” The easier a word is for your child to say, the more willing he or she will be to imitate!

Practicing at home? Try these activities to encourage imitation!

  • To work on /m/, you may work on modeling “milk” when holding your child’s bottle or cup of milk up near your face before giving it to them during a preferred time. Wait five to ten seconds before handing over the milk to provide your child with an opportunity to imitate. You may practice this during pretend play with a baby doll as well before giving your child the bottle to feed the baby. Materials: milk bottle/cup, parent, baby doll, pretend baby bottle.

 

  • To work on /h/, practice greetings routinely throughout the day. You may say “hi” to people that you pass by or that come in and out of your home. You may even say “hi” to each of your child’s stuffed animals (i.e. “Hi bunny!”) during play! Materials: People/Stuffed animals.

 

  • To work on /n/, model the horse sound (i.e. “Neigh!”) frequently during play with a barn. You may also teach your child this while providing a pause during Old MacDonald Had a Farm (i.e. “With a…..(Neigh, Neigh) here and a (Neigh, Neigh) there…”). Materials: Farm Animals/Sing-Alongs.

 

  • To work on /w/, you may model “wa” or “Wawa” for water during your daily routine. Provide a pause for your child to imitate before giving him/her their water. You may even pair the word for water in sign language to give your child additional cues! To make the sign, you put your thumb and pinky fingers together to make a “W” with your other three fingers up. Tap your pointer finger to your chin to make the sign for “water.”

 

What if my child will not imitate or make these sounds but will make others?

Don’t worry! Follow your child’s lead and give them the confidence to continue making those sounds. Silly and unexpected sounds and words that are fun for your family are a great way to encourage and support speech sound production skills.

Questions or concerns?

If you have questions or concerns about your child’s early speech sound production skills, please contact us at info@playworkschicago.com or 773-332-9439.

Jaclyn Donahue MS, CCC-SLP
Speech-Language Pathologist

Reference: What Is Speech? What Is Language? (n.d.). Retrieved from https://www.asha.org/public/speech/development/language_speech/

Photo Credit: Martin Lundgren via freeimages.com

Employee Spotlight: Rachel Weiser, MS, DT

What do you love most about working for PlayWorks Therapy?

I love the community PlayWorks provides. Every day I have the opportunity to learn new skills and tricks from my fellow coworkers and the families I work with.

What is your favorite children’s book?

I’m a big fan of anything by Mo Willems! I love his humor and the messages his stories provide.

What do you enjoy most about living in Chicago?

I love that there is always something to do in Chicago! Exploring new restaurants, going to a museum, I love being a tourist in my own city!

Would you rather a mountain or beach vacation?

This is tough for me! Both? My most recent favorite vacation was Grand Lake, CO featuring both a beach and mountains.

Share a proud “therapy moment” with one of your clients?

I was seeing a child with a gross motor delay. He was still learning how to walk. Through a motivating play scheme, I was able to see him take his first steps! It was a great moment!

What’s your hometown?

Deerfield, IL

What do you specialize in?

I specialize in social emotional development. I love helping families increase their child’s frustration tolerance and attention span to adult directed (structured) activities. I incorporate my knowledge from my previous teaching career to set my clients up for success for when they exit Early Intervention.

What do you do in your free time?

I love to do anything outdoors- especially when the weather is nice!

What is your favorite therapy toy?

I love Mr. Potato head! Mr. Potato encourage growth of symbolic play, concept knowledge, and turn taking!

What is your favorite Telehealth activity?

I love doing scavenger hunts! I will hold up colors or shapes and ask a child to find something in their home that is the specific color or shape I am holding up! It’s a great way to get the kids moving and work on following directions!

Share a fun fact about yourself:

I was an extra in the Muppets movie!

Rachel Weiser, MS, DT
Developmental Therapist

Teletherapy 101: What to Expect and Common Questions

PlayWorks Therapy Inc. is committed to ensuring your child receives quality services during this time of uncertainty and have transitioned to all online teletherapy sessions. We are looking forward to this virtual experience with you!

What is Teletherapy?

Teletherapy, also referred to as telehealth, is a type of therapy provided by your child’s therapist online through video chat, much like FaceTime, Skype, or Gchat. Although teletherapy is a new offering at PlayWorks Therapy, it is a model of therapy that has been used and researched in the field for several years. PlayWorks Therapy is remaining current with best practice and continuing to provide evidence-based therapy through this mode of therapy.

What can I expect from a Teletherapy appointment?

Depending on the type of therapy your child receives, the structure of the therapy session may differ slightly than the in-person appointments. The session itself may consist of the therapist reviewing goals and techniques with caregivers as well as assisting in choosing appropriate toys, games, and materials to target those goals. The therapist would then provide recommendations for how to use each material, including specific prompts to use throughout the activities. We realize that your child may not be as engaged or motivated to sit in front of a video so we require a parent or caregiver to be present or nearby for the majority of the session.

Will this really be a productive mode of therapy for my child?

Many providers have been using teletherapy as their primary mode of therapy over several years with success. Because the structure may look different than usual the in-person appointments, our expectation of what makes a “productive” or “successful” session may also change. Your child’s goals may shift slightly in this period but just know that every and any interaction your child has with their therapist informs their continued work. With a strong partnership, both the therapist and caregivers can use techniques with the child to reach targeted goals.

Won’t it be awkward that my child and the therapist are in different rooms?

At first, some children do find it slightly awkward or uncomfortable to work with therapists virtually. Below are strategies we recommend trying to increase your child’s comfort level with this new type of appointment:

  • Find a space that works for you and your child. This does not need to be the quietest or cleanest room in your home; however, be mindful of the visual distractions (e.g. toys, games) in the room as this may affect your child’s attention. We recommend that you choose a favorite place or comfortable space you usually spend time in as this may help your child with the transition.
  • Help your child settle in by allowing them to have a favorite toy or other comforting object with them.
  • With supervision, allow your child understand the technology by gently touching the screen and exploring the different functions, provided by the therapist.
  • Check in with others in your home to see if they want to be present or out of view for the session and ultimately let your child know who will be with them.

I’m not great with technology. Will this be challenging to set up?

In most cases, your teletherapy appointment will take place on a website or app platform. Your therapist will communicate with you about your child’s specific platform, and whether or not to download an app, based on what type of therapy they receive. Your therapist will then send you a confirmation email with the link and any other information you will need to access the appointment. It will be as simple as opening your email and selecting the link! You will then be directly connected to your therapist’s video chat.

I am in the appointment, but now I am experiencing a problem with the connection.

Below are technology tips to help you get the most of your therapy sessions:

  • Be sure to switch on audio and video settings at the start of the session.
  • Confirm a plan with your therapist in case the connection is abruptly ended.
  • Check the use of additional devices. Streaming or heavy use on another device at the same time as your session may slow your connection and video quality.
  • Having multiple tabs open on your device may also impact video quality.
  • If possible, try not to sit in front of a bright window or light.
  • Let your therapist know if you cannot see or hear them clearly – we want you to get the most of your session!

Questions or concerns?

If you have questions or concerns about your child’s eligibility for teletherapy, please contact us at info@playworkschicago.com or 773-332-9439.

Amanda Deligiannis, MSW, LSW
Licensed Social Worker

Photo Credit: GSCSNJ via photopin.com

Brush It Off! Brushing Protocol for Sensory Integration

Therapeutic brushing may be recommended for your child due to tactile defensiveness, or difficulty tolerating a variety of textures. However, engaging in a therapeutic brushing protocol may also help to ease sensory-based anxiety, promote falling asleep, increase attention to task, increase coordination, and overall self-regulation.

What is Therapeutic Brushing?

The Wilbarger Deep Pressure and Proprioceptive Technique (DPPT), also known as the Wilbarger Brushing Protocol, is often used by occupational therapists to promote sensory integration. It is typically used with children demonstrating sensory defensiveness, or children who exhibit signs of over-responsiveness in the protective responses of the nervous system. Oftentimes, it is used with children who exhibit tactile defensiveness, or difficulty being touched by people or a variety of textures.

What Does the Protocol Look Like?

DPPT begins with systematic brushing of the body, followed by joint compressions to a child’s arms, legs, hands, feet, and head. Brushing is completed using a soft surgical scrub brush, often called a Therapressure brush. The correct brush is required in this protocol, as it provides a specific type of sensation to the nerve endings in the skin. Firm, even pressure is used to sequentially brush the arms, back, legs, and feet. Areas such as the stomach and chest are always avoided, as they are particularly sensitive. Following brushing, 10 joint compressions are provided to the child’s hands, wrists, elbows, shoulders, hips, knees, ankles, and feet using gentle pressure. This provides the child with deep pressure proprioceptive input which is calming to the nervous system. The protocol is repeated approximately every two hours while the child is awake. DPPT must always be taught by a trained therapist to ensure that it is safe, effective, and beneficial for the child.

What Does Brushing Do for Sensory Integration?

The brushing portion of DPPT stimulates the nerve endings of the skin, generally serving to “wake up” the nervous system. The joint compressions provide the body with deep pressure proprioceptive input, which typically calms nervous system. Performing the two elements of the protocol helps the central nervous system to better utilize information from the nerve endings of the peripheral nervous system more effectively. This can result in increased overall regulation, decreased anxiety to sensory triggers, and improved ability to transition between challenging tasks.

Who Would Benefit from Therapeutic Brushing?

Your child may benefit from DPPT if he or she:

  • Demonstrates difficulty being touched, wearing a variety of clothing, or tolerating a messy play.
  • Becomes reactive with grooming activities, including having his or her hair washed, or fingernails clipped.
  • Demonstrates difficulty maintaining a calm, alert, and organized state.
  • Experiences difficulty calming down and falling asleep at night.
  • Demonstrates difficulty transitioning between activities
  • Appears to have trouble noticing when he or she is hungry or needs to go to the bathroom.

Questions or concerns?

If you think your child could benefit from DPPT, please reach out to your occupational therapist or  us at info@playworkschicago.com or 773-332-9439.

Natalie Machado, MS, OTR/L
Occupational Therapist

References:

OT-Innovations.com. (2018). Therapeutic brushing techniques. Retrieved from https://www.ot-innovations.com/clinical-practice/sensory-modulation/therapeutic-brushing-techniques/.

Keep Calm and Messy Play On!

Ever wonder why most of us have a baby photo with food all over our hands and faces? An important part of processing our world is through touch, even from a young age. Our sense of touch gives us information about our environment and the characteristics of our surroundings. We are able to determine if something is hot, cold, sticky, dry, soft, smooth, and so on! Messy play is a vital part of child development as our touch processing feeds into our skills such as motor planning, body awareness, visual-motor skills, fine motor skills, and more. At the moment with our schools and businesses closed many of us may be stuck indoors as we quarantine at home. While our current focus might be keeping our hands and homes clean, we can find ways to continue promoting our tactile sensory processing and get messy safely!

Our sensory processing abilities determine how we respond to tactile input. Your child may demonstrate sensitivity or avoidance to tactile input, such as withdrawing their hands when they get messy or splaying their fingers outward when they engage with wet textures. Maybe your child craves tactile input and you have a hard time keeping their hands clean or to themselves. Either way, incorporating messy play or multi-sensory experiences into their day can help them learn to process and respond to tactile input in order to better participate in grooming, meal time, bath time, and other daily routines!

Sensory Materials from Home:

You can always try to repurpose materials that you already have in your home to promote messy play. Try filling up a plastic bin at home with any of the following. You can switch out the material weekly to continue providing a range of tactile sensory experiences.

  • Cotton balls or pom poms
  • Feathers
  • Dried foods: pasta, rice, beans, oats, corn, seeds, coffee beans
  • Wet media: shaving cream, frosting, whipped cream
  • Slime, Gak, Flarp
  • Kinetic sand
  • Beach sand
  • Potting soil
  • Beads
  • Small rocks
  • Shredded paper
  • Water with ice cubes
  • Packing peanuts

Messy Play Activities at Home:

  • Have your child help you cook or bake
    • Roll dough, wash vegetables, mix batter
  • Art
    • Finger paint! Paint your child’s hand and make hand prints on paper
    • If your child has a hard time using their fingers use cotton balls, Q-tip, or a paint brush
    • Use halved apples, peppers, or celery to make vegetable stamps with paint
  • Homemade PlayDoh
    • Add essential oils for a multi-sensory experience
  • Hide puzzles or activities inside of a sensory bin
  • Make a mess with shaving cream in the tub during bath time
  • Practice letter formation in wet messy play such as whipped cream
  • Have your child help you garden by planting seeds or flowers in soil
  • Have your child wash their toys in soapy water
  • Hide beads inside of Theraputty or PlayDoh
  • Play barefoot in grass or sand
  • Blow bubbles and encourage your child to pop them with their fingers or toes
  • Make spaghetti or pasta and color with food coloring for edible messy play
  • Make clough dough or moon sand at home
  • Make homemade gak or slime
  • Go on a nature hunt and collect leaves, sticks, rocks for a nature sensory bin

Make messy play part of your child’s daily routine by adding it to their sensory diet activities or designating a day for messy food play at meal time. Increasing your child’s experience with messy play will help them learn how to process and respond to tactile input and tolerate a variety of textures and materials. It can also be a motivating way to engage children when you are stuck indoors.

Questions or concerns?

If you have questions or concerns about your child’s responses to tactile or sensory input, please contact us at info@playworkschicago.com or 773-332-9439.

Robyn Geist, MS, OTR/L
Occupational Therapist

Photo Credit: JBryson via istockphoto.com

Reuse and Recycle for Reclaimed Fun

Bottles, boxes, and bins…oh my! With everyone quarantined at home for COVID-19, recyclable materials are likely piling up! You may be thinking, “what can I do with all these toilet paper rolls?” Here are a few fun ideas using commonly recycled items. These projects will not only keep children entertained, but also target important developmental skills.

 

Toilet Paper Rolls

With all the toilet paper rolls around the house now, try making binoculars with tape, paper, and string. Play I Spy, and find objects of a particular color or shape to target those early categorization skills. You can also create a bowling set for turn-taking and eye-hand coordination. Decorating the tubes in any way will require plenty of precision and coordination as well!

 

Cardboard Boxes

Round up all of those food boxes and make some new puzzles! If you have older children, have them practice their cutting skills by creating the pieces. The thickness of the cardboard requires a greater amount of strength and coordination to cut. Have your little ones complete the puzzles. You can also use these boxes for imaginative play, like this fun car parking garage.

 

Plastic Bottles

The possibilities are endless with plastic bottles. Put raw beans or rice inside of them for homemade maracas, make a science experiment lava lamp, or use them during bath time for pouring and filling. You can also create animals for container play for young ones to practice fine motor skills. Or have your older children get creative for some cute spring planters.

 

Questions?

If you have questions about how to use other materials or how to adapt an activity specifically for your child, please contact us at info@playworkschicago.com or 773-332-9439.

Kristen McManus, MOT, OTR/L
Occupational Therapist

Don’t Overlook Visual Development in Infants

Parents often look forward to important milestones in their child’s development such as their first steps or first word. They work to encourage their baby to crawl, sit up, or roll over. What parents may not realize is that many of the foundational skills needed to reach these milestones are visual in nature. Visual skills are an essential part of an infant’s early development.

Why do visual skills matter?

Visual skills are important for learning in all areas, as babies frequently learn from imitation. Age-appropriate visual abilities are necessary for a child to see parents or siblings doing something and want to try it out for themselves. Visual skills also provide the motivation for motor milestones like walking or crawling. Babies are usually motivated to move by looking at a favorite toy or seeing a parent waiting with outstretched arms. Without being enticed by what they see, infants are less likely to explore their environment and develop important motor and coordination skills as they do.

Visual skills are closely related to motor skills in other ways, as they allow babies to see and discover their own bodies. Babies then use this connection between their eyes and their bodies to do important things like picking up and holding objects, planning movements, and developing body awareness. New movements allow a child to be in different positions, which in turn causes a change in perspective that further develops visual skills and provides new sensory experiences. Visual and motor skills continually build on each other and connect in important ways throughout early development.

Vision also plays an essential role in the development of cognitive and social skills. Concepts like object permanence (understanding that objects are still there even when they can’t be seen) come from being able to look at and play with objects. Social skills begin to develop when a child can see that there is someone who they want to interact with in his or her environment.

How can I support my child’s visual development?

Infants need opportunities to explore the world around them and practice the visual skills they are trying to develop. The chart below outlines the visual milestones that you should see at each age and activities that you can do to encourage visual development.

Questions or concerns?

If you have questions or concerns about your child’s visual or visual motor development, please contact us at info@playworkschicago.com or 773-332-9439.

Aubrey Day, Occupational Therapy Student Intern

 

References:

American Academy of Pediatrics. (2009). Babies should sleep on their backs, play on stomachs.

American Optometric Association. (2020a). Infant vision: Birth to 24 months of age.

American Optometric Association. (2020b) Ways to help infant vision development.

Folio, M.R. and Fewell, R.R. (2002). Peabody Motor Development Chart.

The Urban Child Institute. (2012). Seeing the importance of visual development.

 

Photo credit: allaboutvision.com