Imitation- A Fundamental Skill A Toddler Needs For Expanding Play & Language Development

Ever heard of the saying, “monkey see, monkey do?” Not only is imitation the best form of flattery, but it is also one of the most crucial steps in a child’s language development.

One of the most frequently asked questions by parents is “why isn’t my child using words yet?” With a closer look at your child’s overall language skills, a Speech Therapist will first evaluate your child’s ability to imitate gestures. They may ask “is your child a copycat?”

Learning how to be a “copycat” is a fundamental skill a toddler needs for expanding play, understanding concepts, learning social cues, and saying new words! A child must present with strong gestures before they start to use words and sounds.

Does your young child copy at least 12 gestures throughout your daily routines? The earliest of gestures begin as soon as 9 months old. Research with young children indicates that the development of gestures from 9 to 16 months predicts language ability two years later, which is significant because preschool language skills predict academic success (First Words Project, 2014).

Is your child able to imitate at least 12 of the gestures below?:

• Reaching hands to be picked up.

• Holding hand out to show an object.

• Shaking head “no” or “yes”.

• Waving hi or bye.

• Blowing a kiss.

• Giving high five.

• Pointing.

• Clapping.

• Using index finger for “shhh”.

• Head nods.

• Thumbs up.

• Holding hands up to question “where are you” or “where go”.

• High five.

• Peace sign.

The second most frequently asked question by parents is “how do I get my child to imitate?” Infants and toddlers are the world's best copy cats. Children learn from their parents, caregivers, teachers and even television (Shriner, 2014). Below are some ideas to get your little monkeys to SEE, and then DO.

• Think of your home as your child’s primary classroom. Choose one gesture that you can incorporate in at least 5 ways throughout your daily activities.

• Include your child in your daily routine, there are endless opportunities for learning!

• Sing songs with lots of gestures. Songs are a great way to foster joint attention, imitation, turn taking and understanding of concepts.

• S L O W down - increase the amount of time between gestures. Don’t be afraid to pause and wait. Your child will be even more engaged when you give them the opportunity to contribute.

• Be silly! Big exaggerated reactions can often motivate your child to play along.

• Use real objects and visuals. The more senses you can incorporate into learning, the better a child will carryover their skills.

• Attempt to limit television. Although TV can be entertaining and a tool for teaching, kids will often imitate the good and the bad. The effects of television's overstimulation on a child may also not be recognized until several minutes later.

Written By: Speech Therapist, Rachel Baldwin, M.A. CCC-SLP

Sources:

https://www.readingrockets.org/article/baby-and-toddler-milestones-16-gestures-16-months

https://www.canr.msu.edu/news/young_children_learn_by_copying_you

The Escalation Cycle

The escalation cycle is a tool that can help us understand how our emotions work during times of big upsets. As caregivers, it can help us think about different strategies that are best to use during these different phases of an escalation. The image below shows the Escalation Cycle with examples of behavioral “warning signs” for each phase of the cycle, as well as reactions that are most helpful during each phase.

Key Takeaways:

When we are very upset, our brains are not thinking clearly and are not able to problem-solve effectively. Trying to “talk it out” or reason with a child (or anyone!) who is at the peak of an escalation is typically counter productive and only adding fuel to the fire.

Think about where your child (and yourself!) is at on the escalation cycle during an emotional escalation. Choose your reaction to their behavior carefully based on what phase of the cycle they are in. For example, if I notice my child is starting to show some small signs of frustration/escalation, I might intervene by taking a few deep breaths, offering two calming activity choices, or redirecting them to take a break and get some exercise outside.

Oftentimes the best and most efficient route to returning to the baseline phase is to simply take a break. Think about reducing the demands being placed on your child (stop asking questions, offering solutions, scolding, reduce noise/stimulation in the environment, etc.) so their nervous system can start winding down and they can access their rational thinking and problem-solving parts of their brain again. Wait to talk about what happened until you are sure they are back at baseline and in a calm and relaxed state - that will be the best time to debrief and brainstorm different choices we can try the next time the same trigger occurs.

Calming Activity Ideas

Here are a few ideas of calming activities and skills you can try with your child and see if they help support regulation. Every child and person is different, so something that’s calming to one child might not be to another. Remember, we want to teach these skills while your child is at baseline and their brains and bodies are available for learning (this is often what we are doing during OT at the clinic!).

• Deep Breathing: Use bubbles, a pinwheel, a whistle, a harmonica, etc. to learn to take deep breaths during play. Remember to breathe in through your nose, and slowly out through your mouth.

• Squeeze the Lemons: Tighten and relax your fists to squeeze the juice out of an imaginary lemon. Squeeze and count to 5, then slowly relax and shake the juice off your hands. Repeat several times.

• Dots & Squeezes: Make a ‘dot’ in the left palm with the opposite thumb and massage. Next, firmly squeeze the left wrist with the right hand. Continue to move your hand up your arm doing a series of squeezes. Repeat on the other side.

• Exercise!: Hop on a bike or scooter, run a lap around the yard, kick a ball, climb on a play structure, or do some “animal walks” (bear crawl, crab walk, frog jump, etc.). During winter months, try making an indoor obstacle course using couch cushions and pillows. For less energized exercise, try some simple stretching or a few yoga poses. Exercise is one of the greatest ways to regulate our bodies.

• Music: Talk with your child about how music makes their body feel while listening together. Some music is very alerting and gives us energy, and other music can help us calm and unwind.

• Sensory Tools: Using sensory based play activities and toys like play dough/putty, kinetic sand, a fidget popper, a visual oil drip/liquid motion timer, bouncing or rolling on a yoga ball, and swinging on a swing.

Author: Aly Bothman, MS, OTR/L

Strategies for Choosing & Organizing Toys

Babies and toddlers learn so much from exploring their environment! If their play spaces are too overstimulating, it can make learning a lot more challenging for them. Just like having a cluttered office space or pantry can feel frustrating and make it difficult to keep your attention on a focused task, having too many toys in a play space can be chaotic and make it difficult for tots and young children to develop important play skills. 

Benefits of Using an Organization System:

• Supports development of attention & focus skills by reducing distractions in the environment

• Reduces overstimulation and contributes to better regulation 

• Increases opportunities to build frustration tolerance and problem solving skills - when given less options, children play with the same toy for longer and in more diverse ways

• Improves structure and routine in the home

• Helps kids develop independent play skills and creativity

How to Organize Toys:

1. Declutter

• Think about keeping the “good toys” (see definition below) and consider removing excess over stimulating toys (battery powered) that aren’t special favorites

• Put extra toys away in storage, you will need them for step 3!

1. Set Up & Organize

• Toys are best organized in ways that support your child’s ability to see and access them. Low shelves and labeled bins are great ways to support independent play (as well as your child’s participation in clean up)!

1. Rotate

• Keep the novelty alive! At the start of each month (or when you notice your child is bored of the current toys), swap out some toys for the ones in the storage area. This will keep your child engaged and keep the play space decluttered.

What are “good toys”?

• Are appropriate for the child’s age and developmental level and stimulate learning

• Keep the child’s interest

• Are safe and durable, and have longevity (in other words they are toys that will stand the test of time and can be used by the child in a variety of ways for years, think Legos)

• Everyday household objects make great toys - think stacking cups, tupperware containers, cardboard tubes, and empty boxes 

Try to have a variety of toys available that fall in the following categories:

• Active toys (ride-on toys, outdoor or sports equipment)

• Manipulative toys (construction toys, puzzles, dressing toys, beads, blocks, bath toys, and sand/water toys)

• Make-believe (dolls, stuffed toys, puppets, role play, transportation toys)

• Creative toys (musical toys, arts and crafts materials, digital music)

• Learning toys (games, specific-skill toys such as color sorters and letter identification, books)

Make sure to ask your therapist if you have questions or are seeking specific recommendations to fit your family’s needs.

Author: Aly Bothman, MS, OTR/L

More Resources: 

• Toy Recommendations - https://ei.northwestern.edu/for-parents/toy-recommendations

• Reducing the Number of Toys - http://ei.northwestern.edu/less-is-more

References:

Case-Smith, J., & O'Brien, J. C. (2014). Occupational therapy for children and adolescents - e-book. Elsevier Health Sciences.

Dauch, C., Imwalle, M., Ocasio, B., & Metz, A. E. (2018). The influence of the number of toys in the environment on toddlers’ play. Infant Behavior and Development, 50, 78-87.

Teletherapy Tips for Parents

Telehealth For Pediatric Therapy
With restrictions and hesitations regarding face-to-face therapy sessions, telehealth is a safe and proven way for your family to stay on track with your child’s therapy goals! Oak Tree therapists of all specialties are all trained on the use of the Coaching Model of pediatric therapy, an evidence-based approach to video telehealth sessions that works for children of all ages and abilities. 

What is the Coaching Model? 
The Coaching Model is a research-based method of pediatric therapy that targets caregiver’s learning. When therapists provide home programs and recommendations that help your child progress toward goals, they are using this model. The five characteristics of the coaching model are: joint planning, observation, action/practice, reflection and feedback. During joint planning, the therapist and family collaborate on goals and actions that will be taken during and in between therapy sessions. During observation, the therapist will carefully watch the chosen activity, taking note of which strategies are being used. (An OT or SLP observing a feeding session is a good example of this.) Next, reflection occurs; adults discuss how the strategies worked or didn’t work. The therapist then provides skilled feedback, which often includes updates to the home program recommendations. Between sessions, families can follow the action/practice step by incorporating the recommendations into family routines. (The Coaching Model - Marfield 2010). The process repeats itself during a followup session, in which the therapist will ask the caregiver to reflect on the child’s progress from the prior week. 

Is teletherapy right for me? 
At first, many families may assume that their child is too young for telehealth, or that the child’s abilities do not align with using technology during a therapy session. However, since the Coaching Model is directed primarily at the adults in the family, children of all ages and abilities can benefit from this therapy technique. If your child already receives therapy services at home, clinic or school settings, the transition to teletherapy is not as complicated as it sounds. Initial evaluations and new clients can also benefit from teletherapy. If you are curious or hesitant, schedule a trial session or a phone call with your child’s therapist to discuss if this style of therapy will work for your family. 

Plan ahead! 
Choose a time of day that works well for your family, when your work responsibilities are less demanding, and when the child is rested and attentive. Discuss the session’s agenda with the therapist ahead of time, including any supplies needed. Depending on your child’s goals and type of therapy, some simple supplies such as books, crayons and paper, toys or pillows may be used. Discuss the space requirements with the therapist. They may want an open area for play or movement, or a table for the child to sit attentively. If there are siblings, pets, or other adults in the home, consider if it is possible to have them stay in another room to reduce distractions and sounds. 

Choose your device 
Teletherapy video sessions rely on webcams and web-based programs that are available on laptop computers, tablets or smartphones. Let your therapist know what technology and programs (Zoom, Facetime, etc) you have available or are comfortable using, and your therapist can help you create the best setup for your sessions. For some families, setting up a tablet or laptop in a stationary place in the room works best, for others, keeping a smartphone on hand through the session is fine. Make sure the device is charged or plugged in, and check the microphone and camera ahead of time. 

Be flexible with your expectations 
Not every session will go as planned, and that’s ok. Many therapists plan for a range between 30 to 60 minute sessions to accommodate childrens’ attention spans, and we always have backup plans for when things change directions. Kids are kids, and sometimes emotions, distractions or bathroom breaks impact the therapy session. Therapists understand this, and can accommodate. There is a learning curve to teletherapy for parents too, and it is normal to feel frustrated sometimes. Take things one session at a time. Remember, that home programs are just as important as sessions, and you can always try the activities at a different time. 

Be Present 
For children under 3, therapy sessions utilize the coaching method, in which most interactions occur between therapist and caregiver, and the caregiver leads the activities with the child. For older children, and for some therapies such as speech, the therapist will work directly with the child through the screen. While many children can appropriately manage this with set up, it is important that the caregiver remain nearby to monitor the child’s participation and to be available to communicate with the therapist as needed. 

Speak up! 
As a caregiver, if you are finding teletherapy to be challenging, talk about it with the therapist. Perhaps it’s time to work on other goals, change up strategies, or think about the duration and timing of sessions. Maybe your family needs a week off to regroup, or a different family member can take over some of the sessions. You are your child’s greatest advocate, and the purpose of therapy is to work toward family goals. 

Currently the Illinois Early Intervention program is allowing for telehealth services due to Covid19. Children currently enrolled in the program can opt in at any time and receive teletherapy services at the same frequency as were previously allowed in person. Private insurance is also allowing for telehealth services at this time. Oak Tree therapists are equipped to provide telehealth services to all of our clients.

Quarantine Busters: How to Care For You and Your Family During the Pandemic

Many of us often would remark how little time you have with your loved ones. As our society navigates the magnitude of this pandemic, which swiftly forces us to change the way we behave as social isolation, physical distancing, and shelter in place orders keep us inside our homes. Now that we are approaching nearly a month of Chicago quarantining, we find ourselves having the opposite challenge. Instead, we may find ourselves restless and wondering when all of this will end. We’ve managed to adapt and shift with daily changes and measures put into place for our safety and protection. A trip to get groceries or anything outside of the home can be physically and emotionally draining. It’s OK to feel a range of emotions as we take this day by day. After all I look at this like a marathon, not a sprint. 

Here are a few tips and resources to help you and your children all quarantine together:

Boundaries and Structure:

If you haven’t set them or are having a difficult time holding to these boundaries, it's OK. First give yourself some grace, after all we are dealing with a lot right now. Second, re-evaluate what is working and what is not working in your family structure. Have conversations with your spouse or partner to establish what this looks like. Then invite your children in on these conversations. Discuss school hours, electronic use, and household labor. Who is responsible for cooking, cleaning, laundry, etc. Create a new daily routine together, so everyone understands expectations and roles. If you haven’t already established a calendar or daily chart to help ease this process, it’s not too late! Continue to check in and make changes as necessary. Most importantly, don’t forget about setting a schedule for the weekends too.

Space and Dosing from the family:

We often assume other people may have the same thoughts we do when it comes to taking some “space” or having “alone time”. Take some time to define what having “space” or “alone time” means to you.  Set some parameters around what this means for you and help your children define what it can look like for them. Often children feel like they are missing out of activities and have a tough time carving out time for themselves. Yet, this is important for everyone and they may need you to model this. It’ll be easier to get them on-board when they see you or their siblings doing something alone. 

Communication and Relationship Building:

Even during times of relatively low stress, positive communication is difficult to maintain. Take a breather and check in with yourself. 

1. Try to use “I statements” with your spouse and children. For more information check out this website: "I" Message, "I" Statement

2. Be aware of your tone 

3. Use reflective listening and try to validate feelings

4. Use humor! We need this now more than ever.

5. Maintain connection with friends, colleagues, and family members. Schedule time for a phone or video call. If you are feeling wiped out with all the calls, creating a card or letter can be a fun outlet as well.

Move Your Body:

Find ways to get up and move around. If you are able and can remain a safe distance from others get some fresh air. Take a break for a walk or run. There are several free workouts available online, so take advantage of these options. On average, adults require 30 minutes of moderate exercise a day and double that number for children. Get them involved in daily movement and make it fun. Everyone will be able to release some tension and improve their focus.

These are unprecedented times that will cause an increase in stress and anxiety. Try to shift your focus on supporting one another through challenging thoughts and feelings. Lastly, find things you can control and remind yourself that this will pass. 

By Jean Hausmann, LCSW

How To Improve Your Child's Gross Motor Skills While At Home

Gross motor activities are whole body movements using the large muscles in the torso, arms, and legs such as running, catching a ball, jumping, and sitting upright at tables. 

Benefits Of Improved Motor Skills
Kids rely on gross motor skills for everyday activities at home and school. Working on gross motor skills helps a child gain strength and confidence! It also helps them get physical activity, which is important for a healthy lifestyle. 

How To Optimize Gross Motor Movement
With the majority of time being spent learning indoors these days, parents may wonder how to optimize their child’s learning success at home while also providing them with opportunities to engage in physical activity. Gross motor movement breaks sprinkled throughout the day may help kids calm down, focus and learn. Most children benefit from movement breaks to help them engage and attend to tabletop tasks. Here are some examples of great indoor gross motor exercises to help students of all ages improve their learning outcomes!  

Don’t Touch the Lava

Lay pillows or pieces of paper on the floor and have your child jump from object to object without touching the floor

Bean Bag Toss

Have your child throw bean bags (or rolled up socks) into laundry baskets. See how many they can get in a row!

Find and Tag It

Have your kiddo engage in a fun scavenger hunt around the house and locate specific items to tag 

Move Like an Animal

You can get creative with this activity but here are a few examples! Move like a snake by wiggling tummy on floor. Move like an elephant with heavy stomping or move like a penguin with arms pinned to side and waddle with legs together 

Hopscotch

You can use painters tap to make the outline on the floor and have them push cars or trucks through the road 

Tape Road

Make a tape road and have them push a car or truck through it 

Balloon Fun

Blow up balloons and see if your child can keep the balloon from hitting the floor 

Obstacle Course

Use furniture, pillows, blankets, etc. to crawl over, climb over or crawl underneath 

Allison Boyan OTR/L

Sources: https://teachpreschool.org/2013/12/11/winter-time-large-motor-play-for-the-preschool-classroom/

Why Is The “R” Sound So Hard For Some Kids?

It is normal for young children to display speech-sound errors that they will outgrow as they get older. A hallmark feature of many young children’s speech is substituting “W” for “R”. This error may make it sound like a child is saying “Little Wed Widing Hood” for “Little Red Riding Hood.” While this pattern is common for toddlers and preschoolers, children are expected to produce /r/ correctly by the early elementary years. Since /r/ is one of the most common sounds in the English language, it is no surprise that children who display difficulty with this sound will be difficult to understand. Most of us can speak clearly and precisely without thinking twice, so we may take for granted the intricacy and complexity involved in accurately producing speech. When speaking, a child must coordinate precise movements of the lips, tongue, and jaw along with their breath and voicing. All of this allows them to arrive at specific sound targets, seamlessly flowing from one sound to another to create meaningful words and sentences. If any part of the specific pattern required to produce a sound is just the tiniest bit off, it will result in an articulation error. Speech-language pathologists use many methods to teach children to coordinate the various aspects of the speech system to incorporate new sounds into their speech. Once the child is able to produce a sound in isolation, the speech-language pathologist supports him or her to use the sound in words, sentences, and finally in conversation. It is not an easy task to learn a new sound when you have never produced it before! /r/ in particular is a hard sound to teach even in isolation for many reasons. Below are the three top reasons why so many kids have trouble producing the /r/ sound.

1. Abstract motor movements

Unlike many other speech-sounds, the motor patterns involved in /r/ are not easy to see. Take for instance, bilabial sounds (in other words, sounds that require the lips to come together). A child can easily see that the lips must be closed to produce the /b/, /p/, and /m/ sounds, making those sounds easier to teach and learn. Additionally, for sounds like /t/, /d/, and /n/, a child can see that the tongue should be placed on the ridge just behind the top front teeth (alveolar ridge) to produce this sound. While most kids (and adults!) will not be able to tell you where they are placing their tongue to produce a given sound, being able to visualize the position of the articulators (lips, tongue, and jaw) is helpful for learning. It is very difficult to see where the tongue should be held inside the mouth to create a good “R” sound.

2. Different ways to make the /r/ sound

So how should the lips, tongue, and jaw be positioned to create a good /r/ sound? There are a few different configurations that can be used, and different people may interchange the positions in different contexts (Westbury, Hashi & Lindstrom, 1998). A few criteria, however, must be met for the /r/ sound to be produced: The tongue is held in the middle of the mouth, the tongue creates a ridge or hump to constrict airflow through the oral cavity, and the sides of the tongue make contact or approximate contact with the inside portion of the back molars. Below are the two major configurations that are produced when making the /r/ sound: , Bunched “R”: In this configuration, the tongue is “scrunched” tightly towards the middle/back of the oral cavity with the tongue tip down. The central portion of the tongue makes a hump that gently touches the hard palate. Retroflexed “R”: The configuration is produced with the tongue tip facing upwards, almost touching the palate.

3. Not just one “R” sound

The letter “R” is actually associated with many different speech sounds! “R” sometimes acts like a consonant. “R” usually acts like a consonant when it comes before a vowel, such as in “red,” “around,” and “green.” “R” can also act like a vowel. R acts like a vowel in words such as “feather,” “learn,” and “fur.” Children may be able to produce “R” in some contexts, but not others. To make matters more complicated, there are many variations of the vocalic “R” that all require slightly different transitions from the preceding sound to the /r/ sound. These vocalic variations include “AR,” “EAR,” “ER” “IRE” and “OR.” These vowels all require slightly different transitions from one articulatory gesture to another, and just because a child is able to produce one variation does not mean they can automatically produce the rest. For example, a child may be able to accurately produce words with “AR,” such as “star” or “army,” but struggle to use words with “OR” such as “more” or “boring.” The good news is, targeted practice with one variation of “R” often results in generalization to at least some untrained versions (Hoffman, 1983). Still, children with “R” difficulties typically need practice with several different variations of the sound in different word positions before mastering “R” in all contexts. 

As you can imagine, the “R” sound takes time and patience to learn, as it is very complex. If your child is not consistently producing the “R” sound by the time they are in first or second grade, it may be time to consult with a certified speech-language pathologist.

References:
Hoffman, P. R. (1983). Interallophonic Generalization of /r/ Training. Journal of Speech and Hearing Disorders, 48(2), 215–221. doi: 10.1044/jshd.4802.215

Westbury, J. R., Hashi, M., & Lindstrom, M. J. (1998). Differences among speakers in lingual articulation for American English /ɹ/. Speech Communication, 26(3), 203–226. doi: 10.1016/s0167-6393(98)00058-2

Social Skills Groups - Creating Connections: Building and Enhancing Social Skills

As we shuffle about, typically these days with our heads down and eyes locked into the glow of our digital device, something is amiss. You may have found yourself being one of these folks or on the receiving end of a trip, a bump, or a full blown crash as you move about your day. Ouch! Watch it! We are not just encountering this with adults, but also with children young enough to walk, or the gaggle of teens taking over sidewalks. The digital age is sculpting the way we interact, connect, and socialize with one another. Our youth have always needed us to model and teach them social skills, now more than ever.

Some youngsters learn how to engage with peers by watching adults model behaviors. However, some with learning and thinking differences sometimes struggle with relationships. If your child struggles with social connections with same age peers, a social skill group can help. Social skills, otherwise known as “soft skills” are crucial for making friends, succeeding in school, and later on getting and maintaining a job. Below describes the what's and how’s to social skill groups.

What?

Social skills groups are small and typically between 3-8 children or teens. They can help your children learn how to navigate conversations, friendships, and how to solve problems. Additionally, they can help teach emotional regulation and how to understand others perspectives.

How?

Perhaps your child has difficulty striking up and/or maintaining a conversation. Or possibly, they don’t quite understand facial expressions or know how to read body language. These groups have an educational element embedded into the curriculum and also involve “role plays” and other games to help individuals practice skills learned.

Benefits?

There are numerous ways your child can benefit from these groups and they include:

• Starting a conversation and staying on topic

• How to respond to someone

• How to share and take turns Learning to read body language and facial cues

• How to ask for help and guidance

All children and teens can benefit from social skill groups, especially those with learning difficulties including ADHD, adjustment disorders, developmental delays, and non-verbal learning disabilities. When searching for a group, please keep in mind that groups facilitated by licensed social workers, counselors, and other behavioral therapists will have the skills and training to effectively lead these groups. It’s also important to work with an organization who believes in collaborating and partnering with schools, parents, and caregivers.

By Jean Hausmann, LCSW

What is Central Auditory Processing Disorder?

Central Auditory Processing refers to the process of our brains recognizing and interpreting sound.  Children who have Central Auditory Processing Disorders, tend to have difficulty recognizing subtle differences between sounds in words, or may have difficulty understanding longer strands of auditory information.

Common Signs and Symptoms of Central Auditory Processing Disorders

Some common signs and symptoms of CAPD revolve around difficulty paying attention to material presented orally. This could translate into difficulty following multi-step directions (ex: “Before you put on your shoes, grab your water bottle and backpack from the shelf!”), needing extended time to process information, behavior problems, and difficulty with reading, comprehension, spelling, and vocabulary.

Consider Speech Pathology

If you suspect your child might have difficulty with processing verbal information, seeking out a speech and language evaluation is a great first step!  A speech and language pathologist will take an in-depth look at your child’s language processing and help determine if they should visit an audiologist for an official Central Auditory Processing diagnosis!

Source:

https://www.superduperinc.com/handouts/pdf/130%20CAPD.pdf

Author:

Katherine Reynolds M.A. CCC-SLP/L
Speech-Language Pathologist
Early Intervention Specialist

Why Visual Motor Skills Are Important For Your Child’s Development

Visual motor skills are an important in helping us perform all types of activities throughout the day. For example, writing, playing catch, and constructing puzzles are all examples of visual motor skills. These skills help a person to integrate visual input and motor skills. Since these activities are comprised of several different skill sets, it is important to understand where the disconnect is coming from. A child must use visual processing skills, visual perceptual skills, and motor skills when completing visual motor tasks. A child with visual motor difficulties may have problems processing visual information; meaning how their eyes move and process visual input. These skills include convergence of the eyes, visual fixation, and visual attention. Another child with visual motor difficulties may have problems with visual perceptual skills; meaning how they make sense of visual input. These skills include visual memory, spatial relations, figure ground discrimination, and many more. Yet another child with visual motor difficulties may have problems with their motor skills, either fine or gross motor. An Occupational Therapy evaluation can help determine where the problem is stemming from and establish goals to target the area.

Red Flags for Visual Motor Difficulties In Children:

There are some things to look out for, when wondering if your child has visual motor difficulties. If you notice any of these, it may be beneficial to have your child evaluated by an occupational therapist. 

• Difficulty copying shapes or block structures

• Reversing letters

• Poor letter formation

• Lack of pencil control

• Inconsistent spacing or sizing of letters

• Difficulty copying written work

• Trouble throwing and catching a ball

• Clumsiness

• Difficulty with puzzles

• Difficulty keeping place when reading and writing
  

Activities to Try at Home:

Visual motor activities are more common than you may think, and very easy to incorporate into daily life. Here are a few ideas to try at home!

• I Spy games

• Visual mazes

• Dot-to-dot activities

• Puzzles

• Color, cut, and paste activities

• Playing catch

• Hopscotch

• Bozo buckets

• Use a popsicle stick to help with tracking while reading

• Highlight top and bottom lines on 3-lined paper to help with letter sizing

• Search and find books

• Building with blocks or Legos

Author:
Melissa Melnick, MOT, OTR/L 
Oak Tree Developmental Center
1640 N Wells St
Unit 103, Chicago, IL 60614
Phone: (312) 642-4300

Sources:
https://www.theottoolbox.com/visual-motor-skills/?spref=pi

Summertime Is A Great Time To Get In Heavy Work For Your Kids!

So what exactly is “Heavy Work”? Essentially, it is any activity that pushes or pulls against the body. It may help kids feel more regulated and can also help with their attention and arousal level. While performing these activities, our sense called proprioception, or body awareness is engaged. This form of sensory input to muscles and joints can be very calming and organizing for children. Often times, kids seek out heavy work input in order to help regulate themselves and may neglect safety doing so. Now that is it summer, it is the perfect time for kids to engage in safe, outdoor heavy work activities while enjoying the beautiful weather! 

Here are some ideas:

• Swim

• Push a wheel barrow 

• Climb up a slide or playground equipment

• Ride a bicycle or tricycle

• Jump on a trampoline

• Swing on monkey bars

• Push a friend on a swing

• Dig in the sandbox

• Gather firewood

While correcting your child's sense of proprioception can be improved through the use of sensory integration therapy with an occupational therapist, these simple and fun outdoor activities will naturally improve proprioception as well.

Build Your Child's Self Esteem and Coping Skills with Cognitive Behavioral Therapy

What is Cognitive Behavioral Therapy (CBT)?

Cognitive Behavioral Therapy (CBT) is a popular therapeutic approach that focuses on practical steps to address, reduce symptoms of, and treat mental disorders and psychological distress.

According to a 2012 study published in the Journal of Cognitive Therapy and Research, CBT offers patients an opportunity to challenge limiting beliefs and modify harmful behavior patterns. This is because through CBT they become, “an active participant in a collaborative problem-solving process.”   

Cognitive Behavioral Therapy can be used for children and teenagers for a multitude of mental disorders or psychological distress.

How Does Cognitive Behavioral Therapy Work?

At Oak Tree Development Center, pediatric social workers work not only with the child, but also with parents to solve pertinent issues at home or at school. The focus is on the child’s personal needs. Through positive encouragement and self-esteem building, child behavioral therapists promote success and progress.

Our staff ensures effective counseling by offering a safe environment to promote feelings of support and comfort. After getting to know the children and family, our pediatric social workers develop a treatment plan through cognitive behavioral therapy to guide positive changes.

Benefits of Cognitive Behavioral Therapy

Through CBT, children and teens learn to not accept a self-critical thought. Instead, they learn to look at their thoughts in a more realistic way. Behavioral therapists will teach your child to consider their actions before taking action, which may help prevent them from feeling worse in the long run.

The Royal College of Psychiatrists, which sets and raises UK psychiatry standards while supporting practicing psychiatrists, states that during cognitive behavioral therapy, therapists help identify combined patterns in thought, behavior, and action. Our pediatric social workers assist in helping change unhelpful thoughts and behaviors. They will create a plan for your child to practice on their own until their next therapy session.

In our Cognitive Behavioral Therapy sessions here in Chicago, clients learn practical skills they can use in their everyday lives. If a child or teen experiences additional behavioral symptoms, they can use the skills they learned in therapy to aid in changing the unwanted behavioral patterns.  These life skills are beneficial for all areas of development and growth—tools your child, and your family as a whole, can continue to use for years to come.

Is cognitive behavioral therapy right for you?

Our cognitive behavioral therapists are here to help you and your family. They can be beneficial for children with various issues such as, ADHD, behavioral disorders, aggression, anger management, anxiety, depression, eating disorders, life events such as divorce, death or new siblings, OCD, separation disorder, tantrums and more.

If you’re interested in learning more or if cognitive behavioral therapy is right for your child or teen, please reach out today to see if we can help.

SOURCES:

Cognitive Behavioral Therapy (CBT). (n.d.). Retrieved January 26, 2019, from: https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/cognitive-behavioural-therapy-(cbt)

The Royal College of Psychiatrists, which supports practicing psychiatrists while setting and raising UK psychiatry standards.

Hofmann, S., Asnaani, A., Vonk, I., Sawyer, A., & Fang, A. (2012, October 1). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Retrieved January 26, 2019.

Using Books to Elicit Language with your Toddler

Reading with your child is one of the best ways to improve your child’s speech and language skills.

This post will highlight a few books that are age-appropriate for toddlers and preschoolers that can be used at home to increase your child’s speech and language skills—even if they don’t have any speech or language related problems.

Brown Bear, Brown Bear - by Bill Martin Jr. and Eric Carle

Appropriate for children ages 2-5, toddlers - kindergarten.
This book is full of repeating lines, and that’s an opportunity for your child to predict and interact with the story. Encourage them to help you finish that repeating phrase (ex: Looking at me!) by pausing and allowing them time to complete the phrase. This book is a great opportunity to engage your child by allowing them to be silly and make animal noises and act out the animal movements!

Dear Zoo - by Rod Campbell

Appropriate for children ages 1-4, toddlers - preschool.
This is a lift-the-flap book that encourages your child to engage with the book! It has a repeated line (“I sent him back”), which encourages your child to predict the words! It’s also a great opportunity to practice animal noises and teach animal vocabulary.

The Very Hungry Caterpillar - by Eric Carle

Appropriate children 3 and up.
This is a great book to teach vocabulary and sequencing. As with our other books, this encourages your child to interact with the story. Have them look at the pictures and help you tell all the food the caterpillar is eating!

That’s not my Puppy (or any Usborne touchy-feely books) - by Fiona Watt and Rachel Wells

Appropriate for children ages 0-5, toddlers - preschool

This is a touch and feel book that has a puppy on every page with a different texture. Encourage your child to interact with the book. Practice answering yes/ no questions (ex: do you like how that feels) and use descriptive vocabulary to talk about how each puppy feels! There is a mouse on each page that you can find and show with a pointed finger!

Click here to contact Oak Tree Development Center.

Blog Written By: Katherine Reynolds MA CCC-SLP/L

Improve your Child’s Speech And Language Skills

The Importance of Play in Childhood Development

Play has a beneficial role in every child’s growth and development. Play allows a child to be able to use their creative senses in order to connect with the world around them. Playful interactions can foster new skills such as fine motor, gross motor, and executive functioning skills. Certain play can increase a child’s physical activity, making it an important part of a healthy lifestyle while combating unhealthy choices and building healthy bodies. Play also enables children to develop emotional regulation skills such as coping mechanisms, impulse control, and sharing skills.

Through play a child is able to master their world while conquering their fears. Children learn how to work with peers while negotiating and resolving conflicts. When a child is able to direct the play, he or she can practice important life making decisions that will carry over into their adult years.

Play Improves The Therapeutic Relationship
Play is a key component to the therapeutic relationship between a child and the occupational or behavioral therapist. Play in therapy allows a child to enhance learning readiness, attention span, and problem solving skills. In fact, according to research by Dr. Karyn Purvis, scientists have discovered that it takes approximately 400 repetitions to create a new synapse in the brain, unless it is done in play, in which case it only takes 10 to 20 repetitions. Whether it be board games, crafts, puzzles, or imaginative games, a child is always learning. For learning to occur in play, it should be done in a stress-free environment and it should be meaningful for the child. It is important to foster the development of skills in play in order to help children reach their full potential.

Blog Post By:
Stephanie Nereppil, MSOT, OTR/L

Attributed Resources:
http://pediatrics.aappublications.org/content/119/1/182
http://homeschoolingalmanac.com/teaching-learning-games-10-20-repetitions-vs-400/

Occupational Therapy Can Target Many Important Skills While Teaching Children To Bake!

In need of something to do with your children in the cold winter months? Warm up your ovens and do some baking! Occupational therapists are always stressing the importance of carry-over of skills in the home, as well as increasing a child’s ability to function as independently as possible.

OT Skills Development
Baking is an activity that addresses many “OT skills” in ways you may not have thought of. For example, your child will be working on their problem solving skills, bilateral coordination (using two hands together), sequencing skills, manipulating tactile input, hand strengthening, hand-eye coordination, and simple math. All of these skills can be practiced while making long lasting memories of baking with your child. Bonus, there is a yummy treat waiting at the end!

Problem solving skills: You can address this skill by having your child pick out the ingredients at the grocery store. Have them first look in cabinets and decide what ingredients are already in the house, and which ingredients need to be bought. Bonus handwriting task: have your child write a list of ingredients to buy at the store.

Bilateral coordination skills: Using a rolling pin, holding a bowl with one hand and stirring with the other, even rolling dough into balls are all ways your child will be using both hands together to complete a task.

Sequencing skills: Baking is a special kind of science; a recipe must be followed in the correct order, or your treat might not turn out right. Create a checklist for your child to follow step-by-step directions.

Manipulating tactile input: Have your child use their hands instead of a wooden spoon to mix together dry ingredients. Using your hands to knead dough is gooey texture that children are not exposed to on a daily basis. If your child is sensitive to tactile input, ensure then they are able to wash their hands as soon as they are done. Feel free to use latex-free gloves for those that are extra sensitive.

Hand strengthening skills: Hand strengthening does not always have to be tedious and boring. Using a fork/whisk to whisk eggs, using a spoon to mix wet and dry ingredients together, and kneading dough are all ways to make hand strengthening a bit more fun.

Hand-eye coordination: Having to pour ingredients or batter takes more skill than you think; if you miss you may have a big mess to clean up! Using icing to decorate cookies is another great way to practice hand-eye coordination.

Math Skills Also Improved
Simple math skills: I bet you never thought about using math while baking! Using measuring cups and measuring spoons, as well as counting are simple ways to incorporate math into your baking experience.

One of the best benefits of using baking as a way to incorporate OT skills into your daily routine is having that reward of eating what you created. Now go find your favorite recipe, or try out a new one!

Sources: https://www.ot-mom-learning-activities.com/baking-with-kids.html#SpatialPerceptionPlanning

Written by: Melissa Melnick, MOT, OTR/L

What is Speech Therapy?

There are many facets to speech therapy.  This can range from babies developing sounds to children communicating effectively with peers and adults.  Does your child have difficulty understanding words or using words to communicate? Does your child have difficulty with social communication skills that allow one to interact with friends?  Is your child’s speech difficult to understand? If so, your child may benefit from speech therapy.

Speech therapy is provided by a licensed speech pathologist.  Speech Pathologists are professionals who specialize in communication.  They work with children of all ages to improve their ability to communicate.  Therapy may be provided in the clinic, home, or school. Children receive either individual therapy or therapy within a group.  There are benefits to both!

Speech Pathologists focus on:

Articulation:  How we make speech sounds with our mouth, tongue or lips.  How we pronounce specific sounds or words so that we speak clearly and others can understand us.

Receptive Language:  How we understand what others say and follow directions.

Expressive Language:  How we communicate using words to request wants and needs and share ideas and thoughts.

Social Communication:  Social communication is often called “pragmatics.”  This includes greeting peers, taking turns when talking and staying on topic when conversing.  Pragmatics also include using appropriate facial expressions and eye contact and using appropriate body language.    

Fluency:  Fluency is also called “stuttering” and is how well our speech flows.  Children who stutter may repeat sounds, words or phrases. They may pause when they are talking.  Some children may stutter for a period of time but then outgrow it.

Voice:  How our voice sounds to others and how we use our vocal folds to make sounds.  If we are speaking too softly others may not be able to hear or understand us. If we are speaking too loudly and yelling too much we may hurt our vocal folds and our voice may be raspy or hoarse.

Feeding and Swallowing:  How we suck, chew and swallow food and liquid.   

If you have concerns in any of these areas, speech therapy may be appropriate for your child.

Blog Posted By:  
Mary Lee MA CCC-SLP/L
Oak Tree Developmental Center

Attributed Sources:

ASHA: Who Are Speech-Language Pathologists, and What Do They Do?
https://www.asha.org/public/Who-Are-Speech-Language-Pathologists/

ASHA:  What is Speech?  What is Language
https://www.asha.org/public/speech/development/language_speech.htm

What is Behavioral Therapy?

Behavioral Therapy

A child’s environment influences the way they behave. Often, problematic and unhealthy behaviors are unintentionally rewarded. Cognitive behavioral therapy helps parents gain the skills and knowledge to help redirect unwanted behaviors. Behavior therapies can be applied to a wide range of psychological symptoms among adolescents and children.

Although behavioral therapies can vary substantially from disorder to disorder, a common thread is that behavioral therapists encourage children and adolescents to try new behaviors, reward desired behaviors, and to allow unwanted behaviors to “extinguish” (that is, ignore unwanted behaviors).

In behavior therapy, parents and children learn to promote desirable behaviors and reduce unwanted behaviors. 

One common trap that families fall into is unintentionally rewarding the wrong behavior. For example, take the teen who has not finished his homework, but really wants to take the car. Despite initial objections, the teen persists, and becomes angry, irritable, and disobedient towards his parents. Following a tantrum, the parents decide they cannot take the hassle anymore and allow him to borrow the car. In this way, the parents unintentionally reward, or reinforce, the teen’s oppositional behavior. The best way to handle these situations is to planfully ignore acting out behavior and to reinforce wanted behavior (homework attempts) as much as possible. Behavioral therapists seek to understand such links between behaviors, rewards, and learning, and to help youth and parents shape their own behaviors to meet individual and family goals.

Behavioral Parent Training
Behavioral parent training was developed to teach parents how to reinforce desirable behaviors in their children, discourage unwanted behaviors, and improve parent-child interactions. In this form of therapy, the parents play a significant role in treating their children’s behavior problems. During the therapy sessions, parents learn how to carefully observe their children’s behaviors at home and are taught skills to reward their children’s positive behaviors by using praise, positive attention, and rewards. They are also taught to use rule-setting, time-out, and ignoring to discourage bad behaviors.

Blog Post By:

Sarah Irvine, LCSW

Oak Tree Developmental Center

Attributed Source(s):

https://effectivechildtherapy.org/therapies/what-is-behavior-therapy/

Steven W. Evans, Julie Sarno Owens, & Nora Bunford (2013). Evidence-Based Psychosocial Treatments for Children and Adolescents with Attention-Deficit/Hyperactivity Disorder. Journal of Clinical Child & Adolescent Psychology Vol. 43 Issue 4, 527-551. http://dx.doi.org/10.1080/15374416.2013.850700

Charmaine K. Higa-McMillan, Sarah E. Francis, Leslie Rith-Najarian, & Bruce F. Chopita (2016). Evidence Base Update: 50 Years of Research on Treatment for Child and Adolescent Anxiety, Journal of Clinical Child & Adolescent Psychology, 45:2, 91-113, http://dx.doi.org/10.1080/15374416.2015.1046177

How An Occupational Therapist Can Help With Sensory Processing Disorder

What is Sensory Processing Disorder (SPD)?

Sensory Processing Disorder (SPD) is a condition in which the brain has trouble receiving and responding to information that comes in through the senses. The sensory system is comprised of our sense of smell, taste, touch, sight, and hearing. In addition we have two more "unknown senses". These are our sense of proprioception and vestibular sense. Proprioception and vestibular, which are a part of the sensory system, are often referred to as the “unknown senses”. The proprioceptive sense helps your body understand where it is in space, as well as how much force is needed to move your body within your environment. The vestibular sense refers to your body’s ability to understand how fast it is moving and helps to maintain balance. SPD can cause a person to be either over responsive or under responsive to sensory stimuli.

Sensory Diet For SPD

A sensory diet can be useful to help a child with SPD stay in a regulated state throughout the day, as well as cope when they become dysregulated. A child who is over responsive to touch may find certain clothing fabrics to be uncomfortable. A child who is sensitive to noises may be seen to cover their ears to noises that seem novel to others. Those with food aversions may be over responsive to taste or smell. Those who are under responsive to proprioceptive input may enjoy crashing or falling. Finally, those with difficulty regulating vestibular input may be seen to have “on the go” tendencies, or prefer to not move very much at all.

OT Support For SPD Parents

To accommodate SPD, an occupational therapist will work alongside parents and children to develop a tailored sensory diet to each child’s specific needs. No two children have the same sensory needs; therefore, no two sensory diets will look the same.

Blog Post By: Melissa Melnick, MOT, OTR/L

Attributed Resource: Super Duper Publications: Using a “Sensory Diet” with Children with Sensory Processing Disorder (SPD) by Amber Swearingen, MOT, OTR/L

.Please watch the insight video below, to experience a child's view of sensory processing disorder:

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