Let’s Play! The Stepping Stones to Verbal Communicators

If you are a parent of a toddler receiving speech and language therapy, you may have noticed your child’s therapist playing games such as peak-a-boo, and wondered to yourself, “What do these games have to do with learning to talk?” While learning to talk is of course the ultimate goal in speech and language therapy, there are actually many skills a child needs to develop before they are ready to start talking. Some of these skills include joint attention, turn-taking, and responding to people and their environment, among others. One of the best ways to support acquisition of these pre-linguistic skills is to engage in social games with your child.

What are social games and why are the important?

Social games are people-based in that they are interactive games between you and your child rather than the use of toys. Examples include peek-a-boo, songs with corresponding actions, hide and seek, tickles, etc. Engaging in social games with your child will help to develop their interaction, communication, and social skills. Through social games, children learn to pay attention to others, anticipate what will happen next, and imitate actions. Additionally, through these games children learn important skills such as how to take turns and connect with others. These pre-linguistic skills are the foundation of verbal language. For example, a child who has difficulty using joint attention, which is shared attention with another person, will not have as many opportunities to learn about their environment from the people around them. Additionally, a child who is not using turn-taking will have difficulty understanding the back and forth nature of conversation. Through acquisition of these pre-linguistic skills a child becomes ready for communication and verbal language use.

How to play and what to look for?

You will want to engage in social games repeatedly so that your child learns the routine. For example, if you play peak-a-boo with your child play it over and over again and look for your child learning the game. You may notice that they have learned the game once they start to smile or laugh in anticipation of you saying, “boo!” Over time, you might see your child’s initiation skills emerging when they cover their eyes with their hands or cover themselves up with a blanket to request playing a peek-a-boo game with you. Eventually, you can try to pause after “peak-a…” and see if your child can fill in the word, “boo!” Once your child has learned the routine they will be able to anticipate what is going to happen next.

When thinking about your child’s language development it is important to remember that there are many steps that come before talking and children must master pre-linguistic skills before they can be successful with verbal language. So, when think you are just “playing” remember that you are actually teaching your child foundational skills to become an active learner and communicator!

Questions or concerns?

If you have questions or concerns about the importance of social games and your child’s language development, please contact us at info@playworkschicago.com or 773-332-9439.

Claire Hacker MS, CCC-SLP
Speech Language Pathologist

Photo Credit: from Pixabay

Min, Mod, and Max Cues: What does it all mean?

 

When a child begins therapeutic services, long-term and short-term goals or objectives are developed as a way to guide therapy and gauge progress. If your child is already partaking in speech, occupational, physical, or developmental therapy, you’ve probably seen the words “minimal,” “moderate,” or “maximal cues” written in his or her goals. Amongst sometimes “wordy” goals, it can be difficult to interpret meaning of the specific objective, let alone understand what exactly a “cue” means.

What is a cue?
When helping a child reach his or her therapeutic goals, a “cue” is simply something that is going to aid in that child’s success. When I am providing speech therapy to a child, my goal is ALWAYS for that child to be successful; however, the number and type of cues that child needs to be reach his or her goal may vary. Think of a cue as a hint; as a child becomes familiar with the goal, he or she is going to need less “hints” to be successful and, thus, will become more independent. As a child progresses in therapy, the quantity of cues required for a child to effectively complete an objective will decrease. This is one way that therapists gauge a child’s progress.

What types of cues are there?
Generally speaking, many therapists use tactile, visual, or verbal cues in therapy tasks. Each category of cues has several variations:

Tactile cues: Tactile cues are used when a therapist uses physical touch to guide a child towards successful completion of a therapy objective. In speech therapy, this may be demonstrated by gently touching under a child’s chin in an attempt to help produce the /k/ or /g/ sound, or gently tapping a child’s hand to help him or her produce the correct number of syllables in a word. In occupational or physical therapy, the therapist may tap a child’s arm/leg to remind a child to use that specific body part.

Visual cues: Visual cues are used when a therapist provides a visual reminder that helps the child complete his or her task. In speech therapy, this may be as simple as drawing a snake to remind a child to use his “snake” sound to produce /s/; the therapist may tap the picture if the child omits this sound. Gestural cues are a specific type of visual cue; when targeting this same sound, the therapist may run her finger down her arm to demonstrate the long, fluid motion of /s/. Have you ever used a sticky note to remind you to complete a specific task? That’s an everyday example of a visual cue!

Verbal cues: Verbal cues are used when a therapist provides a verbal reminder that helps the child complete his or her task. Using the same /s/ example as outlined above, the therapist may say, “don’t forget your snake sound!” One specific example of a verbal cue is called a phonemic cue. If a child is working on asking for “more,” the therapist may cue the child by vocalizing “mmm.” A carrier phrase is another form of a verbal cue. Instead of using the phonemic cue, “mmm,” the therapist may say, “I want ____” to encourage the child to finish the phrase. A verbal model may be provided if verbal cues are simply not enough at that time; in this example, the therapist may model the word, “more” before handing the child the desired item.

What does “min,” “mod,” “max” mean?
Now that you have a better understanding of the types of cues used in therapy, what does “min,” “mod,” and “max” mean?

“Min,” “mod,” and “max,” stand for minimal, moderate, and maximal. When developing goals, therapists determine how much cuing a child realistically needs to reach his or her goals. Ideally, the level of cuing necessary decreases as a child participates in therapy. While the criteria of minimal, moderate, and maximal is fairly subjective, many therapists determine that minimal cues are used approximately 25 percent of the time, moderate cues are used approximately 50 percent of the time, and maximal cues are used approximately 75 to 100 percent of the time. Therapists may also report using “faded” cues, which means a child may have required moderate cues as the session started, but required minimal cues as the sessions progressed.

Can I “cue” my child at home?
Of course you can! In fact, you’re probably already cuing your child and you may not even realize it. When your child is about to do something undesirable, do you ever catch yourself counting, “one, two, three…?” You just gave your child a verbal cue, which helped him or her to reflect on his or her behavior and (ideally) change it accordingly. If your child is currently receiving therapeutic services, ask his or her therapist for ideas to best cue him or her to reach his or her goals.

Questions or concerns?
If you have questions or concerns about your child’s therapeutic goals, please don’t hesitate to ask his or her clinician for more information. If you have questions or concerns about your child’s development, please contact us at info@playworkschicago.com or 773-332-9439.

Sarah Lydon, MA, CCC-SLP
Speech-Language Pathologist

Photo Credit: Heriberto Herreravia via freeimages.com

Teaching Mindfulness to Kids

As an increasing number of adults explore the practice and benefits of mindfulness, you may begin to wonder if this technique can benefit kids as well.

The simple answer?

ABSOLUTELY!

But how do we teach our kids to practice mindfulness in a way that is both age-appropriate and effective? Let’s start by reviewing what mindfulness is, and then take a look at some tips for teaching mindfulness to kids.

Mindfulness: What is it and why is it helpful?

Mindfulness is most often defined as one’s personal awareness of present feelings, thoughts, experiences, and environment. It is a mental state in which a person becomes purposefully conscious of what is happening both inside and outside of his/her body at any given moment. This state of awareness involves acceptance and is free from judgment. Mindfulness is the practice of recognizing what is happening right now, without labeling thoughts as “right” or “wrong” and without trying to change anything. Numerous studies find the benefits of mindfulness to include a decrease in stress, depression, and anxiety as well as an increase in focus, attention, and self-regulation. Performing a mindfulness exercise will not only bring about a sense of calm in one specific moment but will also better prepare your body and mind to react more calmly in future moments of stress. With regular practice, mindfulness can eventually lead to improved coping skills and an overall increased sense of daily contentment.

Tips for teaching mindfulness to kids

  1. Model mindfulness
    • As a parent, you are your child’s best teacher! By committing to the practice of mindfulness yourself, you will not only help your child to learn these new skills, you will also begin to feel the benefits within your own life.
  2. Practice mindful breathing
    • One of the best ways to begin exploring mindfulness (for adults and children) is to practice mindful breathing. Find a quiet space to sit with your child and take a few moments to just pay attention to your breath. Set an expectation that together you will take five big breaths and you will both try very hard to pay attention only to those breaths. Help bring your child’s awareness to his/her breathing with questions such as: Where can you feel it? Does it make any sound? What parts of your body move when you breathe?
  3. Take a mindful walk
    • Just as with the breathing exercise, it will be helpful to set expectations before taking part in this practice. Tell your child you will take a walk together and during this walk you are going to pay close attention to what you see, what you hear, and what you feel. You can even turn this into a game to make it more fun: “Let’s see how many birds we hear while we are walking today!”To help your child focus during this practice, talk as you walk: “What do you see? What do you hear? What do you feel?”It is also helpful to draw your child’s attention specifically to things you notice. “I hear a dog barking. I feel the wind blowing on my arms. I see three ants walking on the sidewalk.” As you walk, try not to linger too much on any particular feeling or sensation. Identify what you notice, pause, and then move on.
  4. Stay simple
    • Be sure to practice mindfulness at a level appropriate for your individual child. Young children will benefit from language that is more familiar than “mindful” or “conscious.” Instead you can use words such as “listen,” “look,” or “notice.” The focus of this practice is not on the specific language used but on the awareness in a particular moment. Start with simple words and as your child grows (in both age and mindfulness knowledge) you can start to add in more complex language.
  5. Make mindfulness part of your routine
    • Set aside a set amount of time each day to practice mindfulness with your child. You can start by setting the goal to practice mindfulness for 5 minutes each day—adding this time before or after something that is already part of your daily routine. Perhaps mindfulness can become part of your bedtime routine, or maybe it is something you can try every day before dinner. Remember: mindfulness is not just a tool to be used in times of stress. It is most beneficial when incorporated regularly throughout your family’s daily routine. Practice until it becomes habit!

More resources

Check out this website (Guided Meditation for Children) for some freeguided meditations for children and more information on mindfulness!

Questions or concerns?

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

Stephanie Wroblewski, LCSW
Licensed Clinical Social Worker

Reference: Wedge, M. (2018, September 18). 7 Ways Mindfulness can Help Children’s Brains. Retrieved from https://www.psychologytoday.com/us/

Photo Credit: khamkhor via pixabay.com

Tips for a Successful IEP Meeting

Whether your child is transitioning from the Early Intervention program to the public school system, or they have recently qualified to receive services through the school, it is important to set them up for success by advocating for them at their annual Individualized Education Program (IEP) meeting.

What is an IEP?
An IEP, or individualized education program, is designed to create a plan to ensure your child receives a free and appropriate public education in the least restrictive environment (LRE), as is mandated by the Individuals with Disabilities Education Act (IDEA). A meeting is held once a year at your child’s school to create, review, and or adjust this plan to best serve your child’s learning needs.

What can I expect?
There may be several professionals at the meeting including your child’s teacher, the special education teacher, your child’s therapists, the principal, and a representative of the school district. The team (which includes you!) collaborates and shares your child’s present level of development and what progress has been made in the last year. They discuss goals for the coming year and what services and accommodations may be beneficial and necessary.

What can I do?
1. Ask questions if you do not understand something. Every profession has their specific jargon, and it is easy for professionals to slip into the alphabet soup (IEP, LRE, IDEA, OMG!). Read over your copy of your rights that they provide and have the team review any portion you do not understand. Understanding the jargon and knowing your rights sets you up to successfully advocate for your child.

2. Bring ideas with you to the meeting about what you want for your child. This will help keep the goals relevant to your child rather than using goals that are too generic. You are a valuable and necessary contributing member of the team since you are the expert on your child. They need more from you than just your signature on forms. They need your input about your child’s strengths, areas of challenge, and what has or has not worked in the past.

3. Voice your concerns. This applies to during the meeting and also throughout the year. If you feel something is not working after an appropriate amount of time, ask to brainstorm other strategies and approaches. Remember that the laws say your child should lean more towards inclusion in a typical classroom (LRE).

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

Becky Clark, MS, DT
Developmental Therapist

Reference: Cheatham, G.A., Hart, J.E., Malian, I & McDonald, J. (2012). Six things to never say or hear during an IEP Meeting: Educators as Advocates for Families. TEACHING Exceptional Children, 44(3), 50-57.

Wrightslaw (2007). IDEA 2004 Roadmap to the IEP, IEP Meetings, Content, Review and Revision, Placement, Transition & Transfers.http://www.wrightslaw.com/idea/art/iep.roadmap.htm

Photo Credit:Photo by mentatdgt from Pexels

DR. DR., Give Me The News: What is a Neuropsychological Evaluation?

A neruo what?! Why does my child need this? Does that mean my child will have a diagnosis? What are they testing for? How long will it take? Will my child need medication? A neuropsychological evaluation can raise many questions and concerns for families. The information below can help provide some clarity about what a neuropsychological evaluation is and if your child would benefit from one.

What is a neuropsychological evaluation?

A neuropsychological evaluation is a test completed by a licensed clinical psychologist and may include additional providers, such as an occupational therapist or social worker, from a multi-disciplinary team approach. The team will interview the child’s parents, in addition to any other adults that may be able to provide feedback about the child (e.g. therapist, teacher). The evaluation is a series of tests, both written and verbal, which are completed over the course of several sessions and all appointments can vary in length of time. These tests help to better understand the brain development, strengths, and weaknesses of that individual.

What does/can it test?

The evaluation is recommended for children over the age of five. The initial and primary concerns will determine the exact tests administered throughout the evaluation. Generally, tests assess academic functioning, attention and executive functioning skills, and motor functioning. These skills are essential for children to establish and develop in order to fully function in a classroom setting independently. The evaluation also monitors the child’s sensory profile in addition to their social-emotional development.

What about the diagnosis?

It is possible that your child might receive a diagnosis after the evaluation (e.g. ADHD, anxiety, autism spectrum disorder). Any diagnosing information will come from the Diagnostic and Statistical Manual of Mental Disorders, 5ThEdition (DSM-5). This information can often be difficult for families to accept and understand what it actually means. Receiving a diagnosis does not always mean that your child will have that diagnosis forever; however, many neurological disorders are often influenced by brain structure. A diagnosis can provide answers, information, and recommendations for your child and family. The information can better support your child’s care team to provide an Individualized Educational Plan (IEP) within the classroom setting and additional therapeutic services which may only be available through insurance. If your child is recommended medication at the evaluation, talk with your current treatment team of providers and your child’s primary care doctor, to see if and when beginning medication is the right step for your child.

Who can it help?

These evaluations can help provide the child, family, and support teams with a detailed description or a “blue print” of how the child’s brain works. These reports include specific recommendations for each child at home, in the classroom, and within the community as needed. Sharing your child’s neuropsychological report with their school, doctor, and therapists will ensure your child’s care team is working collaboratively to achieve the targeted goals.

Questions or concerns?

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

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

Photo Credit: Berzin via pixabay.com

Baby Boot Camp: The Importance of Tummy Time

Tummy time promotes development, strength, and a new visual perspective for your baby. Growing babies require many hours of sleep, which means your baby spends a large amount of time on his or her back to maintain a safe position while sleeping. Tummy time is pivotal during waking hours to strengthen the head, neck, and shoulder muscles and promote head control. Tummy time also gives your baby a fresh new perspective on the world as they can interact with toys and reach for objects in the environment. Tummy time is fundamental to your baby’s development and builds skills that promote later milestones of rolling over, crawling, and playing.

Getting started with Tummy Time

Tummy time can be started at any age, it is even recommended for newborns! Tummy time should always be a supervised activity. Gradually introduce your baby to tummy time by placing them on your stomach or chest in a reclined position such as laying on the couch. This allows your baby to continue bonding and interacting with you and may help them tolerate this new position. Start with short intervals on a safe and firm surface, such as the floor, for two to three minutes per day. You can progress up to 20 to 30 minutes of tummy time per day depending on your baby’s tolerance. Aim for tummy time at a time of day when he or she is alert, such as after nap time. Remember to always pay attention to your baby’s needs and look for signs of tiredness, such as crying or laying their head down on the floor.

How can I promote a successful tummy time experience?

  • Provide extra support with a bolster
    • Try rolling up a thin towel or blanket to make a bolster
    • Place the bolster under your baby’s chest with his or her arms positioned over the roll and hands in front
    • Always keep your baby’s chin in front of the roll to ensure their airway remains open
  • Promote weight bearing
    • Make sure your baby distributes his or her weight to both sides of the body in order to equally strengthen
  • Promote reaching for play
    • Get down on the floor with your baby to promote engagement and motivation
    • Hold a toy in front of your baby to encourage head control and reaching
    • Place toys in a circle around your baby to promote reaching in all directions
  • Try out other positions
    • Side-lying: Lay your baby on his or her side and support their back with your hand or a rolled towel. Place your baby’s arms out in front to promote reaching and play in this position.
    • Airplane: Lay down and hold your baby in your arms while he or she is on their belly. This a fun and motivating new perspective for babies with head control.
  • Make tummy time a routine
    • Incorporate tummy time during everyday tasks such as diaper changes, songs, toweling off, or reading a book.
    • Try burping your baby with him or her laying across your lap on their tummy
  • Make it a multi-sensory experience
    • Use a visually stimulating blanket or towel
    • Try placing your baby on a variety of textured blankets or mats
    • Use a mirror to motivate your baby to lift his or her head to see their reflection and encourage self-recognition
    • Alternate between various safe surfaces in your home such as carpet, tile, or wood

What are red flags to look out for? 

  • Pay attention if your baby shows a head preference. For optimal development, your baby should look to both sides equally. Does he or she have a strong preference towards one side?
  • Does your baby have difficulty weight bearing on one side of the body? For development, it is important that your baby strengthen both sides of the body and weight bear equally through both hands and arms.
  • Does your baby have a flat patch on the side or back of the head? Is your baby’s head asymmetrical? Flat patches may develop due to a strong head preference or increased time spent on their back.

If your child is demonstrating some of the observations above, consider contacting one of our occupational therapists or the Illinois Early Intervention system for more information.

Questions or concerns?

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

Robyn Geist, MS, OTR/L
Occupational Therapist

Reference: Pumerantz, Christa & Zachry, Anne (2018). Tips for living life to its fullest: Establishing tummy time routines to enhance your baby’s development. American Occupational Therapy Association.

Photo Credit: Moswyn via iStock.com

Is My Child Stuttering? How to Identify Typical Disfluencies Versus Red Flags for Stuttering

As a pediatric speech and language pathologist, I often find myself listening as a child tells me, “my mom – my mom – my mom – my mom – likes green!” You may find yourself in a similar situation, waiting for your child’s response, as they repeat sounds, parts of words, whole words, or even phrases. Now, how much of that is typical? The information below will help you determine whether your child’s fluency is characteristic of their age and stage of development, or if there are red flags for stuttering present.

What is Disfluency

A disfluency is anything that interrupts the forward flow of speech. Within every person’s speech, children and adults alike, there are disfluencies present. As adults, we become acutely aware of these disfluencies during times of increased pressure, such as during an oral presentation or an interview. Even something as simple as taking a big breath, sneezing, or coughing can impact our fluency. Some types of disfluencies are typical, while some may be indicative of something more significant, such as a fluency disorder (i.e. stuttering).

So, what is typical disfluency?  

Typical disfluencies include repetitions of whole words (my – my dog is small) or phrases (can I – can I – can I go outside?). They also include interjections (um, like) and revisions (I went to the – I saw a chicken at the farm). With typical disfluency, the speaker does not demonstrate physical characteristics of difficulty, such as increased tension in their face or body.

Developmental Disfluency

Children may have periods of increased disfluency from two to five years of age, as these are years of significant expressive language development. Between these years, children often transition from using single words and two-word phrases to engaging in adult-like conversations. This is sometimes referred to as “preschool stuttering” and consists largely of the typical disfluencies outlined above. If your child is using mostly typical disfluencies in their speech, does not have negative feelings about their fluency, and does not appear to be physically struggling to complete their sentences, then it is likely typical and not cause for concern at this time.

Stuttering

If a fluency disorder or “stuttering” is present, it can lead to breakdowns in communication, which can impact your child’s participation across settings.

What are the red flags for stuttering?

  1. A family history of stuttering is present
  2. Your child is a male
  3. Your child is repeating sounds (b-b-b-ball) or syllables (break-break-fast) in addition or instead of words and phrases
  4. Your child is prolonging sounds (sssssoup)
  5. Your child has periods of time when they are trying to speak, but no words are coming out
  6. Your child appears to be tense or struggling while talking
  7. There are observable secondary behaviors present (i.e. blinking eyes, changing pitch or volume, grimacing)
  8. Your child has negative feelings regarding their speech
  9. Your child is avoiding speaking in general or speaking in certain situations
  10. Your child has been stuttering for over six months
  11. Your child has other speech and language related concerns
  12. Your child began presenting with significant disfluency after three and a half years of age

What can I do?

If your child is demonstrating some of the behaviors above, consider contacting a speech and language therapist who can provide your family with helpful tips and tricks to encourage fluency, or recommend therapeutic intervention as necessary. In the meantime, visit The Stuttering Foundation’s website for tips for talking with your child.

Questions or concerns?

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

Ana Thrall Burgoon, M.S., CCC – SLP 
Speech-Language Pathologist

Reference:

Coleman, Craig. “How Can You Tell if Childhood Stuttering is the Real Deal?” LeaderLive, ASHA, 26 Sept. 2013.

Photo Credit:Limor Zellermayer via Unsplash

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

Feeding our Senses: What is a Sensory Diet?

Does your child love to run, swing, and jump? Engage in messy play with finger paint and shaving cream or seek out hugs and cuddles? Or perhaps they prefer to watch other children navigate the rock wall at the playground or quickly wipe their hands clean when dirty? Our sensory systems are responsible for how we take in sensory stimuli from our environment, process and interpret the information internally, and produce appropriate responses. We rely on proper functioning of eight senses (yes, eight!) to maintain a regulated state, in which we are better able to understand, interact with, and grow within our environments.

What are the eight sensory systems?

  1. Sight: helps us process what we see
  2. Hearing: helps us detect and process sounds, beats, and frequencies
  3. Smell: helps us detect and process scents and odors
  4. Taste: helps us process and distinguish between different tastes
  5. Touch: helps us process and understand how things feel on our skin, such as soft or hard, hot or cold
  6. Vestibular: provides us with a sense of balance, movement, and an awareness of orientation in space
  7. Proprioception: provides information about position and movements of our muscles and joints, including pushing, pulling, and deep pressure sensations
  8. Interoception: provides an internal sense of how our organs feel, such as hungry or thirsty, our sense of temperature, our feelings of pain, and when we need to use the bathroom

What happens if our sensory systems do not process stimuli correctly or efficiently?

When our brains are unable to make sense of the information our bodies receive, we often respond to the environment in inappropriate or unexpected ways. While the reactions formed in this disorganized state, often referred to as deregulation, present differently for every child and depend on both the type and number of sensory systems affected, responses often aim to find more of (seek) or stay away from (avoid) input. Examples include but are not limited to:

  • Sight: excessively looking at moving, spinning, or shiny objects; appearing bothered by bright lights
  • Hearing: appearing to ignore people when spoken to; becoming distracted in noisy settings; covering ears in response to loud noises
  • Smell: showing heightened sensitivity or aversion to scents and odors; may impact feeding routines
  • Taste/oral: preferring a limited variety of foods; difficulty trying new foods; excessive drooling
  • Touch: difficulty tolerating having nails trimmed or wearing certain clothing textures; refusing to touch or play with various textures, such as grass, sand, finger paint, or Play-Doh; wiping hands clean immediately after getting dirty
  • Vestibular: appearing to excessively enjoy or look for movement opportunities (running, jumping, rocking, etc.); seeming clumsy; appearing fearful of ordinary movement, such as when both feet are off the ground (e.g. swinging)
  • Proprioception: biting or chewing on non-food items; excessive bumping into, pushing, or hitting peers or objects in the environment
  • Interoception: not feeling full after eating; missing the urge to use the bathroom at the appropriate time

These sensory responses may lead to overarching difficulties with a child’s ability to attend to academic activities in the classroom, maintain balance and coordination, plan and sequence novel tasks, build social relationships, perform self-care activities, such as dressing and feeding tasks, and participate in family routines and schedules.

Sensory diet: what is it and how can it help?

A sensory diet is a carefully designed series of sensory-based activities in which a child is encouraged to participate to increase regulation and attention throughout the day. Much like we eat healthy foods to give our bodies the nutrients they need, sensory diets are made to meet the specific sensory needs of each child. While sensory diets typically incorporate touch, movement, and proprioceptive input, strategies targeting any sensory system can be included to promote optimal regulation. Sensory diets are often organized into schedules based on a child’s daily routines, activities, and family plans to maximize participation and success and can be easily modified as the child’s needs change over time. See below for an example of a sensory diet:

If implemented correctly, sensory diets provide consistent access to specific amounts of sensory input needed throughout the day and result in more appropriate responses to environmental stimuli over time. When successful, children are better able to participate in meaningful activities and daily routines, develop important foundational skills, and more effectively understand and engage in the world around them.

Questions or concerns?

If you have questions or concerns about whether your child may benefit from a sensory diet, please contact us at info@playworkschicago.com or 773-332-9439.

Caitlin Chociej, MS, OTR/L
Occupational Therapist

References:

Bodison, S., Watling, R., Kuhaneck, H.M., & Henry, D. (2008). Frequently Asked Questions About Ayres Sensory Integration. American Occupational Therapy Association. Retrieved April 14, 2019 from http://www.aota.org/Consumers/WhatisOT/FactSheets.aspx.

Smith Roley, S., Mailloux, Z., Miller-Kuhaneck, H. & Glennon, T. (2007). Understanding Ayres’ Sensory Integration. OT Practice 12(7).

STAR Institute for Sensory Processing Disorder. (2018). Your 8 Senses. Retrieved April 14, 2019, from https://www.spdstar.org/basic/your-8-senses.

Photo Credit: Sharon McCutcheon via Pexels

Ouch! My Child is Biting!

It is never a fun moment when your child’s teacher calls, informing you that your child bit a classmate. Or what about when your child bites you or their siblings? Biting is a stressful experience for everyone involved. Let’s discuss why it may happen and what can be done to prevent it.

Is biting normal?

While not every child will bite, it is a very common behavior in toddlers. Biting usually stops by three or three-and-a-half. However, just because it is a normal stage of development does not mean it is an acceptable behavior. In order to try to prevent age-appropriate biting, we first need to try to understand what may trigger it.

Why is my child biting?

Toddlers are experiencing so many new feelings, both physically and emotionally, during this time in their development. These changes could lead to feeling the need to bite. Understanding why your child may be biting may help you support them from biting.

  • Teething – This can be a painful process, especially getting those two-year-old molars, and sometimes clenching their teeth on something (or someone) helps relieve the tension they are feeling in their mouths.
  • Sensory needs – Our bodies seek out what it needs in many different ways. Some children’s mouths need more stimulation to feel “awake” or regulated. Their bodies may also need more large muscle activities, such as running, climbing, and jumping to release that tension and energy they are releasing with their jaws.
  • Big emotions – Have you ever been so excited or angry that your clench your jaw or fists? Luckily you have the inhibition skills to avoid biting those around you in those moments. Toddlers are learning about a lot of new feelings and how they make their body feel. Sharing, tiredness, fear, and overstimulation are really tough to navigate when you’re just learning and can be overwhelming. Toddlers are also learning to be more independent from their caregivers and recognizing that things they want may not be what the people around them want for them. That causes frustration that may lead to biting too.
  • Few words – Toddlers are also learning language skills. Often times their communication skills are not developing as fast as the large emotions mentioned earlier. Biting can be an effective way to get a point across when they do not have the words to do so. You may see more biting in children who have a language delay.

What can I do?

  • Do some detective work – Are there any patterns to your child’s behavior? Do they tend to bite before lunch/nap time? Is it when other children encroach on their personal space? Have there been recent changes to their regular routine or family dynamics? By noting when biting happens most often, it may prompt you to give extra support during those times, such as offering a snack, making naptime a little earlier in the day, or having two of the same item to assist with sharing.
  • Offer an alternative – If your child is biting due to teething or sensory input, redirect them to a chewy tube or teething ring. Sometimes a wet washcloth kept in the refrigerator or freezer offers a soothing sensation to chew on for sensitive gums.
  • Model appropriate language – As mentioned before, sometimes biting gets a message across faster than words can come out. Help teach your child the power of words by modeling language they can use. For example, “I need space!” “Move, please” “My turn!” Encourage them to ask for help from an adult if their words are not enough with their peers.
  • Read books – There are many children’s book about biting, such as Teeth are not for Bitingby Elizabeth Verdick. Reading together can provide the opportunity to talk through situations without the intense emotions of the moment.
  • Reinforce expectations – Remind your child that, no, biting is not allowed. Be firm, but try to not to express anger. You want your child to know that you do not approve of the behavior, but that you still love them. Remember to replace the unwanted behavior with the preferred behavior. Example: “Ouch! It is not okay to bite. Biting hurts. You can bite this teether instead, but you may not bite your friends.”
  • Wash, rinse, repeat – Children learn through repetition. They may not remember to stop biting after the first time you redirect them. Or the fifth. Like learning any new skill, it takes time, practice, and patience. Remember that children’s inhibition skills are still developing until age four, even if they know what they are doing is wrong. And to be honest, some of us adults are still mastering avoiding the things we know are not good for us!

Questions or concerns?

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

Becky Clark, MS, DT
Developmental Therapist

Reference:Zero to Three. (2016, February 22). Toddlers and biting: finding the right response. Retrieved April 8, 2019, from https://www.zerotothree.org/resources/232-toddlers-and-biting-finding-the-right-response.

Lieberman, A. F. (1995). The emotional life of the toddler. New York: Free Press.

Photo Credit: PublicDomainPictures from Pixabay