Helping My Child With Transitions

getting ready

What counts as a transition? 

Transitions are the times in the day that your child moves from one activity to the next. When looking at a typical daily schedule, transitions occur from the moment your child wakes all the way through his or her bedtime routine. Examples of transitions include:

  • Getting dressed
  • Leaving the park
  • Sitting down for a meal
  • Cleaning up
  • Preparing for bed

Why does my child have difficulties with transitions?

It is important to first determine that your child’s basic needs have been met; is my child hungry, tired, or sick? If you answered “yes”, then the expectations at that time may be unrealistic for your child to follow. Before beginning a behavior routine, ensure that your child is at his or her best ability to successfully participate.

Many children struggle with transitions as their environment moves at a quicker pace, and their desire for independence grows. The demands placed on your child become stressful, developing frustration for both you and your child. This is when a power struggle begins!

Children with disabilities, such as autism, may have a greater need for predictability, difficulty when a pattern is interrupted, or trouble with understanding what activity is coming next.

How do I turn my child into a transition master?

There is great news – trouble with transitions is NOT a new problem. Many therapists, teachers, and parents use tried and true methods for helping children move from one activity to the next.

Consistency: If a transition occurs frequently (e.g. bedtime, brushing teeth), it is important to make the transition as consistent as possible. For example, if your child avoids brushing his or her teeth, make the expectation known that brushing teeth occurs as soon as your child wakes up and before reading a book at night. Once your child knows the routine, the difficulties following it disappear.

Provide (limited) choices: When it comes time to clean up an activity, you can ask your child “Do you want to clean up by yourself or would you like me to help you?” At first, your child might ignore you or begin to tantrum. When this happens, calmly use hand-over-hand assistance to help your child put their toy away. It is essential for your child to learn to follow your directions! At first, you may become more upset; however, your child will quickly learn to successfully follow instructions.

Use visuals: It is often helpful for a child to understand what is coming next. A visual schedule using pictures of each activity for the day will prepare a child for what is coming next. A timer will allow your child to understand what “two more minutes” means and prepare accordingly.

Allow your child to feel heard: When your child is upset, explain that you understand. For example, you can say, “I can see that you are feeling sad.” I know that you were having fun with your cars! Right now it is time for lunch. We can play with your cars tomorrow”. This not only allows you to demonstrate empathy, but also gives your child a model for appropriate language to express him or herself.

If you have further questions regarding transitions or other behavior concerns, please contact a social worker at Playworks Therapy to help meet your needs!

Ask an Expert: But, my child doesn’t have an occupation??

My child doesn’t have an occupation, why does she/he need occupational therapy?

Social Work Web

Occupations can be defined as “activities that people engage in throughout their daily lives to fulfill their time and give life meaning” (AOTA, 2008). For young children these occupations can include activities of daily living (dressing, eating), play, rest and sleep, and social interaction. If something is preventing a child from participation in these occupations such as a diagnosis or developmental delay, occupational therapy can help. Occupational therapists are trained to modify the environment, develop skills, and promote meaningful engagement in all the areas of occupation for children.

References: Occupational Therapy Practice Framework: Domain and Process (2008). The American Occupational Therapy Association, Bethesda, MD.

Tips for the “Picky” Eater

By Brittney LaTurno, MS, CF-SLP

PickyEater

As a parent, do you feel like you are constantly making multiple meals at each sitting to accommodate that “picky eater” in your home? Many parents and care takers report they have difficulty getting their child to try new foods and that their toddler may only have four or five types of food that they will eat on a daily basis.

It may seem like there is a constant battle at meal time, but it is important to remember that shifting from a full liquid diet to pureed and table foods may be a difficult, overwhelming transition for your kiddo. Listed below are some helpful tips to increase your child’s interest in trying new types and textures of food!

  • Introduce a new food with food your child already enjoys.
  • Do not introduce more than one new food at a meal.
  • Continue introducing food if your child refuses it the first time (this will help he/she become comfortable with it).
  • If child prefers one type of consistency (sticky), introduce other foods with the same consistency – this will help them feel comfortable with the foods they are eating while trying new flavors.
  • Allow your child to be involved in the preparation of food. For instance, they may help warm food in microwave, put food on their plate, etc. Also, let them pick out their own utensils.
  • Serve as a good model for your child’s eating. Show them that you enjoy eating the foods that you want them to try.
  • Give your child small servings of food (1/2 tablespoon for each year of child’s age). An abundance of food on the child’s plate may be overwhelming.
  • Make meal time a relaxed atmosphere, do not pressure your child to finish all of their food. Try to talk about other enjoyable things during meal time.
  • Serve foods at different temperatures (hot, cold, warm). Talk about how each temperature feels and see which temperature he/she enjoys most.
  • Serve your child milk during meal time. However, try to give water between meals so he/she is not full when it is time to eat!
  • If your child enjoys soft foods, mix foods in applesauce or yogurt to give food a softer consistency.
  • Allow your child to practice “playing” in the mouth with chew tubes or straws
  • Allow your child to “dip” food into things they enjoy (Nutella, peanut butter)
  • PLAY with food!
    • Bring your child’s favorite toy to the table to “try” the food. For instance, if your child enjoys dolls, bring doll to table and have your child feed the doll.
    • Allow your child to get messy with food! They can explore food by feeling different textures, “painting” with food, etc.
    • Allow your child to smell foods without forcing them to eat food.
    • Play with food away from the dinner table. This will help take some pressure off.
    • Let your child make art projects using food (dry pasta, cereal). You can use a sticky consistency as the “glue.” This will help make food exciting!

It is important to note that if your child demonstrates avoidance behaviors as strong as gagging, vomiting, coughing, or extreme discomfort through mealtime, your pediatrician should be consulted.  

Ask an Expert: “Tongue tied”

Mother and daughter playing with finger toys

How do I know whether my child’s speech and language delays are due to being “tongue tied?” When is surgery appropriate?

Tongue tied is when the child’s frenulum, the connective tissue that connects the bottom of your tongue to the floor of mouth, is either partially or completely fused to the floor of the mouth. The medical term for this condition is ‘ankyloglossia.’

When children have this condition, it impacts the range of motion of the tongue for tongue tip protrusion (sticking the tongue out past the teeth) and elevation (tongue tip to palate). Decreased lingual range of motion can have negative effects on feeding; specifically, how a child chews the food and forms a food bolus and/or swallows. Many children with akyloglossia, however, do not present with speech or feeding difficulties and proficiently eat a variety of foods and liquids, elevate the tongue tip for speech sounds /t, d, n/, and protrude the tongue for the interdental sounds (voiced and voiceless “th”).

In effect, there is no clear evidence that there is a causal relationship between akyloglossia and speech delays, and it should not be assumed that a surgical intervention will solve speech sound disorders. For more information, please contact us!

(Reference: ASHA)

6 Sensational Spring/Summer Activities for Speech & Language

By Caitlin Brady, M.A., CCC-SLP

We at PlayWorks Therapy Inc. are so excited that the weather seems to finally be turning spring-like! Spring and summer bring the opportunity for vacations, long days of playing outside, exploring new places, drawing with chalk, barbeques and other fun outdoor activities! Here are six sensational spring/summer activities that are great for speech and language practice – how about that for alliteration?

Playworks Therapy

So, grab your kids, toys and sunblock, it’s time to start playing!

1.) Sunscreen Body Parts

Speaking of sunblock, applying sunblock provides a great opportunity to practice naming and identifying body parts! You can target receptive language (language comprehension) by having your child point to or lather up a named body part (i.e. “Put this on your nose!” or “Show me your ears!”) and expressive language (language output via speech, signs, etc.) by encouraging your child to name or imitate the name of various body parts. You could also have your child continue this practice as they help you put on your sunblock.

2.) Chalk

One of my favorite memories from childhood summers includes decorating my long driveway with hopscotch, family portraits, shapes and other chalk drawings with my neighbors and brother. A few ideas include drawing and labeling shapes, naming colors, singing a song related a picture (i.e. Wheels on the Bus, Hopscotch song, etc.) You could also draw animals and name them and their respective noises. For older kiddos, see if you can categorize farm animals vs. jungle animals, etc.

3.) Hide and Seek

Hide and seek is my favorite way to practice spatial concepts including on top, under, behind, next to, etc. You can hide in a yard, home or hide a toy and look for it together. Be sure to identify where the toy or person was hidden. This is also a great way to continue adding new phrases to your child’s vocabulary (i.e. ball under tree). For younger kids, you can practice naming the hidden object (i.e. ball, banana, etc.)

4.) Explore (zoo, aquarium, vacation)

Summer brings many opportunities to explore new places including a new vacation locale, the zoo, the beach, the library, a local playground or park, and these places provide tons of new vocabulary words! Be sure to talk about what you are doing and seeing (i.e. animal names/noises, digging, playing, swimming, books, build, hike, etc.) You can also target receptive language by having your child follow one-step or multi-step directions (i.e. “Go get the ball and bring it to me!” or “Give me the bucket, then the shovel.”) or by practicing pointing to new words (i.e. “Point to the giraffes”).

5.) Water/Sand Play

Summer provides endless opportunities for sensory-based play including, but not limited to, sand, water, Play-Doh, playing with shaving cream, finger painting, etc.! You can build castles in the sand, make water balloons, play in an outdoor baby pool, pretend car wash toy cars (or real ones), draw shapes in the sand or shaving cream, make shapes or animals in Play-Doh. Sensory play provides opportunities to talk about what you’re making (i.e. shapes, animals, etc.), as well as opportunities to talk about how things look and feel (wet, cold, color, etc.) You could also incorporate body parts, action words.

Quick tip: I always find it helpful to keep a wet cloth nearby in the event that your child is uncomfortable and would like to wipe his or her hands or face.

6.) “Cook” together

This last one is my favorite, as I’m a serious foodie. I love to cook (and eat) and grew my love of food by cooking with or watching my mom cook. However, this is an activity that you can do with children of all ages as you could have them help with something simple like mixing pudding and milk. Cooking provides great opportunities to teach sequencing (first, then, last, etc.), taste words (sweet, sour, salty, crunchy, smooth) and try new foods together! Another fun idea is to make homemade Play-Doh or peanut butter Play-Doh together. There are various recipes available online.

Enjoy these activities, the warm weather and contact me at Caitlin@playworkschicago.com with any questions!

Let’s Go, Go, Go! – Tips for Promoting Your Child’s Speech and Language Skills When You’re on the Run

By Autumn Smith, MS, CF-SLP, Speech-Language Pathologist

baby at grocery store

These days it seems like we all have jam-packed schedules and we’re constantly on the go with work, errands, or countless other small jobs on our ‘to-do’ lists. So it’s not uncommon for many on-the-go parents to find themselves in the following predicament: its 2:00pm, you have yet to go grocery shopping, pick up the kiddos from school, go to swimming lessons, make dinner, eat dinner, and get ready for the next day. So fitting 20- to 30-minutes of speech therapy practice into the mix shouldn’t be too hard, right?

Thankfully, there are numerous ways that you can incorporate your child’s speech and language goals into everyday routines. All are quick, simple, and (most importantly) fun ways to promote your child’s language development without having to add another item to your ever-growing ‘to-do’ list! Check out a few of my favorite activities to try when you’re on the go:

I Spy

‘I Spy’ is a great way to practice vocabulary and expressive language skills with your child. You can play practically anywhere – in the car, at the grocery store, or even getting ready for bed. Encourage your child to imitate objects after you say them or after the object has been found. If they are more advanced they can practice saying the phrase “I spy…” and then choose the object for you to find. If the phrase “I spy” is too difficult for them to say, you can modify the game to say “I see…”

Make a “Favorite Things” Book

Most cell phones now come equipped with cameras, so why not use them to take pictures of the things your child is most interested in to promote their vocabulary growth? Whether you are at the store, waiting to pick up older siblings from school, or on a walk, you can quickly snap photos of your child’s favorite things to print later and turn into a “Favorite Things” book. Your child will be extra motivated to ‘read’ their book at bedtime since they had a part in making it! If you do not want to print photos, try jotting down the items when you spot them with your child, and then let them draw or color pictures of their items once you are home.

Songs and Fingerplays

Listening and singing along to familiar songs is a wonderful way to promote language use! You can listen to the radio, children’s CD’s or even make up your own songs! Fingerplays are also fun to incorporate into your daily routines, as you all can play along with the songs as you sing. A few favorites are Old MacDonald Had a Farm, Itsy Bitsy Spider, and Wheels on the Bus. Once the songs become familiar to your child, you can pause at certain parts of the song to encourage them to fill in the blank (“Old MacDonald had a ___, E-I-E-I-___”). Don’t be afraid to be silly, either! The more you enjoy yourself, the more your child will have fun, too.

Keep Books on Hand

Small board books are great to keep in your car or purse so that you can use your downtime for reading. You do not have to read the story word for word, though–have fun and ‘play’ in the books by ‘popping’ bubbles, ‘eating’ food on the page, or making car/animal noises. This is a great way to encourage language development in the little ones who are not yet using words or phrases, too. Prompt your child to imitate the beginning sounds of basic items in the book, such as “b-b-ball” or “d-d-dog.” Check out the previous post on this blog for some suggestions of exciting books to promote speech and language development!

There’s No Need to Make Extra Time for FUN!

Whether you are running to the store or to school, the post-office or a play-date, you can incorporate fun and simple activities into your routine to target your child’s speech and language skills! Talking to your child and providing them with models of new words and phrases is one of the most important things you can do to support their language growth at a young age. Luckily we can incorporate talking into almost everything we do! So get ready to tackle that ‘to-do’ list, and feel confident that you are supporting your child’s speech and language development at the same time.

Using Books to Encourage Language

By Meryl Schnapp, MA, CCC-SLP

Reading to children from a young age has been found to foster cognitive and language development (Rodriguez et. al., 2009). Early exposure to books also helps to promote later literacy (Dickenson, 2012) in children. Incorporating reading into your child’s regular routine can help him/her learn to sit and attend to a book.

How do you choose books for your child?

Very young children often have limited attention spans and will not sit and attend to long stories. Choosing books with colorful pictures and a limited number of words per page can allow for meaningful interactions with your child. For children under 24-months look for sturdy board books that allow even the youngest children to handle pages with minimal damage.

100wordsbook

Early word books, such as First 100 Words by Roger Priddy or First Words by DK Publishing, allow for the introduction of early vocabulary by providing children with pictures that are colorful and realistic. Try pointing to the pictures in the book and naming them with your child.

brownbear

Books with repetitive text are great for toddlers. Some favorites include: Brown Bear, Brown Bear, What Do You See? by Eric Carle and Bill Martin, Jr. and It Looked Like Spilt Milk by Charles Green Shaw, and Goodnight Gorilla by Peggy Rathmann.

As your child gets to know the story, try pausing and allowing your child to fill in familiar words.

dear zoo

Lift the flap books often keep children engaged by allowing them to interact with the book. Some favorites include: Dear Zoo by Rod Campbell, Where is Baby’s Belly Button? by Karen Katz, and any of the Fisher-Price Little People books.

time to get dressed

Books can be a great way to introduce new skills such as getting dressed or potty training. Time to Get Dressed! by Elivia Savadier is a must-have for daily routine.

Choose some books that are relevant to your child’s interests. There are many engaging books about animals, trucks, food, etc. Look for books featuring favorite your children’s favorite characters such as Elmo and Dora the Explorer.

Enjoy your time reading together with your child!

References

Dickenson, D.K., Griffith, J.A., Golinkoff, R.M., Hirsh-Pasek, K. “How Reading Books Fosters Language Development around the World.” Child Development Research,Vol. 2012, 2012.

Rodriguez, E.T., Tamis-LeMonda, C.S., Spellmann, M.E., et. Al., “The Formative role of home literacy experiences across the first three years of life in children from low-income families,” Journal of Applied Developmental Psychology, Vol. 30, no.6 pp. 677-694, 2009.

Favorite Toys for Your Toddler’s Speech and Language Development

By: Danielle Kaplan, MS, CCC-SLP – Speech-Language Pathologist

Playtime is always a great learning opportunity for toddlers, especially considering that for the most part all waking hours involve play. Below are some of my favorite toys for eliciting and teaching speech and language skills to young children and strategies for educative play.

First, let’s review some recommendations for all toys.

Encourage your child to make choices. When it is time to play, give him/her a choice of two or three toys. Begin by labeling the items and then encourage your child to choose by pointing, naming, using a phrase, or simply imitating the first sound of the item requested (i.e. if saying “Mr. Potato Head” is too hard, suggest verbalizing “puh” or “tato”), or a combination of any of the above.

Keep toys out of reach or in containers that the child cannot open (especially your child’s favorites). This will help to support your kiddo’s initiation and spontaneous language/communication. Encourage your child to ask for “help”, ask to “open” the container, or name preferred items. This can also help to keep your space organized and keep toy parts together!

Don’t forget to play WITH your child! Toddlers’ spongy brains are ready to soak up what you have to teach them. Model the language you want him/her to use. Don’t be afraid to be silly and creative, toys do not have to be used in the exact way they were intended. If your toddler wants to use Mr. Potato Head’s hand as a shovel, go with it. Have fun!

Toy Recommendations

Mr. Potato Head 

Mr.-Potato-Head

Mr. Potato Head is a great toy for teaching body parts. Encourage your child to ask for body parts or choose the correct item out of two or three different parts. Tell the child to “push.. (push.. push)” pieces “in.. (in.. in)” and “pull” them “out”. Mr. Potato Head is also great for working on fine motor skills. If your kiddo has trouble getting the pieces in the holes, remind him/her to ask for “help”!

Animals with a Barn

barn yard

Animal Planet Barnyard Playset is great for teaching animal names and sounds. Make the animals climb “up” the roof and “whee” go “down”. “Open” and “close” the doors while saying “hi” and “bye” to the animals inside. Can also work on action words by having the animals “run,” “jump,” “fly,” “eat,” “sleep,” etc.

Reusable Sticker Books

sticker book

The Melissa and Doug reusable sticker books are great for encouraging creativity, working on following directions/comprehension, requesting, and learning to describe/give directions. Plus, kids love stickers! Encourage your child to request the sticker he/she wants (using the above requesting/choosing suggestions). Tell him/her where to put the sticker using location/color words (i.e. “put the girl on the blue train,” “put the hippo in the water” or “put the cow next to the horse”).

Other great toys include:

  • Gum-ball Machine (B. Sugar Chute)
  • Play Doh
  • Puzzles
  • Legos/Blocks
  • Books
  • Velcro food cutting set
  • bubbles
  • Baby Einstein Treasure Box
  • Fisher Price Piggy Bank.

Transitioning into Motherhood

By Jana Kramer, Case Coordinator 

Jana Kramer, Playworks' Case Coordinator, shares her journey of transitioning into motherhood with an extremely colicky baby.

Jana Kramer, Playworks’ Case Coordinator, shares her journey into motherhood with an extremely colicky baby.

When my son was two weeks old, I read an article in People magazine spotlighting new celebrity mothers. Every one of them said something like, “This is the most magical, amazing experience of my life” or “I don’t care if I sleep at all – I just want to look at my baby 24 hours a day.” Reading their effusive quotes, I couldn’t help but think, “What is wrong with me?” This certainly was not the most amazing, magical time in my life – it was, in fact, the hardest thing I had ever experienced. And, as far as lovingly watching my baby 24 hours a day, instead I was trying to sneak in 10 minutes of sleep whenever I could just to maintain my sanity.

When my son was born, my entire world turned upside-down. I’ve since heard that the transition from no kids to one is among the hardest transitions in life. You go from thinking primarily about yourself and your own needs to suddenly having all those needs (sleep, food, using the bathroom, etc) become secondary to this new little being that rules your life. On top of that, you’ve just been through a huge physical and emotional trauma giving birth. I found myself completely lost, thinking, “What have I done to my life?” Nothing seemed the same and everything seemed impossibly hard.

My son’s temperament as a baby certainly didn’t help matters. From day one, he was an extremely colicky baby – cried (screamed) all the time and rarely slept. One time a friend told me that she worked in the church nursery’s infant room and they called their tiny charges the “Sleepers.” I didn’t get it – why would anyone call babies sleepers? In my experience, you spent 24 hours a day trying to get your screaming baby to sleep, but he would only close his eyes for maybe 10 minutes here or there.

I also found it incredibly difficult to bond with this type of baby. I tried singing sweet songs and gently rocking my baby to sleep, but he would just arch his body away from me and scream until I stood up and bounced around the room as hard as I could. To tell you the truth, I always loved my baby, but I don’t feel like we really established a strong bond until he was closer to being a one-year-old. In our case, it took time to develop our relationship – which is hard to say when you’re surrounded by images of people falling deeply and instantly in love the moment their baby is born. But now, with my son almost three years old, we are incredibly close and have a wonderful loving relationship. The older my son got, the happier he became. The more he could do, the better he was able to handle stimulation in a productive way. I remember seven months being a turning point for us. Sure, he has plenty of toddler moments these days (tantrums, not listening, etc) but in general, I feel like he is now really interesting, fun, and a good kid.

One reason I’m sharing all of this is that I feel like we, as mothers, are surrounded by Facebook posts and Instagram shots that tout the joys of motherhood – how adorable our babies are, how much fun we’re all having, etc. And it’s rarer that you really hear about the nitty gritty and just how incredibly hard this journey can be – not only for the mother of a colicky baby, but for any new mother. I’ve had countless moments in the past three years of wondering what I did wrong in those early days, why I didn’t enjoy my son’s infanthood, why it took so long to bond with my baby. I think I will always have those questions and a certain level of guilt whenever I see a new mom so in love with her baby and taking to motherhood so naturally. But my hope is that if we start sharing some of the uglier stories as well, maybe we won’t feel so alone in these feelings.

Creating a Routine for your Toddler’s Bedtime

By Marissa Palmer, MSW, LSW, DT

bedtime

Who needs a bedtime routine?

After a full day of playdates, climbing on furniture, sloppy mealtimes, and energetic chatting, who needs help to fall asleep? The answer is everyone. You’ve probably created a routine for yourself without realizing it. Do you typically brush your teeth, check Facebook one last time, watch a favorite show, and kiss your partner goodnight? Knowing what to expect allows your body to relax and prepare for a successful night of sleep. Let’s create a routine for your child as well!

How do I construct a bedtime routine?

1.) Think about what you already do with your child at night. Do you typically have bath time, read a book, brush teeth, or sing a song?

2.) Jot down 4-5 ideas of activities you’d like to include in your schedule.

3.) Reflect on your child’s current bedtime. Does he start rubbing his eyes at 8:00pm? Is he staying up until 10:30pm while jumping on his bed? Start the routine approximately 30 minutes before your ideal bedtime. If you want lights out at 8:00pm, begin at 7:30pm. Please refer to the sleep chart for the appropriate amount of evening sleep for your toddler.

Learn more about your child's needs based on their age group at www.Parents.com

Learn more about your child’s needs based on their age group at www.Parents.com

4.) Choose 3 or 4 of the activities you wrote down and put them in an order that makes sense for you and your family, along with what time you would like it to occur. For example:

7:30pm: Bathtime
7:45pm: Brush teeth
7:50pm: Read a book
7:58pm: Sing the bedtime song

5.) Document your schedule, place it somewhere visible, and follow the routine!

I did it! Anything else I should know?

Consistency is key. By sticking to the routine, your child will quickly learn the schedule and begin to thrive at his or her own bedtime! Children are comforted by boundaries and consistent expectations. The more you follow your own schedule, the more successful it will be.

Imitate nature in your own home. Keep the lights dimmed, the sounds soothing, and electronics to a minimum. Lights from phones, televisions, and computer screens have been shown to disrupt sleep in children and adults.

If you continue to struggle with your child’s sleep, consult your child’s pediatrician or contact the team of Social Workers at Playworks Therapy, Inc.