Home for the Holidays

It’s hard to believe the holidays are already upon us, and this year could bring some new challenges. Seeing family and friends is a great part of the holidays, but when your family is working with a therapist to meet developmental milestones, these interactions can cause additional stress. You may be wondering how to talk about it with your family. Or you may be wondering how your child is going to do playing, communicating or eating during the celebrating.

Here are some quick tips to help you get through:

• Talk with your therapist about concerns you have, and ask for specific ideas and activities that you can do over the holidays.
• As much as possible, keep your child’s daily routine in tact.
• Talk with friends and family before the actual visit, so you can spend your time celebrating instead of explaining.
• Sometimes, the best way to explain is to demonstrate. Give some information, and then show your family how to do what you are talking about. This gives YOU the chance to be the therapist
• Bring a few of your child’s favorite toys with so that he/she feels more comfortable, and has an opportunity to play in a familiar way.

Realize that your child will likely act differently when put in new environments. This is expected and perfectly normal. Offer your child more help, and be sure to add in some extra positive reinforcement. If you notice the family visits are getting too stressful for anyone, take a break!

Sarah Pifkin Ruger, MS, CCC-SLP

36-48 Month Milestones in Speech and Language Development

Is your child aging out of the Early Intervention program? Questions about what to look for next in terms of speech and language development? Our speech-language pathologist Jessie Delos Reyes provides a helpful checklist for upcoming milestones and developmental red flags:

36-48 months of age

Receptive Language (what your child understands):

  • Understands 1,200-2000+ words
  • Hears and responds when you call them from another room
  • Follows simple commands if item is out of sight
  • Follows two- and three step directions
  • Understands words for some primary colors (i.e. can point to named colors)
  • Understands some simple shapes (circle, square)
  • Understands concepts (big/small, soft/hard, rough/smooth) when contrast is presented
  • Follows simple two- and three-step directions
  • Listens and understands longer stories

Expressive Language (how your child uses language to express himself and communicate needs and wants):

  • Uses 1,000-1,600+ words
  • Speech intelligibility is 90% or greater
  • Talks about activities at school or with friends
  • Talks about daily happenings using about four sentences at a time
  • Requests permission
  • Shares and ask for turns
  • Answers simple “who?”, “what?”, and “where?” questions
  • Asks “when” and “how” questions
  • Uses pronouns: I, you, me, we, they, us, hers, his, them
  • Uses plurals
  • Uses four or more words in a sentence
  • Labels parts of an object (wheels, steering wheel)
  • Begins to express feelings (sad, happy, frustrated)

Speech and language red flags:

  • Difficulty being understood by familiar and unfamiliar listeners
  • Consistently dropping beginnings or endings of words (“ike” for “bike,” “ca” for “cat”)
  • Difficulty producing three to four word phrases
  • Difficulty following two- and three-step directions and simple sequences
  • Inconsistently answering simple WH questions (who, what, when, where)
  • Difficulty stating wants and needs
  • Difficulty playing with others or a lack of interest in other children

If you have concerns regarding your child’s speech and language development, call our office to schedule an evaluation with a speech language pathologist.

Jessie Delos Reyes, MA, CF-SLP

The Best Thing I have Learned During My Time at PlayWorks Therapy, Inc.

For over a year, I’ve had the absolute pleasure of working with the families that PlayWorks Therapy, Inc. serves and alongside the therapists that have also made helping children and families their life’s work. I have seen early words emerge. I have clapped alongside parents who were so proud of their child who just pointed out every single picture in a book. I have built towers, and forts, and racetracks. I have heard giggles and I have seen smiles. But most of all – I have learned right along with the kids and families I’ve been teaching!

Every child is different – no statement has ever been truer. Walking into each and every therapy session means coming prepared to adjust my plans to help that child meet communication goals. What is true and effective for one family might not prove effective for another – and that’s okay! As therapists, we are equipped to pivot and move forward. After appropriately implementing a therapeutic strategy with a family, we reconvene together to discuss its effectiveness. Have we seen progress? If not, what else can we try?

But there’s a big piece that we need help with, and it comes from… families! Parents are the experts on their child! Without parent expertise, we would be without the wealth of knowledge that comes from spending every day with the children we support. So that brings me to the most important thing I’ve learned during my time at PlayWorks –

Therapists and families form one big team!  Therapists are there to provide intervention, support, home programming, ideas, progress, and expertise. Families are there to provide fun, home practice, insight, and expertise!

It has been such a joy working with all of the families and therapists I’ve met during my time here. As I move on to my next adventure in Austin, Texas, I go with a smile on my face thinking of all the progress I’ve seen and fun I’ve had. Thank you to everyone at PlayWorks Therapy, Inc., and thank you to the families for sometimes being our experts!

Leanne Sherred, MS, SLP-CF

Fun Fall Arts and Crafts

Here are some easy and creative activities you can make at home to practice matching with your children this fall!

Popsicle Stick Puzzles

  • Line up and tape five to six large wooden popsicle sticks together on the back to create a little puzzle board.Picture1

 

 

 

 

 

 

 

  • Paint the other side of the popsicle sticks or use markers to create a simple picture and let dry. Get creative! For a fall theme, you can draw pumpkins, apples, or a spooky ghost!
  • Once dry, take the tape off of the back of your puzzle pieces and play!

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This is a great way to get your little one to work on problem solving in addition to working on matching of pictures and colors. For older children, you can help them learn to spell their names or other words by writing a letter on each popsicle stick!

Pumpkin Shape Matching

  • Draw or print out a pumpkin on paper or cardstock (cardstock and lamination is recommended if you plan on using it more than once)
  • Draw shapes on the pumpkin with a black marker to create a face
  • Cut corresponding shapes out of black construction paper (again, cardstock and laminate to use again!)
  • Use tape or sticky velcro on the back of the shapes
  • Provide shapes for your child to match the pumpkin’s “face”

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To make it more challenging or to incorporate movement, print out a few pumpkins with different shapes on each and post them on the wall in your play area. Allow your child to choose a shape and find which pumpkin it matches! This activity will encourage matching and problem solving – and it’s a great indoor activity that gets your child up and moving when stuck inside on cool fall days!

Pumpkin Face Matching

  • Print out several (5 or so) simple pictures of pumpkins with different jack-o-lantern faces.

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  • Using construction paper or colored felt, cut out a large pumpkin outline and different styles of eyes/mouths based on the simple pictures of the different jack-o-lantern faces.
  • Have your child select one jack-o-lantern and select the correct features to make that face.

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Not only is this a great activity to practice matching, but it is also good for shape recognition. You can also incorporate number concepts by encouraging your child to count the pieces used for each face.

Kimberly Shlaes, MAT, DT

Fall Family Fun!

Last fall, I brought my Goddaughter and her younger sister to an amazing apple orchard/pumpkin patch called All Seasons Orchard in Woodstock, Illinois. In addition to the apple orchard, All Seasons has a corn maze, tractor and pony rides, a petting zoo, a mini zip line, tube slides and multiple bouncy houses! It is about an hour outside of Chicago, but well worth the drive! Whether you make it out to All Seasons or find an apple orchard closer to the city, check out these awesome ways to support your child’s speech and language development on your fall outings:

Vocabulary: Label both the familiar and novel items you encounter on your outing, and talk about ways to describe the new objects (big/little, soft/hard, wet/dry, etc.). You can easily teach and reinforce animal names at the petting zoo; fruits, veggies and other food labels at the country store; parts of a tree in the apple orchard; etc. Use the object labels frequently to reinforce their meaning:

“Look! A big leaf. My leaf is red. What color is your leaf? My leaf feels crunchy.”

Following simple directions: Target two skills at once by giving your child a direction using familiar attributes, such as “Put one apple in the red basket” or “Give the little pumpkin to your brother.”

Increase expressive language: There are many fun and exciting activities at the apple orchard that will have your child communicating like you’ve never seen before! If you are working on sign language, encourage requesting ‘more’ or ‘help’ for picking more apples, going down the slide, or jumping in the bouncy house, for example. If you are working on simple one- to three-word phrases, expand on your child’s utterance by one word and encourage them to imitate your model:

Child: “More!” or “Go horsie!”

Adult model: “More slide!” or “Go on horsie!”

Basic concepts: Teach basic preschool concepts, such as colors, shapes, numbers, etc. by identifying objects throughout the orchard. A simple way to target these skills is by playing “I Spy…” Encourage your child to find what you label and help them come up with their own objects for you to find!

If you would like more information on All Seasons, you can check out their website: http://www.allseasonsorchard.com/

Happy Picking!

Autumn Smith, MS, CCC-SLP

Our Favorite Board Books for Your Child

Reading books with your child is a great way to bond, and to encourage early language skills; however, toddlers are not always as cautious as we would like when interacting with books. Board books are built to hold up to small fingers and mouths repeatedly tugging on the pages. When choosing board books to engage your child look for simple repetitive language, and clear simple pictures that are likely to hold a child’s attention. The following books are some favorites that are sure to withstand the test of time.

  1. Brown Bear Brown Bear, What do you See? by Eric Carle
    This book provides great illustrations of animals. The repetitive rhyming texts allows young children to “read” along with their caregivers. Try pausing as you get to the end of a phrase, and allow your child to fill in the familiar text.
  2. Moo, Baa, La La La! by Sandra Boynton
    Once again rhyming text helps to keep little ones This is a great book for introducing animal sounds.
  3. First Words by Bright Baby
    This simple word book has one image per page allowing your child  to learn new words as you label images in the book. The clear realistic images allow for generalization of new words into his/her every day life.
  4. Good Night, Gorilla by Peggy Rathmann
    This book has very few words per page allowing your child to use his/her own language to describe the scenes.
  5. Where is Baby’s Belly Button? by Karen Katz
    This book helps introduce body parts, and the lift the flap format will keep young children engaged.
  6. Where is Spot? by Eric Hill
    This is another lift the flap book to help keep little ones engaged. This book is also great for working on “yes” or “no” questions.
  7. Dear Zoo by Rod Campbell
    This book combines a repetitive narrative with flaps for little ones to lift. There is a good reason that this book is still popular after 25 years.
  8. Yummy Yucky by Leslie Patricelli
    This book, along with the other Leslie Patricelli board book, have simple repetitive language and themes, paired with simple pictures. These books do a great job of teaching early concepts to curious young minds.
  9. Llama Llama Red Pajama by Anna Dewdney
    This is another great choice with a relatable theme, and a simple engaging rhyme scheme.
  10. The Little BlueTruck by Alice Schertle
    Another book made the list due to its simple, engaging rhyme scheme. This book is also a great choice for introducing animal and environmental sounds to your child. Try pausing to allow your child to fill in the sounds as you read.

Story time should be enjoyable for both you and your child. Don’t worry if your child has not yet developed the attention span to listen to a whole story. Allow your child to get up as needed, and wander back to the book when he is ready. Keep in mind that it is not necessary to read every word on the page. Simply identifying pictures as your child flips through the pages is another great way to introduce your child to the joy of reading.

Meryl Schnapp M.A., CCC-SLP

Withholding Desired Objects to Encourage Speech: What to think about.

Q: My toddler’s speech therapist instructed me to withhold desirable objects to encourage communication. Every time I try to do this, my child has a complete meltdown. How is this supposed to help him talk?

A: Withholding preferred or highly favorable objects is a common technique used by many speech-language pathologists to encourage language expression. It is just one of the many tools in your talking “toolbox” that you can use to model appropriate requesting, either verbally or through sign language. By withholding a favorite object, you are essentially setting up an opportunity to model what you want your child to do in order to request that object (“You want ‘more.’ Tell Mama, ‘ma-ma-more’”). But here’s where it gets tricky: As soon as you prompt your child to use sign language or to imitate your verbal model, they have a meltdown, despite imitating your therapist’s prompts 30 minutes earlier with no problem.

While frustrating, your child’s behavior makes complete sense. He has been able to meet his wants and needs up until now using nonverbal communication, such as gestures (pointing, pulling on your hand, etc.) or eye contact. Now you are requiring him to do something much more difficult, and this change to his routine is stressful! But the key to success is repetition, so don’t give up! As a rule of thumb, prompt your child to imitate your model no more than three times before helping them with hand-over-hand cueing of sign language. This teaches your child that they have to use at least one form of expressive language before you are going to meet their needs. Model the sign while verbally saying the request, and then give them the object while praising them for great talking. The idea is not to make them so upset that they no longer want to communicate with you, so use your judgment to keep your child from getting to that point.

The bottom line is, every child is different and you know your individual child’s wants, needs, abilities and frustration tolerance better than anyone. So trust your instincts and pull back when you know your child is being pushed farther than his/her tolerance. With practice and patience, you will be able to use this technique to support the progress of your child’s expressive language development.

Autumn Smith, MS, CCC-SLP

“I don’t like it when they yell at me”: Deescalation and the Calm Response

“I don’t like it when they yell at me.”

I often hear this phrase when working with children. Imagine you have driven into a busy intersection before your turn and another driver starts yelling and honking loudly. It would be easy to become defensive and ready to argue with the other driver. This could also be a natural response for a resistant child who is yelled at by mom or dad. Yelling seems to be an easy fix to an immediate problem when we feel tired or overwhelmed, but it will often make your child more upset.

It has been said that a gentle answer will deescalate anger. Often, an angry person can be calmed down by a simple, quiet, and empathetic response. He or she will be more likely to communicate and resolve the issue that is causing them to feel angry or frustrated. When your child is upset, don’t match their level of emotion. Try to remain calm and clear headed. Use quiet, kind words to help them relax to a point where they are able to express their thoughts and feelings. Your child will feel respected and understood, even if they cannot have their way.

As always, consistency is the key to any discipline process. It is important to set boundaries with your child and this may take time as you develop a habit of calm communication. If your child has become accustomed to yelling, he or she may no longer respond to it. Don’t give in to harsher words or a higher volume. With patient work and loving communication, you and your child can enjoy living in a yell-free home!

If you have questions related to determining strategies for responding to behavioral challenges, please contact one of our pediatric social workers.

Laura Mauriello, MS, LCSW, DT

Falling into Speech and Language!

Children learn best when actively participating in hands-on activities. Here are four great Fall activities to promote speech, language and development in your little ones!

How do you elicit language with art?

Start by laying out the materials. You can get them out one by one to help keep your child’s attention. You will discuss the supplies, and what you can do with them. Additional ideas for enhancing language and learning are listed under each activity.

  1. Fruit Loop Fall Tree Craft

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Materials:

  • Fruit loops cereal (or healthy alternative)
  • Glue
  • White cardstock paper (Don’t have cardstock? Try gluing two pieces of regular paper together.)
  • Toilet paper roll
  • Scissors

Directions:

Cut out the top of the tree with the white card stock paper. Cut two slits across from each other in the empty toilet paper roll. Put glue all over the tree top and decorate with fruit loops. Be sure to lightly press on each foot loop to make sure it sticks. Allow fruit loops to dry and slide the paper tree top inside the slits!

Enhance the Activity:

Start by playing with the fruit loops only and allowing your child to decide what color they want to use in their tree. Work on developmental skills such as counting, matching and sorting. For example, sort the colors they want to use (say, red and green). Discuss each step as you’re doing it using key sequencing words such as, “first,” “next,” “then,” “last.” Label objects and verbs as you work (trunk, leaves, tree, glue, scissors, cut, press). Use prepositions (on, in) while placing fruit loops on the tree. Expand language by talking about where you see trees, who lives in trees (squirrels), and asking simple questions like “Do trees grow?”

  1. Apple Stamps 

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Materials:

  • Apples, cut in half from top to bottom
  • Large paper
  • Paint (use what you have – examples include red, brown, green, yellow)
  • A smock!
  • Glue
  • Optional Materials:
    • Paintbrush to paint branches
    • Scissors and green construction paper to cut out leaves and caterpillars
    • Black marker to make a caterpillar face

Directions:

Cut the apple in half. Pour paint onto a paper plate (or other surface) and dip apples into the paint or use paintbrush to paint and smaller amount of paint onto the apple. Stamp the painted apple onto the paper and create you very own apple design! You could stamp brown paper bags for your child’s lunch, small paper and turn it into a “Thank You” card, or large paper and paint in tree branches. Be creative and have fun with it! For the optional part of this project, you can paint the branches ahead of time for younger kiddos.  You can also pre-cut some leaves and caterpillars, but older children can do that themselves. After the apples are stamped, add the leaves and caterpillars.

Enhance the Activity: Example discussion and language opportunities for this project include…

Cut an apple in half. Ask, “What do you think we are going to do with the apples?” (prediction).

“I have an apple. It’s a fruit.” (category). “What do you do with an apple?” (object function).  “I wonder how they taste?” (sweet, crunchy, juicy). Let your child try a piece.

“I like red apples, do you? What other colors can they be?” (describing). “Can you think of other things that are red?”

(category).  “Hmmm, where do you think apples come from? Do they grow on the ground?” (in/ on-prepositions)

“I have some paint too. What else do I need to go with paint? A brush? Why do I need a brush?” (Wh? questions, object function).

Continue discussing the glue, scissors and paper. Vocabulary may include sticky, wet, sharp, cut… you’ll think of these as you go! Include words like “first,” “next,” “last” as you go through the steps of your project to practice sequencing and following directions. Asking questions like, “Okay, what do you need first?” to ensure understanding. Use verbs like dip, push, stamp. Quantity words could include few, many and some.

  1. Cinnamon Dough

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Ingredients:

Directions:

First, combine the flour, salt, cream of tartar, and ground cinnamon in a medium saucepan. Next, add the water and oil and stir it all together. Cook it over medium heat stirring continually until a ball forms. Then, dump it onto the table and knead it a bit.  (You may want to do this part at first because the dough will be quite warm).  Once it’s mixed up a bit and cooled off, give a section to your child.  They will love to squish it while it’s still warm.

Enhance the Activity:

Baking is the perfect way to practice sequencing skills and following oral directions! Encourage these skills in your little ones by having them follow directions involving “first,” “then,” “next” and “last.” Ask “WH” questions to ensure understanding. For example, “What will we put in NEXT?” Use self-talk to talk about what you are doing to your child. Narrate your actions – for example, “I am kneading the dough. Now, it’s your turn to knead the dough.”  Talk about what your child is doing, seeing, or touching. Narrate what he/she is doing – for example, “Bobby is mixing the flour. Great job mixing Bobby!” (parallel-talk). Discuss action words and vocabulary including: mix, stir, pour, squish, etc.

  1. Easy DIY Bird Feeders

 

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Materials:

  • Toilet paper rolls
  • Peanut butter
  • Bird seed
  • Butter knife or other tool for spreading

Directions:

Give each child a toilet paper roll and have them carefully cover it in peanut butter. Once covered have your kiddo roll the toilet roll in bird seed. That’s it!  Once the feeder is covered in seed it is ready to be hung. You can hang it directly on a tree branch or string rope, yarn or shoe string through it and use that to hang it. Your child will love watching for birds to come eat from the feeder they created!

Enhance the Activity:

Talk about each material as you take it out. What is it? Why do you need it? (WH questions). Label the tools and materials. Present clear and simple directions for your child to follow. Talk about and identify actions words from the activity: roll, stick, spread, hang etc. Before and After: Take a picture of the materials before you begin, at the end of the finished product and after a couple of weeks when the birds have eaten the seeds. Discuss before and after! How is it the same? How is it different?

Kelly Fridholm, M.C.D., CCC-SLP

When is Picky Eating a Problem?

My child is a picky eater!  Is it a problem?

This comment comes up so often with parents, as many toddlers have strong preferences for the types of food they like and will eat.  With picky eaters, mealtime can easily become a constant battle of the wills between parents and kids. You may feel like they are eating the same thing every day, and you may question if they are getting the nutrients their growing body needs.

Here are some questions to ask yourself to help understand the differences between picky eating and a potential feeding disorder:

  • Does my child eat at least 1-2 items from each food group?
  • Does my child universally reject a certain category of food (i.e. certain color, certain temperature, certain texture)?
  • Do my child’s preferences change over time?
  • If given lots of opportunities, will my child ultimately try the food? If not, will they touch it?
  • How stressful is the situation when a new food is attempted? How strong is the child’s reaction and can they recover and continue with the meal?

The key is to know when you child is acting like most other toddlers, or when the picky eating is more concerning.  The more rigid, inflexible and stressful your child is, the more concerned you should be.  If you think your child may be more than just a picky eater, consider a feeding evaluation with a speech language pathologist.  Mealtime is meant to be fun and enjoyable and just another way for your child to explore the world around them!

Sarah Pifkin Ruger, MS, CCC-SLP