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

There are many prerequisite skills that a child develops before speaking their first words – eye contact, comprehension, vocal play and babbling, gesture imitation, etc. However, parents often feel that their child is understanding language at an appropriate level, but not yet using words. To encourage the emergence of first words and word imitation, there are simple strategies that can be used during daily routines or play!

Simple verbal imitation is just a half-step down from imitation of true words. A child is more likely to imitate a set of sounds or words if it is simple and achievable for them; for instance, they are more likely to imitate “woof!” than they are to imitate “butterfly.” If your child is able to imitate gestures (such as waving, pointing, clapping) and play actions (such as making a stuffed animal eat pretend food, stacking blocks and knocking them down), practice with verbal imitation is a great next step to encouraging words. Instead of trying to prompt your child to “Say ‘ball!’” or imitate when you say “Milk,” try using natural modeling of environmental sounds. Environmental sounds can be thought of as words that represent sounds – think animals (moo, quack quack, nay, baa, woof, meow, buzz), vehicles (beep beep, vroom, crash), exclamations (mmm, whoa, yay, uh oh) and other noises you hear that can be words. Don’t worry about prompting your child to “say” these sound words, just try to make any activity as fun as possible!

Outside of environmental sounds, you can also create your own consonant-vowel combination play sounds. Early developing consonants, such as B, P, M, D, N, H, and W, can be used to form small non-words that are attached to a play action. For example, as you make a toy car go up the back of the couch, add “Doo-doo-doo-doo-doo!” Stomp your feet on the ground while you march around saying, “Ba! Ba! Ba!”

Verbal routines are another fantastic way to encourage early verbal imitation. Verbal routines are sets of words that become familiar and predictable, preparing your child to know what should come next. “Ready, set, go” is a favorite among speech-language pathologists – try combining it with a fun activity, saying “Ready, set,…..” and waiting for your child to fill in “go!” “Peek-a-boo” is another simple routine that can be practiced almost anywhere! Verbal routines can also be practiced through songs, and kids usually love music! Some familiar kid’s songs: The Itsy Bitsy Spider, The Wheels on the Bus, If You’re Happy and You Know It, Old McDonald, Five Little Monkeys, Head Shoulders Knees and Toes, and Row Row Row Your Boat.

 Children are expected to imitate consonant-vowel combinations and non-speech sounds by between 9 and 12 months. First words are expected to emerge between 9 and 15 months. If you are concerned about your child’s expressive language skills, contact your local Early Intervention Child and Family Connections or contact us at PlayWorks Therapy, Inc.!

Leanne Sherred, MS, SLP-CF

Paper bags can have endless uses! You can use them to carry groceries, pack lunches and picnics or even make a pretend city!

What you will need:

• Paper bags, grocery or lunch size
• Newspaper
• Paint and/or markers
• Stapler

Want the know-how? Start by making roofs for all of your buildings at the opening of the bag; add doors, window, flowers and any decorations that you want! Let your child decorate and decide what buildings they want in their city. Create a school, hospital, library, your own house or friends’ homes!

Once your bags are all decorated, stand them up and add crumpled newspaper or double the bags for added stability. Fold the top of the bag and staple shut (you can also leave them open and cut out windows and doors for extra fun!)

You are ready to play pretend! Add cars and your favorite characters for expanded play!

This activity great for building your toddler’s vocabulary! Talk about the buildings, what colors they are, who might go to a building and why, what decorations you are making, or how big or small to make a decoration. Adding stickers is a great opportunity to practice requesting (i.e. “I want the flower.”). In addition, stickers often offer opportunity to request “help” opening or unpeeling the back of the sticker. Once your project is finished, be sure to talk about where a character or a vehicle is going, who they are going to see, or what they are doing, the opportunities for play are endless!

Send us pictures of your pretend house or city and be featured on our blog!

 **This activity requires adult-supervision, especially for children under the age of three.**

Picture and activity are adapted from kidsactivityblog.com

Jessie Delos Reyes, MA, CF-SLP

While this summer has brought us some beautiful weather, there are still those rainy days where we are forced to stay inside. Are you looking for new, cheap activities for your children? Here are two fun and easy recipes for entertaining your little ones:

1. Homemade Play-Doh

Ingredients:

1 cup flour

1 cup water

½ cup salt

1 Tbsp. crisco oil

2 tsp. cream of tartar

Food coloring

Directions: Combine all of the ingredients into a sauce pan and cook over medium/high heat (stirring constantly) until ball forms. Knead the doh for a couple minutes. Store in an airtight container.

Play-doh is a good interactive activity to encourage engagement with your child by showing your child how to roll the doh into a ball, poke the doh with your finger, or form the doh into fun shapes and animals. Play-doh can also be used as a sensory activity, in which the squeezing and tearing of the doh helps children use their sense of touch to regulate their behavior and calm their bodies.

2. Home Car Wash

Ingredients:

Squirt bottle with water

Hand soap with pump

Scrubbing tool (e.g. sponge, toothbrush)

Towel

Toy cars

Directions: Put some cars into a bowl and ask your child to spray them with the water bottle. Then ask the child to pump some soap onto the cars. Take the scrubbing tool and have the child scrub the different parts of the car (e.g. wheels, doors, windows). Then ask the child to spray the soap off with water before drying the car off with the towel.

This car washing activity works on using a child’s fine motor skills with the squeezing of the water bottle, pumping of the soap, and scrubbing of the car. This activity can also encourage following directions by asking the child to complete a step before moving onto the next. If you have a number of colored cars, you can work on color identification by asking the child to wash a specific color of car with each wash.

Brittany Hill, MS, MSW, LSW, DT

Many children in the early language developing years (anywhere from one to five years old) pass in and out of stages of increased disfluency. This is often seen when children go through a time of rapid language growth, where they increase their vocabulary and begin to combine words into short phrases. Children may frequently struggle with word finding in connected speech and repeat sounds and syllable shapes as they ‘look for’ the right word. They also use fillers, such as “uh” or “um,” in conversation.

Young children may repeat the sounds at the beginning of words (“Ka-ka-cookie”) or they may repeat whole words at the beginning of phrases (“My-my turn”). Normal disfluencies are two- to four-repetitions long (“I-I-I want ice cream”) and the child will continue their phrase without pause. The majority of typically developing children are unaware that they are disfluent and show little to no signs of frustration. They often do not follow a pattern of disfluency, but may experience times of increased disfluency when they are excited, tired, upset, or when under stress to talk or answer questions. They may be disfluent for a few days or weeks at a time, and then enter periods of relatively fluent speech. This occurs naturally as children learn how to use language in a new way. These periods of disfluency are considered age-appropriate and usually disappear on their own.

As a parent, you can support your child by allowing him or her to finish their word/phrase on their own before responding. Acknowledge their communication attempt by giving them plenty of time to communicate and use slow, unhurried speech in your response.

Moderate to severe stuttering is characterized by longer repetitions, effortful speech, and tense facial muscles.  Children with atypical disfluencies may experience a ‘block’ in speech, where no airflow or sounds occur for a few seconds. They may become embarrassed about talking or avoid talking altogether.

If you have any concerns about your child’s fluency or communication skills, email info@playworkschicago.com to schedule a speech-language evaluation with one of our experienced clinicians.

The transition to preschool can be an intimidating one for families – every parent wants the very best for their child! Here are some questions to consider when choosing the right school for your child and family:

What is the school’s educational philosophy?

Parents are encouraged to ask schools this question however may be unsure of their own educational philosophy. Here are some things to keep in mind:

• Is the program play-based? Are the children allowed to explore and discover or do they complete mostly drill work (i.e. worksheets)?
• What is the school-family relationship like? Are families welcome and/or expected to volunteer? Is there an open door policy or do families need to make appointments to stop in?
• What curriculum is used in the classroom?

Does the school use a skills based assessment?

It is important to learn how your child’s preschool program will be tracking their progress over time. Are they assessed every 6 months? Once a year? What tool is used to assess their skills? You want to make sure that your child’s cognitive, social-emotional, and physical development is monitored to ensure they are successful in the classroom and getting any support they may need.

What qualifications or educational background do the teachers have?

Qualifications to teach in a preschool classroom can vary from school to school – some require a bachelor’s degree in early childhood education, elementary education, child development, etc. Others may require only a few hours of coursework and complete the rest of their training in-house. You want to make sure that you are comfortable with their educational background and experience, as these are the people who will help your child learn and grow!

What is the school’s discipline policy?

It is essential that a preschool’s and classroom’s rules are clear to both the parents and child. You want to be certain the program is setting children up for success in the classroom. How often are the rules reviewed with the children? Are they posted it the classroom or around the school?

You also want to make sure you agree with the way the school handles discipline, should the situation arise. Do they use the “timeout” method? Do they redirect the child when possible? Do they talk with the child to explain why they are being disciplined and to resolve the situation? Are children rewarded or acknowledged for good behavior?

Does my child need to be potty trained to attend?

Some schools require children to be potty trained in certain classrooms and may not allow a child to move up to the next room until they are using the toilet regularly. Other schools do not require children to be fully potty trained and help out in the practice.

Kimberly Shlaes, MAT, DT

Developmental Therapist

Please refer to part one, Modeling Empathy, of this two-part blog post.

Practice Kindness

The next logical step after empathy is kindness. What is kindness? It’s an attitude of empathy that leads to an action. You model kindness when you act in ways that express empathy. Kindness is a choice to do something or to say something that shows you care.

You can show kindness to your child by offering an alternative to help them overcome their anger at needing to clean up their toys: “After you calm down, you can help me set the table for dinner.” We learn to be kind by receiving kindness. When your child is experiencing a negative emotion, your kindness towards them will be keenly felt. You validate their worth when you show kindness despite a difficult interaction, and your child will learn compassion.

You can also encourage kindness by suggesting appropriate action towards others:
“When do you think you should give Sarah a turn to swing?”, or “Let’s help John pick up all those crayons!”

Try to create opportunities to practice showing kindness to others:
“How about we bring a couple of extra water bottles to the park for someone that doesn’t have one?”, or “I think it would be kind to help somebody today. Shall we look for someone who could use a hand while we are at the store?”

Older children may be encouraged to understand kindness by playing games like charades. Try discussing real or made-up scenarios and compare kind or unkind responses. Talk to your child about kind or unkind actions they may see on TV or read about in their books.

Kindness may also be expressed in words. Teach your children a language of kindness. Speak kindly to your children. Never use harsh words, and tell them how much you appreciate them. Demonstrate speaking kindly to others. Don’t allow your children to insult you or others. Remember that words are powerful, whether positive or negative.

Conclusion
Remember, you are your child’s first and most influential teacher. He or she will emulate your words and actions. When your child learns to identify with the feelings of others and practices kindness towards them, respect for the needs of others is a natural result. When you treat other people like they matter, your child will watch and learn!

If you have questions related to supporting your child’s social emotional development, please contact one of our pediatric social workers.

Laura Mauriello, MS, LCSW, DT

In the United States, more than 20% of school-aged children speak a language other than English at home. As soon as I learn that a client is exposed to more than one language I always make sure to answer any questions related to bilingual language development. Often times, I encounter families that speak more than one language at home, but they decide to only expose their child to one language in fear that speaking more than one language will confuse their toddler. Other times, I meet families that attribute their child’s language delay solely to the fact that they are exposed to more than one language. Here are a few of the most common questions related to bilingual language development that I have encountered as a speech-language pathologist and an Early Intervention provider.

Question: “Is it okay that I expose my child to more than one language at home?”
Answer: Absolutely. In fact, research states that there is a “critical period” – or, a window of time during early childhood when it is easiest to learn a language.

Question: “My child is 2 years old and is not producing any words. They’re exposed to English and Spanish at home, so it’s okay that they’re not talking yet. Right?”
Answer: Wrong! Though a child who is simultaneously learning more than one language may start talking a little later than monolingual children, they should still begin talking within the normal range. If your toddler is 2 and not producing any words at all, this definitely warrants a speech-language evaluation.

Question: “My child frequently goes back and forth between languages when they’re talking to me. Is this normal?”
Answer: Yes. This is called “code-switching.” “Code-switching” is typical and it is a process that both children and adults who speak more than one language experience. Children might do this when they know a word in one language but not the other. This should not be looked at as a sign of language delay or confusion.

Question: “I want my child to be bilingual. What can I do at home to make sure my child learns both languages successfully?”
Answer: Do what is most natural and comfortable to your child and your family. Some families prefer that one parent speak to their child in one language while the other parent talks exclusively in another. Some families decide to mix languages amongst caregivers. Whatever approach you decide to take, trust that it can lead to bilingualism.

Julie Euyoque MA CCC-SLP

As children learn to talk, there are often times that we have difficulty understanding what they say. There are a number of complex steps between thinking a word and saying it clearly. The differences may be hard for parents to recognize, and it could be even more complicated to determine if it is normal speech development or not. Here is some information that may help determine if parents should seek a speech-language evaluation.

What is the difference between articulation and phonology?
Articulation refers to the motor act of a speech sound – all the movements that our articulators (lips, tongue, teeth) need to do to make the right sounds. Phonology refers to the ability to organize speech sounds into the patterns that form words.

Why can my child sometimes produce a sound correctly, and other times get it wrong?
Your child may display the use of sounds within certain words, but seem unable to produce the same sound in a different word. For instance, they say “Go!” but pronounce “doggie” as “doddie”. It is possible he or she is having difficulty with their phonology – or use of sound patterns within words. These difficulties are called phonological processes or patterns. Children display phonological processes in an attempt to simplify adult speech to an achievable level for them. It is not that they have trouble physically producing the sound, but that they are having difficulty organizing the sounds at the phonemic level in their brains.
Most phonological processes are considered to be age-appropriate for a certain amount of time as a part of speech development. Others are never considered typical, and may indicate a phonological disorder. Additionally, if a child continues to demonstrate patterns after a certain age, they are no longer typical and may implicate a need for remediation through speech therapy. Please click the link below for a detailed chart of phonological processes.

Phonological Process Chart

If you are concerned about your child’s speech, or have questions after reviewing this information, please email us at info@playworkschicago.com!

Leanne Sherred, M.S., CF-SLP

A routine is anything that we do with regularity. For example, a bedtime routine for a young child could include the following: milk, a bath, brush teeth, and read a story. Children thrive on routine and repetition. Routines create patterns that allow children to easily understand and predict their days. Routines are often repeated in a specific sequence, and this repetition builds an understanding of what is happening and what is coming next which often decreases the uncertainty that can cause anxiety and/or tantrums.

In addition, routines are great for creating independence in your toddler. If they know what is happening next, they can begin to initiate the next step. Routines are also great for language development and comprehension of basic sequences! Talk about the actions and objects within each step of your routine. For example, during your bedtime routine you can talk about getting milk and modeling the word and/or sign for “milk.” Encourage your child to sign or say “milk” to request it. Praise all attempts even if they are not accurate! Bath time is another great opportunity for language practice. Label verbs such as “wash” and “dry,” as well as body parts; e.g. nose, eyes, belly button, toes, etc.! You can also have your child point to body parts or imitate these verbs if they are not quite ready for verbal imitation. The more your toddler hears a word connected with a specific object or action the deeper their understanding of that word becomes. A fun addition to routines could be a visual schedule which often includes pictures of your child performing various activities within the routine, providing a visual cue for what comes next.

Adding routines to your day is easy! Include a specific routine, such as the bedtime routine mentioned earlier, or a loose, but consistent, structure to your day; e.g. wake up, eat breakfast, play, eat lunch, take a nap, play, eat dinner, go to bed. Once your child becomes familiar with the sequence routines become more natural, and they are a great opportunity to bond with your toddler and model language!

Still have questions? Please e-mail us at info@playworkschicago.com.

Jessie Delos Reyes, MA, CF-SLP