Tag Archives: pediatric speech therapy

How to Expand Your Child’s Play!

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Play is highly correlated to your child’s cognitive and speech and language development and is a great way to bond with your little one! Many parents are challenged by how to play with their little one and get involved in their world. Not only is learning to play important, but equally important is the expansion of your little one’s play.

Some toddlers get “stuck” in wanting to play with a toy in only one or two ways. Toddlers who play with a toy in a limited number of ways are showing us that they do not quite understand the function or multiple functions of a toy. Take for example a child who only moves a car back and forth on a table. This little one is showing us they understand that the car can move, but they are not yet aware of all the other things we can do with that same car. We can drive the car up the couch, it can crash or fall, the car can get gas or a car wash, pick up pretend toys and animals, or take us to different places like the grocery store or to see friends and family.

Why Do We Want to Expand Play?

Expanded play shows us your little one’s expanded understanding of the world. Play allows adults to label and model actions that your child is completing, in turn, helping your child’s speech and language skills develop.

The higher levels of play your little one demonstrates, the more they understand their world and the more language they have. If a child is playing with an object in just one way, there is a limited amount of words we can use to talk about that play interaction. For example: Your little one hands you a ball. You could say: “Ball!” “Look, ball.” “Red ball.” “Big ball.” If your child throws a ball to you, you can add “Throw ball.” “Bounce!” “Go ball!” “My turn!” “Your turn” and so much more. By expanding from showing to playing, there are SO MANY more words we can use to support your little one’s vocabulary development!

Tips for Expanding Play:

  1. Get on your child’s level:Sit on the floor or at the table together so you are physically at the same level as your child. Being on the same level also increases your eye contact and is easier to share attention with your child.
  2. Follow their lead:If your kiddo is playing with a car, you play with a car too! Try finding another of the same toy so you each have a toy and you don’t have to take turns.
  3. Add ONE play idea at a time:Sometimes we get a little over-zealous showing our kids 50 different ways to do something—it can be overwhelming. Remember expanding play is a gradual process and each child learns at their own pace. Your little one might need you to show something once or they might need some more help to copy your play—that is okay. Start by adding ONE step. Your child shows you a ball. You roll the ball back to them. Once your child is imitating one action, show them something new (try bouncing the ball)!
  4. Keep your language simple: We want to say one word above what our child is saying. If your little one says, “Ball” add an action word to describe how you are playing: “Ball go!” “Bounce ball.” etc. If your little one isn’t saying anything yet, just label the object or the action, or even just make a silly sound (slurping if you’re playing with a pretend cup)!
  5. Don’t force it:If your little one is getting frustrated that you are changing their play, show them one more time and move on. We want to keep play fun, exciting, and enjoyable for both of you! If your little one abandons an activity, move with them or take a short break and join them later to play again.

For more info on play and play milestones, check out some of PlayWorks’ previous blog posts:

Play in speech and language therapy: http://playworkschi.wpengine.com/toddlers-speech-therapist-playing-child/

Toy guide for babies through toddlers: http://playworkschi.wpengine.com/toy-guide-babies-toddlers/

Jessie Delos Reyes, MA, CCC-SLP
Speech-Language Pathologist

Image: https://www.sheffield.ac.uk/news/nr/want-to-boost-your-toddlers-development-put-a-toy-chicken-on-your-head-1.485117

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

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

Playing with Books!

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Children’s books can be used at any stage of development to facilitate improvements in both expressive and receptive language skills. Today, we will be focusing on building preverbal skills and eventually eliciting first words by playing with books. Before children begin to use words, they use gestures to communicate. They then begin to pair these gestures with vocalizations to obtain desired items or actions, and eventually use animal noises, exclamatory phrases, and sound effects in play.

Books are filled with a variety of age-appropriate pictures that are easy to pair with gestures and sounds. Pick one or two pictures per page so that your child can start to do them spontaneously. If they are not copying your gestures right away, do not be afraid to take their hand and help them “beep beep” on the truck or “tickle tickle” a baby’s feet.

Below, I have attached a table with examples of common pictures found in children’s books and what I might do when I see them.

Once your child builds their imitation of gestures and sounds, they might begin to fill in routine phrases, which come up often in repetitive books. As your child becomes familiar with the book, you can pause and have them fill in a word. For example, in Brown Bear Brown Bear, each page ends with, “What do you see?” You can set the child up to fill in that phrase by saying, “what do you…” and looking at your child in anticipation.

Have fun!!

Ana Thrall, MS, CCC-SLP

Speech-Language Pathologist

Taking the Pressure off Talking!

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If you are a parent who has tried implementing some of the language strategies your speech therapist has taught you with your little one- only to end in your child running off or having a meltdown- this blog is for you! Often the reason for these meltdowns is due to pressure. Not only the pressure put on your child but also the pressure you put on yourself. Below are three strategies for ways to encourage language development while avoiding a meltdown.

  1. Finding your child’s limit- Knowing how much you can push a child can be tricky. We want to encourage and challenge our little ones, but not to the point that we see a meltdown. Try starting with something that is easy for them and make slow, gradual changes to increase the difficulty. The moment you notice your child is at their limit pull back. It’s important to keep in mind that your child’s limit can change daily or even by activity and we may need to adjust accordingly.
  2. Play- The best way to encourage language development in our little ones is to play! Rather than planning a specific activity, think about what toys or activities your child loves and how you can incorporate language into that. If it something that they like then they will be more interested and engaged and you will be more likely to avoid a meltdown. If your child loves trucks- play with trucks. You can practice the sounds that they make or talk about their size and color. If you’re having fun then your child will too!
  3. Get moving- Sitting for extended periods of time can be hard for toddlers., so incorporate movement into your activities. This is a great way to engage your child and keep their attention while avoiding a tantrum. If you’re doing a puzzle you can put the pieces on the other side of the room so your child has to run to go get each piece or you could make an obstacle course out of pillows and blankets and work on following directions.

By taking the pressure off talking you will see your child become more engaged and eager to participate. I hope these strategies are helpful and as always if you have any questions or concerns, please feel free to contact us!

Claire Kakenmaster, MS, CCC-SLP
Speech Language Pathologist

Infant Sign Language and Your Child

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Is it okay to use infant (“baby”) signs with my child?

Throughout my time working with families and talking with friends, I have come across a common misconception or worry that the use of infant sign language will slow or even prevent verbal language development. However, that is simply not the case.

So, quick answer to the title question above: Absolutely yes!

A language is a system of symbols that signify meaning to others, specifically those that understand that same system. A sign is a symbol just like a verbally spoken word is a symbol. So regardless of mode, signing ‘more’ or saying, “more” aloud, they are using a specific symbol to communicate a specific want or need.

The recommendation is for infant signs to be introduced to typically developing babies around six to eight months of age. Their use has been shown to reduce frustration (both parent and child) and facilitate language development. They also play a huge role with babies/toddlers that have delayed speech-language development.

Children learn to imitate and use gestures (like waving, pointing) before they learn to imitate and use sounds in words. Signs come in especially handy during this time, when children have the capacity to use language, but their mouths cannot yet execute the complex movements required for speech. The use of these signs facilitates joint attention, teaches cause-effect, builds imitation skills, and helps establish bonds between child and caregiver, all of which are vital skills preceding use of sounds and words.

It is in our nature to take the path of least resistance, that is, as soon as kids are able to use words, they drop the infant signs. Many times, the signs that they were using consistently become their first verbally spoken words.

Please see below for a few examples of infant signs (images via Boardmaker).

Ana Thrall, MS, CF-SLP

Speech-Language Pathologist

Frequently Asked Questions about Augmentative and Alternative Communication (AAC)

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What is AAC?

AAC is a term used to describe any method of communication that adds to or “augments” speech. This can include anything from signs and gestures, to picture symbols or even high-tech devices involving computer technology.

Will AAC impact language development?

The use of AAC will not delay or impede language development, and often can help improve spoken language. It also allows for many individuals to express themselves fully when spoken language may be difficult.

Who uses AAC?

Anyone who has difficulty expressing themselves via spoken language may benefit from AAC. AAC users may have limited spoken language, unclear speech, or find spoken language difficult in social settings. The cause of the communication impairment may be present at birth (autism or cerebral palsy), occurring later in life due to injury or illness (stroke or head injury), or may worsen throughout the person’s life.

How do I know if AAC is right for my child?

Your child’s speech-language pathologist (SLP) can help guide you through the decision process. You may notice that your child is already using simple AAC such as signs and gestures in his therapy sessions. If a more robust system would be beneficial for your child, your child’s SLP may recommend a more comprehensive evaluation in which various professionals can help select the most appropriate system.

Meryl Schnapp M.A., CCC-SLP
Speech-Language Pathologist

Why is My Toddler’s Speech Therapist Only Playing with My Child?

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The importance of play in language development

Many parents are confused when their birth-to-three speech therapist arrives and begins talking about “play skills” instead of “speech skills.” Do not fret! Speech and play skills are HIGHLY related. Play, and more specifically pretend play, gives us a look into your child’s world. Play skills demonstrate your child’s cognitive skills, which are your child’s ability to think, process language, play attention, learn, and plan their next move. All of these skills are essential for speech and language development!

Let’s break it down!

 

There are four basic types of play: Exploratory, Functional, Constructive, and Pretend.

Exploratory:  using senses of touch, taste and smell to learn about new objects. This begins when your child has intentional control over their body. Children who enjoy shaking, mouthing or smelling new objects are in the exploratory stage.

Functional: using toys and objects as they were intended. Functional play, such as is using a spoon to stir, racing cars or rolling a ball. Pay attention to whether your child is using an object or simply enjoying watching one part of the object, such as wheels turning.

Constructive: manipulating objects to make something new. This stage of play includes more trial and error to see how pieces can work together with a final goal in mind. Constructive play includes building train tracks, assembling and disassembling blocks and other toys, or sorting shapes and objects.

Pretend or symbolic: using objects in imaginary ways. Such as, pretending your hand or a block is a phone, emptying a box to make a doll a bed or bathtub, pretending a baby is crying and soothing a baby, or making a pretend steering wheel for a car. Children who dress up and act like a specific person are also engaging in pretend play.

Why is it important?

If your child is using functional play then they are demonstrating an understanding of what objects are and why they are used. When your child uses pretend play, they are demonstrating symbolic understanding of one object for another object. Words are also symbolic! Words are a symbol to represent objects, people, events, feelings, and physical states. If your child is using objects for another object, then your child demonstrates understanding that words have symbolic meaning and the cognitive skills for using words meaningfully!

Children who are using words, but are not yet playing functionally or symbolically, likely do not yet have a solid understanding of word meanings and may have difficulty using the same words in a variety of contexts. For example, think of all the ways we can play with a ball: we can roll, throw, or bounce a ball. There are different balls for different sports, or we could even pretend a ball is an apple. A child who only knows “ball” for labeling or does not yet play with a ball meaningfully is not understanding what that toy is used for and how it can be related to other objects or people. Children who are not using pretend play by the time they are two years old are at risk of cognitive and speech and language deficits.

Ways to help your toddler!

Meet your little one where they are with play. If your child is still in the exploratory phase, try modeling constructive play (fill and dump or assemble and knock down) and functional play to begin showing how objects go together. For example, a spoon can be used for stirring or eating food, but we don’t use a spoon to wiggle in front of our face.

Once your little one has some early play skills, get creative and add additional prompts or a new way to play. Pretend food, animals and baby dolls are some of my favorite toys for pretend play!

For more information on pretend and symbolic play, check out a previous blog from Kim Shales, our director of developmental therapy.

If you have further questions or concerns, call PlayWorks Therapy, Inc. for a full speech and language evaluation.

Jessica Delos Reyes, MA, CCC-SLP

Speech-Language Pathologist

Image: https://www.google.com/search?q=pretend+play&source=lnms&tbm=isch&sa=X&ved=0ahUKEwirjJi9097WAhUi3YMKHdKuDyQQ_AUICygC&biw=1198&bih=700#imgrc=-kgdDwYHFdD1kM:

What is joint attention and how can I work on it with my child?

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Joint attention is the shared focus of two people on an object. It is achieved when one person alerts another to an object via eye contact, pointing, or other verbal or non-verbal means. Joint attention is an important part of learning language, because we learn through interaction with other people. Language is ultimately a social way of interacting, and in order to communicate with others we must first demonstrate the social skill of jointly attending with them. When a child does not independently engage in joint attention it is important to target this skill to increase their ability to absorb language and other developmentally appropriate skills.

Strategies to encourage Joint attention include the following:

  • Give your child objects at your eye level to encourage eye contact
  • Try to be at your child’s eye level while playing
  • Play social games such as peek-a-boo, pat-a-cake, hide and seek, etc.
  • If your child becomes overly focused on a toy, tap them and say their name to remind him that you are there and playing with the toy too.
  • Use animated voices and exaggerated faces while playing. Animated voices and faces are fun for kids and will create a positive experience that may encourage future eye contact.
  • Use verbal routines such as “ready, set…go!” to alert your child that something exciting is about to happen. This should encourage them to look towards you to find out what that is.
  • Do what your child likes. They will be more likely to wish to interact with you if you are doing something that is fun for them.

Activity ideas to practice joint attention:

  • Peek-a-Boo: Peek-a-Boo is a fun social game that encourages turn taking and eye contact.
  • Bubbles: Bring the bubble wand to your eyes before blowing a bubble to encourage your child to look at you. Once they look at you blow bubbles as a reward. To make the game more interactive you can move around the room and only blow more bubbles when your child follows you and looks at you.
  • Scavenger Hunt: Hide objects around the house (or a specific room) and try to find them together. When you find an object point and say “look!” to encourage your child to jointly attend to the object with you. You can then bring the object to your eye level to encourage eye contact. If they find something celebrate while standing/sitting/laying at his or her eye level.
  • Choo-Choo Train: Lay your child on their back and hold their legs while leaning over them. Say: “the train is going up the track” while lifting their legs in the air. Say: “the train is going down the track” while bringing their legs down to the floor. Repeat this several times. Then push their legs in and out while saying “chuga chuga chuga chuga chuga chuga”. When your child makes eye contact with you say “choo-choo!” while lifting their legs into the air. (activity credit: Laura Mize teachmetotalk.com).
Katie Dabkowski, MS, CF-SLP
Speech-Language Pathologist

Speech and Language Milestones: Ages 3 to 5

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We’re concluding our discussion of typical language development and red flags for communication difficulties for children ages birth to 5! Below you will find a list of age-appropriate speech and language skills for children 3 to 5 years old (36 to 60-months). If you have questions or concerns about your child’s speech and language development, feel free to contact us at info@playworkschicago.com or 773-332-9439 to set up an evaluation.

 

Kelly Fridholm, MCD, CCC-SLP

Speech-Language Pathologist