Phonological Processes: What are they and is my child using them?

Do you find yourself asking your child to repeat what they said, utilizing your detective skills to figure it out, or perhaps acting as your child’s commentator for people that are less familiar with their speech? We know that children can sometimes be difficult to understand when they are learning to speak. It can be tricky to know if this is part of typical development or if your child would benefit from support. In this post, we will help you understand phonological processes and their potential impact on your child’s overall speech intelligibility.

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April Showers Bring Sensory Powers!

Not only do April showers bring May flowers, but with these rainy days also come the perfect opportunity to have your child engage in fun and exciting indoor sensory activities to get their creativity flowing!

Photo Credit: PublicDomainPictures via Pixabay

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Just Go to Sleep: Strategies for Improving Sleep Habits in Your Family

We all know sleep is important for maintaining a healthy, happy lifestyle. Unfortunately, sleep doesn’t always come easy, even to children. Some children, especially those with sensory processing issues and other difficulties, struggle to get to sleep and remain asleep through the night. What’s more, chances are, if your child isn’t sleeping, you aren’t either. The result is a cranky, sleep-deprived child and a cranky, sleep-deprived adult. Here are some strategies for improving your child’s “sleep hygiene,” or habits that promote healthy sleep.

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Snow Day! Heavy Work Activities to Promote Sensory Regulation in Your Child

Snowy days provide great opportunities for heavy work proprioceptive input! Proprioception refers to our sense of awareness of body position, which our bodies process by receiving input through the muscles and joints. This type of input is typically calming for most children, but can also be alerting for some children. Proprioceptive input generally occurs through heavy work activities that involve deep pressure or weight through the muscles and joints.

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What’s Inside the Mystery Box?!

Let’s make a mystery box!

It’s no mystery that families and children been spending more time at home than ever before. When we are constantly surrounded by the same scenery, including the same toys and games, it can be difficult to brainstorm ways to mix it up (without constantly rushing to the store or clicking ‘buy now’ on Amazon).

As a pediatric therapist, I am always seeking new ways to turn every day household items into fun, motivating, and enriching toys. I’ve found that some of the best toys are not ‘toys’ at all. One of my favorite non-traditional toys is a do-it-yourself mystery container/box!

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Play Together!

What Are the Benefits to Social Therapeutic Playgroups?

Play is the universal language of early childhood. It has been proven that children learn from each other. Therapeutic playgroups are interdisciplinary programs that allow children with developmental delays to grow through learning in a social setting. In this group setting, children learn how to foster their engagement by developing social-emotional and cognitive skills along with their peers. Therapists help facilitate organic social interactions between children. Therapists help foster relationships by encourage children to use them as a resource to engage with others. Playgroups are play-based programs that allow for children to be intrinsically motivated by their peers, grow their problem-solving skills, and facilitate social language in a sensory friendly environment.

The power of a play-based playgroup allow for children to grow their sense of self. Play therapy is used to promote cognitive development and social-emotional strategies to help children succeed in multiple environments. These play-based activities encourage children to problem-solve in a natural environment that is different from their home. Problem-solving skills are important for children to develop as these skills will be with them throughout their lives. In these playgroup children also learn how to follow directions. Children learn from peer models to follow familiar and novel directions. Peers grow their engagement for structured and unstructured play-based tasks by learning alongside on another. Unstructured tasks promote creativity and allow children to grow their symbolic play skills. Structured activities allow children to attend to adult-led activities and grow their task completion. The cognitive and social-emotional skills that children learn from playgroups allow them to succeed in a variety of environments and throughout their educational experiences.

 

Rachel Weiser, MS, DT
Developmental Therapist

 

Photo: PlayWorks Therapy classroom, Photographed by Thomas | © 2019 TK Photography |

Interoception: The Eighth Sense

Our sensory system is how we experience the world around us, and when we have difficulty processing one or more of these senses, our daily experiences can be hugely impacted. Children also use their senses to take in the world around them and learn new skills, whether through watching a bubble float by with their eyes, feeling gooey slime squish between their fingers, or tasting that delicious piece of cake with their tongue. While some of the senses are better known, there are others that are “hidden,” but equally as important in your child’s development. Some children have difficulty processing sensory information and producing a response that is appropriate, which can be seen through a variety of challenges in completing important daily activities. Understanding what our senses do for functioning is the first step in improving our ability to process them!

What is interoception?

It is likely that you learned about the “five senses” sometime early in your life: touch, taste, smell, sight, and hearing. These senses help you initially interact with the world around you and are important in helping you participate in everyday activities as an infant and young child. As you got older, you may have learned of the next two senses that are not as obvious but still very important to daily functioning: the proprioceptive and vestibular sense. Proprioception is the sense that identifies the position of your body in space with the use of receptors in your joints and muscles, and the vestibular sense helps us with movement, balance, and controlling our posture.

Interoception is the eighth sense we have; it is often called the “hidden sense” because it is not something we can see, but what we feel on the inside of our bodies. Imagine it is 2:00 in the afternoon and you have not eaten since 7:00 in the morning. Your stomach starts to make a growling noise. That is your interoceptive system working to let you know that you are hungry and that your body needs food to maintain a balanced state. When responding appropriately, you would recognize that sound and feeling to mean hunger, and you may go to the kitchen and get a snack.

Our interoceptive sense allows us to feel important body functions like hunger, pain, nausea, itch, needing to use the bathroom, coldness, and even emotional states such as nervousness, fear, or excitement. This sense uses internal signals that tell us how our body is feeling and can give clues to how we can respond to restore balance and find a place of comfort. Our bodies want to feel regulated, and how we get there may be different for everyone.

What does it look like when a child has difficulty with the interoceptive sense?

When the interoceptive sense is not processed appropriately, your child may have difficulty understanding what the signals inside of his/her body are trying to communicate and then will have difficulty responding appropriately to these messages.

Generally, this means challenges with:

  • Bedwetting, constipation, and frequent accidents
  • Identifying appropriate ways to dress for the weather/temperature
  • Not being able to identify hunger, thirst, sickness, pain
  • Self-regulation, self-awareness, and emotional outbursts
  • Having flexible thoughts and behaviors
  • Problem-solving
  • Social skills and participation

Self-regulation, or the ability to monitor and manage your emotions and behaviors, is a vastly important aspect to consider with your child who may be struggling with interoception. For example, your child may not be able to feel or recognize getting angry; that is, a faster heartbeat, the face getting hot, or muscles tensing. Your child will then have difficulty identifying that these feelings mean anger, possibly not even until the emotion has already produced an inappropriate response. Without understanding and being aware of how these body sensations are making us feel, it will be difficult to identify the emotion being experienced and react in a way that is appropriate.

How can occupational therapists address interoception skills in children?

As daily occupations (i.e. using the bathroom, dressing for the weather, interacting with friends) are often affected by our understanding of our internal body sense, occupational therapists have a role in working with children who may have difficulty with the interoceptive sense. Occupational therapists (OTs) at PlayWorks follow guidelines from the Interoception Curriculum, a program designed by Kelly Mahler, a licensed occupational therapist and expert in interoception.

Using a step-by-step framework, OTs work to improve awareness of sensations within the body by introducing body experiments and body checks. These activities seek to improve your child’s understanding of how his/her body feels and can enable him/her to respond appropriately to improve participation in daily activities. Following this curriculum, OTs may also use a visual representation of the body to aid in recognizing and understanding body signs. This can be accomplished by using a visual drawing of a person with different body parts, combined with a list of different sensations or describing words. This will enable your child to practice matching the descriptor words to different body parts to increase understanding and connection of internal body cues and daily activities.

What can I do to support interoception in my child?

While interoception should be addressed in therapy, you can also support these challenges while at home. It will be helpful to start labeling body language as you notice it during different activities. For example, you can say, “I see that your breathing is getting heavy and your face has become a little red. I think you might be feeling angry.” This may help to link specific body language to emotions that they are feeling.

Additionally, you can try out some mindfulness activities, such as meditation, yoga, or reading a book centered around being mindful. While doing so, you can point out or ask how their body is feeling when they are doing these different activities to bring awareness to internal body cues. While this may be a challenging sense to understand for some children, there are many ways we can work with you and your child to increase his/her knowledge and recognition of these cues to improve participation in daily activities!

Questions or concerns?

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

 

Molly Ross

Occupational Therapy Student Intern

 

References:

Interoception: The Eighth Sensory System (2016). Retrieved from https://docs.wixstatic.com/ugd/b303b5_ab07aaedc04c45b3a96e519fc262ecd1.pdf

Mahler, K., McLaughlin, E., & Anson, D. (2020). Interoception Across Varying Degrees of Mental Wellness. American Journal of Occupational Therapy74(4_Supplement_1), 7411505251p1-7411505251p1. https://doi.org/10.5014/ajot.2020.74S1-PO9513

 

Photo Credit: Ketit Subiyanto via https://www.pexels.com

SNOW WAY! Sensory Activities for Winter Days

Winter can be cold and snowy, but it’s always a wonderful time to engage in different sensory activities! Use the snow, cold weather, and holiday season to expose your child to countless sensory-based play activities, both indoors and outdoors. Playing with objects of various scents, textures, colors, and sounds, or engaging in activities that require your child to move their body in different directions and transition between various positions are great for providing sensory input. This will help them learn more about the world and how to process the sensory information they are constantly receiving.

Build a Snowman

Do you want to build a snowman? Yes! Getting outside to roll snowballs and build a large snowman provides great proprioceptive input. Proprioception is also known as the “joint sense” and lets us know where different body parts are in space, how they move, and how much pressure our body wants or needs to stay regulated. Encourage your child to pack the snow in their hands, roll it on the ground to gather more, and build massive snow balls to stack on top of each other!

Watch those Snowflakes

While you’re still outside, why not lie in the snow, make some snow angels, and stare at the snowflakes falling down? This provides great visual input! You and your child can pretend you’re inside a snow globe, looking at all of the snowflakes falling around you. You can also gather snow in your hands and encourage your child to blow it into the air! This provides great oral and visual input, all while your child is simply enjoying the snow day.

Sip Something Tasty

Go on inside and warm up with some hot chocolate! Sipping and sniffing a warm cup of hot-cocoa will give your child some great tastes and smells for their sensory system to process. Put a spin on the classic hot chocolate by stirring it with a candy cane or adding whipped cream or marshmallows. The added flavors and textures will provide increased oral input for your child.

Create a Snow Sensory Bin

Sensory bins are a great way to explore different textures, colors, and smells in one place! Help your child create a snow sensory bin by gathering some snow and adding other items. Feel free to include items from outside, such as rocks, leaves, or sticks. Add some from inside the home too, such as spoons and cups to scoop and pack the snow. Hide waterproof toys inside the bin and encourage your child to search for them. Sprinkle some glitter, paint, or food coloring into the bin for a visually-exciting spin on the usual white snow. The options are endless!

Questions or concerns?

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

 

Morgan Haak

Occupational Therapy Student Intern

 

References

Proske, U., & Gandevia, S. C. (2012). The proprioceptive senses: their roles in signaling body shape, body position and movement, and muscle force. Physiological reviews92(4), 1651-1697.

 

Photo Credits: Nelly Aran via Pexels; Victoria Borodinova via Pexels; Nelly Aran via Pexels; Jill Wellington via Pexels; Matej via Pexels

Green Screen Teletherapy

I spy, dinosaur hunts, and apple picking, oh my! As pediatric therapists, we have been faced with the challenge of engaging children of varying ages and diagnoses over teletherapy. Children, families, and even therapists are still getting used to this virtual format. I want to walk through some ways I have utilized green screen technology for speech therapy during my time as a graduate student clinician at PlayWorks Therapy, Inc. I have found that using the green screen technology creates a fun and engaging way to target goals, while keeping our clients’ attentions for longer periods during our virtual telehealth sessions.

How do you use green screen technology?

Green screen technology is easily utilized over Zoom (PlayWorks’ medium of delivering teletherapy).

To set up the green screen: You need a green screen, or another brightly colored background. Mine is a plastic green tablecloth hung with command hooks. Next, log into zoom. Click the up arrow in the “stop video” button on the lower left corner of the zoom window and click “choose virtual background…”. Now, in your camera view, there is a small circle in the bottom right that has a color. Click that circle, then click your mouse on your background in the camera view. This tells Zoom what color to detect as your background, so it can transfer your given image to your green screen.

To transfer activities to Zoom backgrounds: Download/export your activity in a “.jpg” format to your computer. Follow the above directions to get to the virtual backgrounds settings. Then, click the plus sign (+) to upload the background images.

What goals can be targeted in green screen teletherapy?

I have targeted my clients’ speech and language goals using elements of the green screen. I have even used the same green screen activity for clients of varying ages and goals by modifying the way I use the activity, my language level, and my prompts. Using green screen activities is a great way to create a “theme” for each week. Being fall, my clients have enjoyed a variety of fall-themed activities from apple picking to exploring a spooky mansion for Halloween.

Articulation

Articulation is easily targeted using these curated, story-like green screen activities. For example, for the apple picking activity, courtesy of “GoGo Speech”, I will have the client say their given target word 5 times, put the word in the sentence, and then we pick the apple together. You pick all the apples this way, but watch out for the worm who just might eat all our precious apples!

Language

Language goals can be targeted as well, including expanding language to age-appropriate utterance lengths, spatial concepts, pronouns, wh- questions, and more. I have used “I Spy” to practice expanding a child’s phrase length. I have used “GoGo Speech” materials for spatial concepts, where the clients must tell me where they see the chipmunk during our picnic: “is it behind me? Is it on top of the rock? In the tree?” I have used a “fall hunt” activity, modeled off of the classic “we’re going on a bear hunt” story, to target wh- questions and expressive language. The opportunities are endless!

What are some go-to resources?

My go-to resources come from a private Facebook group, entitled “Green Screen Speech Therapy”. Speech-Language Pathologists post many resources that can be downloaded, personalized to meet your client’s speech and language goals, and then added to Zoom for use during a speech therapy session. This Facebook group also has an incredibly useful video explaining how to set up a green screen and how to use it. My other go-to has been “GoGo Speech”. If you subscribe to their services, they send activities for free (and videos on how to use them) to your email inbox.

Is green screen technology only useful for speech therapy?

Other disciplines can use green screen technology to keep their client engaged and target goals simultaneously, too! This means that physical therapists, occupational therapists, social workers, and developmental therapists can use green screen resources as well.

Do I have to have a green screen to use these resources?

No, you do not. You can download the resources in a PowerPoint format. Then, share your screen during your sessions to take advantage of the same resources without having a green screen.

 

Gwen Berglind, B.S.

Speech-Language Pathology Graduate Student Clinician

 

Credits: “GoGo Speech”, “Green Screen Speech Therapy” Facebook Group

Express Yourself: Building Self-Esteem

Self-Esteem and self-confidence are something we think of adults either having or lacking… but can kids either have or lack these skills? (Answer: Yes and yes!)  And if so, how do we help boost a child’s confidence and self-esteem?

What is self-esteem?

Self-esteem is having the confidence in one own’s worth and abilities, in addition to self-respect.

What is self-confidence?

Confidence is the trust in oneself, a measure of faith in one’s own abilities.

Why is this important for children to develop?

A positive sense of self is important for children to develop in order to establish and maintain a healthy lifestyle, coping skills, and interpersonal relationship skills with others. Having increased self-esteem and self-confidence is essential for children to grow up with a positive mindset, have the ability to try and complete new challenges, and identify their strengths. Children who are mindful of their self-esteem and self-confidence levels, have the potential to manage unexpected stress with more resiliency and the ability to accept and forgive themselves and others.

How can I improve my child’s self-esteem?

You can increase your child’s self-esteem at any time: during the day, when they are trying something new, or picking out their clothing.

  • Start by giving your child lots of praise (“I’m so proud of you!”)
  • When giving your child praise, explain what they did and why you are proud of them (“I’m so proud of you for cleaning up after yourself by putting your dish in the sink.”)
  • Identify their differences and support their choices (within reason), even if they are not always correct. (“I love the way you used *pipe cleaners* to build the wall, very creative!”)
  • Try as much as possible to stay and remain positive with your child. They will imitate and learn from your reactions. (“It’s so frustrating we are lost, let’s do some teamwork to solve this together.”)
  • Identify and comment on positive traits and characteristics about your child (“Wow Johnny, you climbed all the way to the top, you are so strong, brave, and determined!”)
  • Be supportive, understanding, and caring when your child fails. (“I know learning how to ride a bike is tricky. You are tough, hard-working, and intelligent! We will keep practicing together when you’re ready.”)

 

Questions or concerns?

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

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

Photo Credit: Haydn Golden via Unsplash.com