Tips to Target Therapy Goals in Your Daily Routine

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Therapy is often compared to going to the trainer: if you go to the trainer once a week but don’t continue the exercises or healthy eating, the training session isn’t going to do much for you! It is so important to carry over activities from therapy to ensure your child makes progress and meets their goals. Everyone is so busy these days and adding additional learning opportunities to your child’s life shouldn’t be daunting. Here are a few ideas of how you can address common play therapy goals into your daily routine!

Laundry

  • Matching/Sorting Concepts
    • Have your child to match socks
    • Have your child sort clothing into different piles by color or by item
  • Size Concepts
    • Have your child compare his small t-shirt to a family member’s larget-shirt
  • Association Concepts
    • Ask your child which body parts different clothing items are put on
    • Discuss the occasion or weather you would wear certain clothing items

Meal Prep

  • Symbolic Play
    • Provide your child with (safe) kitchen utensils for them to also “make dinner”
  • Size Concepts
    • Encourage your child to explore size concepts with different sized Tupperware
  • Identifying Colors
    • Discuss the colors of the food you are preparing
  • Following Directions
    • Show your child how you follow directions when following a recipe
    • Give your child simple directions to follow during meal prep
  • Association Concepts
    • Describe the functions of the different kitchen gadgets while using them

In the Car

  • Color Identification
    • Use colors to describe what you see:
      • “That construction cone is orange”
      • “The blue truck is next to us”
    • For older children, you can play games like “I Spy”. Take turns choosing a color and encourage your child to label everything they see of that color. This not only works on color identification but also vocabulary!
  • Size Concepts
    • Use size words to describe what you see:
      • “Look at the little dog on the sidewalk”
      • “That is a big dump truck”
  • Social-Emotional Development
    • Discuss:
      • Plans for the day (where you’ll go, who you’ll see)
      • What your child did at school/daycare that day
      • Encourage your child to ask you questions

And most importantly – have fun together; make it silly and stress-free! You are your child’s first teacher and can help frame their perspective on learning! Please feel free to discuss specific ideas with your child’s therapist to ensure he or she is getting the most out of their therapy.

Kimberly Shlaes, MAT, DT
Director of Developmental Therapy Services

Image credit: https://netmums.cdn.prismic.io

Why Messy Eating Is a Good Thing for Babies and Toddlers

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Do you fear letting your baby get messy? Can’t stand the sight of food in their hair or on the floor and dread the work that it means for you afterwards? You are not alone! Lots of parents have a really hard time allowing their baby to be a complete and total mess while eating. But did you know that this mess is more than just a headache for you later on? It is actually a critical learning experience for your little one! So next time you cringe at the sight of your toddler flinging applesauce across the room or your baby dropping yet another yogurt-covered spoon on the floor, remember that you are helping their development.

Below is a list of reasons why you should let your little one get messy while eating.

Messy eating…

  1. Provides important sensory experiences
    • Messy eating is a form of sensory play! It is an opportunity for your little one’s brain to receive feedback from their food regarding different textures, temperatures, colors, quantities and the difference between solid and non-solid foods. This sensory play promotes exploration and helps build a positive environment around their food.
  2. Leads to greater acceptance of foods
    • Once children are familiar and comfortable with the sensory information of their food, they are more willing to eat it. Sensory play and exploration helps kids overcome their fear of new textures and flavors and results in eating a more diverse diet.
  3. Promotes appropriate self-feeding skills
    • Allowing your little one to explore their food builds confidence and promotes independent eating.
  4. Develops fine motor skills
    • Self-feeding involves pinching, picking-up, reaching, holding a spoon and a number of find motor skills that your kiddo may be missing out on if you are always the one in control of the food container and spoon.

Tips to help the messy eating routine:

  1. Prepare for a mess by feeding your baby or toddler in a room with hard, easy to clean surfaces (i.e. tile, wood) and avoiding carpeted areas. Use placemats, floormats or even lay a towel or sheet down under the highchair.
  2. Ditch the nice clothes and opt for an old t-shit or onesie instead. You can even let your little one eat in only their diaper to avoid excess laundry! As long as it is a comfortable temperature in your house, your baby will not be too cold and it will save you a lot of time and hassle.
  3. Embrace the messy eating. Remind yourself that this GOOD and fun! Enjoy these moments and capture one of those classic-baby-moment pictures.

Kelly Fridholm, MCD, CCC-SLP

Speech-Language Pathologist

Additional resources/related articles:

https://www.reuters.com/article/us-food-fears-children/playing-with-food-may-help-preschoolers-become-less-picky-eaters-idUSKBN0O41MD20150519

Picture: Shutterstock

School Behavior Vs. Home Behavior

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Sometimes, parents ask us why their child is able to behave more appropriately at school but not at home. Parents can become confused and frustrated as to why the teachers do not report any concerns for their child but yet the child is having more difficulties managing their behaviors at home. Here are some tips for parents to implement into their homes to help mimic the school environment:

1. Create house rules-knowing that the classroom has set rules for the children to follow, we want to make sure there are also house rules to help mimic the sense of consistency and expectation for the child. House rules will not only help the parents be on the same page but also give the child a visual reminder of behaviors that are not acceptable in the home. Examples of house rules may include:

  • No hitting
  • Clean up toys before bedtime

*It would be best if the parents could write the two- to three- rules on a piece of paper and post it on the refrigerator to serve as a reminder for the entire family. After these are written down, talk to the child about the rules and what will happen if he/she is unable to follow them, such as resulting in a time-out.

2. Reinforce turn taking and sharing-knowing that children are expected to share and take turns with their peers at school, we want to make sure they are also expected to practice these skills at home. Here are some fun ways to incorporate these skills:

  • Play a board game with your child and use turn-taking. You take a turn and then have your child take a turn.
  • Engage in your child’s favorite activity and incorporate sharing. For example, ask your child if he/she can share the toy with you and then give it back after a couple of minutes. Continue to practice asking your child to share toys throughout the day.

*The child may show resistance to turn-taking and sharing outside of the school environment. The best way to implement these skills is to be consistent. Even if the child becomes upset over taking turns or sharing, it is important that the parent continue to follow through with the request in order to establish expectations for the child.

Brittany Hill, MS, MSW, LCSW, DT
Licensed Clinical Social Worker
Developmental Therapist
Photo Credit:
http://iloveboardgames.com/family-games/
https://www.wikihow.com/Run-a-Household

Should I be working on pre-academic skills with my child?

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Although pre-academic skills such as letters, numbers, shapes and colors are important to learn, these skills should not be targeted until a child is able to functionally use language.  Can your child ask you for “more” of a preferred item? Can your child tell you what toy they would like to play with or what food they would like to eat? Can your child ask you for “help?” If the answer to these questions is no, then save working on pre-academic skills until your child has a stronger grasp on using language functionally.

What is functional language?

Functional language can be thought of as your child’s ability to make their wants and needs known. This includes core vocabulary words that are relevant in everyday life, such as names of important food items, toys, people, etc. It also includes words such as “more,” “help,” “all done,” and other requests that allow your child to communicate what they want or need. Working on these core vocabulary words is key in teaching your child to communicate with you. For language to be considered “functional,” it should be used for a communicative purpose such as requesting, commenting, or interacting with you rather than just labeling words.

Why is it important to have functional language before teaching pre-academic skills?

We want children to be able to say words that are important for everyday situations before they can say their colors, numbers, shapes, and letters. We want children to be able to converse with you meaningfully and ask you to have their needs met before they learn pre-academic skills. Of course it is great if a child can say “green,” “two,” or “circle,” but if they are not able to ask you for “more milk” it is time to take a step back from learning pre-academic vocabulary and focus on increasing your child’s ability to use language functionally.

When is it appropriate to work on pre-academic skills?

Pre-academic skills are concepts that are typically learned in the pre-school setting. If your child is using language to functionally communicate with you, it would be appropriate to learn pre-academic skills together if this is an important topic for you and your family.

Katie Dabkowski, MS, CCC-SLP
Speech-Language Pathologist

What’s the Deal with W-Sitting?

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W-sitting is a familiar term for many parents, teachers and clinicians, and most of them could tell you that it is not good for a child to sit this way. But what is the real issue with this seated position that so many children demonstrate?

What is W-Sitting?

W-sitting is when a child sits on their bottom, with both knees bent and their legs pointing out and away from their body. When looking from above, the child’s legs appear to form the letter “W.”

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Why is W-sitting so common?

W-sitting is a very common and often preferred position for children. Many children find this to be a comfortable position because it provides a wider base of support and lowers their center of gravity, which provides more stability through their hips and trunk and compensates for any weakness in these areas. This allows a child to engage in play without having to concentrate on keeping their body upright and balanced.

Why is W-sitting a problem?

-Muscles of the hips and legs can become shortened and tight, resulting in muscle weakness as well as back and pelvic pain as a child grows.

-In this position, a child’s hips are internally rotated, which can lead to bone malalignment and abnormalities during development. This can result in pigeon-toed walking, which increases a child’s risk for falls.

-Trunk rotation and weight shifting are limited when in this position. A child needs to engage in these movements to develop balance reactions as well as to cross midline (reach across their body) with each arm.

-The wide base of support created by W-sitting provides too much trunk stability and control, meaning the child is not properly engaging and strengthening their core muscles.

-The W position puts increased strain on a child’s joints and can increase the likelihood of hip dislocation

How can we address W-sitting?

The best thing a parent, teacher or clinician can do when a child is W-sitting is to redirect by verbally cueing or physically assisting them into a different position. You can practice using a verbal cue that works best for your child, such as “Fix your legs/feet” or “Fix your sit.” You may also need to physically assist the child in adjusting their posture. Other positions you can encourage include:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

There are many ways you can encourage participation and play while in these various positions. And though it may be difficult for a child to break the “W” habit and challenge their trunk strength and balance, it is one small change that can have a big impact on a child’s development.

Ashley Heleine, MS, OTR/L

Occupational Therapist

Photos sourced from:

www.dinopt.com

https://www.childsplaytherapycenter.com/w-sitting-correct/

http://activebabiessmartkids.com.au

https://pathways.org

Self-Care for Caregivers: Do you recharge your phone more than you recharge yourself?

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If you are asking yourself that question, then it is probably time for some much needed, self-care. With hectic schedules, homework, and snow days, everyone needs a break once in a while, and yes, a screen break too! Allow yourself to fully disconnect and recharge your batteries.

 Self-Care ‘Splurges’ Suggestions:

*Plan a ‘You retreat’, whether it’s for a few hours, days, or weekend getaway filled with relaxing activities you enjoy (massage, manicure, museum).

*Join a fitness group/gym/exercise hobby you enjoy. Working out relieves stress and can be your ‘recharge’ time.

*Go shopping for a few new items to spruce up your wardrobe, even if you buy yourself new socks. Buy something for yourself that you want.

*Begin weekly therapy sessions for yourself to just talk about ‘life’.

*Plan a night out/vacation with your favorite adult.

We are a society that is constantly go, go, go! It is important we take some time for ourselves, to slow down, and really appreciate each day for what it is. Check out this link below for some easy daily accommodations to challenge yourself and make time for you. Happy self-caring!

Simple Self-Care Tips

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

Photos

https://mobiwoz.com/revealed-causes-iphone-battery-explode/

http://www.healthyskindayspa.com/

http://www.latinaonrealestate.com/en/2017/02/08/hispanic-latino-latina-and-latinx-what-do-they-all-mean/

 

Skill Building and Repetition

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“It feels like we’re doing the same things over and over, why hasn’t my child learned this by now?”
“We’ve tried that and it didn’t work.”
“My child said that once, but hasn’t said it again since.”

CareyHope/Getty Images

Toddlers with language delays often learn along the same developmental path as “typically” developing children, they may just require more time to learn skills, more repetition of models, more cueing or help, more practice with each new concept, word, or skill, etc. Often times, children with language delays don’t just pick up words overheard in adult conversation and they don’t repeat things they have heard within full sentences. They require more direct teaching of each word or concept, which often includes a lot of exposure to each target, keeping things simple and concise, and a lot of repetition and practice before it truly becomes part of their repertoire. Some children may process a new word after five repetitions, some may require 20, some may require 50 or more, it all depends on the complexity of the concept or word, their interest level in said concept or word, what cues or aids they have when being exposed to this concept or word (e.g. pictures, physical objects, models of actions, etc.) and a variety of other factors. Just as we as adults often need practice or multiple exposures to be good at something new, children’s brains, oral motor mechanisms, and bodies need a lot of repetitions to efficiently learn and use new skills.

At times it may feel like our toddlers are not listening or intentionally refusing to do or say something we’ve seen or heard in the past, but it’s important to be aware that just because we’ve heard something or seen it done once, twice, or even a handful of times, does not necessarily mean it’s been mastered; therefore, we cannot necessarily always expect it done. Until each new skill is used consistently, children need continued repetition and practice. Oftentimes, we will hear some children in the initial phases of learning to talk repeating words to themselves for seemingly no apparent reason, but they are practicing when there is no pressure to perform!

Once we’ve seen a new skill or heard a new word, resist the urge to move on to the next new thing. Elicit this over and over to help your toddler practice! Make it a game to perform the action or repeat the word again and again. Make it functional so the child has more motivation to keep trying or participating. For example, saying “Say ___. Say it again. ____. Say ___,” is not a functional use of this new word. While it seems to be the quickest, easiest way to get high repetitions of the word in a short period of time, they will quickly lose interest, in addition to not necessarily equating this new word with it’s true meaning. Instead, with each target word, give a little at a time so the child is motivated to use to the word again in order to receive the desired output. For example, give one piece of the snack until your child uses the word again to request more of it, give one piece of a desired toy until they use the word again to get another one, or perform one silly action and pause until they use the word to request another performance. It may feel redundant, but modeling or eliciting a new concept, skill, or word with high repetition is key to your toddler’s acquisition of it. Once children find something they like, they will attempt to get it over and over again anyways, so you might as well use it as an opportunity for repetitive exposure and practice!

Therese Schmidt, MS, CCC-SLP
Speech-Language Pathologist

Self-Stimulatory Behaviors (“Stimming”) in Children

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What is stimming?

“Stimming” is a term which is often used to refer to self-stimulatory behaviors in children. These are repetitive behaviors that children engage in to stimulate their various sensory systems. Common forms of stimming may include hand flapping for increased proprioceptive (body awareness) input, rocking back and forth for increased vestibular (movement) input, lining up toys or staring at spinning objects for increased visual input, and humming or making other repetitive noises for increased auditory input. In extreme instances, stimming behaviors can be self-injurious (such as head-banging, self-scratching, or biting).

Self-stimulatory behaviors are often used by children to help them regulate their bodies and make them feel calmer or more engaged in certain situations. When children under-stimulated by their environments, they often participate in self-stimulatory behaviors for extra sensory input that may help them feel more engaged in the moment. When overstimulated, repetitive stimming behaviors can provide extra sensory input that many children find calming.

Is stimming bad for my child?

Self-injurious behaviors can be dangerous and may require you to intervene to physically stop the behavior before your child hurts him or herself. However, most self-stimulatory behaviors are simply socially inappropriate. In these situations, you can try to meet your child’s sensory needs through other activities, so he or she feels less of a need to seek out additional sensory information.

What can I do to help?

For children seeking out extra visual input, try playing with bubbles, balloons, or other toys which are easy to visually track. If your child seeks out additional proprioceptive input through hand flapping, you can try wheelbarrow walking, encouraging the child to sit on his or her hands, or providing hand squeezes to provide extra pressure in his or her joints. Try playing music, using a white noise machine, or playing with bubble wrap if your child engages in auditory stimming behaviors. If your child rocks or spins, try swinging in a blanket, climbing playground equipment, or rolling on the ground for increased vestibular input.

Natalie Machado, MS, OTR/L

When to Skip the Sippy Cup

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Many parents love sippy cups- they are great for “on-the-go” days and avoiding spills and messes! However, the problem with sippy cups is that prolonged and frequent use can impact a child’s development of speech and feeding skills. Below are three reasons why you may consider skipping the sippy cup:

  1. Tooth decay: Constantly sipping on anything that is not water can lead to tooth decay because the child does not have the opportunity to rinse away the sugars from the juice or milk with their own saliva. The acid from the drink may break down the tooth enamel leading to tooth decay. If you are going to use sippy cups for anything besides water, it is best to limit to only meal times and to take breaks with water to rinse your child’s teeth.
  2. Oral-motor delays: At around 12-months, a baby’s swallowing pattern matures from a front to back swallowing pattern to a more advanced swallowing pattern where the tongue raises to the top of the mouth and starts a wave-like motion for swallowing. It is important for babies to move to this new swallowing pattern as it allows them to transition from soft solids and liquids to more advanced foods and textures. When using a hard-spouted sippy cup, the sprout rests on the front of the tongue impeding the ability of the tongue to elevate to the top of the mouth. When a child uses a hard-sprouted sippy cup for a prolonged period of time, it can impact their ability to develop a mature swallowing pattern necessary for chewing and swallowing age-appropriate foods.
  3. Speech and language delays: Prolonged use of a sippy cup can impact a child’s ability to develop a mature swallowing pattern which means that their oral-motor skills may not be well-developed. Decreased oral-motor skills may lead to a greater likelihood that the child has difficulty saying and imitating certain sounds.

Other options? A great alternative to the sippy cup is a straw cup. There are some great options for spill-proof straw cups at most stores. Straw cups can offer the same “on-the-go” convenience of a sippy cup while still promoting appropriate oral-motor development!

Claire Kakenmaster, MS, CCC-SLP
Speech Language Pathologist

Toys: How Many Is Too Many?

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“It is a happy talent to know how to play,” -Ralph Waldo Emerson.

Toys help foster children’s play development. Toys are one of the first opportunities that a child has to explore and interact in their environment. They open up a world of learning opportunities through education of play. Toys provide developmental growth when it comes to cognition, language, motor skills, and social interactions (plus many more). They create opinions, reactions, and fun experiences. These experiences allow a child to engage independently and socially. Toys must be introduced and used interactively with another social/ communitive partner (i.e. an adult or parent). A child must learn how to functionally play with a toy in order to use a toy to the fullest.

Although toys have many benefits for toddlers and preschoolers, having too many toys can feel overwhelming and distracting. A toddler can feel distracted by the overload of toys and not use the toys to their full potential. A toy must be introduced to a toddler first to learn the functionality of the toy. Too many toys can distract a child from focusing their attention on one toy at a time. Many children will pick up toy bins/containers, dump them out, move them around, the room, instead of using them for their functionality. Using a toy functionally with adult assistance will help a toddler use the toy to the fullest. After a child is done using a toy having them clean up and move on to the next activity will help with the growth of their attention span. Having too many toys does not encourage the growth of their attention span.

Tips

  • When your child gets a new toy engage with the toy together first! Get on your child’s level (one the floor) and look at the toy together! Talk about what the toy is, what the toy can do, and play with your toddler and the toy.
    • Example: “Wow look at your new red car! I love how shinny it is. Vroom Vroom let’s see how fast the car goes!”
  • Select toys that have multiple developmental benefits. For example, find toys that can be used to benefit cognition and language growth.
  • Organize your child’s toys into bins to help your child organize what they are playing with.
    • Use pictures to highlight what toy goes in which bin
  • Switch out the toys and the bins to keep things fresh.
    • Example: don’t have all your toys out at reach for your child at all times. Put some toys out of sight so that your child can focus their attention on the toys in front of them.

Have fun playing!

Rachel Weiser, MS, DT

Developmental Therapist

Resources:

http://www.telegraph.co.uk/science/2017/12/05/many-toys-bad-children-study-suggests/

https://www.naeyc.org/resources/pubs/yc/may2017/case-brain-science-guided-play

https://www.therapyshoppe.com/