Playing with Books!

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Children’s books can be used at any stage of development to facilitate improvements in both expressive and receptive language skills. Today, we will be focusing on building preverbal skills and eventually eliciting first words by playing with books. Before children begin to use words, they use gestures to communicate. They then begin to pair these gestures with vocalizations to obtain desired items or actions, and eventually use animal noises, exclamatory phrases, and sound effects in play.

Books are filled with a variety of age-appropriate pictures that are easy to pair with gestures and sounds. Pick one or two pictures per page so that your child can start to do them spontaneously. If they are not copying your gestures right away, do not be afraid to take their hand and help them “beep beep” on the truck or “tickle tickle” a baby’s feet.

Below, I have attached a table with examples of common pictures found in children’s books and what I might do when I see them.

Once your child builds their imitation of gestures and sounds, they might begin to fill in routine phrases, which come up often in repetitive books. As your child becomes familiar with the book, you can pause and have them fill in a word. For example, in Brown Bear Brown Bear, each page ends with, “What do you see?” You can set the child up to fill in that phrase by saying, “what do you…” and looking at your child in anticipation.

Have fun!!

Ana Thrall, MS, CCC-SLP

Speech-Language Pathologist

Toddlers in the Classroom: Strategies for Teachers

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Are you a teacher of two- or three-year-old children? Do you struggle with feeling like your classroom is hard to manage at times? You’re not alone! Many teachers strive to create an environment in which the class is following their direction, but aren’t sure what strategies to put in place to help maintain control.

The following are some easy tips to really make a difference in your classroom:

Tip #1:
When children understand exactly what is expected of them, it provides much-needed consistency. Setting expectations also frees you to engage with the students more, rather than attempt to “put out fires.”

Strategies:
• Print and laminate a visual aid, such as pairs of feet, for the children to line up at the door.
• Create a job chart to hang on the wall with the children’s photos pasted onto popsicle sticks – they can choose their job for the week and move their stick to the correct spot during Monday’s circle time.
• Make sure that all of the children have the same rules, and follow through as best as you can. For example, if one child gets to perform jobs throughout the week, they should all have jobs. Please do not remove any children from group activities such as circle time in order to perform special jobs with the teacher – consistency is key!

Tip #2:
Use words and non-word prompts.

Strategies:
• Tell the children what will come next as they are engrossed in an activity. For example, as they are having snack, tell them, “Ok, everyone, when you are done with snack, you can go to the ____ (or play with ____) before we start ______.
• Use a NON-WORD prompt for transitioning; such as a bell or a certain part of a song, rather than frequently telling them “Time to clean up! Time to line up!” Breaking out of the pattern of consistently telling them with words generally encourages children to pay attention to those non-verbal cues.

Tip #3:
Help the children decrease impulsivity and learn to attend to task.

Strategies:
• Some children really benefit from sensory input while they are attending to a seated task. Examples include: a sit disc or cube chair at circle time, an exercise band wrapped around their chair’s legs (so they can kick or stretch against it), and fidgets for keeping hands busy during reading time.
• Allow for plenty of options for independent and teacher-led movement throughout the day. Examples include: animal walks during transitioning, teacher-led songs or activities such as Simon Says and “Going on a Bear Hunt,” reducing sitting time throughout the day.

With these strategies in place, your classroom will be calm rather than rowdy!

Jen Brown, MS, OTR/L
Director of Occupational Therapy Services

Can Prolonged Pacifier Use Affect My Child’s Speech and Language Development?

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Sucking is a postnatal reflex and is a natural part of your child’s development. So it is no wonder that a large majority of infants and toddlers use pacifiers to help them self-soothe throughout their daytime and nighttime routines. Pacifiers may be helpful for comforting your child in stressful situations, distinguishing between a fussy and hungry infant, and also as a sleep aid. But how old is too old for pacifier use? And are there any negative affects from prolonged use of pacifiers?

Pediatricians recommend that babies be weaned from pacifiers around four- to six-months of age. Pacifier use is no longer needed as a calming strategy after six months, primarily because the sucking, or “rooting,” reflex has disappeared. Prolonged use may result in the pacifier becoming a habit and therefore more difficult to wean.

Speech-language pathologists also recommend discontinued pacifier use by 12 months of age for many reasons. First, your child’s oral development is changing rapidly during the first few years of life. Prolonged sucking may in fact create a raised or indented palate, resulting in an oral cavity that is too large for typical articulation. This may manifest as a speech disorder around four to five years of age, often requiring therapy to remediate. Additionally, sucking on a pacifier encourages an immature suck-swallow pattern, resulting in possible feeding difficulties and articulation concerns.

Pediatric dentists recommend that pacifier use be discontinued by 24 months of age at the latest. The constant sucking on a foreign object beyond 24 months may cause the palate, gums, and teeth to develop atypically. This is primarily seen in the atypical eruption of permanent teeth, leading to crowding and/or gaps in the teeth.

If you are ready to tackle the job of weaning your child from his/her pacifier, there are a few strategies that can ease the transition. It is not recommended to go ‘cold turkey’ at first; rather, tell your child that the pacifier is for sleeping only and keep it out of sight during the day. Once you have established this routine, remove the pacifier from nap times and eventually from bedtime. It is helpful to offer a brand new comfort item (such as a new blanket or stuffed animal) that your child can use as a replacement for self-soothing. The most important thing to remember for weaning your child from a pacifier is to remain consistent with the rules you set in place!

While there is variability in the recommended age for weaning your child from a pacifier, general consensus is that pacifiers should not be used at any time (day or night) after 24 months of age. Consult your speech-language pathologist or dentist if you have any questions about your child’s pacifier use, as well as for recommendations and support for weaning your child from the pacifier.

Autumn Smith, MS, CCC-SLP
Director of Speech-Language Services

Let’s Get Cooking!

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The benefits to getting your picky-eating toddler in the kitchen!

Cooking with your little one can be so much fun and can help with picky eating! Having your child even in the kitchen while you are cutting veggies, fruits or making toast is a GREAT way to introduce them to new foods and give them a no-pressure look at what you are making! Kids in the kitchen get to SEE, SMELL, and TOUCH their food. It is a great time to label foods, actions (stir, cut, eat, cook, flip), talk about simple sequences (first cut, then cook), and kitchen safety (hot, sharp, adult-only)!

Here are some simple steps to get your toddler in the kitchen!

  1. Place your toddler in the kitchen with you! Booster seats or step stools are great for little ones to see what is happening on the counter. You can give your little one pretend food to “practice” with you if you are using heat or sharp knives. Talk about what you are making, the ingredients and the steps!
  2. Get little ones involved! Help your child make their snack plate, let them place foods onto plates and bowls to carry to the table. Give them a spoon to help you stir batters, butter knives to make toast or sandwiches, or place different fruits and veggies into your blender to make a smoothie!
  3. Start with something FUN and PREFERRED! Your picky eater likes anything tan? Try making toast together and getting out multiple spreads to try! Kids are much more likely to try something when they feel in control. If they get to choose the topping or help spread it on the toast, it may be more rewarding to eat. Cooking is great for experimenting and trying new things! Box brownies or cookies are great for cooking with toddlers! They usually require few ingredients and you can place each ingredient in a bowl for your toddler to pour into the big bowl and help you stir.
  4. Keep it simple! Your toddler likely does not yet have the attention to watch you make a gourmet meal, but may have the attention to make a snack or a simple pasta dish. Keep it simple so you and your toddler can enjoy your time together.
  5. Give choices! Let your child take some control with cooking! Deciding what kind of sandwich, pick the dip for veggies, or decide on fruits and veggies for smoothies! Cookie cutters are a fun way to change the shapes of sandwiches, jello, rice crispies or even sliced veggies!

Some fun, kid friendly recipes are below!

English Muffin Pizzas: http://acraftyspoonful.com/english-muffin-pizzas-simple-toddler-meals/

Ice Cream in a Bag: http://www.growingajeweledrose.com/2013/07/summer-fun-ice-cream-in-bag.html?m=1

Trail Mix: http://www.bsuperb.com/toddler-trail-mix/

Actor Misha Collins shares his adventures cooking with his son: https://www.youtube.com/watch?v=H3pjP79-sJc

Jessie Delos Reyes, MA, CCC-SLP

Family Time: Helps kids grow!

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During the holiday season, many families have the pleasure of spending time together, increasing their daily family time. There are many fun family activities that you and your child can do to promote their cognitive development.

Winter scavenger hunt: Create a winter themed scavenger hunt around your home and outdoors.

  • Tip:
    • This is a great way for children to work on their picture concepts, matching skills, and helps them in making associations.
  • Activities:
    • Indoor Hunt: Hide items around your home related to winter and have your child find them (e.g. hat, coat, gloves).
    • Outdoor Hunt: Talk about the different things your child might see while walking outdoors during the winter (e.g. snow, snowmen, shovels). Go on a “hunt” to find these items while spending time outdoors.

Organization/ laundry: Have your child help you organize your home and take care of daily chores.

  • Tips:
    • This is great for categorization of colors or sizes.
    • Learning where items go around your home will help further develop spatial relationship knowledge.
  • Activities:
    • Turn this into guessing game around your house.
  • Examples:
    • Narrate what you are doing and have your child join along: “Hmm, I wonder where I should put away Jon’s toys.”
    • Make a mistake and have your child catch/correct it: “I should put the pillows away on the kitchen table.”

Singing songs: Singing songs is a great way to work on your child’s engagement and imitation songs.

  • Tip:
    • Using songs that your child has interest in will help maintain their attention span and further work on their engagement and imitation skills.
  • Activities:
    • Sing together: Listen to music around the house and in the car. Select music that your child shows interest in. Model singing and dancing along with the music.
    • Finger play songs with gestures (i.e. “If You’re Happy and You Know it”, “Wheels on the Bus”, “Twinkle, Twinkle Little Star”): Model gestures for the song and encourage your child to imitate the gestures. Use hand over hand assistance if needed to help your child imitate the gestures.

Pin up pictures: Put pictures around your child’s room or in your home to practice picture identification.

  • Tips:
    • This activity helps your child work on word associations and improve memory.
    • You can pick pictures of your family (especially those that you will see during the holiday season) or your child’s favorite things (e.g. favorite toy, blanket, food item).
  • Activities:
    • First go around the house and label the pictured items for your child (i.e. “Look, there is a picture of your train set.”). Point to the pictures while labeling them out loud, then start asking your child to label the pictures themselves.
    • Turn it into a game! After you feel your child can identify specific pictures ask your child to retrieve specific ones.

Winter crafts: Arts and crafts are a great way to engage with your child in creative ways. These activities help them practice their fine motor skills, their color concept knowledge, and their concept knowledge.

  • Tips:
    • Talk about the characteristics of the paint (e.g. the color, temperature).
    • Work on color identification. Label the colors for your child and have them work on labeling them independently.
    • Work on number identification. Count the cotton balls with your child. Have your child work on giving you “one” cotton ball at a time.
  • Activities:
    • Ice paint: Put food coloring into an ice tray with water and a popsicle stick. Freeze the “paint”. Once frozen, take tray out and have your child paint with it on paper
    • Painting the snow: Use food coloring and a spray bottle. Fill the spray bottle with a few drops of food coloring and water. Take the snow paint outdoors and have them spray the snow.
    • Cotton ball snow man: Draw the outline of a snow man on a piece of paper for your child. Have them glue cotton balls inside the snowman to make it look like snow.

Have a great winter season!

Rachel Weiser, MS, DT

Developmental Therapist

References:

http://dailymom.com/nurture/encouraging-cognitive-development-through-arts-and-crafts/

http://www.parents.com/toddlers-preschoolers/development/intellectual/toddler-development-activities/

Taking the Pressure off Talking!

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If you are a parent who has tried implementing some of the language strategies your speech therapist has taught you with your little one- only to end in your child running off or having a meltdown- this blog is for you! Often the reason for these meltdowns is due to pressure. Not only the pressure put on your child but also the pressure you put on yourself. Below are three strategies for ways to encourage language development while avoiding a meltdown.

  1. Finding your child’s limit- Knowing how much you can push a child can be tricky. We want to encourage and challenge our little ones, but not to the point that we see a meltdown. Try starting with something that is easy for them and make slow, gradual changes to increase the difficulty. The moment you notice your child is at their limit pull back. It’s important to keep in mind that your child’s limit can change daily or even by activity and we may need to adjust accordingly.
  2. Play- The best way to encourage language development in our little ones is to play! Rather than planning a specific activity, think about what toys or activities your child loves and how you can incorporate language into that. If it something that they like then they will be more interested and engaged and you will be more likely to avoid a meltdown. If your child loves trucks- play with trucks. You can practice the sounds that they make or talk about their size and color. If you’re having fun then your child will too!
  3. Get moving- Sitting for extended periods of time can be hard for toddlers., so incorporate movement into your activities. This is a great way to engage your child and keep their attention while avoiding a tantrum. If you’re doing a puzzle you can put the pieces on the other side of the room so your child has to run to go get each piece or you could make an obstacle course out of pillows and blankets and work on following directions.

By taking the pressure off talking you will see your child become more engaged and eager to participate. I hope these strategies are helpful and as always if you have any questions or concerns, please feel free to contact us!

Claire Kakenmaster, MS, CCC-SLP
Speech Language Pathologist

Self-Care for Caregivers

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What is self-care? Self-care is taking care of yourself!! As a caregiver of small children, you are probably thinking, “When was the last time I did something for myself?” With the stressful holiday season quickly approaching, it is extremely important to develop some self-care skills.

Self-care is something that you do for YOU (not for your partner, kids, or work). It is a time to re-charge your batteries so you can feel taken care of in a hectic day/week. Self-care should be something that you enjoy doing and can easily incorporate in a very busy schedule and week. Activities will depend on your interests, time available, and extra spending money (don’t worry there are plenty of free activities to do too!) It is especially important to talk to your family members about taking time for yourself, they will not know you need time unless you tell them you do. Coordinate times/days with family members to watch the kids or schedule/arrange times to complete your self-care when they are in bed or at school.

Self-Care ‘On a Budget’ Suggestions:

*Take a warm shower/hot bath (especially at night before bed) You can keep it simple as a time to relax or include bath bombs, music, and candles if you want.

*Before bed, take a few minutes to massage some lotion into your hands and feet.

*Try 10 minutes of guided meditation before bed to relax and practice mindfulness. There are tons of options on YouTube to browse through depending on preference. Some videos have someone speaking and some have nature sounds. Try a few and decide what works best for you!

*Sleep!! This is something that every parent needs. Communicate with your family members and friends to schedule a play date or when you know your child will be out for another activity. If your child will be home, take a nap with them. Naps are great, especially in the winter months!

*Try yoga/stretching at home. Locate your tightest muscles and look for some stretching positions and yoga poses to help alleviate that stress. Start with 10 minutes in the morning or right before going to bed to help stretch and relax your body. (YouTube is great for searching for new pose!)

*Watch a movie or T.V. show that YOU want to watch. Relaxing in the comfort of your own home can be just as relaxing as sleeping.

*Take a walk or find a local and free indoor track at a nearby park district.

*Talk to a friend/family member that you trust/have them over/or go to their house

*If you play a musical instrument, practice.

*If you quilt, sew, or craft. Feel free to get creative!

*Read a book at home in a cozy spot

*Journal

*Give yourself a facial. I like to make a honey and cinnamon one. (See the link below)

*Go to a movie by yourself. Even if you are not interested in the movie (no kid’s movie) it is a great spot for a quiet adult only nap.

Self-care is something we all do to take care of ourselves: mentally, emotionally, physically, nutritionally, and spiritually. Having insight and developing new skills will help you deal with stress and manage difficulties in everyday life.

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

Infant Sign Language and Your Child

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Is it okay to use infant (“baby”) signs with my child?

Throughout my time working with families and talking with friends, I have come across a common misconception or worry that the use of infant sign language will slow or even prevent verbal language development. However, that is simply not the case.

So, quick answer to the title question above: Absolutely yes!

A language is a system of symbols that signify meaning to others, specifically those that understand that same system. A sign is a symbol just like a verbally spoken word is a symbol. So regardless of mode, signing ‘more’ or saying, “more” aloud, they are using a specific symbol to communicate a specific want or need.

The recommendation is for infant signs to be introduced to typically developing babies around six to eight months of age. Their use has been shown to reduce frustration (both parent and child) and facilitate language development. They also play a huge role with babies/toddlers that have delayed speech-language development.

Children learn to imitate and use gestures (like waving, pointing) before they learn to imitate and use sounds in words. Signs come in especially handy during this time, when children have the capacity to use language, but their mouths cannot yet execute the complex movements required for speech. The use of these signs facilitates joint attention, teaches cause-effect, builds imitation skills, and helps establish bonds between child and caregiver, all of which are vital skills preceding use of sounds and words.

It is in our nature to take the path of least resistance, that is, as soon as kids are able to use words, they drop the infant signs. Many times, the signs that they were using consistently become their first verbally spoken words.

Please see below for a few examples of infant signs (images via Boardmaker).

Ana Thrall, MS, CF-SLP

Speech-Language Pathologist

Frequently Asked Questions about Augmentative and Alternative Communication (AAC)

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What is AAC?

AAC is a term used to describe any method of communication that adds to or “augments” speech. This can include anything from signs and gestures, to picture symbols or even high-tech devices involving computer technology.

Will AAC impact language development?

The use of AAC will not delay or impede language development, and often can help improve spoken language. It also allows for many individuals to express themselves fully when spoken language may be difficult.

Who uses AAC?

Anyone who has difficulty expressing themselves via spoken language may benefit from AAC. AAC users may have limited spoken language, unclear speech, or find spoken language difficult in social settings. The cause of the communication impairment may be present at birth (autism or cerebral palsy), occurring later in life due to injury or illness (stroke or head injury), or may worsen throughout the person’s life.

How do I know if AAC is right for my child?

Your child’s speech-language pathologist (SLP) can help guide you through the decision process. You may notice that your child is already using simple AAC such as signs and gestures in his therapy sessions. If a more robust system would be beneficial for your child, your child’s SLP may recommend a more comprehensive evaluation in which various professionals can help select the most appropriate system.

Meryl Schnapp M.A., CCC-SLP
Speech-Language Pathologist

What’s the Problem with W-Sitting?

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W-sitting is a way of sitting on the floor that is preferred by many children. When W-sitting, a child sits with his or her bottom on the ground, with both knees and the feet positioned outside of his or her hips. When viewed from above, the line of the legs and body appear to make a W shape. As a parent, you may have been told that this position is “bad” and that you should immediately have your child change sitting positions. It is perfectly normal for children to move in and out of a W position for brief periods of time as they play. However, there are negative effects associated with prolonged W sitting, particularly if it is your child’s primary sitting pattern.

Firstly, W-sitting can put unnecessary strain on a child’s hip joints. If a child has orthopedic issues or is prone to high muscle tone and tightness, excessive W sitting can further tighten the major muscle groups that allow for outward rotation of the legs. This can lead to problems with coordination, balance, and in the most severe cases, hip dislocation.

Many children sit in a W position because it widens their base of support. This is a very stable position that doesn’t require much weight-shifting or core engagement to stay upright. For this reason, it is often the preferred seating choice of children who are very flexible or have low muscle tone. Because this position is so stable, children do not use their core muscles much as they are playing, which limits the development of trunk strength. Developed core and trunk strength is necessary to reach the arms away from the body to participate in fine motor activities like writing, coloring, or using scissors. Children with poor trunk strength may fatigue easily and demonstrate more difficulty remaining seated upright at a desk as they grow older.

Additionally, W-sitting does not allow for much trunk rotation while playing. Trunk rotation helps children develop the ability to cross midline (reach their arms across their bodies), which is an essential skill for differentiating between and coordinating the two sides of the body.  Because the W position is so stable, it is relatively easy for children to complete tasks with either hand when seated this way. This can delay the development of hand dominance. Therefore, excessive W-sitting can affect the core strength, postural control, and coordination necessary to develop precise fine motor skills, and should therefore be discouraged.

To help your child break the habit of prolonged W-sitting, you should try to anticipate when they are about to W-sit, and encourage a different position. Sitting in a “criss-cross” position or with the legs out in front of a child’s body promotes core and trunk development. Sitting with both legs to one side is also an appropriate position. If you find your child already seated in a W position, try giving them a verbal reminder to “fix your feet”, and help them move into a different position. You can also try letting them sit on a cushion or an inflatable disc as an alternative to sitting on the floor.

Natalie Machado, MS, OTR/L
Occupational Therapist

References:

Pathways.org. (2017). What is W-sitting? Retrieved from https://pathways.org/blog/what-is-w-sitting/