Tag Archives: Therapy Evaluation

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

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“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

Early Intervention Initial Evaluation: What to Expect

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Making the call to Early Intervention (EI) can be the daunting first step in addressing developmental concerns for your child. What comes next? PlayWorks Therapy’s Director of Developmental Therapy, Kim Shlaes, explains what to expect during an Illinois Early Intervention initial evaluation.

Service Coordinator
After a referral is made for your child, a service coordinator is assigned to your case. The service coordinator:

  • Is the point of contact for you and your family to help guide you through the EI process.
  • Is responsible for conducting an intake meeting to collect all the needed information and paperwork to set up an initial evaluation.
  • Coordinates the evaluation and ongoing services, should your child qualify.
  • Is responsible for writing and updating the Individualized Family Service Plan (IFSP) based on recommendations made by providers during their initial evaluation, goals you and your family have for your child, and assessments while in EI.
  • Is responsible for informing a family of their rights while in EI.
  • Helps facilitate the transition from EI as the child ages out of the program at three years old.

Initial Evaluation
Next, your service coordinator organizes a team of at least two credentialed evaluators. The evaluation team is selected based on developmental concerns you have for your child. An evaluation team typically has a combination of the following: developmental therapist, occupational therapist, physical therapist, and/or speech and language pathologist. Other providers, such as social workers, nutritionists, interpreters, and others are added to an evaluation team as needed.

The initial evaluation typically takes about one hour to complete. A parent/guardian is required to attend the evaluation. A typical evaluation follows the following routine:

  • Review reasons for the referral to EI, including parental and pediatrician concerns.
  • Review the child’s birth and medical history. The evaluators will also ask questions about your child’s milestones, their social history (including who your child lives with, who cares for your child during the day, any languages your child is exposed to), and your child’s opportunities to socialize with other children.
  • The evaluators take turns playing with your child.
  • The evaluators ask you several questions about your child’s development (i.e. how your child completes “self-help” skills such as eating and dressing, how they socialize with other children, how they communicate with you, how they process sensory information, etc.).
  • Evaluators then score their assessments and make recommendations for ongoing therapy or additional evaluations. If your child qualifies for services, you and the evaluators write discipline specific goals for your child, based on what your family wants to target while in EI. This part of the evaluation is the “IFSP meeting”.

What comes next?
Should you decide to move forward with Early Intervention services, your service coordinator organizes a team of credentialed therapists to provide service to your child. These therapists contact you directly to schedule your child’s therapy sessions, which are held in a natural environment for your child, most commonly your home or their school/daycare. Services typically begin within a few weeks of the initial evaluation.

Questions or concerns?
If you have questions or concerns about your child’s development or the Early Intervention process, please contact us at info@playworkschicago.com or 773-332-9439.

Kimberly Shlaes, MAT, DT
Director of Developmental Therapy Services

Photo Credit: willingness.com.mt/types-of-play-therapy/