School VS Clinic Treatment Setting

by FS&TS

Speech language Pathologists, Occupational Therapists and Physical Therapists work to to identify, evaluate and treat children in settings that meet their academic, family and social needs. We work in a variety of settings but most commonly children are receiving services through a “school setting” and/or a “clinic setting”. Parents looking for services for their child will sometimes ask which of the two service settings will be most beneficial. The answer really is, both. Here’s why:

School VS Clinic Setting Blog Post.jpg

 

Qualifying:School and clinic settings hold different criteria to determine whether a child is appropriate and would be considered “qualifying” for services. Both settings use standardized tests, parent report and take into consideration the child’s strengths and weaknesses. School districts evaluate to determine the child’s areas of need to improve academic success. Depending on the school district, there can be a variety of screenings and teacher based interventions that will be attempted before a formal evaluation is completed. Clinic therapists evaluate and make treatment recommendations based on the needs in home, school and community settings.  Qualifying for clinic services is not only determined by performance on tests but take into consideration the child’s overall functioning. These services are often covered by their insurance company when scores indicate a significant need.

Expertise: Therapists recognized by their state and national organizations are qualified to work in either setting however therapists in the school district most often also hold a department of education licensure.  Both settings have access to equally qualified and trained professionals. Therapists in both settings have a wide array of experience, continuing education and resources.

Goal Focus: Services provided in the school setting are tailored to improve the skills of the student within the academic setting. This includes the child’s ability to use speech and language skills to communicate, improve literacy skills, develop fine motor skills for writing and navigating their school environment safely and to the best of their potential. The clinic setting allows the therapist to develop similar goals which may allow the child to be successful in any setting he or she may be involved including school, home, community, daycare, etc. Goals can be easily adjusted in the clinic setting to suit the child’s and family’s changing needs.

Documentation: Within the school, services are described and monitored via an IEP (Individualized Education Program) or an IFSP (Individualized Family Service Plan), which is a legally binding document once signed and in place. This includes regular meetings and input from the student’s teachers and other academic providers. In the clinic, progress is reported to the family, the child’s physician and if appropriate, the insurance company.

Treatment: Within the school, services can be provided within the classroom setting, often referred to as the “push-in model”. This allows the service provider to facilitate learning within a setting that is most natural, in collaboration with his or her teacher while monitoring the student’s progress first hand. The student may also be pulled out of their classroom to develop their skills in a one-on-one setting or within a group. The duration of the visits can vary from 5 minutes to 60 minutes, and up to several times per week. The clinic setting allows a one-on-one interaction allowing for dynamic activities and custom treatment approaches; fresh ideas sent home with parents following each session. In the clinic, the therapist designs activities and learning opportunities specifically for the child’s interests and needs. Sessions can range from 30 minutes to a hour.

Taking a Team Approach: Both treatment settings offer a connection with a skilled professional with the child’s learning as top priority. Parents are able to seek and obtain services in both settings to determine the best fit for their child. Also, parents can request that their school and clinic therapists collaborate to bridge the gap between settings. Another strategy for success includes finding time to connect with your SLP/OT/PT on a regular basis either via phone call, email or during the first or last 5-10 minutes of your clinic visit. As always, ask your therapist or service provider if you have any questions about how to initiate services in either of these settings.

5 Halloween Apps for Speech and Language

by FS&TS

By Crystal O'Malley, SLP

Halloween is just a few weeks away! Here are 5 great Halloween Apps that you can use to work on a variety of speech and language goals.

5 Free Halloween Apps for Speech and Language (1).png

1. Halloween Games for Kids by Moo Moo Lab

175x175bb.jpg

This app contains sticker and coloring pages. These activities are great to work on following 1-2 step directions and describing the pictures using attributes.

2. Monster Pet Salon By Ninjafish Studios

2.jpg

This activity allows kids to give their monster pet an outfit and put them in different scenes. It provides natural opportunities for you to give them directions to follow and for them to describe the scene they are creating using grammatically correct sentences.

3. Halloween Kids Puzzles By Scott Adelman Apps

3.jpg

This app is great for working on following directions containing positions (i.e. above, below, next to, under, etc). You can describe the pictures after you’ve completed the puzzle.

4. Carve-a-Pumpkin By Parents Magazine

4.jpg

Instead of carving out an actual pumpkin, you can do it within an app. It’s wonderful for working on sequencing. Of course you can also work on following directions and describing during the activity.

5. Halloween Secret Hidden Object By Detention Apps

5.jpg

I use this one to talk about where objects are located with a focus on prepositional phrases (i.e. under the ___, next to ____, behind the ___.

Eating Doesn't Have to be Scary: Halloween Holiday Food Exploration

by FS&TS

By Jessica Naiberg, OTR/L

Holidays and changing seasons are natural times to explore new foods due to the changing seasonal produce and meals. For our children, this change can be exciting AND scary.

Halloween Sweets Blog Graphic (1).png

 

Playing with food is one way we can encourage our kids to explore new or non preferred food items: flying food like an airplane, playing peek-a-boo with food placed under a napkin or even making art with food. “Painting” with applesauce using a pretzel stick or creating “food art” by making pictures on a plate is a great way to increase exposure through sight, touch and maybe even taste.

To enhance flexibility around food and encourage adventurous eating, one of the first steps is to alter the appearance of already preferred food items. This strategy can be as basic as cutting a sandwich diagonally, instead of vertically, or as complex as creating food art with familiar food.

Halloween and other holidays are great times to borrow food art ideas from Pinterest or blog posts.

Happy Halloween!

You’re Not Crazy, and Your Kid’s Not a Liar: The Inside-Scoop on Sensory Processing

by FS&TS

By Jennafer Young, OTRL

I recently had a mom tell me her child has never cried at a finger prick, and he loves to bang his head against the wall. Another admitted her daughter has a screaming-and-kicking meltdown if a haircut is mentioned or a new food is presented at dinner. Still another explained her son can’t sit still long enough to put his socks on, let alone eat an entire meal or listen to her directions.

You’re Not Crazy, and Your Kid’s Not a Liar- The Inside-Scoop on Sensory Processing.png

As a pediatric occupational therapist,  I meet kids like these every day. What do all these children have in common? They’re not spoiled-rotten, picky, high-strung, ADHD-diagnosed time bombs waiting to explode. They have signs of Sensory Processing Disorder. I know, the word “disorder” sounds a little scary...especially if your son or daughter reminds you of any of these kids I’ve met. But research shows that as many as 1 in 20 kids is affected by signs of SPD (Ahn, Miller, Milberger, & McIntosh, 2004). So hang with me - you’re in good company, and there’s hope.

We usually only talk about having five senses - sight, hearing, taste, smell, and touch. But in actuality we have at least seven different senses.  The extra few senses (proprioceptive & vestibular) are related to sensing movement. They give us our ability to detect the speed, direction, and position of each part of our body. “Sensory processing” is our brain’s ability to take in information from each of the seven senses, interpret the meaning of the sensation, and respond in an appropriate way. For those with Sensory Processing Disorder (SPD), one or more of the seven senses is felt or interpreted in a non-typical way.

So what does SPD have to do with your child’s unpredictable meltdowns or insatiable thrill-seeking? Kids with signs of SPD may be over-responsive or under-responsive to the sensory input in their environments. Either tendency leads to...well, an unexpected behavioral response.

For those with under-responsive nervous systems, it takes a lot of extra input to help them experience the world at a desirable level. These kids may constantly be on the go (seeking the movement senses), constantly listen to music (seeking auditory input) or constantly chew on gum...or their pencils...or their shirt (seeking oral/taste input). If they don’t receive the input they crave, they have a hard time managing their emotions. It’s like being hungry - if your drive for food isn’t satisfied, it’s hard to keep your attitude in check. But for these kids, any of the seven senses could be what they’re lacking, and until that sensory tank is full, their behavior-truck ain’t running smoothly.

What about the flip side? You know, the super-sensitive kids who notice everything...and complain about it?! They have over-responsive nervous systems to one or more of the senses. It’s hard to imagine, but the long-sleeve shirts he refuses to wear because they “hurt his arms” probably irritate his well-tuned sense of touch. The generic brand Cheetos she refuses to eat may startle and overwhelm her keen sense of taste. And, yes, the sound of the toilet flushing is as unbearable as fingernails on a chalkboard. The world is overwhelming to a kid with an uber-sensitive system, and this child needs to learn how to adjust or manage the input bombarding them before they either shut down or meltdown.

So where’s the hope in all of this? Well, the bright side is that you, Mom, are not crazy. You’re not crazy for thinking your daughter is more observant, more sensitive, more “picky” than her friends. And you’re not crazy for thinking your son is louder, more energetic, or more rough than his peers.

The other bright side is that your child is not a liar. Or manipulator. Or hopeless whiner. He or she is simply communicating how they experience the world - either as exhaustingly mundane for the under-sensitive, or unbearably overwhelming for the over-sensitive. Either extreme makes it difficult to simply “behave.”

Crazy or not, I realize that all these haywire senses can still cause painful meltdowns and family tension. That’s where professional help comes in: Occupational therapists are trained to understand all seven of the sensory systems and how they impact a child’s emotions and behaviors. Through a “sensory processing” or “sensory integration” approach, OT’s can identify, design, and teach you and your child strategies to meet their sensory needs. And when their needs are met, these kids are much more prepared to live, laugh, and learn.

October is Sensory Awareness month. So take a moment to reflect:

When your child’s responses to the world seem baffling, consider if there’s more than “behavior” going on here. Have you seen signs that your child is a super-sensor or a seldom-sensor? Please share your stories!

Citations:

Ahn, R. R., Miller, L. J., Milberger, S., & McIntosh, D. N. (2004). Prevalence of parents’ perceptions of sensory processing disorders among kindergarten children. American Journal of Occupational Therapy, 58, 287–293. https://www.spdstar.org/sites/default/files/file-attachments/ahn_miller.pdf

Playground Benefits

by FS&TS

By Kristina LaBarre, MOT, OTR/L

Playgrounds are filled with wonderful equipment designed to help bolster your child’s gross motor, sensory motor, and social skills. The best part is that kids are busy having fun while they are developing their skills in age appropriate ways!  
These are just some of the MANY playground benefits from an occupational therapist’s perspective: 

Proprioceptive processing

This sensory system takes information from the muscles and joints that sends it to our brain to communicate about where our body is in space.  This input is required for coordination, body awareness, rate/timing of movements, and force modulation (the amount of force required for activities). 

  • Activities such as hanging, climbing, jumping, crashing, pushing, pulling help develop this sense

Vestibular processing

This sensation allows us to maintain balance, arousal regulation, spatial orientation, ocular motor skills, postural control, weight shifting, motor coordination, attention, and speech development.  This can be achieved through changes in head position. 

  • Equipment and activities that develop this sense include monkey bars, slides, zip lines, swings, merry-go-rounds, log rolling, somersaults


Tactile processing

This sensory system gives us information about our environment, determine pain, the amount of pressure required for activities, body scheme, and assist with developing fine motor coordination required for writing and completing fasteners.  

  • Equipment and activity that develop this sense include: sand boxes, grass, rocks, climbing on different surfaces


Auditory processing

This can be addressed via filtering out and tuning into certain sounds during play.  Children with difficulties in this area may rely on other senses especially touch and sight during play.

  • Nature sounds can also provide a calming effect.  


Visual system

This system helps us make sense of what we see, assist with spatial relations, and directionality.  
Strengthening

Playgrounds provide opportunities to strengthen the whole body and endurance. 

  • Activities that develop this sense include: climbing, hanging, swinging


Social skills, safety awareness, and attention are also developed naturally at the playground.
 

Tips for Back to School Transitions

by FS&TS

By Sarah Anderson, OTR/L

Transitioning back to school after summer break can be a stressful time for parents and children.  Summer is a nice time to change the schedule and have less routine, but that can also cause difficulties as you transition back to a scheduled routine during the school year.   Remember that most children like routine and perform better in school when they have a predictable schedule, especially during the school week.   Young children especially need a predictable schedule because they do not fully understand the concept of time.

 

Here are a few tips that can help as you begin the transition back to school.

  • Start to shift bedtime by 10 minutes earlier each night in order to get back to your preferred school-night bedtime. This should only take a week or two at most.  (It is easy to stay up late on non-school days but research suggestions it is better to go to bed and get up around the same time, or at least within a hour of you or your child’s typical bedtime)

  • Set up and evening routine/bedtime routine that stays the same on school nights.  Allow for quiet reading time to ease into sleep.  (Research suggests to refrain from screen time  up to an 1 hour before going to sleep)

  • Set up a designated spot in the house where backpacks stay at the end of the school day and then practice taking with you to the store or shopping and then put in those spots when you come home to get into a routine.  

  • Set up an important “school papers” bin or basket to use throughout the school year.

  • Try not to schedule too many after school activities at the beginning of the school year.  Allow for outside free play after school and adjustment to the school routine before adding too many activities.  

  • Have a “save” box in a closet for the artwork or special assignments you want to save.  (Parents can also go thru at a later date and throw out as needed)

 

Here are a couple articles that offer some great ideas as the transition back to school begins.  

 

http://www.education.com/magazine/article/importance-routines-preschool-children/

http://www.parentfurther.com.php53-8.dfw1-2.websitetestlink.com/resources/enewsletter/archive/getting-back-into-school-routine

 

 

The Key to Fidgets

by FS&TS

By Brenna Patterson, MS OTR/L

In the past few months, fidget spinners have become all the rage and it appears most kids (and pets!) have found uses for these gadgets. While these spinners are fun for the fingers and minds, it also appears that they have distracted kids from school activities as well. There is merit to these fidget spinners, but to clear the name of “fidgets,” I wanted to provide information about how to find the optimal fidget for your child and how you can tell that this fidget is effective.

Fidgets, by definition, are objects or tools that a child or adult uses to improve their attention to activities that they are doing. Having a fidget often provides sensory input that a person may not be getting from their environment and enabling them to filter out the distracting input they otherwise may have had difficulty filtering out. Contexts for “fidgets,” may include work meetings, lessons at school, doing homework, waiting a turn during a game, and focusing on a conversation with a friend or family member.

For some people, the tactile and proprioceptive input provided by writing or typing is sufficient to improve their attention to what they are doing in the moment. However, for other people this may not be enough and their mind may require additional textures to the tactile input or squeezing to decrease this “wandering” or “seeking” for this input. For an item or object to be considered a fidget, it must be small in size, improve the person’s attention, be safe, have a reasonable cost, and is not distracting to others around them. Thus, if the fidget makes additional sound it may be more distracting than supporting attention (For example, has someone around you clicked and unclicked a ballpoint pen over and over again and driven you crazy to the point that this is all you hear? This is an example of that!).  

Fidget Spinners provide proprioceptive input through squeezing the middle circle, as well as tactile input through the smooth texture of the plastic. Some of the fidget spinners have visual input provided as well, such as lights, which may actually impede someone’s attention or the attention of others around them. If you find your attention going to and staying with the fidget spinner, this is not an effective fidget for you! When looking into fidgets, it is important to consider certain textures or input that the person may avoid/dislike, when they appear most “fidgety,” for determining when it will be used, and try to use sensations that are sought after by that person-this will be most calming and supportive. In addition, consider rules you may need to introduce when instructing or educating your child on the fidget and its uses so that the fidget is used well and does not get taken away or accidentally used in a distracting way!

There are a number of low-tech fidgets that can be found all around you, and you may already be using them without knowing! Rubber bands, coins, paper clips, links on a chain, slime, theraputty, stress balls, and foam blocks are all examples of low-tech fidgets. This is not to say that you cannot use the nice and novel fidgets-these have their benefits as well! Everyday objects can also be used as fidgets and wanted to provide these as options. Some of the newer fidgets provide a variety of textures and pushing/pulling opportunities; for example, there is a “fidget cube,” that many children have reported as helpful to increase their attention during the day.

One of the keys to occupational therapy is finding practical and functional ways to improve a skill that is required for daily life, and everyone needs to have attention for activities, whether these are hobbies, recreational, or work-related activities. These are some of the functional and practical ways to increase attention during the activity, and I hope that this was helpful in exploring some of the options. Please see your occupational therapist if you have further questions or would like more information on what fidgets would be beneficial for your child.

Sugar Cookie Day- How Baking Cookies is Good for Development- PLUS Recipes

by FS&TS

By Christine Peters, OTR/L

July 9th is SUGAR COOKIE DAY! Not only do we love to eat these sweet treats, but we also love to utilize baking cookies to work on child development!

Take advantage of this “holiday” and work on developmental skills such as:

-Following Directions (reading or hearing step-by-step directions from a caregiver)

-Coming to Midline (pouring ingredients into measuring devices)

-Crossing Midline (stirring, reaching for ingredients, rolling dough with rolling pin)

-Strengthening (stirring dough, rolling dough with rolling pin)

-Bilateral Coordination (rolling dough with rolling pin)

-Visual Motor (measuring ingredients)

-Tactile Input (messy play with kneading dough)

-Auditory Input (mixer or hand-mixer)

-Safety (working with hot oven and/or hot cookies right out of the oven- this is a good opportunity to discuss oven and kitchen safety)

 

Following are sugar-cookie and frosting recipes that have dietary restrictions in mind:

COOKIE RECIPES:

-Classic Sugar Cookie

http://www.inkatrinaskitchen.com/best-sugar-cookie-recipe-ever

-Gluten-Free Sugar Cookie

http://flippindelicious.com/2013/02/soft-sugar-cookies.html

-Dairy-Free Sugar Cookie

http://mywisemom.com/dairy-free-christmas-cut-out-sugar-cookies

-Allergy Friendly Sugar Cookies (dairy-free, egg-free, soy-free, peanut-free, tree nut-free)

http://momversusfoodallergy.com/2016/02/11/allergy-friendly-sugar-cookies/

-Low-Sugar Sugar Cookies

http://heavenlyhomemakers.com/sugar-cookies-the-whole-wheat-low-sugar-super-delicious-way

FROSTING RECIPES:

Classic Icing:

http://www.cleverlysimple.com/how-to-make-the-best-and-easiest-sugar-cookie-icing-glaze/#sthash.osQLAck0.qjtu

Dairy-Free Frosting:

http://www.kiwimagonline.com/dairyfreefrosting?recipe=dairy-free-vanilla-frosting

A Schedule...in the Summer?

by FS&TS

By Gina Czmowski, MOTR/L

Summer. School is out, lake season is in full swing, and the warm weather is upon us. While most Minnesotans anticipate this time of year, others dread the thought of their child having hours upon hours of unstructured ‘free time’ on his plate.

Despite summer being considered a laid back, carefree time of year, many families experience significant stress as negative behaviors begin to increase with too much ‘together time’.

This may largely be due to the fact that many children thrive on routine and clear expectations, which typically aren’t present once school is out. To reduce the stress that summer may bring to your home, consider the following recommendation

  1. Have a set wake-up time and bedtime: While it’s fun to stay up late and lounge around the next morning, this will lead to tired kids. And what do we know about tired kids? Tired kids have a difficult time regulating emotions. So to help avoid these emotional breakdowns, be consistent on wake-up and bedtime routines.
  2. Incorporate a mix of structured and unstructured time in your schedule: I’m sure we have all heard the saying, balance is the key to life. Balance in your summer schedule is just as important. While it isn’t necessary to have a minute-by-minute schedule, having a general structure both you and the kids know helps the day go more smoothly. Below is an example of a simple summer schedule.  

  • Wake-up, get dressed, eat breakfast
  • Play outside
  • Learning activity
  • Free play
  • Lunch
  • Quiet time/ nap
  • Snack
  • Free play
  • Screen time
  • Dinner    

3. Limit screen time: Screen time is both entertaining for kids and provides a ‘break’ for Mom and Dad. However, too much screen time is harmful for development and often leads to unnecessary arguments. Limit screen time to 30-60 minutes per day. This encourages the rest of the time to be spent engaging in imaginative play, learning activities, or being physically active.


4. Be active: Running, jumping, climbing, twirling...the list could go on and on. All of these movements are part of play and help children learn about their environment. Physical activity will also burn energy, tiring a child out, which helps Mom and Dad out when it comes to bedtime.

4th of July Sensory Tips

by FS&TS

By Christine Peters, OTR/L

  1. Prepare your child. Talk about the plan the day before, then remind your child of the day’s schedule that morning of. If your child tends to be anxious about new situations, a visual schedule with checkboxes may be helpful- they will be able to process the plans throughout the day and may make transitions easier.

  2. Bring familiar snacks. Having familiar food stored away may be helpful if your child suddenly decides that the hot dogs and burgers “tastes different” and refuses to eat. This can also be helpful if your child has dietary restrictions.

  3. Give your child an important job. It can be overwhelming for a child to be in a new situation with many other people. Giving them a “job” can help them focus on the task and can also give them the added benefit of heavy work, which can be very calming and regulating. Heavy work activities include pushing, pulling, and carrying, such as moving chairs or carrying a basket of food.

  4. Give your child the opportunity to take a break. Let your child know they can ask for a break, either verbally or with a “break card”. Good places to take a break would be inside a house, a tent, or any comfortable area away from the general “party area”. Light activities should be available in the break area, such as providing a fidget or paper and colors. Be aware that providing a tablet may decrease the likelihood of the child returning to the day’s activities.

  5. Help mute the fireworks. Noise cancelling headphones/earbuds or headphones with relaxing music can help when the auditory input of the fireworks becomes overwhelming. It may also be helpful to listen to audio of fireworks before that day so the child knows what noises to expect. 

  6. Have a Plan B. When a child is frightened, the “fight or flight” response kicks in. Have a plan of where to bring your child if the fireworks experience is too overwhelming. Let other’s know ahead of time of your plan B.

Everyday Language Outside Activities

by FS&TS

By Rebecca Walton, MS/CCC-SLP

Being outside is one of the best things about Summertime. It’s also a great place to target your child’s receptive and expressive language skills. There are so many opportunities to label objects, actions, and describe things.  You can also practice following directions in a fun environment and your child probably won’t even realize that they’re “working”.

outside speech and language activities

 

Three Outside Speech & Language Therapy Activities

  1. Use the playground equipment to practice labeling all the activities that are there: “Swing, slide, steps, tire, sand”.  You can also label the actions that your child is doing: “climb, walk, run, jump, slide, swing, go up, go down”. Describing things is also an easy way to get some 2-word phrases: “red slide, big slide, soft sand, small swing, jump high, swing fast”.
  2. Practice following directions by telling your child, “first go on the slide, then get on the swing” or “Come scoop some sand, then blow some bubbles”. You can also play a game such as “I Spy” with a couple of changes to help your child learn to listen to details.  It’s very easy, and can be a fun game. Start describing something with 2-3 attributes and then have your child guess what you’re describing then they can go play on the describe item. Example: This activity is red. You have to use stairs to get to it. It’s made of metal.  Answer: “Slide”
  3. You can use these kind of activities for pretty much any outdoor fun that you’re having this Summer. Sidewalk chalk is also a fun activity to practice labeling items and describing items. It’s also a fun way to target following directions. If your child is old enough, you can tell them to “first draw a circle, then put a nose in the middle” or “pick up the green chalk and write the letter B”.

Father's Day

by FS&TS

By Faith Schoenecker M.A.,CCC-SLP

Whether he’s a father, uncle, grandfather, cousin, teacher or coach, the men in our children’s lives play a critical role in the development of foundational skills. Each of our families and social relationships are constructed of unique blends of men and women who form our memories and teach lifelong lessons. Our children benefit from the guidance of both maternal and paternal role models.

Last month we celebrated the moms and maternal caregivers. The nurturers, the words of caution and verbal encouragement. This weekend, let’s take time to observe, appreciate and thank the guys for their unique teaching and parenting style.

Researchers have spent time analyzing the differences between mother’s and father’s play interactions with their children and have found distinct characteristics between the two genders. Fathers are more likely to engage their kids in rough and tumble styles of play. They are more likely to encourage their children to take more risks during play.

Further, studies have found that the quantity and type of vocabulary words used by fathers to their children vary from their maternal communication partners. For example one study found that fathers used less total language, less supportive language, less negative language and more directive and informing language than did mothers. This “to the point” communication style is further demonstrated through play interactions.


Here are some ideas on how we can expand our play routine this weekend:

  1. Get outside: play hide and seek around the back yard, search for worms in the dirt, play tag (You’re it!), roll down the hill.

  2. Get building: build a fort from cushions, blankets. Talk about what you’re doing, ask questions about what supplies are needed. Model the “non-word” words (ooooh!, uh oh!, wow!)

  3. Get physical: Be airplanes, carry your little one above your or run with arms outstretched. Play “don’t touch the lava!” and jump from spot to spot using mats or paper plates in the grass.  Compete in a foot race from one end of the yard or house to another (Use words like “Ready, set, go!”)

  4. Get reading: Act out the scene of your favorite book.

Happy Father’s Day and say “Thanks!” to the special guy in your life!

Summer Travel Tips

by FS&TS

By Sarah Becker Anderson, OTR/L

As school ends and summer begins, many families are beginning to plan for summer travel.  Whether it is a short trip or a long journey, traveling can be both exciting and stressful.   Here are a few tips and ideas to help as families plan summer vacations.  

1. Plan the trip as a family and prepare a travel map: Children anticipate events and are often very excited and may ask regularly, "how many more days".  Use a calendar to show how many days are left before leaving on vacation.  You can put a sticker on the day you are leaving and cross off days one week prior to leaving.  Plan out your route with the children using a map. They can learn to read a map at the same time. Although we tend to use our "google maps" on our phones or navigating systems, use a paper map too. With small children, you can draw out a simple map with them so they have some understanding of what they might see along the way.  Create a family travel book.

2. Avoid using screen time while traveling:  If you are going on a long journey, watching a movie or playing games on IPADs or phones can be nice for some down time, but it is important to limit the amount of screen time, just like at home.  Too much screen time has been shown to increase behaviors and could lead to more "meltdowns". Plan out when screen time will be acceptable so you avoid the "can I play on your phone" question over and over. Instead of screen time, play travel games like "I Spy",or look for license plates from other states. See how many states you can find.  Traveling can also be a great time to listen to audio books or music.  Bring along lap trays so you can use play doh, coloring books and crayons, word finds, crossword puzzles or dot-to-dots.  Magnetic travel games and puzzles are also an option, or brain teasers. Put together an activity bag that can be readily available.  

3.  Schedule rest or quiet time: It is important to have some quiet rest time.  This can be a great time to put on quiet music and limit the amount of noise or activity in the car.  Try to have this planned out ahead of time to avoid those moments of complete frustration.  It can be very hard to have "quiet time" when everyone is overwhelmed.  

4.  Avoid eating fast food and long stops at gas stations. Stop for picnics instead:  Picnics are a great way to get out of the car and run around while making sure everyone is eating healthier options. Plan to stop at rest stops so you can use the bathroom too.  It is a great way to avoid long stops at the gas station and spending money on those unwanted treats or snacks.  Bring your own snacks or treats for the car.  Try and stick to drinking water, limiting juice or pop.  When you do have to stop for gas, but you don't want to get everyone out of the car, play guessing games.  How long will it take to get gas or can you count to 100 before the car is full, or how many times you can sing the ABC's?  See if you can find all the letters of the alphabet while waiting for the car to fill up.  

5. Incorporate writing into your trip:  One way to keep your child writing or engaged in learning is to create a time for daily journaling.  Older children can write a daily entry about what they saw or learned each day and younger children can draw pictures.  This can be a great way to remember your vacation.  Or, you can do this as a family.  Keep a family journal.  This can be a great way to end your day, reflecting on the adventures of the day.  

6. Some children may benefit from talking about "unexpected events" prior to leaving on vacation.  Flat tire, road detours, traffic congestion, weather.  This may help them prepare, if something does happen and can also be a great time to talk about being flexible or being able to "go with the flow".

Enjoy your summer travels and have fun!

Benefits of Baby Sign Language

by FS&TS

By Sarah S. Anderson, MS CF-SLP

I have many parents ask me about additional things they can be doing with their kiddo to help support their language growth.  The first thing I usually ask is "do you use Baby Sign?" 

For many parents the idea of learning American Sign Language seems really overwhelming, but using just a handful of signs can be a very beneficial way to support your little one's language.  In addition, little one's who use Baby Sign before they are able to talk have been found to develop more expressive language and articulation skills when compared with same aged peers (Goodwyn, Acredolo, and Brown, 2000).   Researcher Goodwyn et al. (2000) proposed that, just as crawling serves as a critical stepping-stone to walking, gestures serve the same purpose for speaking.

What is Baby Sign?

Baby Sign is defined as a way of facilitating communication with typically developing hearing infants by early exposure to sign language (Mueller, Sepulveda, and Rodriquez, 2013). Usually, there is a use of functional everyday signs (i.e. help, water, more, all-done) that are used/signed by a primary caregiver during good exposure times (e.g. feeding time and play time). The parent models the sign with the expectation of not having their little one sign it immediately, but introduce it as a symbol for an action and/or word. Over time, and repeated use of the sign by the caregiver within interactions, the child then discovers that they to can use the sign to carry meaning (Anderson, 2016).  

How to use Baby Sign and What to Expect?

It's important to start small.  Maybe just two signs until you are comfortable (e.g. more, all-done).  The best time to use Baby Sign is when you are on your kiddo's level and have their attention.  Try introducing it during feeding or play.  These times are great because, usually your little one is motivated and watching you.  The first few times you use a sign be sure you have their attention, and that you not only sign the word, but say the word as well. Try assisting your child in producing the sign 1-2 times so they can get the feel for the movement.  Over time, your child will go through a series of stages as you start using Baby Sign:

  1. They may watch you with intent
  2. You may start to see some hand movements that are similar to the sign you are making, HONOR THEM!
  3. Your child may start using the sign regularly and with purpose
  4. Your child may sign and start to verbalize the word too
  5. Eventually, your child may just use the word verbally (this is the goal but their is no rush to drop the sign)

Helpful Tips

  1. Get down to your child's level so it's easy for them to watch you model the Baby Sign you are using
  2. Be sure you have your child's attention before attempting sign 
  3. Use the sign while talking in a short simple sentence.  For example "you want MORE?"
  4. Repeat the sentence at least 2 times so the child can learn it more easily (e.g. you want MORE?, you want MORE?)
  5. Pick a time of day when you are both interactive like during meal time or play
  6. BE PATIENT.  A child needs to see/hear something many times before they can learn that vocabulary, so they may not use the sign the first time you try, and that is ok

Each child is unique and learns at a different rate.  When parents ask me "how long will it take before I start seeing them sign," I usually let them know that it may take a week, or it may take a month, but if parents are consistent and using the sign several times during their child's day you will be surprised by what your child will pick up.

Good Places to Reference for signs:

  • www.aslpro.com has a great dictionary online with videos of many signs
  • www.lifeprint.com has a clear picture dictionary online for people to access
  • Baby Sign Time is available for purchase or can be found on YouTube

A Very Sensory Spring

by FS&TS

By Jennafer Young, MS, OTR/L

Spring is here! And with it come many advantages to outdoor sensory play.

The outdoors is the perfect place for your child to encounter rich, meaningful, fun, and challenging sensory experiences! Think about it: playing outside provides some of the greatest variety in sensory experiences. You naturally have many sounds (birds, cars driving by, children down the street)...many smells (grass, pine needles, rain)...many sights (various colors, sizes, distances, and patterns)...and many textures (light breeze on your face, sticky mud on your hands, soft grass on your feet).

On top of all this input, you have plenty of movement input (vestibular and proprioceptive) from the play children naturally participate in when they are outside: running, swinging, puddle jumping, rolling, digging, sliding, climbing...the list goes on!

When children are playing outside, they get to learn about challenging and wonderful sensory input in a natural, non-threatening way. They get to learn about the world that will always be around them, rather than a contrived world of sensory bins and structured play. Don’t get me wrong - I love these too. But these activities imitate rather than replace the sensory-rich experiences found in nature. So let’s set aside our grown-up and all-too-practical ideas of uber cleanliness, hyper-safety patrol, and total control. Let’s encourage our kids to get outside, get sweaty, and get dirty! Here are a few ideas:

Instead of staying inside to create home-made play dough for a texture experience, why not go dig in the sandbox or make mud pies?

Rather than having animal races down the hallway, why not have your races outside where the whole body is engaged in a sensory experience?

Instead of playing in a water basin or bathtub, why not put on old clothes and go puddle jumping?

Rather than host a dance party to get the wiggles out, why not climb trees or have rolling races down the hill in the backyard?

And don’t forget to invite the neighbor kids! You may be amazed at the sensory input your child will accept when they have a friend laughing and playing right along with them.


Happy Spring!

Mother's Day Presents

by FS&TS

By Gina Czmowski, MOTR/L

Macaroni necklaces. Hand-made cards. Modeling clay figurines. If you are a mother, you have surely received one, if not all, of these homemade gifts from your young one for Mother’s Day. And although these gifts may not get you quite as excited as say, jewelry, a massage, or a night out, you’d be happy to know that through the creation of that gift, your child was working towards his/ her occupational therapy goals. How, you might ask?

Well, that macaroni necklace...

It required the use of fine motor skills to pick up the noodles and visual-motor skills to get the noodles onto the string.

That hand-made card…

It required bilateral coordination and visual motor skills to cut out the construction paper heart. Or, sensory processing was necessary to be able to make that giant handprint flower out of paint. Or, fine motor skills were needed to draw that abstract picture of “Mommy and Me”.  

Those modeling clay figurines…

It required hand strength to knead the clay. Fine motor skills were used to craft each tiny detail, and sensory processing for your child to know where their body was in space, in order to not crush the figurine each time one of those little details was added.

 

So as we prepare our best “excited faces” for this year’s Mother’s Day gift, take a minute to remember the many skills your little one executed in order to fabricate that “one of a kind” creation.

10 Ways That Speech Therapy Can Help Your Child

by FS&TS

By Kelly Hungaski, MS/CCC-SLP

When I tell people that I am a speech language pathologist, I receive a blank stare.  They sometimes ask if I am working with dead people.  I’m not.  I explain that I work with children providing speech therapy.  Most people smile, nod or share a story of someone they know who needed to get speech therapy to produce “s” or the elusive “r” sound.  

Speech language pathologists are experts at teaching children how to produce speech sounds.  We know how to work with children who are missing a few sounds or children who are not producing hardly any sounds.  Speech therapists can teach the child how to use more mature patterns of speech, the placement for consonant and vowel sounds and how to speak more clearly.  But that’s not all we do.  Read on for my top ten ways that speech language therapists help children of ages.

1. Teach children how to follow directions or how to answer questions.

Speech language pathologists assess a child’s ability to understand language.  We can figure out which parts of the direction a child is having difficulty with.  Are longer directions harder or does the child not hear the smaller location words in a direction (in vs on)?  We can help children understand question words (who, what, where, when, why) and how to answer these questions.

2. Teach correct grammar.

We call it syntax.  These children may have difficulty producing pronouns like he or she (him is sitting down) or they may have a hard time using the correct verb tense forms.  They might say “he runned” instead of “he ran.”  Difficulties with understanding pronouns and verb tense forms make it difficult for children to understand what is happening at school.  

3. Help children learn how to tell about a personal experience.  

Some children jump into the middle of a story or forget to tell you who was there.  They may have a difficulty organzing their story into a logical manner.  We can help them learn how to provide all of the relevant information (but not too much information) and how to sequence a story so that you can understand what they are talking about.

4. Teach children how to chew and swallow foods safely.

Speech language pathologists have extensive training on the anatomy of the mouth and respiration system.  We can help strengthen muscles and improve coordination for children who are unable to chew and swallow foods, who choke or gag on foods, who take a long time to eat or who have difficulty drinking liquids.  

5. Decrease stuttering or dysfluent behaviors .

Speech therapists can help teach breath support and fluency enhancing strategies for children who stutter.  We love to educate parents and teachers about stuttering and how to respond to someone who stutters.

6. Teach children how to participate in conversations

Some children always answer I don’t know or like to dominate a conversation with their interests.  Speech language pathologists can teach turn taking and understanding the parts of the conversation.  We can teach how to start and end a conversation and how to ask questions and comment.

7. Teach social skills and problem solving skills.

Speech language pathologists help children developing perspective taking skills (how to understand that other people have different thoughts from us.)  We can teach strategies for how to make friends.  We can teach them the steps for identifying and solving problems.  

8. Teach first words.

When toddlers are delayed in talking, you can turn to your speech language pathologist for help.  We are experts in teaching children how to request and comment using toys, games and books.  

9. Teach other methods of communication.

Some children have a really difficult time developing speech-or speech that other people understand.  Speech language pathologists can provide recommendations for communication books or computer programs that will allow these children to communicate.  Once the device or book is received, we use routines and typical activities to teach the child and family how to communicate using their new system.

10. Improve vocal quality and hygiene.

Speech language pathologists can work with doctors to assist children who have vocal nodules or voice disorders.  We can help children develop healthy voice habits, improve breath support and teach strategies for relaxing the muscles when speaking.  

5 Fun Books for Spring

by FS&TS

By Emily Jung, M.S.CCC-SLP

Here are 5 great books to celebrate leaving the cold winter behind and celebrating the arrival of spring! All of these books contain great imagery and descriptive words to help expand your child’s language skills.

Hurray For Spring
Hurray for Spring is a whimsical welcome to a child's favorite season. Delightful, rhyming text with lots of fun words make this a wonderfully cadenced anthem to spring. Adorable illustrations with larger-than-life details spring off the page. 

And Then It’s Spring
Following a snow-filled winter, a young boy and his dog decide that they've had enough of all that brown and resolve to plant a garden. They dig, they plant, they play, they wait . . . and wait . . . until at last, the brown becomes a more hopeful shade of brown, a sign that spring may finally be on its way.

Mouse’s First Spring
One bright day, Mouse and Momma head outside to play. The wind blows in something feathery and plump (a bird), something wiggly and pink (a worm), and something green that hops and leaps (a frog). But before it’s time to go back inside, Mouse finds something with petals that’s soft and new...the prettiest flower he’s ever seen! Could it mean spring is finally here?

There Was An Old Lady Who Swallowed a Frog
Spring is in the air, and everyone's favorite old lady is ready to celebrate!
That zany old lady is back--and with a serious case of spring fever! This time she's swallowing items to make the most of the season...with a beautiful garden!
With rhyming text and funny illustrations, this lively version of the classic song will appeal to young readers with every turn of the page--a wacky story for the first day of spring

My Spring Robin
When spring arrives, a young girl looks everywhere for the robin who sang for her last year. She sees all the sights and sounds of the new season: a blooming crocus, a buzzing bee, a colorful magnolia tree, a brief rain shower…but where is the robin?
 

Building Language Outside

by FS&TS

As the weather turns warm and the grass starts to green, outdoor play is upon us! Here are some fun and effective ways to improve your child’s language skills while enjoying the outdoors. 

Categories

Have your child practice naming categories or listing items from a category. For example, have your child name 3-5 different animals that you can find outside. Have your child name 3-5 items that are at a playground. Have your child name 3-5 items in a garden. You could also list 3-5 items from a category and ask your child what category the items belong to.

Questions

Playing ‘I spy’ can work on your child’s ability to ask and answer questions. Pick an object you see and have your child ask you questions to figure out what your object is. Then have your child pick an object and you can answer questions so that you can figure out what his/her object is.

Following Directions

Have your child help you prepare something and break the tasks into 1-2 steps at a time. For example, ‘Carry the sandwich buns outside and open the bag.’ ‘Place a bun on each plate.’

Sequential Concepts

Have your child tell you about an event or activity he/she did using sequential concepts (ex. ‘first’, ‘second’, ‘then’, ‘last’). You could tell him/her about an event or story using sequential concepts and then have him/her re-tell it. For example, ‘First you were playing on the swings, next you went to the sandbox, and then you came into the house’ and have your child re-tell what you told them.

Categories, questions, directions, and sequential concepts are just a few ways to help your child build their language while being outside. Working on these skills can be fun and the change of weather presents many opportunities to do so!

Interoception, what is it and how do I improve it?

by FS&TS

By Kristin Connell, OTR/L

What is interoception?

Your stomach is grumbling, your mouth is dry, your heart is racing, your fists are clenched.  This is your internal system signaling your brain that you are that you are hungry, thirsty, nervous or angry.   You are using your interoceptive system to be aware what of what your body is telling you.

Interoception an internal sense, and the the 8th sense in our sensory system (see previous Vestibular and Proprioceptive posts for information on the 6th and 7th senses).

It is the signalling and perception of internal body sensations and emotions. The receptors inside our body, organs, muscles, skin, etc send their signals to the brain.  The brain interprets these messages for us to feel body states such as hunger, thirst, pain, temperature and emotions.

This system is important because when we feel a certain way, your body responds (ie. stomach grumbling-you eat, you feel nervous-you find comfort, etc).  If we feel our internal system is “off”, we try to change the imbalance by doing something.

Many people with sensory processing disorder, autism or developmental delays do not have good interoceptive awareness, therefore are not aware of their body’s sensations or emotions. Bringing awareness to these feelings will improve independence with self care skills, self regulation, perspective taking and problem solving.

How do I improve it?

Interoception is a topic that has only recently been researched and written about, so currently there is limited information on the best ways to improve this area.  Here are the two most effective ways to begin the process of increasing interoception awareness.  

Occupational therapy!

An OT can help improve a child’s body awareness through providing specific sensory input in the clinic and at home to improve the child’s self awareness.

In addition, various programs such as Therapeutic Listening and Integrated Listening Systems (iLS) and Zones of Regulation can improve body awareness and self regulation skills as well.

Body check chart

Older children:

Begin this process with positive experiences like after running around outside, after a warm shower, after a meal, etc.  

Draw an outline of the person.  Label specific parts-head, eyes, ears, mouth, voice, chest, heart, hands, stomach, feet, skin, muscles, etc.

Have the child label one body part and how it feels at that moment (i.e. eyes-sleepy, awake, watery, itchy, dry, etc).  Continue to add body parts and corresponding sensations, depending on the level of the child.

After noticing the sensations of various body parts, give each sensation meaning. For example:

  • when your eyes are watery/itchy, it means you are tired
  • when your heart is beating fast, you may feel nervous or angry about something
  • when your stomach makes a grumbly noise, it means you are hungry

As the child continue to progress, have them match different body states or emotions to their specific body sensations. (i.e. Nervous: hands sweaty, heart racing, legs moving, stomach fluttery)

Younger children:

Trace their body on a large piece of paper.  Point to a body part on the drawing and have them wiggle it on their own body to build body awareness.  You could also play a game of Simon Says to build awareness: touch your heart, clench your fists, breath really fast.


During a body state/emotion-label the body sensations you see, in a non judgmental way (your hands are wiggling, you are breathing fast), and write it on the drawn body. This will help bring about awareness to their sense of self and begin to understand their body’s signals.