Parent Question: How does developmental therapy support speech and communication skills?

“The initial evaluation team recommended developmental therapy for my child but my concerns are with her speech. How can developmental therapy help support her speech? I thought that it focused on preschool readiness skills?” — Concerned Parent

Developmental therapy (DT) focuses on the whole child and often addresses different areas of development, including speech and communication. DT can often be used to complement and support speech therapy by helping your child learn pre-communication skills. These skills include sharing joint attention, attention span, imitation of gestures and play ideas, and general play skills and are essential in learning how to speak! This blog will explain these skills and how you as a parent can help your child with their pre-communication skills.

Pre-communication skills
Joint attention: Joint attention is when two people share attention with an object or activity. This can be demonstrated by sharing eye contact, using gestures, and/or other non-verbal and verbal communication. While children can learn some skills from toys and objects independently, they absolutely need to be able to share joint attention with another person to learn language and how to communicate with others.

Attention span: In order to learn any new skill, one must have the attention span to attend to an activity. On average, a child is expected to attend to a single activity for – at minimum – one to one-and-a-half minutes per year of age. And as they age, a child should be able to attend to several activities in a row.

Imitation of gestures: Imitation of gestures always comes before imitation of words. It is important for your child to learn that they can imitate what other people are doing! Once your child is consistently imitating familiar gestures (such as waving or clapping), novel or play gestures (feeding the baby a bottle, for example), and “invisible” gestures (this is a gesture that you can do but not see yourself do, such as sticking out your tongue or tugging your ear), we know that your child is on track to using sounds and words to communicate.

Play skills: A child’s “work” is play! It is important for your child to engage in functional play with toys to learn the concept the toys are targeting. Engaging in functional play provides your child opportunities to use language to communicate. Play is also a great measure of a child’s cognition!

How can parents support pre-communication skills?
Joint attention: Engage in a preferred activity that your child has mastered – we want to make sure they can focus on learning the skill of joint attention and not forcing too many cognitive demands at once. For example, if your child does not yet match, you would not use a puzzle for this activity. Activities with lower cognitive demands – such as popping bubbles – is much more appropriate for a joint attention activity (but if your child has mastered matching, feel free to use a puzzle!) After blowing bubbles a few times for your child, pause the activity. Give him or her the opportunity to come to you and show you that they want “more” by using eye contact or gesturing to you what they want. If they only look at or touch the bubbles, bring the bubbles near your face to encourage eye contact. Once they look to you, provide praise and blow more bubbles! Continue this routine as long as your child will tolerate.

Attention span: Toddlers are notorious for having a decreased attention span! Everything is so new and interesting to them, no wonder they want to bop around the room and get into everything! Make sure you create a learning and play space that is conducive to attending to activities. Having a large number of toys available at all times or always having the television can create many distractions for your child.

When starting to work on increasing your child’s attention span, your goal should be to complete one activity – that’s it! An activity with a clear beginning and end, such as a puzzle or book, are great activities to start with. Engaging in symbolic play with a baby doll, for example, would be considered an open-ended activity that can be finished after one minute or ten. And again, you want to choose something that they have mastered so they are not expected to complete an activity that is new or particularly challenging.

Imitation: To work on a child’s imitation skills, you can start by imitating them! If they bang a toy on their highchair, you do the same. Encourage your child to do the gesture again before imitating it again. Once you go back and forth a few times, change the gesture – rub an object on the highchair instead for example. If your child does not imitate this gesture, do it again. If they continue to not imitate this gesture, provide hand over hand assistance to show them exactly how to imitate this gesture.

Play skills: Sometimes, children need to be taught how to play functionally with objects! Just like any other skill, play needs to supported and taught and it is up to the child’s first teacher – their parents – to show them just that. Parents should be modeling appropriate play with toys and encouraging the child to do the same (this is also where those imitation skills come in handy!) Help your child master functional play by setting aside a few minutes every day to provide your child your undivided attention and PLAY!

Questions or concerns?
If you have questions or concerns about your child’s pre-communication skills, please contact us at info@playworkschicago.com or 773-332-9439.

Kimberly Shlaes, MAT, DT
Director of Developmental Therapy Services

Reference:

Teach Me to Talk. (July 30, 2018). Sorting Out the 11 Prelinguistic Skills… Retrieved April 25, 2019 from http://teachmetotalk.com/2018/07/30/sorting-out-the-11-prelinguistic-skills/

Photo Credit: PublicDomainPictures from Pixabay

Reducing Screen Time in the Home

Tablets, smartphones, computers, televisions, and more…our world today often seems to be dominated by screens. Yet, one of the most common warnings heard by parents everywhere is:

“Don’t let your child have too much screen time!”

This warning may instantly lead many parents to wonder, “How much is too much?” And once that is determined, “What can I do to set limits on screen time in my home?” Let’s take a look at these common thoughts and questions!

Why is too much screen time a bad thing?

Recent research has produced a variety of results on the potential negative outcomes for children who spend too much time each day watching or using screens. Dr. Cara Booker and colleagues discovered that children who use screens heavily tend to be less happy and suffer from more social/emotional problems than their peers. The content of what is behind many screens can often encourage feelings of discouragement and low self-esteem.  Children who spend a large amount of time “tuned-in” to a screen also tend to miss out on learning and practicing important social skills, such as maintaining conversation and managing social conflict. Additional studies report that children who spend more time watching and using screens also spend less time sleeping at night. Screens can cause physical stimulation within your child’s brain, causing excitement that makes it more difficult to calm down and get ready fro sleep. Too much screen time is also linked to a higher risk for obesity, one reason being that screen time while eating can distract a child’s body from understanding when it is full, which may lead to over-eating. Overall, children who are exposed to increased screen time tend to present with increased cognitive, language, and social/emotional delays.

How much is too much?

With significant potential harms noted, it is important to ask, how much screen time is too much? To answer this question, The American Academy of Pediatrics created age-based guidelines on screen time for children. The exact numbers, as well as additional useful tips on appropriate media usage for children, can be found on their website:The American Academy of Pediatrics Age-Based Guidelines.

Helpful Tip: The American Academy of Pediatrics also offers online tools for families to create a unique “Family Media Plan” or to use a “Media Time Calculator.” Find both tools here.

Remember, these guidelines are just that – a GUIDE – and every family will run into days where screen time exceeds the recommended amount. That is okay!You may find that during a particularly stressful day at home, or over a long weekend spent mostly in the car, your child’s screen time total adds up to much more than the number stated in these guidelines. As long as these “excess” days are limited, and not the norm, they will not have the same negative effects on your child.

Steps to Reducing Screen Time

Once you begin to notice that excessive screen time is the norm in your home, it is time to consider taking action! Here are seven steps to get you started:

  1. Eat all meals without a screen
  • Allow meals to be a time to interact with one another. Share a favorite story from the day, or something you hope to see happen that day!
  1. Set up “technology-free” zones
  • Choose one area of your home. This is a great opportunity to get your child’s input. If they contribute to creating the technology-free zone, they will be more likely to actually utilize the technology-free zone! *NOTE: Be sure all beds are zoned to be “TECH-FREE”
  1. Set a timer when using screens
  • Sand timers, kitchen timers, and digital alarm clocks all work well! Before screen time begins, have your child set the timer with you (to the pre-determined time allowed) and review what happens when the timer goes off.
  1. Schedule specific times each day to “un-plug”
  • As a family, decide on a period of time during the day when you will collectively “un-plug.” This means parents too! Together you will put all phones, tablets and computers away. Turn off the TV and tune into your environment instead. *NOTE: Timers can be used to track your un-plugged time too!
  1. Use parental controls
  • Most devices offer an option for parental controls. Using this setting will allow you to set time limits and make sure that your child is only exposed to parent-approved content.
  1. Model limited screen use
  • Your children learn from watching you! Practice limiting your own screen time so that your child will see it can be done (and hopefully see the benefits as well).
  1. Replace screen-time with a different engaging activity
  • Have a plan ready for what your child can do with the time he/she used to spend with a screen. Below are just a few of many options available for activities that can replace screen-time, and better promote your child’s health and development!

Examples of Alternative Activities

Questions or concerns?

If you have questions or concerns about your child’s development or the effects of screen time in your home, please contact us at info@playworkschicago.com or at (773) 332-9439.

Stephanie Wroblewski, LCSW
Licensed Clinical Social Worker

References:

Grant, Sheena. “Do Children Have Too Much Screen Time and Does It Matter How Much Time They Spend on IPads, Smartphones and Laptops?” East Anglian Daily Times, 17 Oct. 2015, www.eadt.co.uk/ea-life/do-children-have-too-much-screen-time-and-does-it-matter-how-much-time-they-spend-on-ipads-smartphones-and-laptops

The American Academy of Pediatrics Website, (Itasca, IL, USA). American Academy of Pediatrics Announces New Recommendations for Children’s Media Use. Retrieved from: https://www.aap.org

The American Academy of Pediatrics Website, (Itasca, IL, USA). Family Media Plan. Retrieved from: https://www.healthychildren.org

Photo credit: Photo by Hal Gatewood on Unsplash

What’s in Your House: DIY Activities for Language Development!

Due to all that’s available online and in stores, many parents feel inclined to buy the newest toys on the shelf to support their children’s development. Unfortunately, as a result, parents can overlook the valuable materials in their own homes! Tons of common household items can be converted into toys or activities that stimulate your child’s creativity, expand his or her play ideas, and facilitate language growth and development. Not to mention encouraging your child to play with common household items can reduce clutter, cut down costs, and help your child get creative with what they have! Here are some common household items that function as agents for language use during play. You might be surprised by all you can do with what you have!

Toilet Paper Rolls

Save your empty toilet paper rolls! Encourage vocal play by turning your empty toilet paper rolls into microphones! Taking turns saying sounds and words into your microphone helps to build your child’s imitation skills. You can also tape two rolls together to make a set of binoculars! Use your binoculars to target object naming and object identification, through fun games like I-Spy and hide-and-seek.

Pots, Pans, and Spoons

Channel your child’s inner musician by playing with pots and pans! You can sing familiar songs or model strings of single words or sounds, such as “tap tap tap” or “bang bang bang,” as you play with your culinary instruments. By imitating the things you say and do, your child is practicing a critical step in learning reciprocal communication.

Laundry Basket

Laundry baskets (or any other open container) can easily be transformed into cars, trains, boats, or planes with a little imagination. As your child drives the makeshift vehicle, model target phrases and environmental sounds, such as “drive,” “go car,” “choo choo,” “vroom,” “beep beep,” etc. After taking your laundry basket for a spin, try using it as a basketball hoop and ask your child to throw different objects inside. This is a great way to target object labels and following single-step directions within a fun routine!

Painter’s Tape

Tape a line on the floor to serve as a road or balance beam. To target verbal requests, rip bits of tape off at a time to verbal requests such as, “more road” or “tape on” or “need tape.” You can also take turns hopping, crawling, or tiptoeing on the tape to practice imitation of gross motor actions! Imitating gross motor actions is a great precursor to imitating gestures, sounds, and words!

Blanket

Aside from using blankets for pretend play (i.e., putting a baby doll to sleep), you can use blankets for a variety of social games. Peek-a-boo is a great game to target joint attention and verbal turn taking. After you lift the blanket up, say the phrase, “Peek-a….” and wait for your child to fill in, “Boo!” before lowering the blanket. This helps build anticipation and establishes a cause-effect relationship between your child’s words and your actions. Other social games include blanket swing, blanket train or magic carpet, and silly sneezes (i.e. Lifting the blanket and saying, “Ah, ah, choo!” as you lower it).

Questions or concerns?

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

Jill Teitelbaum, MS, CF-SLP
Speech-Language Pathologist

Photo Credit: Michal Bar Haim on Unsplash.com

What Toys Are Best For My Child?

As a walk down any toy aisle will tell you, there are many types of toys for all ages of children.  Most will indicate on the packaging what age they are geared toward (“for ages 2+”), but how do you know which toys will provide the best developmental opportunities for your child?

Choose toys that are open-ended.

Get the most bang for your buck by choosing toys that can be adapted as your child grows. For example, blocks are great for infants to bang together to practice cause and effect, as well as bringing their hands to the midline, a great exercise for the brain. Toddlers can begin to stack blocks for fine motor development. They can also use blocks to encourage imaginative play by pretending they are cars driving across the floor or as a telephone to call a loved one! Preschool children can use blocks to build more elaborate structures with playmates to encourage social skills and negotiating conflict. Blocks also enhance dramatic play and can be used to create a house for stuffed animals, a storefront for a restaurant, or bridge to connect people, things, and ideas.

Adapt “toys” you already have.

Parents joke that children often prefer the box the toy came in to the actual toy. Go with it! Let your creativity loose and find new purpose for items in your house. What about that mesh loofa? It makes a great sensory experience for infants, and it is easy for them to grasp as their hand-eye coordination is developing. It also makes a safe option for toddlers to throw and kick around the house. What about using it in paint for a unique texture on paper? Or add it your play with a doll or stuffed animal and practice the bath time routine.  The possibilities are endless!

Don’t forget your child’s favorite toy: You!

Playtime is not necessarily about the type of toy, but how it is used in relation with the caregiver. As caregivers, our schedules are packed, but even just a few moments of playing peek-a-boo your infants or singing a rousing rendition of “Wheels on the Bus,” with your toddler, complete with motions, will help your child’s brain develop synapse connections as they learn about the world around them. Point out your eyes, nose, etc.during bath time with your little one or try playing I-Spy in the car on the way to the store with your preschooler. Your child learns best in the context of a loving relationship with you, so go ahead, have a tickle-fest in the middle of that toy aisle and take advantage of the most priceless toy your child could have! You!

Questions or concerns?

If you have questions or concerns about developmentally appropriate toys, please contact us at info@playworkschicago.com or 773-332-9439.

Becky Clark, MS, DT
Developmental Therapist

Reference: Cook, R. E., Sparks, S. N. (2008).  The art and practice of home visiting. Baltimore, MD: Paul H. Brooks Publishing Co.

Photo by Susan Holt Simpsonon unsplash.com

Why is Play Important?

Play is a natural and important part of development that begins in early childhood. Children learn to connect with and understand their world through their play. Play contributes to cognitive, social-emotional, motor, and language growth in young children. Children learn through toys and people how to explore, discover, and play.

Sensory Exploration (3 to 6 months): A child explores an object texture by using their senses. They will put an object in their hands, mouth, or visually watching the object as a caregiver is displaying it to them. This is when a child is learning how to comprehend new experiences.

Relational Play (9 to 12 months): This is when a child use two different but related objects. For example, a child will bring a brush to a doll’s head.

Functional Play (12 to 15 months): This is when a child plays with an object according to how it works. For example, cups are for drinking or cars are for pushing.

Symbolic Play (15 to 18 months): A child is using an object for something else. For example, a child may use a block as a phone, or a straw as a toothbrush. A child can also use realistic props such as, pretend food to engage in symbolic play with realistic props.

Imaginative Play (24 to 30 months): This is when a child is starting to process their environment through play. For example, a child may act out a visit to the doctor’s office or pretend to have a birthday party.

The different stages of play help support the meeting of developmental milestones. Encouraging play in your child’s day will allow these play stages to naturally form. Playing and interacting with your child from the beginning of birth will help you encourage these developmental milestones to flourish. In each stage of play, children are learning how to interact with others in their environment. They are learning how to manipulate toys, move around the room to access activities they are interested in, how to problem solve, and how to share their ideas through communication. Play skills develop as a child develops. As a child’s understanding of the world and how it works develops so do their interests in toys and in social interactions with their caregivers and peers.

Rachel Weiser, MS, DT
Developmental Therapist

Resources:

http://pediatrics.aappublications.org/content/119/1/182

http://www.earlychildhoodnews.com/earlychildhood/article_view.aspx?ArticleID=240

https://www.naeyc.org/resources/topics/play